Rapid versus stepwise negative pressure application for vacuum extraction assisted vaginal delivery

The rapid negative pressure application for vacuum assisted vaginal birth appears to reduce duration of the procedure compared with stepwise procedure without difference in maternal or neonatal outcomes.

Comment: The quality of evidence is downgraded by study limitations (lack of blinding).

Summary

A Cochrane review included 2 studies with a total of 754 subjects. The success rate of vacuum procedure was the same 98.2% by both methods (RR 1.00, 95% CI 0.98 to 1.02; 1 trial, n=660). Significant reductions in the time between applying the vacuum cup and delivery was shown in both trials, (mean difference (MD) -6.10 minutes, 95% CI -8.83 to -3.37; 1 trial, n=74, and the other trial with median difference -4.4 minutes, 95% CI -4.8 to -4.0; n=660). There were no significant difference in detachment rate (RR 0.85, 95% CI 0.38 to 1.86; 2 studies, n=754), in Apgar score below 7 at one minute (RR 1.04, 95% CI 0.51 to 2.09) and five minutes (RR 1.00, 95% CI 0.29 to 3.42), in scalp abrasions or lacerations, cephalhematoma, subgaleal hemorrhage and hyperbilirubinemia.

Clinical comments

Date of latest search: 8 May 2012

Ədəbiyyat

1. Suwannachat B, Lumbiganon P, Laopaiboon M. Rapid versus stepwise negative pressure application for vacuum extraction assisted vaginal delivery. Cochrane Database Syst Rev 2012;(8):CD006636.