Neonatal complications of vacuum-assisted delivery
Neonatal complications of vacuum-assisted delivery
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DOI：
10.1097/01.aog.0000255981.86303.2b
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发表时间：
2007-03-01
影响因子：
7.2
通讯作者：
Rozenberg, Serge
中科院分区：
文献类型：
--
作者：
Simonson, Colin;Barlow, Patricia;Rozenberg, Serge
目的：为了系统地评估真空辅助分娩队列中新生儿并发症的程度，确定与这些并发症的发生相关的风险因素，并评估真空提取后颅骨X线和经额骨超声检查的有用性。方法：我们回顾了一个队列，1,123例尝试真空提取的单胎在2000年1月至2004年12月之间进行。在此期间，一个系统的筛选，使用transfontanellar超声检查和颅骨X线进行真空extraction.Results后：在913成功的真空辅助，足月分娩，25.7%的新生儿重症监护室。通过头颅X线片评估头皮水肿、头部血肿和颅骨骨折，分别占18.7%、10.8%和5.0%。颅内出血8例（0.87%）。Nulliparity，真空尝试在中站，提取需要三个以上的牵引，并脱位的杯与这些并发症，但有较低的预测value.CONCLUSION：严重的新生儿并发症与真空提取是罕见的。系统的X线和超声波检查导致无症状并发症的发现。由于这些并发症的临床意义尚不清楚，我们不建议将其作为常规筛查工具。
OBJECTIVE: To assess systematically the extent of neonatal complications in a cohort of vacuum-assisted deliveries, identify risk factors associated with the occurrence of these complications, and to evaluate the usefulness of skull X-ray and transfontanellar ultrasonography after vacuum extraction.METHODS: We reviewed a cohort of 1,123 attempted vacuum extractions of singletons performed between January 2000 and December 2004. During this period, a systematic screening using transfontanellar ultrasonography and skull X-ray was performed after vacuum extraction.RESULTS: Among 913 successful vacuum-assisted, full-term deliveries, 25.7% were admitted to the neonatal intensive care unit. Scalp edema, cephalhematoma, and skull fracture were assessed by cranial radiography and were present in, respectively, 18.7%, 10.8%, and 5.0% of cases. Intracranial hemorrhage occurred in eight cases (0.87%). Nulliparity, a vacuum attempt at mid station, an extraction requiring more than three tractions, and dislodgment of the cup were associated with these complications but had a low predictive value.CONCLUSION: Severe neonatal complications associated with vacuum extraction are uncommon. Systematic X-ray and ultrasonographic examination led to the discovery of asymptomatic complications. Because the clinical significance of these complications is unknown, we do not recommend them as routine screening tools.