Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord?
This retrospective cohort study assessed the association between nuchal cord and adverse outcomes during vacuum-assisted delivery (VAD). Women with singleton pregnancies, 34–41-weeks gestation, who underwent VAD, from 2014 to 2020 were included. The primary outcome was umbilical cord pH ≤ 7.1. Secon...
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| Format: | Article |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/6970 |
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| author | Hanoch Schreiber Gal Cohen Nir Mevorach Maya Shavit Michal Kovo Tal Biron-Shental Ofer Markovitch |
| author_facet | Hanoch Schreiber Gal Cohen Nir Mevorach Maya Shavit Michal Kovo Tal Biron-Shental Ofer Markovitch |
| author_sort | Hanoch Schreiber |
| collection | DOAJ |
| description | This retrospective cohort study assessed the association between nuchal cord and adverse outcomes during vacuum-assisted delivery (VAD). Women with singleton pregnancies, 34–41-weeks gestation, who underwent VAD, from 2014 to 2020 were included. The primary outcome was umbilical cord pH ≤ 7.1. Secondary outcomes were neonatal intensive care unit admission, Apgar scores, pH < 7.15, subgaleal hematoma, shoulder dystocia and third/fourth-degree perineal tear. Outcomes were compared between neonates with (1059/3754, 28.2%) or without (71.8%) nuchal cord after VAD. No difference in cord pH ≤ 7.1 was found between groups. The nuchal cord group had a lower rate of nulliparity (729 (68.8%) vs. 2004 (74.4%), <i>p</i> = 0.001) and higher maternal BMI (23.6 ± 4.3 vs. 23.1 ± 5, <i>p</i> = 0.017). Nuchal cord was associated with higher rates of induction (207 (19.5%) vs. 431 (16%), <i>p</i> = 0.009) and lower birthweights (3185 ± 413 vs. 3223 ± 436 g, <i>p</i> = 0.013). The main indication for VAD in 830 (80.7%) of the nuchal cord group was non-reassuring fetal heart rate (NRFHR) vs. 1989 (75.6%) controls (<i>p</i> = 0.004). The second stage was shorter in the nuchal cord group (128 ± 81 vs. 141 ± 80 min, <i>p</i> < 0.001). Multivariate regression found nulliparity, induction and birthweight as independent risk factors for nuchal cord VAD. Although induction and NRFHR rates were higher in VAD with nuchal cord, the rate of umbilical cord acidemia was not. |
| first_indexed | 2024-03-09T17:43:55Z |
| format | Article |
| id | doaj.art-bd99268b5e064c8497c9debdffd79bd5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:55Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-bd99268b5e064c8497c9debdffd79bd52023-11-24T11:20:45ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123697010.3390/jcm11236970Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord?Hanoch Schreiber0Gal Cohen1Nir Mevorach2Maya Shavit3Michal Kovo4Tal Biron-Shental5Ofer Markovitch6Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelDepartment of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelDepartment of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelDepartment of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelDepartment of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelDepartment of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelDepartment of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba 44281, IsraelThis retrospective cohort study assessed the association between nuchal cord and adverse outcomes during vacuum-assisted delivery (VAD). Women with singleton pregnancies, 34–41-weeks gestation, who underwent VAD, from 2014 to 2020 were included. The primary outcome was umbilical cord pH ≤ 7.1. Secondary outcomes were neonatal intensive care unit admission, Apgar scores, pH < 7.15, subgaleal hematoma, shoulder dystocia and third/fourth-degree perineal tear. Outcomes were compared between neonates with (1059/3754, 28.2%) or without (71.8%) nuchal cord after VAD. No difference in cord pH ≤ 7.1 was found between groups. The nuchal cord group had a lower rate of nulliparity (729 (68.8%) vs. 2004 (74.4%), <i>p</i> = 0.001) and higher maternal BMI (23.6 ± 4.3 vs. 23.1 ± 5, <i>p</i> = 0.017). Nuchal cord was associated with higher rates of induction (207 (19.5%) vs. 431 (16%), <i>p</i> = 0.009) and lower birthweights (3185 ± 413 vs. 3223 ± 436 g, <i>p</i> = 0.013). The main indication for VAD in 830 (80.7%) of the nuchal cord group was non-reassuring fetal heart rate (NRFHR) vs. 1989 (75.6%) controls (<i>p</i> = 0.004). The second stage was shorter in the nuchal cord group (128 ± 81 vs. 141 ± 80 min, <i>p</i> < 0.001). Multivariate regression found nulliparity, induction and birthweight as independent risk factors for nuchal cord VAD. Although induction and NRFHR rates were higher in VAD with nuchal cord, the rate of umbilical cord acidemia was not.https://www.mdpi.com/2077-0383/11/23/6970vacuum-assisted deliveryoperative deliverynuchal cordcord pH |
| spellingShingle | Hanoch Schreiber Gal Cohen Nir Mevorach Maya Shavit Michal Kovo Tal Biron-Shental Ofer Markovitch Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? Journal of Clinical Medicine vacuum-assisted delivery operative delivery nuchal cord cord pH |
| title | Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? |
| title_full | Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? |
| title_fullStr | Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? |
| title_full_unstemmed | Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? |
| title_short | Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? |
| title_sort | is there an added neonatal risk in vacuum assisted deliveries with nuchal cord |
| topic | vacuum-assisted delivery operative delivery nuchal cord cord pH |
| url | https://www.mdpi.com/2077-0383/11/23/6970 |
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