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PubMedDate not supplied

[Abortion at 10 to 12 weeks using a plastic syringe or electric aspirator].

The study included 170 women subjected to menstrual regulation. The double-valve band syringe was used in 96 and the electric pump (the vacuum source usually used at the Department) in 74 cases. Nearly all the procedures were performed under general anesthesia, using 8 mm, 10 mm or 12 mm plastic rigid cannulae. Three abortions with the hand syringe also required dilatation and curettage, and all three women suffered blood loss exceeding 100 ml. There was one cervical laceration surgically repaired and a case of adnexitis reported among the hand syringe group. Immediate complications occurred in 7.3% of the cases using the hand syringe and in 4.1% of using the electric pump. The mean procedural time was 4.2 minutes and 4.0 minutes, respectively, with the hand syringe and the electric pump. Only three women reported complications or complaints at the follow-up visit, all of them from the electric pump group.

Abortion, Induced↗
PubMed2003

Failed individual and sequential instrumental vaginal delivery: contributing risk factors and maternal-neonatal complications.

BACKGROUND: To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal and neonatal morbidity associated with failed individual and sequential instruments used. DESIGN: A retrospective case-control study. METHODS: From January 1995 to June 2001, there were 39 508 live births at >37 weeks' gestation of which 2628 (6.7%) instrumental vaginal deliveries were performed, 1723 (4.4%) were vacuum extractions and 905 (2.3%) were forceps. A total of 155/2628 (5.9%) patients who had failed instrumental delivery were matched with 204 patients who had successful instrumental delivery. The patients were divided into five groups. Group I (n = 129) had failed vacuum extraction, group II (n = 13) failed forceps, group III (n = 13) failed both (i.e. failed attempt at both instruments sequentially), group IV (n = 138) had successful vacuum extraction and group V (n = 66) successful forceps. RESULTS: The failure rate for vacuum extractions 129/1723 (7.5%) was significantly higher than that for forceps 13/905 (1.4%) [odds ratio (OR) = 5.6, 95% CI 3-10.3]. There were no significant differences in all maternal complications (25.5% vs. 26.6%) between vacuum (groups I and IV) and forceps (groups II and V) assisted deliveries. There were more maternal complications in group III (46.2%) than in groups I (35.7%), II (23.1%) and V (27.3%) that did not reach statistical significance but were significantly higher than in group IV (15.9%, OR = 4.5, 95% CI 1.2-16.9). There was a significantly higher rate of all fetal complications in group III [11/13 (84.6%)] than in groups I [69/129 (53.5%)], II [7/13 (53.8%)], IV [35/138 (25.4%)] and V [22/66 (33.3%)] (OR = 4.8, 95% CI 0.9-19.9). CONCLUSIONS: Applying the instrument at < or =0 fetal station, nulliparous women, history of previous cesarean section and fetal head other than occipitoanterior position were risk factors for failed instrumental delivery. Sequential use of instrumental delivery carries a significantly higher neonatal morbidity than when a single instrument is used.

Adult↗
PubMed1995

[Trends in the frequency of obstetrical operations and perinatal mortality in the Czech Republic in comparison with other countries].

In an international epidemiological survey during a 10-year period the increase of obstetric operations was investigated in 11 countries with advanced perinatal care. Major differences were found as regards the frequency of Caesarean sections as well as vaginal operations (forceps and vacuum extraction). The mean effectiveness of the increase in the frequency of Caesarean sections on the reduction (evaluated by the mille drop of perinatal mortality rate is reduced when the frequency of Caesarean section) exceeds about 10%. Of all investigated countries only the Netherlands and the Czech Republic achieve a low perinatal mortality, while the frequency of Caesarean sections is low. The author discusses the reasons for the revealed differences between different countries.

Cesarean Section↗
PubMed1990

Neonatal and maternal outcome in low-pelvic and midpelvic operative deliveries.

A retrospective analysis of low-pelvic and midpelvic operative deliveries (according to the new definitions by the American College of Obstetricians and Gynecologists, 1989) matched with cesarean section deliveries of similar station was undertaken. In all vaginally delivered groups there was significantly decreased maternal morbidity, maternal hospital stay, and estimated blood loss. In the midpelvic deliveries, there was a significant increase in the frequency of neonatal resuscitation and an increase in base deficit for the umbilical artery. In both the midforceps and low-forceps groups, there was a significant increase of neonates with cord arterial pH less than 7.10, and an increase of base deficit, even when cases of fetal distress were eliminated. The midforceps group also had an increased rate of admission to the intensive care nursery and an increase in the risk of significant birth trauma. In considering a midforceps or midvacuum operative delivery, the potential associated risks to the neonate must be balanced against the benefits to the mother.

Birth Injuries↗
PubMed1987

A randomized study of two cups for vacuum extraction.

O'Neil designed a set of suction cups which, because of more efficient lateral pull and greater maneuverability, were claimed to be more efficient and perinatally safer than the Malmström model. These claims were checked by comparing the two instruments in a randomized controlled trial comprising 410 attempted elective extractions. The two instrument groups were comparable at entry and the operators had a similar degree of experience, the sole inter-group difference being the 0.5 cm larger diameter of the O'Neil cups. No significant differences were found between the two types of instrument as to failure rate, incidence of correct cup positioning, and capacity of eliciting internal rotation nor was there a significant divergence in neonatal safety. In a few cases the perineum was lacerated by the traction cord affixed to the O'Neil instrument. The results of this study indicate that the relative advantages and disadvantages of the two cup models are unremarkable.

Extraction, Obstetrical↗
PubMed1976

[Vacuum extraction in interruption of pregnancy using a jagged cannula].

The author describes his experience with artificial abortus using vacuum aspiration performed with a jagged cannula of his own construction. In 2150 interruptions of pregnancy, the complications were as follows: residua in 0.2%, bleeding in 4.7%, and febrile condition in 2.5% of cases. The loss of blood was 30-200 ml.

Abortion, Induced↗