ArticleBJOG : an international journal of obstetrics and gynaecology2018
Perinatal and maternal morbidity and mortality among term singletons following midcavity operative vaginal delivery versus caesarean delivery.
Article in BJOG : an international journal of obstetrics and gynaecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 69 citations in OpenAlex.
- Perinatal outcome after vacuum assisted delivery with digital feedback on traction force; a randomised controlled study.BMC pregnancy and childbirth · 2021Trial
- Long-term neurodevelopmental outcomes after vacuum-assisted delivery: A population-based cohort study.PLoS medicine · 2026Article
- Transperineal ultrasonography assisted examination improves maternal and neonatal outcomes of forceps delivery: a propensity-score-matched analysis.Scientific reports · 2026Article
- Variation in outcome reporting in studies comparing vacuum-assisted birth versus second-stage caesarean section: A systematic review.European journal of obstetrics & gynecology and reproductive biology: X · 2026Article
- Maternal morbidity following a trial of labor after cesarean birth: A scoping review of operative vaginal birth compared with cesarean birth in the second stage of labor.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Selection of the apposite vacuum extractor during operative delivery: A biomechanical study.Journal of the Chinese Medical Association : JCMA · 2025Article
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- Neonatal mortality and associated factors among newborns in Mogadishu, Somalia: a multicenter hospital-based cross-sectional study.BMC public health · 2024Article
- Maternal and neonatal trauma during forceps and vacuum delivery must not be overlooked.BMJ (Clinical research ed.) · 2023Article
- Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study.BMJ paediatrics open · 2023Article
- Risk factors associated with severe perineal lacerations during vaginal delivery: a 10-year propensity score-matched observational study.AJOG global reports · 2023Article
- Can We Predict Feto-Maternal Adverse Outcomes of Vacuum Extraction?Geburtshilfe und Frauenheilkunde · 2022Article
- Traction force profile in children with severe perinatal outcomes delivered with a digital vacuum extraction handle: A case-control study.Acta obstetricia et gynecologica Scandinavica · 2022Observational
- Maternal and neonatal trauma following operative vaginal delivery.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Article
- Obstetric anal sphincter injury following previous vaginal delivery.International urogynecology journal · 2021Article
- Article
- Babies in occiput posterior position are significantly more likely to require an emergency cesarean birth compared with babies in occiput transverse position in the second stage of labor: A prospective observational study.Acta obstetricia et gynecologica Scandinavica · 2020Observational
- Episiotomy use among vaginal deliveries and the association with anal sphincter injury: a population-based retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify severe perinatal and maternal morbidity/mortality associated with midcavity operative vaginal delivery compared with caesarean delivery.
designPopulation-based, retrospective cohort study.
settingBritish Columbia, Canada. POPULATION: Term, singleton deliveries (2004-2014) by attempted midcavity operative vaginal delivery or caesarean delivery in the second stage of labour, stratified by indication for operative delivery (n = 10 901 deliveries; 5057 indicated for dystocia, 5844 for fetal distress).
methodsMultinomial propensity scores and mulitvariable log-binomial regression models were used to estimate adjusted rate ratios (ARR) and 95% confidence intervals (95% CI).
main outcome measuresComposite severe perinatal morbidity/mortality (e.g. convulsions, severe birth trauma and perinatal death) and severe maternal morbidity (e.g. severe postpartum haemorrhage, shock, sepsis and cardiac complications).
resultsAmong deliveries with dystocia, attempted midcavity operative vaginal delivery was associated with higher rates of severe perinatal morbidity/mortality compared with caesarean delivery (forceps ARR 2.11, 95% CI 1.46-3.07; vacuum ARR 2.71, 95% CI 1.49-3.15; sequential ARR 4.68, 95% CI 3.33-6.58). Rates of severe maternal morbidity/mortality were also higher following midcavity operative vaginal delivery (forceps ARR 1.57, 95% CI 1.05-2.36; vacuum ARR 2.29, 95% CI 1.57-3.36). Among deliveries with fetal distress, there were significant increases in severe perinatal morbidity/mortality following attempted midcavity vacuum (ARR 1.28, 95% CI 1.04-1.61) and in severe maternal morbidity following attempted midcavity forceps delivery (ARR 2.34, 95% CI 1.54-3.56).
conclusionAttempted midcavity operative vaginal delivery is associated with higher rates of severe perinatal morbidity/mortality and severe maternal morbidity, though these effects differ by indication and instrument. TWEETABLE ABSTRACT: Perinatal and maternal morbidity is increased following midcavity operative vaginal delivery.
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