Observational studyActa obstetricia et gynecologica Scandinavica2022
Traction force profile in children with severe perinatal outcomes delivered with a digital vacuum extraction handle: A case-control study.
Observational study in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Long-term neurodevelopmental outcomes after vacuum-assisted delivery: A population-based cohort study.PLoS medicine · 2026Article
- Experimental Assessment of Traction Force and Associated Fetal Brain Deformation in Vacuum-Assisted Delivery.Annals of biomedical engineering · 2025Article
- Pelvic floor injury during vaginal birth is life-altering and preventable: what can we do about it?American journal of obstetrics and gynecology · 2024Review
- 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
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionDuring the second stage of labor, vacuum-assisted delivery is an alternative to forceps delivery and emergency cesarean section. Extensive research concerning perinatal outcomes has indicated that the risk of complications, although rare, is higher than with a spontaneous vaginal delivery. An important factor related to perinatal outcomes is the traction force applied. Our research group previously developed a digital extraction handle, the Vacuum Intelligent Handle-3 (VIH3), that measures and records traction force. The objective of this study was to compare traction force profiles in children with and without severe perinatal outcomes delivered with the digital handle. A secondary aim was to establish a safe force limit. MATERIAL AND
methodsThis was an observational case-control study at the delivery ward at Karolinska University Hospital, Sweden. In total, 573 children delivered with the digital handle between 2012 and 2018 were included. Cases were defined as a composite of severe perinatal outcomes, including subgaleal hematoma, intracranial hemorrhage, hypoxic ischemic encephalopathy 1-3, seizures or death. The cases in the cohort were matched 1:3 based on five matching variables. Traction profiles were analyzed using the MATLAB® software and conditional logistic regression.
resultsThe incidence of severe perinatal outcomes was 2.3%. The 13 cases were matched with three controls each (n = 39). A statistically significant increased odds for higher total traction forces was seen in the case group (odds ratio [OR] 1.004; 95% confidence interval [CI] 1.001-1.007) and for the peak force (OR 1.022; 95% CI 1.004-1.041). Several procedure-related parameters were significantly increased in the case group. As expected, some neonatal characteristics also differed significantly. An upper force limit of 343 Newton minutes (Nmin) revealed an 86% reduction in severe perinatal outcomes (adjusted OR 0.14; 95% CI 0.04-0.5).
conclusionsChildren with severe perinatal outcomes had traction force profiles with significantly higher forces. The odds for severe perinatal outcomes increased for every increase in Nmin and Newton used during the extraction procedure. A calculated total force level of 343 Nmin is suggested as an upper safety limit, but this must be tested prospectively to provide validity.
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