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, Fergal D. Malone, Jay D. Iams

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

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 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.

Original languageEnglish (US)
Pages (from-to)493-499
Number of pages7
JournalAmerican Journal of Perinatology
Volume27
Issue number6
DOIs
StatePublished - 2010

Keywords

  • Cesarean
  • Forceps
  • Umbilical cord blood gases
  • Vacuum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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