Neonatal Outcomes and Operative Vaginal Delivery Versus Cesarean Delivery

作者：Contag Stephen A^*; Clifton Rebecca G; Bloom Steven L; Spong Catherine Y; Varner Michael W; Rouse Dwight J; Ramin Susan M; Caritis Steve N; Peaceman Alan M; Sorokin Yoram; Sciscione Anthony; Carpenter Marshall W; Mercer Brian M; Thorp John M Jr; Malone Fergal D; Iams Jay D

来源：American Journal of Perinatology, 2010, 27(6): 493-499.

DOI：10.1055/s-0030-1247605

• Cesarean
• forceps
• umbilical cord blood gases
• vacuum

We compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at >= 36 weeks' gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess (p = 0.35 and 0.78 for failure of descent and nonreassuring fetal status) or frequencies of pH below 7.0 (p = 0.73 and 0.34 for failure of descent and nonreassuring fetal status) among the three delivery methods. Birth outcomes and umbilical cord blood gas values were similar for those neonates with a forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. The occurrence of significant fetal acidemia was not different among the three delivery methods regardless of the indication.

• 出版日期2010-6
• 单位西北大学