Second stage expedite delivery of low birth weight neonates: emergent cesarean delivery versus vacuum assisted delivery - 02/04/21
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Abstract |
Objective |
To determine maternal and neonatal outcomes among women undergoing second stage emergent cesarean delivery (ECD) versus vacuum-assisted delivery (VAD) of low birthweight neonates.
Materials and methods |
A retrospective cohort study from two tertiary medical centers. We included women who underwent either ECD or VAD during the second stage of labor, and delivered neonates with a birthweight of <2500 grams during 2011-2019. Characteristics and outcomes were compared between the groups. The primary outcome was the rate of a composite adverse neonatal outcome, defined as the presence of ≥1 of the following: Apgar 5 minute <7, respiratory distress syndrome, neonatal intensive care unit admission, mechanical ventilation and intrapartum fetal death.
Results |
The study cohort included 611 patients, of whom 46 had ECD and 565 had VAD. Baseline characteristics did not differ between the groups. The rate of Apgar score <7 at 1 minute was higher among the ECD group]10 (22%) vs. 29 (5%), OR (95% CI) 5.1 (2.3-11.3), p<0.001[. Other neonatal and maternal outcomes were similar in both groups.
Conclusions |
Neonatal and maternal outcomes do not differ substantially between ECD and VAD of neonates weighing <2500 grams. This information may be useful when contemplating the preferred mode of delivery in this setting.
Le texte complet de cet article est disponible en PDF.Keywords : Cesarean delivery, low birthweight, perinatal outcome, second stage, vacuum extraction
Plan
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