title: Decreased neonatal pain response after vaginal-operative delivery with Kiwi OmniCup versus metal ventouse.
abstract: Vaginal delivery, especially operative assisted vaginal delivery, seems to be a major stressor for the neonate. The objective of this study was to evaluate the stress response after metal cup versus Kiwi Omnicup® ventouse delivery.
  
  
  
  The study was a secondary observational analysis of data from a former prospective randomised placebo controlled multicentre study on the analgesic effect of acetaminophen in neonates after operative vaginal delivery and took place at three Swiss tertiary hospitals. Healthy pregnant women ≥35 weeks of gestation with an estimated fetal birth weight above 2000 g were recruited after admission to the labour ward. Pain reaction was analysed by pain expression score EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) directly after delivery. For measurement of the biochemical stress response, salivary cortisol as well as the Bernese Pain Scale of Newborns (BPSN) were evaluated before and after an acute pain stimulus (the standard heel prick for metabolic testing (Guthrie test)) at 48-72 h.
  
  
  
  Infants born by vaginal operative delivery displayed a lower pain response after plastic cup than metal cup ventouse delivery (p < 0.001), but the pain response was generally lower than expected and they recovered fully within 72 h.
  
  
  
  Neonatal pain response is slightly reduced after use of Kiwi OmniCup® versus metal cup ventouse.
  
  
  
  Trial was registered under under NCT00488540 on 19th June 2007.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland. evelyn.huhn@usb.ch.
authors.forename: E A
authors.initials: EA
authors.lastname: Huhn
authors.affiliation: Department of Obstetrics and Gynaecology, Cantonal Hospital Baselland, Liestal, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Visca
authors.affiliation: Clinical Trial Unit, University Hospital Basel, Basel, Switzerland.
authors.forename: D R
authors.initials: DR
authors.lastname: Vogt
authors.affiliation: Clinical Trial Unit, University Hospital Basel, Basel, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: von Felten
authors.affiliation: Department of Paediatrics, Insel Hospital, University of Bern, Bern, Switzerland.
authors.forename: E M
authors.initials: EM
authors.lastname: Tinner Oehler
authors.affiliation: Department of Neonatology, Charité University Medical Center, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bührer
authors.affiliation: Department of Obstetrics and Gynaecology, Insel Hospital, University of Bern, Bern, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Surbek
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Zimmermann
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Hoesli
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D001724:Birth Weight; D005865:Gestational Age; D006365:Heel; D006854:Hydrocortisone / Q000032:analysis; D008670:Metals; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods; D010812:Physical Stimulation / Q000379:methods; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry; D013312:Stress, Physiological / Q000502:physiology; D013557:Switzerland; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D014621:Vagina / Q000601:surgery
chemical_list: D006854:Hydrocortisone; D008670:Metals
keywords: Bernese pain scale; EDIN pain scale; Kiwi OmniCup®; Metal cup; Vaginal operative delivery