Comparative Study of Slip Rate and Neonatal Complications in Vacuum Extraction between Stepwise and Rapid Application of Suction

Abstract

Comparative Study of Slip Rate and Neonatal Complications in Vacuum Extraction between Stepwise and Rapid Application of Suction

Chullasak        Sroiwatana                  MD

Paiboon          Charoenchainont        MD

Kasem            Kaewkiattikun             MD

Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective : To compare the slip rate and neonatal complications in the first 5 days in vacuum extraction between stepwise and rapid application of suction.

Study design : Experimental study.

Setting : Labor room, Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital.

Subjects Two hundred pregnant women with 37 weeks gestation age or more, attending at the labor room of BMA Medical College and  Vajira Hospital from September 1997 to June 1998, who were in the second stage of labor and had indications for operative delivery without contraindications for vacuum extraction use.

Methods All 200 patients were divided into 2 groups by simple random sampling from the last number of hospital numbers. In group 1 (n = 100) with the last number of hospital numbers of 1, 3, 5, 7 and 9, the vacuum pressure was gradually and stepwise decreased before traction, while group 2 (n = 100) with the last number of hospital numbers of 0, 2, 4, 6 and 8, was rapidly decreased pressure. Slip rate and neonatal complications of 2 methods were noted.

Main outcome measures : Slip rate and neonatal complications of both groups.

Results The slip rates between the stepwise (7%) and rapid (6%) application of vacuum extraction groups were no statistically significant difference (p = 0.78). The rates of scalp abrasion laceration occurring in stepwise and rapid groups were 11% and 8% respectively, which were no statistically significant difference (p = 0.47), and rates of cephalhematoma occurring in stepwise and rapid groups were 14% and i2% respectively, which were no statistically significant difference (p = 0.68).

Conclusion There were no statistically significant differences of the slip rates and neonatal complications between the stepwise and rapid application of vacuum extraction groups.

Key words : vacuum extraction, stepwise and rapid application, slip rate, neonatal complications

Vajira Med J 2001 ; 45 : 171 - 178