ArticleObstetrics and gynecology2014
Factors influencing the likelihood of instrumental delivery success.
Article in Obstetrics and gynecology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 47 citations in OpenAlex.
- Article
- Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of age.Journal of perinatal medicine · 2024Article
- Precision of vacuum cup placement and its association with subgaleal hemorrhage and associated morbidity in term neonates.Archives of gynecology and obstetrics · 2024Article
- Determinants of fetomaternal complication of instrumental vaginal delivery among women who gave childbirth in Southern Ethiopia: a facility-based cross-sectional study.BMC research notes · 2023Article
- [Risk factors for neonatal asphyxia and establishment of a nomogram model for predicting neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture: a multicenter study].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- Clinical and Physician Factors Associated With Failed Operative Vaginal Delivery.Obstetrics and gynecology · 2023Article
- Maternal Complications Related to Operative Vaginal Delivery and Their Associated Factors among Women Delivered at NEMCS Hospital, Southwest Ethiopia.Obstetrics and gynecology international · 2023Article
- Incidence of Intrapartum-Related Events at the Largest Obstetric Hospital in Hanoi, Vietnam: A Retrospective Study.Children (Basel, Switzerland) · 2022Article
- Complications of instrumental vaginal deliveries and associated factors in hospitals of Western Oromia, Ethiopia.SAGE open medicine · 2022Article
- The association between caesarean section delivery and later life obesity in 21-24 year olds in an Urban South African birth cohort.PloS one · 2019Article
- Incidence and Risk Factors of Obstetric Anal Sphincter Injuries after Various Modes of Vaginal Deliveries in Chinese Women.Chinese medical journal · 2015Article
- Factors associated with adverse clinical outcomes among obstetrics trainees.Medical education · 2015Article
- Management of fetal malposition in the second stage of labor: a propensity score analysis.American journal of obstetrics and gynecology · 2015Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo evaluate risk factors for unsuccessful instrumental delivery when variability between individual obstetricians is taken into account.
methodsWe conducted a retrospective cohort study of attempted instrumental deliveries over a 5-year period (2008-2012 inclusive) in a tertiary United Kingdom center. To account for interobstetrician variability, we matched unsuccessful deliveries (case group) with successful deliveries (control group) by the same operators. Multivariate logistic regression was used to compare successful and unsuccessful instrumental deliveries.
resultsThree thousand seven hundred ninety-eight instrumental deliveries of vertex-presenting, single, term newborns were attempted, of which 246 were unsuccessful (6.5%). Increased birth weight (odds ratio [OR] 1.11; P<.001), second-stage labor duration (OR 1.01; P<.001), rotational delivery (OR 1.52; P<.05), and use of ventouse compared with forceps (OR 1.33; P<.05) were associated with unsuccessful outcome. When interobstetrician variability was controlled for, instrument selection and decision to rotate were no longer associated with instrumental delivery success. More senior obstetricians had higher rates of unsuccessful deliveries (12% compared with 5%; P<.05) but were used to undertake more complicated cases. Cesarean delivery during the second stage of labor without previous attempt at instrumental delivery was associated with higher birth weight (OR 1.07; P<.001), increased maternal age (OR 1.03; P<.01), and epidural analgesia (OR 1.46; P<.001).
conclusionResults suggest that birth weight and head position are the most important factors in successful instrumental delivery, whereas the influence of instrument selection and rotational delivery appear to be operator-dependent. Risk factors for lack of instrumental delivery success are distinct from risk factors for requiring instrumental delivery, and these should not be conflated in clinical practice.
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