Ri-Hua Xie1, Huiling Cao2, Bo Hong3, Ann E Sprague2, Mark Walker4, Shi Wu Wen4. 1. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa ON; Huaihua Medical College, Hunan, P.R. China; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa ON. 2. BORN Ontario (Better Outcomes Registry and Network), Ottawa ON. 3. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa ON. 4. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa ON; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa ON.
Abstract
BACKGROUND: Sequential use of vacuum and obstetric forceps for vaginal delivery is associated with increased risks of adverse maternal and infant outcomes. METHODS: We conducted a retrospective cohort study to estimate the frequency of sequential use of vacuum and forceps for planned vaginal delivery and to identify predictors, using data collected in Ontario between 2004 and 2007. Multivariate logistic regression models were used to estimate the adjusted odds ratios and 95% confidence intervals of predictors of sequential use of vacuum and forceps. RESULTS: Of 186 988 pregnant women with a singleton, vertex presentation at term and a planned vaginal birth, 1062 (0.57%) required the sequential use of vacuum and forceps for delivery. The major predictors for sequential use of vacuum and forceps were mother's primary language being other than English or French, nulliparity, a history of Caesarean section, dystocia, use of epidural or other pain relief, labour induction, labour augmentation, fetal macrosomia, and advanced gestational age. CONCLUSION: In this population-based study we found that 0.57% of planned vaginal births were delivered with sequential use of vacuum and obstetric forceps. Abnormal labour, fetal macrosomia, language barriers, and advanced gestational age are significant predictors of requiring this sequential use.
BACKGROUND: Sequential use of vacuum and obstetric forceps for vaginal delivery is associated with increased risks of adverse maternal and infant outcomes. METHODS: We conducted a retrospective cohort study to estimate the frequency of sequential use of vacuum and forceps for planned vaginal delivery and to identify predictors, using data collected in Ontario between 2004 and 2007. Multivariate logistic regression models were used to estimate the adjusted odds ratios and 95% confidence intervals of predictors of sequential use of vacuum and forceps. RESULTS: Of 186 988 pregnant women with a singleton, vertex presentation at term and a planned vaginal birth, 1062 (0.57%) required the sequential use of vacuum and forceps for delivery. The major predictors for sequential use of vacuum and forceps were mother's primary language being other than English or French, nulliparity, a history of Caesarean section, dystocia, use of epidural or other pain relief, labour induction, labour augmentation, fetal macrosomia, and advanced gestational age. CONCLUSION: In this population-based study we found that 0.57% of planned vaginal births were delivered with sequential use of vacuum and obstetric forceps. Abnormal labour, fetal macrosomia, language barriers, and advanced gestational age are significant predictors of requiring this sequential use.
Authors: Sandra Dunn; Ann E Sprague; Jeremy M Grimshaw; Ian D Graham; Monica Taljaard; Deshayne Fell; Wendy E Peterson; Elizabeth Darling; JoAnn Harrold; Graeme N Smith; Jessica Reszel; Andrea Lanes; Carolyn Truskoski; Jodi Wilding; Deborah Weiss; Mark Walker Journal: Implement Sci Date: 2016-05-04 Impact factor: 7.327