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Fetal rotation duri...
Fetal rotation during vacuum extractions for prolonged labor : a prospective cohort study
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- Kahrs, Birgitte H. (author)
- St. Olav’s University Hospital,Norwegian University of Science and Technology
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- Usman, Sana (author)
- Imperial College London
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- Ghi, Tullio (author)
- Parma University Hospital
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- Youssef, Aly (author)
- St. Orsola-Malpighi University Hospital
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- Torkildsen, Erik A. (author)
- Stavanger University Hospital
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- Lindtjørn, Elsa (author)
- Stavanger University Hospital
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- Østborg, Tilde B. (author)
- Stavanger University Hospital
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- Benediktsdottir, Sigurlaug (author)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Brooks, Lis (author)
- Hvidovre Hospital
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- Harmsen, Lotte (author)
- Hvidovre Hospital
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- Salvesen, Kjell Å (author)
- Norwegian University of Science and Technology,St. Olav’s University Hospital
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- Lees, Cristoph C. (author)
- Imperial College London
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- Eggebø, Torbjørn M. (author)
- Norwegian University of Science and Technology,Stavanger University Hospital,St. Olav’s University Hospital
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St Olav’s University Hospital Norwegian University of Science and Technology (creator_code:org_t)
- 2018-06-12
- 2018
- English 8 s.
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349. ; 97:8, s. 998-1005
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Abstract
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- Introduction: The aim of the study was to investigate fetal head rotation during vacuum extraction. Material and methods: We conducted a prospective cohort study from November 2013 to July 2016 in seven European hospitals. Fetal head position was determined with transabdominal or transperineal ultrasound and categorized as occiput anterior (OA), occiput transverse (OT) or occiput posterior (OP) position. Main outcome was the proportion of fetuses rotating during vacuum extraction. Secondary outcomes were conversion of delivery method, duration of vacuum extraction, umbilical artery pH <7.10 and agreement between clinical and ultrasound assessments. Results: The study population comprised 165 women. During vacuum extraction 117/119 (98%) remained in OA and two fetuses rotated to OP position. Rotation from OT to OA position occurred in 14/19 (74%) and to OP position in 5/19 (26%). Rotation from OP to OA position occurred in 15/25 (60%), and 10/25 (40%) fetuses remained in OP position. Delivery information was missing in two cases. The conversion rate from vacuum extraction to cesarean section or forceps was 10% in the OA group vs. 23% in the non-OA group; p < 0.05. The estimated duration of vacuum extraction was significantly shorter in OA fetuses, 7 min vs. 10 min (log rank test p < 0.01). There was no significant difference in umbilical artery pH < 7.10 between OA and non-OA position. Cohens Kappa of agreement between clinical and ultrasound assessments was 0.42 (95% CI 0.26–0.57). Conclusion: Most fetuses in OP or OT positions rotated to OA position during vacuum extraction, but the proportion of failed vacuum extractions remained high.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- delivery
- fetal rotation
- prolonged labor
- ultrasound
- vacuum extraction
Publication and Content Type
- art (subject category)
- ref (subject category)
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Kahrs, Birgitte ...
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Usman, Sana
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Ghi, Tullio
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Youssef, Aly
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Torkildsen, Erik ...
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Lindtjørn, Elsa
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Østborg, Tilde B ...
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Benediktsdottir, ...
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Brooks, Lis
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Harmsen, Lotte
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Salvesen, Kjell ...
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Lees, Cristoph C ...
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Eggebø, Torbjørn ...
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- MEDICAL AND HEALTH SCIENCES
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Lund University