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Complications with vacuum delivery from a forceps‐delivery perspective: Progress toward safe vacuum delivery
Author(s) -
Seki Hiroyuki
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13685
Subject(s) - medicine , vaginal delivery , forceps delivery , fetal head , obstetrical forceps , forceps , cesarean delivery , delivery system , surgery , pregnancy , fetus , biomedical engineering , genetics , biology
Aim To examine the rates of medical malpractice and cerebral palsy after vacuum delivery in comparison with forceps delivery and establish approaches for enabling safe vacuum delivery from the perspective of forceps delivery. Methods This study reviewed the Japan Obstetric Compensation System report data, which contains data from studies involving 188 cases through May 2013, including cases of emergency delivery. These cases included 118 cases of cesarean section (62.8%) and 70 cases of vaginal delivery (37.2%). Of the 188 patients, 145 required emergency delivery (77.1%), of which cesarean sections were performed in 117 patients (80.7%), vacuum delivery in 24 patients (16.6%) and forceps delivery in 4 patients (2.8%). Results In evaluating the contents of the report with a focus on vacuum delivery, it was found that vacuum delivery was attempted in 35 patients, and delivery was successful in 24 of these patients (68.6%); however, in 11 patients (31.4%), delivery was unsuccessful and cesarean section was required. Thus, vacuum delivery was unsuccessful in approximately one third of the cases. Conclusion For delivery to be completed as successfully and quickly as possible, it is essential for obstetricians to have a good understanding of the process of vacuum delivery, and to have expertise in the relevant techniques. However, it is also necessary to modify the indications under which vacuum delivery is considered safe to perform, from fetal station ±0, that is, engagement of the fetal head, to station +2, or descent of the fetal head.