title: Perinatal outcomes of vacuum assisted versus cesarean deliveries for prolonged second stage of delivery at term.
abstract: BACKGROUND
  To compare perinatal outcomes of interventions for prolonged second stage of labor.
  
  
  METHODS
  Retrospective cohort study, in a single, university-affiliate, medical center (2007-2014). Eligibility: singleton gestations at term, diagnosed with prolonged second stage of labor and head station of S + 1 and lower. We compared perinatal outcomes of cesarean deliveries (CD) with vacuum assisted deliveries (VAD).
  
  
  RESULTS
  Of 62 102 deliveries, 3449 (5.6%) were eligible: 356 (10.3%) underwent CD and 3093 (89.7%) underwent VAD. The rate of five-minute Apgar scores <7 was higher in the CD group as well as rates of NICU admission, neonatal asphyxia and composite neonatal adverse outcome. After adjusting for different confounders, CD was associated with adverse neonatal composite outcome (aOR 1.57, 95% CI 1.21-2.05, p = 0.001) and VAD with cephalhematoma (aOR 4.06, 95% CI 2.64-6.25, p < 0.001). No other differences were found between the groups with regards to other traumatic outcomes.
  
  
  CONCLUSIONS
  Our data suggests that in deliveries complicated by prolonged second stage, CD yield poorer neonatal outcome than VAD, with no apparent major difference in traumatic composite outcome.
authors.affiliation: a Sackler Faculty of Medicine, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Tel-Aviv University , Ramat-Aviv , Israel and.
authors.forename: Anat
authors.initials: A
authors.lastname: Shmueli
authors.affiliation: a Sackler Faculty of Medicine, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Tel-Aviv University , Ramat-Aviv , Israel and.
authors.forename: Lina
authors.initials: L
authors.lastname: Salman
authors.affiliation: b Sackler Faculty of Medicine, Lis Maternity Hospital, the Tel-Aviv Sourasky Medical Center, Tel-Aviv University , Ramat-Aviv, Tel Aviv , Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.affiliation: b Sackler Faculty of Medicine, Lis Maternity Hospital, the Tel-Aviv Sourasky Medical Center, Tel-Aviv University , Ramat-Aviv, Tel Aviv , Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.affiliation: a Sackler Faculty of Medicine, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Tel-Aviv University , Ramat-Aviv , Israel and.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
authors.affiliation: b Sackler Faculty of Medicine, Lis Maternity Hospital, the Tel-Aviv Sourasky Medical Center, Tel-Aviv University , Ramat-Aviv, Tel Aviv , Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.affiliation: b Sackler Faculty of Medicine, Lis Maternity Hospital, the Tel-Aviv Sourasky Medical Center, Tel-Aviv University , Ramat-Aviv, Tel Aviv , Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
mesh_terms: D000328:Adult; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000453:epidemiology / Q000209:etiology; D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second / Q000502:physiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D047929:Term Birth; D016896:Treatment Outcome; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Cesarean delivery, perinatal outcome, prolonged second stage of labor, vacuum assisted delivery