title: Neonatal and Maternal Short-Term Outcome Parameters in Instrument-Assisted Vaginal Delivery Compared to Second Stage Cesarean Section in Labour: A Retrospective 11-Year Analysis.
abstract: BACKGROUND
  This study is aimed at comparing the neonatal and maternal short-term outcomes after instrumental-assisted vaginal delivery and cesarean section (CS) in labour.
  
  
  METHODS
  This retrospective study over a period of 11 years included singleton pregnancies above 34 + 0 gestational weeks, giving birth either by instrumental-assisted delivery or CS in labour. Maternal and neonatal outcome parameters were analysed using t test or linear regression.
  
  
  RESULTS
  A total of 1,971/2,571 deliveries were included for analysis: 149 forceps-, 393 vacuum-assisted deliveries and 1,420 CS in labour. Regarding maternal outcome, the rate of severe anaemia and hemorrhage in women who delivered by CS in labour was lower than in instrumental-assisted delivery. Analysis of neonatal outcome parameters showed a lower cord pH <7.20 in CS; however, 5-min Apgar score and the need for intervention did not differ with the mode of delivery. The mode of anaesthesia affected the neonatal recovery rate. Subanalysis within instrumental deliveries showed reduced rates of vaginal tears, but higher rates of episiotomy in forceps-assisted deliveries. Except for higher rates of cephalhaematomas after ventouse, no differences were detected regarding further neonatal outcome measures.
  
  
  CONCLUSIONS
  Assuming that indication and application is correct, vaginal instrumental-assisted delivery can be considered as an alternative delivery mode to second stage CS in labour.
authors.affiliation: Medical School of Hanover, Departement of Gynecology and Obstetrics, Hanover, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Polkowski
authors.forename: Elna
authors.initials: E
authors.lastname: Kuehnle
authors.forename: Cordula
authors.initials: C
authors.lastname: Schippert
authors.forename: Sudip
authors.initials: S
authors.lastname: Kundu
authors.forename: Peter
authors.initials: P
authors.lastname: Hillemanns
authors.forename: Ismini
authors.initials: I
authors.lastname: Staboulidou
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology*; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology*; D016014:Linear Models; D007744:Obstetric Labor Complications / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects*; D014621:Vagina / Q000293:injuries*
keywords: Cesarean section; Instrumental-assisted vaginal delivery; Short-term maternal complications; Short-term neonatal outcome