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Am J Perinatol 2000; Volume 17(Number 05): 265-270
DOI: 10.1055/s-2000-10009
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

INSTRUMENTAL DELIVERY OF THE FETAL HEAD AT THE TIME OF ELECTIVE REPEAT CESAREAN: A RANDOMIZED PILOT STUDY

James A. Bofill1 , Shaun G. Lencki2 , Sheela Barhan2 , Leonard C. Ezenagu2
  • 1University of Mississippi Medical Center, Jackson, Mississippi and the
  • 2Department of Obstetrics & Gynecology, Wright State University School of Medicine, Dayton, Ohio
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

We sought to ascertain whether the routine use of instruments, forceps or vacuum, at the time of elective repeat cesarean delivery, permits a delivery that is as safe for mother and infant and as easy for mother and physician as traditional manual delivery of the fetal head. In this prospective study 44 women undergoing elective repeat cesarean were randomized to deliver by Vacuum (V), Forceps (F), or by Manual (M) means. Groups were compared with regard to demographic variables and maternal and neonatal outcomes. Deliveries were timed from entry into the uterus until full delivery of the infant. Maternal pain scores were assessed using a 10-cm visual analog scale. There were no differences in demographic variables except that the M group had fewer women with up to two cesareans. A large percentage of women in each group were delivered with the randomized instrument. Use of the V did not demonstrate fewer extensions of the uterine incision or lesser amounts of blood loss as measured by serial hemoglobin determinations. There was a trend for the F group to require a longer period of time for delivery (p = 0.061). Women in the V group reported significantly lower pain scores (p = 0.015). There were no serious neonatal injuries. The routine use of instruments at the time of elective repeat cesarean delivery appears safe and effective.

KEYWORD

Vacuum - forceps - cesarean delivery

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