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PubMed1976

Early termination of pregnancy: a comparative study of intrauterine prostaglandin F2alpha and vacuum aspiration.

The relative safety and effectiveness of vacuum aspiration and the intrauterine administration of 5 mg PGF2alpha for terminating pregnancies within two weeks of a missed menstrual period were evaluated in a study where subjects were randomly assigned to procedures; 100 patients were aborted with vacuum aspiration and 100 patients were aborted with PGF2alpha. All PGF2alpha-treated patients were premedicated with meperidine, diazepam and atropine. Complications were infrequent with either of the procedures. Vomiting occurred more frequently during the PGF procedure (30.0%) than during the vaccum aspiration procedure (9.0%). The intrauterine instillation of PGF2alpha successfully terminated all pregnancies. One patient continued to be pregnant after the vacuum aspiration procedure. Based on the results of this study both study procedures appeared to be safe and effective for terminating early first trimester pregnancies.

Abortion, Induced↗
PubMed1991

[Fetomaternal transfusion in relation to mode of delivery. Comparison of data from the DFG multicenter study "Rhesus negative" (1965-70) with data from the Freiburg University Gynecologic Clinic (1989)].

Fetomaternal hemorrhage with transfusion of more than 10-25 ml fetal blood into the maternal circulation ("macrotransfusion") is one possible cause of the failure of combined pre- and postpartal anti-D prophylaxis. We analyzed the data from 391 patients who delivered at the UFK Freiburg in 1989. We evaluated the amount of fetomaternal bleeding in different modes of delivery. We observed fetomaternal hemorrhage of clinical relevance in 7.5% of spontaneous delivery, 11.1% of vacuum extraction, 17.7% of cesarean section (p less than 0.05). There was no difference concerning macrotransfusions in the above mentioned modes of delivery. Our data are compared with the data of the DFG multicenter trial "rhesus negative" (1965-79).

Cesarean Section↗
PubMed1990

Subaponeurotic haemorrhage in Malaysian neonates.

In a 30-month prospective study, between January 1987 and June 1989, 101 of 64,424 Malaysian neonates (1.6 per 1000 livebirths) born in the Maternity Hospital, Kuala Lumpur were found to have subaponeurotic haemorrhage shortly after delivery. The incidence was highest in neonates weighting 4000 gm or more. There was no significant difference in incidence of this condition in neonates of different ethnic origins. Hypoprothrombinemia was present in only 5/101 (5.0%) of the affected neonates. Sixty seven (66.3%) of the neonates with subaponeurotic haemorrhage had history of trial of vacuum extraction. The incidence of subaponeurotic haemorrhage was significantly higher in neonates delivered by vacuum extraction than by other modes of delivery in this hospital (41.4 per 1000 livebirths in neonates delivered by vacuum extraction versus 1.0 per 1000 livebirths in neonates delivered by other modes). Those neonates who developed subaponeurotic haemorrhage without trial of vacuum extraction had a history of either prolonged labour or difficult delivery. Thirty-three (32.7%) of the neonates with subaponeurotic haemorrhage developed anaemia which required blood transfusion and 3/33 (9.1%) were in shock. Fifty seven (56.4%) of the neonates with subaponeurotic haemorrhage developed hyperbilirubinemia due to the haemorrhage. Four (7.0%) of them had severe unconjugated hyperbilirubinemia which required exchange transfusion. The results of this study suggest that subaponeurotic haemorrhage in Malaysian neonates was commonly associated with vacuum extraction and was not a benign condition.

Extraction, Obstetrical↗
PubMed1996

Forceps and vacuum delivery: a survey of North American residency programs.

OBJECTIVE: To document resident instruction in operative vaginal delivery by forceps and vacuum. METHODS: A survey was sent to all 291 obstetrics-gynecology training programs in the United States and Canada. RESULTS: The overall response rate was 72% (210 of 291). Most programs (60%) have an operative vaginal delivery rate of 10% or less. Nearly all of the responding programs (199 of 209, 95%) teach operative vaginal delivery via the vacuum route; metallic cups are used in only 14% of centers. Forceps are the primary instrument in most programs (68%), but nearly one-third of responding centers use the vacuum method more often than forceps. Instruction in midpelvic operative vaginal delivery is offered in 64% of the programs, with forceps being more common by nearly a two-to-one ratio. Deep transverse arrest is handled initially by forceps by half of the respondents, whereas 28 and 22% would proceed with cesarean or attempt a vacuum extraction, respectively. CONCLUSION: Instruction in both types of operative vaginal delivery is found in most programs. The forceps are used more commonly, but vacuum is the preferred instrument in about one-third of training programs. Instruction in midpelvic delivery is offered in 64% of programs, but we noted a declining trend.

Canada↗
PubMed1979

Acceptability of a nonsurgical method to terminate very early pregnancy in comparison to vacuum aspiration.

Seventy-seven patients applying for abortion during early pregnancy consented to be treated by prostaglandin vaginal suppositories or vacuum aspiration by Kahrman catheter in a random design. They also consented to participate in an acceptability study of the two procedures. Attitude and preference measures were obtained by interviewing and rating scales on three occasions: before assignment to abortion procedure, immediately after treatment, and two weeks later. The first 30 patients with complete abortion by either procedure participated in the acceptability study. Both treatments were positively evaluated but perceived to have very different characteristics. The preference for the method used for own treatment increased in both groups. Before treatment 1/3 of the patients in each group had a positive attitude to a self-administered method to induce abortion outside clinics. This proportion increased significantly after treatment but only in the group that received prostaglandin by the vaginal route.

Abortion, Induced↗
PubMed1990

Long-term neurological sequelae following vacuum extractor delivery.

Two hundred and ninety-five children delivered by vacuum extractor (VE) 10 years ago were studied to determine if they had an increased incidence of neurological abnormality; 302 children delivered spontaneously in the same hospital looked after by the same doctors in the same year matched for maternal age, gestational age and birthweight were used as controls. Fine- and gross-motor control, perceptual integration and behavioural maturity were screened by 4 tasks selected from the Quick Neurological Screening Test. Intelligence assessment was based on scholastic performance, speech ability and ability of self-care as commented by teachers and parents. Similar scorings were found between the 2 groups. Mental subnormality or severe neurological abnormality was found in 3 children delivered by VE and in 3 children delivered spontaneously and there was no evidence that it was birth-related.

Child↗
PubMed1988

Temperament in children delivered by vacuum extraction.

Thomas and Chess's temperament variables were studied via questionnaires in two samples of children delivered by vacuum extraction and in a standardization sample at six months and at one and two years of age. Temperament was not systematically related to vacuum extraction delivery per se or to its indications or to offspring neonatal somatic impairment.

Brain Damage, Chronic↗