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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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Autores principales: Schreiber, Hanoch, Cohen, Gal, Mevorach, Nir, Shavit, Maya, Kovo, Michal, Biron-Shental, Tal, Markovitch, Ofer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739457/
https://www.ncbi.nlm.nih.gov/pubmed/36498545
http://dx.doi.org/10.3390/jcm11236970
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author Schreiber, Hanoch
Cohen, Gal
Mevorach, Nir
Shavit, Maya
Kovo, Michal
Biron-Shental, Tal
Markovitch, Ofer
author_facet Schreiber, Hanoch
Cohen, Gal
Mevorach, Nir
Shavit, Maya
Kovo, Michal
Biron-Shental, Tal
Markovitch, Ofer
author_sort Schreiber, Hanoch
collection PubMed
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%), p = 0.001) and higher maternal BMI (23.6 ± 4.3 vs. 23.1 ± 5, p = 0.017). Nuchal cord was associated with higher rates of induction (207 (19.5%) vs. 431 (16%), p = 0.009) and lower birthweights (3185 ± 413 vs. 3223 ± 436 g, p = 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 (p = 0.004). The second stage was shorter in the nuchal cord group (128 ± 81 vs. 141 ± 80 min, p < 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.
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spelling pubmed-97394572022-12-11 Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord? Schreiber, Hanoch Cohen, Gal Mevorach, Nir Shavit, Maya Kovo, Michal Biron-Shental, Tal Markovitch, Ofer J Clin Med Article 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%), p = 0.001) and higher maternal BMI (23.6 ± 4.3 vs. 23.1 ± 5, p = 0.017). Nuchal cord was associated with higher rates of induction (207 (19.5%) vs. 431 (16%), p = 0.009) and lower birthweights (3185 ± 413 vs. 3223 ± 436 g, p = 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 (p = 0.004). The second stage was shorter in the nuchal cord group (128 ± 81 vs. 141 ± 80 min, p < 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. MDPI 2022-11-25 /pmc/articles/PMC9739457/ /pubmed/36498545 http://dx.doi.org/10.3390/jcm11236970 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schreiber, Hanoch
Cohen, Gal
Mevorach, Nir
Shavit, Maya
Kovo, Michal
Biron-Shental, Tal
Markovitch, Ofer
Is There an Added Neonatal Risk in Vacuum-Assisted Deliveries with Nuchal Cord?
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739457/
https://www.ncbi.nlm.nih.gov/pubmed/36498545
http://dx.doi.org/10.3390/jcm11236970
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