Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
---|---|---|---|
Reviews and meta-analyses | |||
Johanson and Menon 1999 [7] | 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 [8] | Malaysia. 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]. |
Intervention studies | |||
Mustafa and Mustafa 2002 [10] | 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 [9] | 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. |
Observational studies | |||
Broekhuizen et al. 1987 [11] | 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 [13] | 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 [136] | Saudi Arabia. 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. |