Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

Emily S. Miller; Yinglei Lai; Jennifer Bailit; Uma M. Reddy; Ronald J. Wapner; Michael W. Varner; John M. Thorp; Kenneth J. Leveno; Steve N. Caritis; Mona Prasad; Alan T.N. Tita; George R. Saade; Yoram Sorokin; Dwight J. Rouse; Sean C. Blackwell; Jorge E. Tolosa; W. Grobman; G. Mallett; M. Ramos-Brinson; A. Roy; L. Stein; P. Campbell; C. Collins; N. Jackson; M. Dinsmoor; J. Senka; K. Paychek; A. Peaceman; M. Talucci; M. Zylfijaj; Z. Reid; R. Leed; J. Benson; S. Forester; C. Kitto; S. Davis; M. Falk; C. Perez; K. Hill; A. Sowles; J. Postma; S. Alexander; G. Andersen; V. Scott; V. Morby; K. Jolley; J. Miller; B. Berg; K. Dorman; J. Mitchell; E. Kaluta; K. Clark; K. Spicer; S. Timlin; K. Wilson; L. Moseley; M. Santillan; J. Price; K. Buentipo; V. Bludau; T. Thomas; L. Fay; C. Melton; J. Kingsbery; R. Benezue; H. Simhan; M. Bickus; D. Fischer; T. Kamon; D. Deangelis; B. Mercer; C. Milluzzi; W. Dalton; T. Dotson; P. McDonald; C. Brezine; A. McGrail; C. Latimer; L. Guzzo; F. Johnson; L. Gerwig; S. Fyffe; D. Loux; S. Frantz; D. Cline; S. Wylie; J. Iams; M. Wallace; A. Northen; J. Grant; C. Colquitt; W. Andrews; J. Moss; A. Salazar; A. Acosta; G. Hankins; N. Hauff; L. Palmer; P. Lockhart; D. Driscoll; L. Wynn; C. Sudz; D. Dengate; C. Girard; S. Field; P. Breault; F. Smith; N. Annunziata; D. Allard; J. Silva; M. Gamage; J. Hunt; J. Tillinghast; N. Corcoran; M. Jimenez; F. Ortiz; P. Givens; B. Rech; C. Moran; M. Hutchinson; Z. Spears; C. Carreno; B. Heaps; G. Zamora; J. Seguin; M. Rincon; J. Snyder; C. Farrar; E. Lairson; C. Bonino; W. Smith; K. Beach; S. Van Dyke; S. Butcher; E. Thom; M. Rice; Y. Zhao; P. McGee; V. Momirova; R. Palugod; B. Reamer; M. Larsen; C. Spong; S. Tolivaisa; J. P. Vandorsten

doi:10.1055/s-0039-1683439

Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

Emily S. Miller, Yinglei Lai, Jennifer Bailit, Uma M. Reddy, Ronald J. Wapner, Michael W. Varner, John M. Thorp, Kenneth J. Leveno, Steve N. Caritis, Mona Prasad, Alan T.N. Tita, George R. Saade, Yoram Sorokin, Dwight J. Rouse, Sean C. Blackwell, Jorge E. Tolosa, W. Grobman, G. Mallett, M. Ramos-Brinson, A. RoyL. Stein, P. Campbell, C. Collins, N. Jackson, M. Dinsmoor, J. Senka, K. Paychek, A. Peaceman, M. Talucci, M. Zylfijaj, Z. Reid, R. Leed, J. Benson, S. Forester, C. Kitto, S. Davis, M. Falk, C. Perez, K. Hill, A. Sowles, J. Postma, S. Alexander, G. Andersen, V. Scott, V. Morby, K. Jolley, J. Miller, B. Berg, K. Dorman, J. Mitchell, E. Kaluta, K. Clark, K. Spicer, S. Timlin, K. Wilson, L. Moseley, M. Santillan, J. Price, K. Buentipo, V. Bludau, T. Thomas, L. Fay, C. Melton, J. Kingsbery, R. Benezue, H. Simhan, M. Bickus, D. Fischer, T. Kamon, D. Deangelis, B. Mercer, C. Milluzzi, W. Dalton, T. Dotson, P. McDonald, C. Brezine, A. McGrail, C. Latimer, L. Guzzo, F. Johnson, L. Gerwig, S. Fyffe, D. Loux, S. Frantz, D. Cline, S. Wylie, J. Iams, M. Wallace, A. Northen, J. Grant, C. Colquitt, W. Andrews, J. Moss, A. Salazar, A. Acosta, G. Hankins, N. Hauff, L. Palmer, P. Lockhart, D. Driscoll, L. Wynn, C. Sudz, D. Dengate, C. Girard, S. Field, P. Breault, F. Smith, N. Annunziata, D. Allard, J. Silva, M. Gamage, J. Hunt, J. Tillinghast, N. Corcoran, M. Jimenez, F. Ortiz, P. Givens, B. Rech, C. Moran, M. Hutchinson, Z. Spears, C. Carreno, B. Heaps, G. Zamora, J. Seguin, M. Rincon, J. Snyder, C. Farrar, E. Lairson, C. Bonino, W. Smith, K. Beach, S. Van Dyke, S. Butcher, E. Thom, M. Rice, Y. Zhao, P. McGee, V. Momirova, R. Palugod, B. Reamer, M. Larsen, C. Spong, S. Tolivaisa, J. P. Vandorsten

