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5 - Perinatal effects of vacuum operation at vaginal delivery
Resul Karakuş, Doğukan Anğın, Osman Temizkan, Mesut Polat, İlhan Şanverdi, Seren Karakuş, Ferhat Ekinci
Objective: Although number of vacuum operative vaginal deliveries is low nowadays, it still remains important. In this study, maternal and fetal characteristics and perinatal outcomes of the vacuum operative vaginal deliveries were evaluated in a single center during 5 years period.
Material and Method: Study was conducted in Zeynep Kamil Obsetrics, Gynecology and Pediatrics Education and Research Hospital which is a reference hospital. Cases of vacuum operative vaginal deliveries between January 1998 and December 2012 were reviewed retrospectively. Cases where vacuum exctractor was used in single, live and cephalic presentation births were included in the study. Recorded data about maternal demographic characterisctics, intrapartum characteristiscs and neonatal outcomes were analysed with SPSS programme.
Results: During the last 5 years period, 31497 vaginal births occured. Incidence of vacuum exctractor usage during this period was evaluated to be 0.4% (n:126). It was observed that, in the 5 years period, mean vacuum operative vaginal deliveries per year decreased from 0.4% (n:37) to 0.2% (n:11). None of the patients had history of strenuous delivery. Number of nullaparous patients and multiparous patients were 93 (91.9%), 33 (26.2%); respectively. Sixteen percent of the patients (n:21) had perianal laceration, vaginal laceration and cervical laceration. Five fetuses (3.9%) holded occiput posterior position and the remaining 121 fetuses (96%) holded occiput anterior position. Twenty one out of 126 newborn (16.6%) babies had cephal hematoma, 54 babies (42.8%) had caput succadenum. Intracranial hemorrhage, subgaleal hematoma or death was not observed. Babies born in occiput posterior position and occiput anterior position were compared according to cephal hematom occurence. Results were n:3, 60% and n:18, 14.8%; respectively. The difference was statistically significant.
Conclusion: Vacuum extractor usage loses in value by the day and it is not tought how to use it in daily practice routinely in residency training due to its serious complications. But when applied correctly under necessary conditions by experienced phsycians it does not cause maternal and fetal complications also it can decreases perinatal complications. Anyone who is trained in delivery should know to apply vacuum extractor.
Keywords: Vacuum, risk factors, perinatal effects
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