| Popis: |
Objectives: To compare the risk of perinatal complications in vacuum-assisted vaginal delivery (VAC) and spontaneous vaginal delivery (SVD). Methods: We did a retrospective chart review of a random sample of women delivering via VAC at our center between 1995 and 1999 and frequency-matched the sample to an SVD group of the same gestational age, birth weight, maternal age, parity, and ethnic background. Results: A total of 710 patients’ charts (355 patients in each arm) were selected for review. We made a preliminary review of 56 VAC charts and 54 SVD charts. The two groups were comparable with respect to maternal age (mean ± SD in SVD versus VAC; 26.8 ± 5.9 years versus 25.8 ± 6.3 years), gestational age (39.1 ± 2.0 weeks versus 39.0 ± 1.6 weeks), and birth weight (3,222 ± 461 g versus 3,232 ± 526 g). Using logistic regression, gravidity was not statistically predictive of mode of delivery (P = 0.80) and neither was parity (P = 0.58). A woman who had a vacuum delivery was six times more likely to have epidural analgesia (OR = 6.6, 95%CI [2.6,16.6]), and babies delivered by vacuum were almost four times more likely to be admitted to an intensive care unit (OR = 3.7, [1.3,9.6]). There was no difference in the likelihood of meconium (OR = 1 .16,[0.4,3.0]) or laceration (OR = 1.1,[0.4–2.5]). Conclusion: Although commonly used, vacuum deliveries appear to present increased risks to newborns when compared with spontaneous vaginal deliveries. These risks are evidenced by increased intensive care unit admissions. |
