Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Extraction, Obstetrical”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources
PubMed1996

Vacuum sources in obstetrics.

OBJECTIVE: To characterize the performance of vacuum equipment used in operative vaginal deliveries. STUDY METHOD: We measured wall suction in eight Cleveland area labor-and-delivery units. Additionally, we tested samples of hand-operated and electric vacuum pumps. For each apparatus we recorded vacuum in millimeters of mercury using a calibrated, diaphragm-type gauge. We calculated mean maximal vacuum. Work required to produce 500 mm Hg of vacuum was determined for the hand-operated pumps. At increments of vacuum, we compared the vacuum displayed by the gauge head included with the device to our standard. RESULTS: Mean wall suction was 494 mm Hg (range, 248-655). As compared to the Mity-vac, the CMI hand-operated pump needed significantly more work to generate 500 mm Hg of vacuum. Electric pumps produced a reliable and consistent vacuum. Gauges included with the pump had an average error of 4% over 400-600 mm Hg. CONCLUSION: Wall suction was an unreliable source of vacuum. The two hand-operated pumps tested required significantly different amounts of work to achieve an adequate vacuum. Addition of a fluid trap does not affect the vacuum, and head gauges supplied with vacuum pumps are accurate.

Delivery, Obstetric↗
PubMed2005

Risk factors for obstetrical anal sphincter lacerations.

The objective of this study was to identify the rate of anal sphincter lacerations in a large population-based database and analyze risk factors associated with this condition. Data were obtained from Pennsylvania Healthcare Cost Containment Council (PHC4) regarding all cases of obstetrical third and fourth degree perineal lacerations that occurred during a 2-year period from January 1990 to December 1991. Modifiable risk factors associated with this condition were analyzed, specifically episiotomy, forceps-assisted vaginal delivery, forceps with episiotomy, vacuum-assisted vaginal delivery, and vacuum with episiotomy. There were a total of 168,337 deliveries in 1990 and 165,051 deliveries in 1991 in Pennsylvania. Twenty-two percent (n = 74,881) of the deliveries were by cesarean section and were excluded from analysis. Among the remaining 258,507 deliveries, there were 18,888 (7.3%) third and fourth degree lacerations. Instrumental vaginal delivery, particularly with use of episiotomy, increased the risk of laceration significantly [forceps odds ratio (OR): 3.84, forceps with episiotomy OR: 3.89, vacuum OR: 2.58, vacuum with episiotomy OR: 2.93]. Episiotomy on the whole was associated with a threefold increase in the risk of sphincter tears. However, episiotomy in the absence of instrumental delivery seems to be protective with an OR of 0.9 [95% confidence interval (CI): 0.88-0.93]. Instrumental vaginal delivery, particularly forceps delivery, appears to be an important risk factor for anal sphincter tears. The risk previously attributed to episiotomy is probably due to its association with instrumental vaginal delivery. Forceps delivery is associated with higher occurrence of anal sphincter injury compared to vacuum delivery.

Adolescent↗
PubMed1991

A comparison of single prostaglandin E2 vaginal tablet with prostaglandin E2 vaginal pessaries for induction of labor at term.

This study represents the first of its kind in Kuwait. Two preparations of prostaglandin E2 (PGE2) have been compared as agents for induction of labor. In a randomized controlled study of 200 women of low parity and unfavorable cervical induction features induction of labor by means of a single vaginal tablets of PGE2 was compared with locally prepared PGE2 vaginal pessaries. The gradual increase of uterine contractions and the establishment of labor in a similar way to that observed during spontaneous labor was more apparent after PGE2 tablets. Labor induction was successful in 80% of patients in PGE2 tablet group compared with 59% in PGE2 pessaries group. The incidence of cesarean section was equal in both groups (4%), but none was performed due to uterine hyperactivity. The data presented indicate that the PGE2 vaginal tablet is safe and effective in induction of labor in healthy women at term.

Administration, Intravaginal↗
PubMed1994

Worldwide survey of assisted vaginal delivery.

