ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
The impact of metal cup size on neonatal and maternal morbidity in vacuum-assisted deliveries.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The impact of metal cup size on neonatal and maternal morbidity in vacuum-assisted deliveries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Intrapartum Ultrasound in Vacuum Operative Delivery: A Comprehensive Review and Proposal of the Novel Ultrasound Flexion Point Method.Diagnostics (Basel, Switzerland) · 2026Review
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate whether metal cup size influences maternal and neonatal morbidity in vacuum-assisted deliveries (VAD). MATERIALS AND
methodsRetrospective cohort at a single tertiary center (2011-2022) comparing 60-mm versus 50-mm Malmström cups. A 1:1 matched cohort analysis balanced maternal and obstetric variables. Primary neonatal outcomes were a birth trauma composite outcome (brachial plexus injury, cephalohematoma, subgaleal or subdural hematoma) and a severe neonatal composite outcome (neonatal intensive care unit admission, 5-min Apgar score less than 7, umbilical artery pH less than 7.1, intraventricular hemorrhage, hypoxic ischemic encephalopathy, or neonatal convulsions). The primary maternal composite outcome included postpartum hemorrhage, third- or fourth-degree perineal tears or need for postpartum blood products.
resultsAfter matching, 1564 patients were included (782 per group). The 60-mm cup was associated with fewer cup detachments (22 [2.8%] versus 41 [5.2%], P = 0.015), a shorter interval to delivery (4.3 ± 1.9 versus 4.7 ± 2.4 min, P = 0.003) and a comparable failure rate leading to cesarean delivery (5 [0.6%] versus 7 [0.9%], P = 0.56). The neonatal birth trauma composite outcome was less prevalent with 60-mm cups (51 [6.5%] versus 72 [9.2%]; odds ratio [OR] 0.69, 95% confidence interval [CI] 0.47-0.99, P = 0.049) whereas the severe neonatal composite outcome did not differ (83 [10.6%] versus 96 [12.3%], P = 0.302). Maternal composite outcome was similar between groups; however, perineal tears were less common with 60-mm cups (306 [39.1%] vs 369 [47.2%]; OR 0.72, 95% CI 0.59-0.88; P = 0.001).
conclusionIn VAD, use of a larger Malmström cup (60 mm) is associated with fewer cup detachments and a reduced risk of neonatal birth trauma without increasing maternal morbidity.
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