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PubMed1981

Vacuum extractor.

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Extraction, Obstetrical↗
PubMed1978

Vacuum extraction. Use in a community hospital setting.

The history of vacuum extraction and its use in a specific community hospital setting is reviewed. Basic principles for successful use of the extractor are cited. Two hundred twenty-eight consecutive vacuum extraction cases occurring in an 18-month period are evaluated for indications and outcome. The most common indications were fetal distress, 41.6%; malposition of the vertex 35%; and dysfunctional labor 14.6%. Several subjects exhibited more than one condition influencing the decision to use the extractor. Particular reference is made to the occurrence of significant trauma to the fetal scalp in 18.7% of cases. Careful choice of candidates for vacuum extraction and adherence to principles of application and traction technique are emphasized to reduce the incidence of fetal scalp trauma.

Adolescent↗
PubMed1981

Effect of instrumental delivery on the frequency and severity of retinal hemorrhages in the newborn.

The frequency and severity of retinal hemorrhages were studied in 200 newborns within the first 72 hours of life. One hundred of the neonates were delivered instrumentally by either forceps (49 cases) or vacuum extraction (51 cases). Another hundred neonates were delivered spontaneously and served as controls. Both the highest and the lowest frequency of retinal hemorrhages were found among the babies delivered by instrumentation. The actual values were 50 per cent in the vacuum groups and only 16 per cent in the forceps group (p less than 0.01). The spontaneously delivered babies, who served as controls, showed retinal hemorrhages in 41 per cent of the cases. The frequency of severe retinal hemorrhages was five times higher in the vacuum group compared to both the forceps group and the control group (p less than 0.01, p less than 0.001).

Extraction, Obstetrical↗
PubMed1979

Segmental epidural analgesia in labour: related to the progress of labour, fetal malposition and instrumental delivery.

The effect of low-dose continuous segmental epidural analgesia given during the first stage of labour on the progress of labour, the frequency of fetal malpositions and the rate of vacuum extractions was studied prospectively in 100 parturients (epidural group). The results were compared with 100 parturients given none or conventional analgesia (control group). The results showed that in the primiparous epidural group the progress of labour before analgesia was induced was significantly slower than in the control group. After the block, however, the subsequent course of the labour was of equal duration in both groups. The durations of the second stages of labour did not differ significantly between the groups. The differences in fetal malpositions at delivery were statistically insignificant. Nor did the rate of vacuum extractions, 8% in the primiparous and 0% in the multiparous epidural group, differ statistically from the corresponding rate in the control groups. The results signify a normal progress and outcome of labour after low-dose segmental epidural analgesia.

Adolescent↗
PubMed1984

The incidence of acute neonatal respiratory disorders in relation to mode of delivery.

Over a 3-year period all infants (n = 7401) born at the Department of Obstetrics and Gynecology, Central Hospital, Borås Sweden, were studied for signs of respiratory disease. For all infants who developed signs of respiratory disorders the mode of delivery and the type of anesthesia used in cesarean section (CS) were analysed. The incidence of respiratory disorders in the whole material was 3.0% (n = 220) and the mortality rate for these disorders was 0.24%. There was a significantly higher incidence (p less than 0.001) of respiratory disorders in infants weighing greater than or equal to 2500 g born by CS vis-à-vis infants born by the vaginal route. The group born by elective CS under maternal general anesthesia had a higher (p less than 0.05) rate of respiratory disorders than those born by elective CS under maternal epidural anesthesia. It is concluded that the risk of respiratory disorders in infants delivered by CS is related to the mode of delivery per se. Consequently, a reduction in the proportion of such interventions ought to reduce the overall number of infants developing respiratory disease, as indicated in the present study.

Anesthesia, Obstetrical↗
PubMed1991

[A fetal extraction device used in under-equipped countries: the obstetrical vacuum extractor. Results of 393 vacuum extractions in the Maternity Hospital in Sélestat. (Reflections on the use of this device in African practice)].

The level of mortality and feto-maternal morbidity in under-equipped countries is frightening. It is important to find answers. Among these: the obstetrical Ventouse is an instrument that can be used for extracting the fetus without too much difficulty. It is relatively easy to learn and to apply as compared with forceps (so long as the mechanism by which it is used is understood). The conditions under which it can be used are well defined at present: term pregnancy, the woman must be in labour, fetal membranes must be ruptured, the cervix must be completely dilated, presentation must be cephalic and the head must be engaged. 393 Ventouse extractions were carried out between 1982 and 1988 at the Maternity Hospital of Selastat and this resulted in delivery of 393 infants in good health. No maternal or fetal mortality occurred in the series. The maternal morbidity was low at 0.76% and the fetal morbidity was only 4.7%. In view of our experience, we believe that the tendency for black women to have android pelves makes it preferable to use the Ventouse as against the forceps because it has several advantages. In view of the literature and of their practice, the authors advise that the obstetric Ventouse should be used in under-equipped countries where conditions of practice are often precarious and the team poorly qualified. This will reduce the mortality and morbidity due to delivery. Pregnant women are insufficiently educated. The quality of health personnel is inadequate. The health services are inadequate for the needs of the population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

The start of life: a history of obstetrics.

Obstetric intervention originally consisted of extraction of the baby, usually by the breech, to save the mother's life in obstructed labour. Forceps, introduced in the 17th century, were later refined by men-midwives like William Smellie. In Victorian times, Simpson championed chloroform anaesthesia, Lister pioneered antisepsis, and caesarean section was introduced. In 1935, however, Britain's maternal mortality rate was still around 400/100,000. It fell dramatically after antibiotics appeared and is now 11.4. In the 1960s ultrasound and electronic fetal monitoring became widely used. In 2000 the British caesarean section rate reached 20%. Worldwide, childbirth still causes 600,000 maternal deaths a year.

Cesarean Section↗