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Trends in operative vaginal delivery, 2005-2013: a population-based study.

A A Merriam1, C V Ananth1,2, J D Wright1

  • 1Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

BJOG : an International Journal of Obstetrics and Gynaecology
|February 26, 2017
PubMed
Summary
This summary is machine-generated.

Operative vaginal delivery, including forceps and vacuum extraction, significantly decreased in the US between 2005 and 2013. This decline presents challenges for training future obstetricians in these essential delivery techniques.

Keywords:
Forcepsobstetric educationoperative delivery

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Health
  • Clinical Epidemiology

Background:

  • Operative vaginal delivery (OVD) using forceps or vacuum extraction is a critical skill in obstetrics.
  • Understanding temporal trends and associated factors of OVD is essential for clinical practice and education.

Purpose of the Study:

  • To determine temporal trends in forceps and vacuum delivery rates in the United States from 2005 to 2013.
  • To identify obstetric, medical, and demographic factors associated with operative vaginal delivery.

Main Methods:

  • Retrospective cohort study utilizing US birth records from 2005 to 2013.
  • Analysis included live-born, non-anomalous singleton gestations between 36 to <42 weeks of gestation.
  • Multivariable logistic regression models were employed to identify factors associated with forceps and vacuum use.

Main Results:

  • A total of 22,598,971 vaginal deliveries were analyzed.
  • Both vacuum-assisted (4.8%) and forceps (1.1%) deliveries decreased significantly during the study period.
  • Vacuum deliveries declined from 5.8% to 4.1%, and forceps deliveries from 1.4% to 0.9% between 2005 and 2013.

Conclusions:

  • Operative vaginal delivery rates, including forceps and vacuum, have significantly decreased in the US.
  • The declining volume of OVD poses challenges for resident education and may limit alternatives to cesarean delivery.
  • Urgent educational initiatives are needed to ensure future obstetricians maintain expertise in operative vaginal delivery.