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Modified Blood Collection from Tail Veins of Non-anesthetized Mice with a Vacuum Blood Collection System and Eyeglass Magnifier

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[How to proceed after a failed vacuum delivery].

M Chamagne¹, E Perdriolle-Galet², C Baumann³

¹Service d'obstétrique, maternité régionale universitaire, 10, rue du Dr Heydenreich, 54000 Nancy, France.

Gynecologie, Obstetrique, Fertilite & Senologie

|May 24, 2019

Summary

This summary is machine-generated.

Using a second instrument after failed vacuum delivery increases maternal risks like severe perineal tears. Neonatal outcomes are similar unless the second instrument also fails, then infant morbidity significantly increases.

Keywords:

Cesarean section Césarienne Failed instrumental delivery Forceps Maternal and neonatal outcome Morbidité maternofoetale Spatula Spatules Vacuum Ventouse Échec d’extraction instrumentale

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Area of Science:

Obstetrics and Gynecology
Neonatal Medicine

Background:

Vacuum-assisted delivery is a common intervention for prolonged second stage of labor.
Failed vacuum deliveries necessitate alternative operative interventions, such as instrumental rotation or cesarean section.
Understanding the comparative maternal and neonatal outcomes of these interventions is crucial for clinical decision-making.

Purpose of the Study:

To compare maternal and neonatal morbidity between second instrument delivery and cesarean section following a failed vacuum extraction.
To assess the impact of a second instrument's failure on neonatal outcomes.

Main Methods:

Retrospective study of 172 failed vacuum deliveries between January 2006 and December 2014.
Analysis of maternal parameters including blood loss, perineal tears, and episiotomy rates.
Evaluation of neonatal outcomes such as Apgar scores, cord pH, need for resuscitation, and neonatal unit length of stay.

Main Results:

Second instrument use was associated with higher rates of third-degree perineal tears (13.4% vs. 0%) and episiotomy (72.2% vs. 0%) compared to cesarean section.
No significant difference in postpartum hemorrhage or neonatal morbidity was observed between second instrument delivery and cesarean section immediately after failed vacuum.
Failure of the second instrument significantly increased neonatal morbidity, indicated by longer neonatal unit stays, lower pH and Apgar scores, and increased rates of intubation and seizures.

Conclusions:

Second instrument use following failed vacuum delivery increases maternal morbidity, particularly severe perineal tears and episiotomy rates.
Neonatal morbidity is not significantly increased when a second instrument is used compared to cesarean section after initial vacuum failure.
A secondary failure of the second instrument significantly elevates the risk of adverse neonatal outcomes.