Obstetrics & Gynecology

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Objective: This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design: This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results: Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion: The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.

Original language	English (US)
Pages (from-to)	503-510
Number of pages	8
Journal	American Journal of Perinatology
Volume	37
Issue number	5
DOIs	https://doi.org/10.1055/s-0039-1683439
State	Published - Apr 1 2020

Keywords

duration
forceps
operative vaginal delivery
pop-offs
pulls
vacuum

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

Access to Document

10.1055/s-0039-1683439

Cite this

Miller, E. S., Lai, Y., Bailit, J., Reddy, U. M., Wapner, R. J., Varner, M. W., Thorp, J. M., Leveno, K. J., Caritis, S. N., Prasad, M., Tita, A. T. N., Saade, G. R., Sorokin, Y., Rouse, D. J., Blackwell, S. C., Tolosa, J. E., Grobman, W., Mallett, G., Ramos-Brinson, M., ... Vandorsten, J. P. (2020). Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes. American Journal of Perinatology, 37(5), 503-510. https://doi.org/10.1055/s-0039-1683439

Miller, ES, Lai, Y, Bailit, J, Reddy, UM, Wapner, RJ, Varner, MW, Thorp, JM, Leveno, KJ, Caritis, SN, Prasad, M, Tita, ATN, Saade, GR, Sorokin, Y, Rouse, DJ, Blackwell, SC, Tolosa, JE, Grobman, W, Mallett, G, Ramos-Brinson, M, Roy, A, Stein, L, Campbell, P, Collins, C, Jackson, N, Dinsmoor, M, Senka, J, Paychek, K, Peaceman, A, Talucci, M, Zylfijaj, M, Reid, Z, Leed, R, Benson, J, Forester, S, Kitto, C, Davis, S, Falk, M, Perez, C, Hill, K, Sowles, A, Postma, J, Alexander, S, Andersen, G, Scott, V, Morby, V, Jolley, K, Miller, J, Berg, B, Dorman, K, Mitchell, J, Kaluta, E, Clark, K, Spicer, K, Timlin, S, Wilson, K, Moseley, L, Santillan, M, Price, J, Buentipo, K, Bludau, V, Thomas, T, Fay, L, Melton, C, Kingsbery, J, Benezue, R, Simhan, H, Bickus, M, Fischer, D, Kamon, T, Deangelis, D, Mercer, B, Milluzzi, C, Dalton, W, Dotson, T, McDonald, P, Brezine, C, McGrail, A, Latimer, C, Guzzo, L, Johnson, F, Gerwig, L, Fyffe, S, Loux, D, Frantz, S, Cline, D, Wylie, S, Iams, J, Wallace, M, Northen, A, Grant, J, Colquitt, C, Andrews, W, Moss, J, Salazar, A, Acosta, A, Hankins, G, Hauff, N, Palmer, L, Lockhart, P, Driscoll, D, Wynn, L, Sudz, C, Dengate, D, Girard, C, Field, S, Breault, P, Smith, F, Annunziata, N, Allard, D, Silva, J, Gamage, M, Hunt, J, Tillinghast, J, Corcoran, N, Jimenez, M, Ortiz, F, Givens, P, Rech, B, Moran, C, Hutchinson, M, Spears, Z, Carreno, C, Heaps, B, Zamora, G, Seguin, J, Rincon, M, Snyder, J, Farrar, C, Lairson, E, Bonino, C, Smith, W, Beach, K, Van Dyke, S, Butcher, S, Thom, E, Rice, M, Zhao, Y, McGee, P, Momirova, V, Palugod, R, Reamer, B, Larsen, M, Spong, C, Tolivaisa, S & Vandorsten, JP 2020, 'Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes', American Journal of Perinatology, vol. 37, no. 5, pp. 503-510. https://doi.org/10.1055/s-0039-1683439

