Purpose: Even if the prerequisites and the technique of vacuum extraction are largely established, the role of a checklist in this field has not been tested. To evaluate the role of a checklist implementation on the compliance with the recommended rules in operative vacuum vaginal delivery (OVD) and on maternal and perinatal outcomes. Materials and methods: Retrospective cohort study on OVD between January 2012 and December 2015 at two hospitals with a tradition of teaching of OVD. A checklist for OVD was introduced in 2014. Three rules had to be recorded: fetal head station and position determination, no more than four tractions, and no more than three cup applications. Adverse maternal outcomes included third- and fourth-degree perineal tears. Adverse neonatal outcome included asphyxia, need for neonatal resuscitation, NICU admission, major head injuries, scalp injuries, and bone or brachial plexus injuries. Results: Introduction of a checklist for OVD resulted in an increase in the compliance with the rules (83.3 versus 62.8%, p < .001). Cases in which the rules were respected had lower incidence of third- and fourth-degree perineal lacerations after controlling for episiotomy, nulliparity, and indication for OVD (OR = 0.4, 95% CI 0.18-0.89), but similar rates of failure of OVD (2.1 versus 2.2%, p = 1) and adverse neonatal outcome (10.8 versus 11.7%, p=.71). Conclusion: Knowledge and documented compliance with a checklist of recommended rules in OVD may assist in achieving a lower rate of severe perineal and anal sphincter injury but does not alter the success of the procedure or neonatal outcome.

Pintucci, A., Consonni, S., Lambicchi, L., Vergani, P., Incerti, M., Bonati, F., et al. (2019). Operative vacuum vaginal delivery: effect of compliance with recommended checklist. THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 1-7 [10.1080/14767058.2019.1643312].

Operative vacuum vaginal delivery: effect of compliance with recommended checklist

Lambicchi, Laura;Vergani, Patrizia;
2019

Abstract

Purpose: Even if the prerequisites and the technique of vacuum extraction are largely established, the role of a checklist in this field has not been tested. To evaluate the role of a checklist implementation on the compliance with the recommended rules in operative vacuum vaginal delivery (OVD) and on maternal and perinatal outcomes. Materials and methods: Retrospective cohort study on OVD between January 2012 and December 2015 at two hospitals with a tradition of teaching of OVD. A checklist for OVD was introduced in 2014. Three rules had to be recorded: fetal head station and position determination, no more than four tractions, and no more than three cup applications. Adverse maternal outcomes included third- and fourth-degree perineal tears. Adverse neonatal outcome included asphyxia, need for neonatal resuscitation, NICU admission, major head injuries, scalp injuries, and bone or brachial plexus injuries. Results: Introduction of a checklist for OVD resulted in an increase in the compliance with the rules (83.3 versus 62.8%, p < .001). Cases in which the rules were respected had lower incidence of third- and fourth-degree perineal lacerations after controlling for episiotomy, nulliparity, and indication for OVD (OR = 0.4, 95% CI 0.18-0.89), but similar rates of failure of OVD (2.1 versus 2.2%, p = 1) and adverse neonatal outcome (10.8 versus 11.7%, p=.71). Conclusion: Knowledge and documented compliance with a checklist of recommended rules in OVD may assist in achieving a lower rate of severe perineal and anal sphincter injury but does not alter the success of the procedure or neonatal outcome.
No
Articolo in rivista - Articolo scientifico
Scientifica
Checklist; operative delivery; perineal lacerations; training; vacuum delivery
English
Pintucci, A., Consonni, S., Lambicchi, L., Vergani, P., Incerti, M., Bonati, F., et al. (2019). Operative vacuum vaginal delivery: effect of compliance with recommended checklist. THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 1-7 [10.1080/14767058.2019.1643312].
Pintucci, A; Consonni, S; Lambicchi, L; Vergani, P; Incerti, M; Bonati, F; Locatelli, A
File in questo prodotto:
File Dimensione Formato  
14767058.2019.pdf

Solo gestori archivio

Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Dimensione 911.17 kB
Formato Adobe PDF
911.17 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/240418
Citazioni
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 4
Social impact