English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Open

Presents the pdf analysis as premium feature

PDF Analysis

Insights

Presents the summarisation as premium feature

Summarisation

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Objective  To quantify severe perinatal and maternal morbidity/mortality associated with midcavity operative vaginal delivery compared with caesarean delivery.    Design  Population‐based, retrospective cohort study.    Setting  British Columbia, Canada.    Population  Term, singleton deliveries (2004–2014) by attempted midcavity operative vaginal delivery or caesarean delivery in the second stage of labour, stratified by indication for operative delivery ( n  = 10 901 deliveries; 5057 indicated for dystocia, 5844 for fetal distress).    Methods  Multinomial propensity scores and mulitvariable log‐binomial regression models were used to estimate adjusted rate ratios ( ARR ) and 95% confidence intervals (95%  CI ).    Main outcome measures  Composite severe perinatal morbidity/mortality (e.g. convulsions, severe birth trauma and perinatal death) and severe maternal morbidity (e.g. severe postpartum haemorrhage, shock, sepsis and cardiac complications).    Results  Among deliveries with dystocia, attempted midcavity operative vaginal delivery was associated with higher rates of severe perinatal morbidity/mortality compared with caesarean delivery (forceps  ARR  2.11, 95%  CI  1.46–3.07; vacuum  ARR  2.71, 95%  CI  1.49–3.15; sequential  ARR  4.68, 95%  CI  3.33–6.58). Rates of severe maternal morbidity/mortality were also higher following midcavity operative vaginal delivery (forceps  ARR  1.57, 95%  CI  1.05–2.36; vacuum  ARR  2.29, 95%  CI  1.57–3.36). Among deliveries with fetal distress, there were significant increases in severe perinatal morbidity/mortality following attempted midcavity vacuum ( ARR  1.28, 95%  CI  1.04–1.61) and in severe maternal morbidity following attempted midcavity forceps delivery ( ARR  2.34, 95%  CI  1.54–3.56).    Conclusion  Attempted midcavity operative vaginal delivery is associated with higher rates of severe perinatal morbidity/mortality and severe maternal morbidity, though these effects differ by indication and instrument.    Tweetable abstract  Perinatal and maternal morbidity is increased following midcavity operative vaginal delivery.

Perinatal and maternal morbidity and mortality among term singletons following midcavity operative vaginal delivery versus caesarean delivery