|Source||Location and Type of Study||Intervention||Stillbirths/Perinatal Outcomes|
|Reviews and meta-analyses|
|Johanson and Menon 1999 ||
USA, Denmark, Sweden, England, South Africa.|
Meta-analysis (Cochrane). 7 RCTs included (N = 1800 women).
|Assessed the effects of vacuum extraction vs. forceps on maternal and neonatal morbidity.||
PMR: OR = 0.80 (95% CI: 0.18–3.52) [NS].|
[3/901 vs. 4/899 in vacuum vs. forceps group, respectively].
|Johanson and Menon 2000 ||
Cochrane review. 1 RCT included with death as outcome (N = 72 women).
|To assess the effects of soft (intervention) vs. rigid vacuum extractor cups (control) on perineal injury, fetal scalp injury and success rate.||
Death: OR = 1.26 (95% CI: 0.08–20.85) [NS].|
[1/32 vs. 1/40 in intervention and control groups, respectively].
|Mustafa and Mustafa 2002 ||
Pakistan (Multan). Nishtar Hospital.|
RCT. Consecutive patients (N = 931), of which 50 were selected (N = 27 ventouse group, N = 23 forceps).
50/931 consecutive patients were randomly selected either to forceps delivery (Group I) or ventouse extraction (Group II).
|Compared the effects of ventouse vs. forceps delivery on maternal and perinatal outcome.||
SBR: 0/27 vs. 1/23 in the vacuum and forceps groups, respectively.|
Success rate: 26/27 (96.30%) vs. 22/23 (95.65%) in vacuum and forceps groups, respectively.
There was one failure in each category which was later on delivered by Caesarean section.
|Weerasekera et al. 2002 ||
Sri Lanka. Tertiary care setting.|
RCT. Women (N = 442) undergoing instrumental delivery in the second stage (N = 238 forceps group, N = 204 vacuum).
|Compared the impact of forceps vs. vacuum delivery on the stillbirth rate.||
SBR or NMR: 1/238 vs. 1/204 in the forceps and vacuum groups, respectively; P > 0.05.|
There was no significant difference in babies needing resuscitation at birth or admission to neonatal intensive care unit.
|Broekhuizen et al. 1987 ||
USA. Tertiary care setting.|
Retrospective study. N = 256 vacuum extractions, and N = 300 randomly chosen forceps deliveries were analyzed.
|Compared the impact of the vacuum extraction vs. forceps deliveries.||Death: one event in each group.|
|Gachiri et al. 1991 ||
Kenya (Nairobi). Kenyatta National Hospital.|
Prospective study. Vacuum extractions (N = 167).
|Assessed the fetal and maternal outcome among women undergoing vacuum extraction||
SBR: 6/167 (3.6%).|
PMR: 8/167 (4.8%).
|Mesleh 2002 ||
Retrospective review. Vaginal deliveries (N = 304) with instrument use (N = 258 ventouse group, N = 46 forceps).
|Assessed the effects of vacuum vs. forceps deliveries on pregnancy outcomes.||
SBR: 1/258 vs. 0/46 in the forceps and ventouse groups, respectively.|
The single stillbirth in the vacuum delivery group was due to intrapartum asphyxia and true knot in the umbilical cord.