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Adverse outcomes in vacuum-assisted delivery after detachment of non-metal cup: a retrospective cohort study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate neonatal and maternal outcomes associated with detachment of non-metal vacuum cup during delivery and to identify risk factors for these detachments.

Methods

This retrospective cohort study included women with singleton pregnancy, who underwent vacuum-assisted vaginal delivery with a non-metal vacuum cup in a single academic institution, January 2014–August 2019. Failed vacuum deliveries were excluded. Primary outcomes were defined as subgaleal hematoma (SGH) and cord blood pH < 7.15. Secondary outcome included other neonatal complications and adverse maternal outcomes. Outcomes were compared between vacuum-assisted deliveries with and without cup detachment during the procedure.

Results

A total of 3246 women had successful VAD and met the inclusion criteria. During the procedure, the cup detached at least once in 665 (20.5%) deliveries and did not detach in 2581 (79.5%). The cup detachment group experienced higher rates of SGH (8.9% vs. 3.5%, p = 0.001) and cord blood pH < 7.15 (9.8% vs. 7.1%, p = 0.03). There were also more neonatal intensive care unit admissions (NICU) (4.4% vs. 2.7%, p = 0.03) and more fetuses with occiput posterior position (70.8% vs. 79.4%, p = 0.001), the vacuum duration was slightly longer (6 ± 3.7 vs. 5 ± 2.9 min) and more neonates had birth weights > 3700 g (14.1% vs, 10.3%, p = 0.006). Interestingly, there were more males in that group (60.6 vs. 54.6, p = 0.005). All these factors remained significant after controlling for potential confounders.

Conclusions

Vacuum cup detachment has several predictive characteristics and is associated with adverse neonatal outcomes that should be incorporated into decisions made during the procedure.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank Nava Jelin, MS for data analysis and Faye Schreiber, MS for editing the manuscript. They are employees of Meir Medical Center.

Funding

This study was not funded.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel

    Hanoch Schreiber, Gal Cohen, Sivan Farladansky-Gershnabel, Gil Shechter Maor, Maya Sharon-Weiner & Tal Biron-Shental

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Hanoch Schreiber, Gal Cohen, Sivan Farladansky-Gershnabel, Gil Shechter Maor, Maya Sharon-Weiner & Tal Biron-Shental

Authors
  1. Hanoch Schreiber
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  2. Gal Cohen
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  3. Sivan Farladansky-Gershnabel
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  4. Gil Shechter Maor
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  5. Maya Sharon-Weiner
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  6. Tal Biron-Shental
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Contributions

HS: project development, data collection, manuscript writing and editing. GC: project development, data analysis and interpretation. SFG: data collection. gsm: data collection, reviewed manuscript. MSW: data collection. TBS: revised manuscript critically.

Corresponding author

Correspondence to Hanoch Schreiber.

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Conflict of interest

The authors Hanoch Schreiber, Gal Cohen, Sivan Farladansky-Gershnabel, Gil Shechter Maor, Maya Sharon-Weiner and Tal Biron-Shental have no conflict of interest to declare.

Ethical approval

The study was approved by the Meir Medical Center Ethics Committee in August 2019, Approval Number 0246-19-MMC.

Consent to participate

Informed consent was not required due to the retrospective nature of the study.

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Schreiber, H., Cohen, G., Farladansky-Gershnabel, S. et al. Adverse outcomes in vacuum-assisted delivery after detachment of non-metal cup: a retrospective cohort study. Arch Gynecol Obstet 305, 359–364 (2022). https://doi.org/10.1007/s00404-021-06155-y

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  • DOI: https://doi.org/10.1007/s00404-021-06155-y

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