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Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres : a retrospective observational study
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Gurney, Leo, Wattar, Bassel H. Al, Sher, Ali, Echevarria, Carlos and Simpson, Helen (2020) Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres : a retrospective observational study. BJOG: An International Journal of Obstetrics & Gynaecology . doi:10.1111/1471-0528.16589 (In Press)
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Official URL: https://doi.org/10.1111/1471-0528.16589
Abstract
Objective To compare rates of vaginal delivery and adverse outcomes of instrumental delivery trials in obstetric theatre compared to primary emergency full dilatation Caesarean section Design Retrospective cohort study Setting University teaching hospital Population Women with singleton, non-anomalous, pregnancy undergoing instrumental delivery trial in obstetric theatre Methods Data was collected from consecutive cases during 2014 until 2018 using clinical records. Multivariate regression analysis was used comparing groups per first delivery attempt. Main Outcome Measures Primary outcome was completion of vaginal delivery between all methods of instrumental delivery. Secondary outcome was a composite of immediate perinatal adverse outcomes for instrumental delivery modes and primary full dilatation Caesarean section. Results From 971 deliveries analysed: ventouse delivery was significantly less likely to achieve vaginal delivery compared to Keilland’s forceps delivery (OR 0.42, 95%CI 0.22-0.79). Once confounding factors were adjusted for, adverse outcome rates were less frequent in the Keilland’s forceps group compared with primary full dilatation Caesarean section (OR 0.37, 95% CI: 0.16-0.81), however the receiver operating characteristic curve produced from this model demonstrated low predictive value (AUC 0.64). Conclusions Attempting instrumental delivery in delivery suite theatre, as an alternative to primary emergency full dilatation Caesarean section, is both reasonable and safe. Ventouse delivery in this situation may be associated with a higher chance of failure than other modes of instrumental delivery, thus making appropriate choice of delivery method of paramount importance according to each clinical situation. Funding None Keywords Caesarean section, Keilland’s forceps, ventouse, trial of instrumental delivery
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Cell & Developmental Biology Faculty of Medicine > Warwick Medical School > Biomedical Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Cesarean section, Delivery (Obstetrics), Obstetrical forceps, Obstetrical extraction -- Instruments | ||||||
| Journal or Publication Title: | BJOG: An International Journal of Obstetrics & Gynaecology | ||||||
| Publisher: | Wiley-Blackwell Publishing, Inc | ||||||
| ISSN: | 1470-0328 | ||||||
| Book Title: | Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres: a retrospective observational study | ||||||
| Official Date: | 3 November 2020 | ||||||
| Dates: |
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| Date of first compliant deposit: | 29 October 2020 | ||||||
| DOI: | 10.1111/1471-0528.16589 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | In Press | ||||||
| Publisher Statement: | "This is the peer reviewed version of the following article:Gurney, L, Al Wattar, BH, Sher, A, Echevarria, C, Simpson, H. Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres: a retrospective observational study. BJOG 2020; which has been published in final form at http://dx.doi.org/10.22541/au.159414792.20021903. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions." | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
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