OBJECTIVES: To ascertain which instruments are most commonly used for assisted vaginal delivery. METHODS: A postal survey in which 1411 questionnaires were sent to major obstetric centers worldwide. RESULTS: Over 60% (305/508) of the respondents indicated willingness to participate in a multicenter randomized controlled trial between the two instruments. CONCLUSIONS: The forceps remained popular in most of the 'English-speaking' countries, as well as in Eastern Europe and South America. The ventouse was most popular in Africa, Asia and Northern Europe.

Data Collection↗
PubMed2004

Operative vaginal delivery: a comparison of forceps and vacuum for success rate and risk of rectal sphincter injury.

OBJECTIVE: We investigated the success rate of operative vaginal delivery and risk of rectal sphincter injury when forceps or vacuum was used. STUDY DESIGN: Cases were identified by a retrospective review of delivery logbooks and an obstetric database. Rotations were excluded. Failure was defined as inability to deliver the fetus with the initial instrument. Rectal injury was defined as third- or fourth-degree laceration. Institutional review board approval was obtained. P-value of less than .05 was considered significant, and odds ratios (OR) were calculated when appropriate. RESULTS: Data were obtained for 1802 deliveries: 1438 occiput anterior and 364 occiput posterior positions. For occiput anterior position, rectal sphincter injury with forceps was 53.8% and vacuum 26.6% (P < .0001, OR 3.25). Failure rate with vacuum was 6.3% and forceps 0.9% (P < .0001, OR 7.53). For occiput posterior position, rectal injury with forceps was 71.6% and vacuum 33.1% (P < .0001; OR 5.25). Failure rate with vacuum was 33.0% and with forceps 13.6% (P < .0001, OR 3.15). For occiput posterior position, failure rate at mid position with vacuum was 71.4%, and forceps 16.7% (P < .001, OR 12.5). Failure rate at low position with vacuum was 30.8%, and forceps 12.5% (P < .001, OR 3.14). Failure rate with vacuum at mid position was higher than at low position (P < .0001, OR 5.57). Failure rate with forceps at mid and low positions was not significantly different. There was no difference in failure rate between vacuum and forceps at the outlet position. CONCLUSIONS: For both occiput anterior and posterior cases, the use of forceps was associated with a higher success rate than the vacuum, but with greater risk of rectal sphincter injury. The use of either vacuum or forceps from the occiput posterior position was associated with a higher likelihood of rectal injury and lower likelihood of vaginal delivery when compared with the occiput anterior position.

Anal Canal↗
PubMed2001

Does epidural analgesia prolong labor and increase risk of cesarean delivery? A natural experiment.

OBJECTIVE: More than 50% of pregnant women in the United States are using epidural analgesia for labor pain. However, whether epidural analgesia prolongs labor and increases the risk of cesarean delivery remains controversial. STUDY DESIGN: We examined this question in a community-based, tertiary military medical center where the rate of continuous epidural analgesia in labor increased from 1% to 84% in a 1-year period while other conditions remained unchanged-a natural experiment. We systematically selected 507 and 581 singleton, nulliparous, term pregnancies with spontaneous onset of labor and vertex presentation from the respective times before and after the times that epidural analgesia was available on request during labor. We compared duration of labor, rate of cesarean delivery, instrumental delivery, and oxytocin use between these two groups. RESULTS: Despite a rapid and dramatic increase in epidural analgesia during labor (from 1% to 84% in 1 year), rates of cesarean delivery overall and for dystocia remained the same (for overall cesarean delivery: adjusted relative risk, 0.8; 95% confidence interval, 0.6-1.2; for dystocia: adjusted relative risk, 1.0; 95% confidence interval, 0.7-1.6). Overall instrumental delivery did not increase (adjusted relative risk, 1.0; 95% confidence interval, 0.8-1.4), nor did the duration of the first stage and the active phase of labor (multivariate analysis; P >.1). However, the second stage of labor was significantly longer by about 25 minutes (P <.001). CONCLUSION: Epidural analgesia during labor does not increase the risk of cesarean delivery, nor does it necessarily increase oxytocin use or instrumental delivery caused by dystocia. The duration of the active phase of labor appears unchanged, but the second stage of labor is likely prolonged. (Am J Obstet Gynecol 2001;185:128-34).

Adult↗