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首页> 外文期刊>Gynecologie, obstetrique & fertilit >How to proceed after a failed vacuum delivery?
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How to proceed after a failed vacuum delivery?

机译：在失败的真空交付后如何进行？

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Objectives. - Compare maternal and neonatal morbidity in patients delivered by a second instrument versus cesarean section after failed vacuum. Methods. - We performed a retrospective study between January 2006 and December 2014. Case notes of 172 failed vacuum deliveries were studied. The studied parameters were blood loss, perineal tears, pH, Apgar score, neonatal reanimation and length of stay in neonatology. Results. - The frequency of vacuum failure was 8.7%. The use of the second instrument (77.9%) was associated with a higher prevalence of third degree perineal tears (13.4% vs. 0%; P = 0.017) and more episiotomy (72.2% vs. 0%; P< 0.0001). There was no significant difference regarding post partum hemorrhage between cesarean section and second instrument delivery. There was no significant difference regarding neonatal morbidity between cesarean section and second instrument delivery after failed vacuum. When an attempted second instrument delivery failed, the risk of adverse neonatal outcome was increased: newborns had a significantly longer stay in a neonatal unit (2.4 versus 0.6 days; P = 0.026), lower pH (P = 0.017), lower Apgar scores (7.4 versus 8.8; P = 0.0373), needed intubation (P = 0.0471) and had seizures (P = 0.04) more often. Conclusion. - Compared to cesarean section, the use of the second instrument increased maternal morbidity but doesn't seem to increase neonatal morbidity. If the second instrument fails, neonatal morbidity is significantly increased.
机译：目标。 - 在真空失败后，将母体和新生儿发病与剖宫产失败后的患者进行比较。方法。 - 我们在2014年1月和2014年12月之间进行了回顾性研究。案件说明为172例失败的真空交付。研究的参数是失血，会阴撕裂，pH，APGAR评分，新生儿再次成绩和新生儿学的长度。结果。 - 真空衰竭的频率为8.7％。使用第二仪器（77.9％）与第三度的阴部泪液的患病率较高有关（13.4％与0％; p = 0.017）和更多的离析术（72.2％vs.0％; p <0.0001）。剖宫产与第二仪器交付之间的Partum出血没有显着差异。在失败的真空后剖宫产段和第二仪器交付之间的新生儿发病率没有显着差异。当企图的第二仪器交付失败时，不良新生儿结果的风险增加：新生儿在新生儿单位中保持明显长时间（2.4对0.6天; P = 0.026），较低的pH（P = 0.017），降低APGAR分数（ 7.4与8.8; p = 0.0373），需要插管（p = 0.0471）并更频繁地癫痫发作（p = 0.04）。结论。 - 与剖宫产相比，使用第二种仪器提高母体发病率，但似乎似乎似乎不增加新生儿发病率。如果第二仪器发生故障，新生儿发病率明显增加。

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