Neonatal outcomes and operative vaginal delivery versus cesarean delivery
Stephen A Contag, Rebecca G Clifton, Steven L Bloom, Catherine Y Spong, Michael W Varner, Dwight J Rouse, Susan M Ramin, Steve N Caritis, Alan M Peaceman, Yoram Sorokin, Anthony Sciscione, Marshall W Carpenter, Brian M Mercer, John M Thorp Jr, Fergal D Malone, Jay D Iams, Stephen A Contag, Rebecca G Clifton, Steven L Bloom, Catherine Y Spong, Michael W Varner, Dwight J Rouse, Susan M Ramin, Steve N Caritis, Alan M Peaceman, Yoram Sorokin, Anthony Sciscione, Marshall W Carpenter, Brian M Mercer, John M Thorp Jr, Fergal D Malone, Jay D Iams
Abstract
We compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at >or=36 weeks' gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess (P = 0.35 and 0.78 for failure of descent and nonreassuring fetal status) or frequencies of pH below 7.0 (P = 0.73 and 0.34 for failure of descent and nonreassuring fetal status) among the three delivery methods. Birth outcomes and umbilical cord blood gas values were similar for those neonates with a forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. The occurrence of significant fetal acidemia was not different among the three delivery methods regardless of the indication.
Thieme Medical Publishers.
Source: PubMed