@article{626ec95b08244fa0a3ce257bad2aa29f,

title = "Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes",

abstract = "Objective: This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design: This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results: Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion: The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.",

keywords = "duration, forceps, operative vaginal delivery, pop-offs, pulls, vacuum",

author = "Miller, {Emily S.} and Yinglei Lai and Jennifer Bailit and Reddy, {Uma M.} and Wapner, {Ronald J.} and Varner, {Michael W.} and Thorp, {John M.} and Leveno, {Kenneth J.} and Caritis, {Steve N.} and Mona Prasad and Tita, {Alan T.N.} and Saade, {George R.} and Yoram Sorokin and Rouse, {Dwight J.} and Blackwell, {Sean C.} and Tolosa, {Jorge E.} and W. Grobman and G. Mallett and M. Ramos-Brinson and A. Roy and L. Stein and P. Campbell and C. Collins and N. Jackson and M. Dinsmoor and J. Senka and K. Paychek and A. Peaceman and M. Talucci and M. Zylfijaj and Z. Reid and R. Leed and J. Benson and S. Forester and C. Kitto and S. Davis and M. Falk and C. Perez and K. Hill and A. Sowles and J. Postma and S. Alexander and G. Andersen and V. Scott and V. Morby and K. Jolley and J. Miller and B. Berg and K. Dorman and J. Mitchell and E. Kaluta and K. Clark and K. Spicer and S. Timlin and K. Wilson and L. Moseley and M. Santillan and J. Price and K. Buentipo and V. Bludau and T. Thomas and L. Fay and C. Melton and J. Kingsbery and R. Benezue and H. Simhan and M. Bickus and D. Fischer and T. Kamon and D. Deangelis and B. Mercer and C. Milluzzi and W. Dalton and T. Dotson and P. McDonald and C. Brezine and A. McGrail and C. Latimer and L. Guzzo and F. Johnson and L. Gerwig and S. Fyffe and D. Loux and S. Frantz and D. Cline and S. Wylie and J. Iams and M. Wallace and A. Northen and J. Grant and C. Colquitt and W. Andrews and J. Moss and A. Salazar and A. Acosta and G. Hankins and N. Hauff and L. Palmer and P. Lockhart and D. Driscoll and L. Wynn and C. Sudz and D. Dengate and C. Girard and S. Field and P. Breault and F. Smith and N. Annunziata and D. Allard and J. Silva and M. Gamage and J. Hunt and J. Tillinghast and N. Corcoran and M. Jimenez and F. Ortiz and P. Givens and B. Rech and C. Moran and M. Hutchinson and Z. Spears and C. Carreno and B. Heaps and G. Zamora and J. Seguin and M. Rincon and J. Snyder and C. Farrar and E. Lairson and C. Bonino and W. Smith and K. Beach and {Van Dyke}, S. and S. Butcher and E. Thom and M. Rice and Y. Zhao and P. McGee and V. Momirova and R. Palugod and B. Reamer and M. Larsen and C. Spong and S. Tolivaisa and Vandorsten, {J. P.}",

year = "2020",

month = apr,

day = "1",

doi = "10.1055/s-0039-1683439",

language = "English (US)",

volume = "37",

pages = "503--510",

journal = "American Journal of Perinatology",

issn = "0735-1631",

publisher = "Thieme Medical Publishers",

number = "5",

}

TY - JOUR

T1 - Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

AU - Miller, Emily S.

AU - Lai, Yinglei

AU - Bailit, Jennifer

AU - Reddy, Uma M.

AU - Wapner, Ronald J.

AU - Varner, Michael W.

AU - Thorp, John M.

AU - Leveno, Kenneth J.

AU - Caritis, Steve N.

AU - Prasad, Mona

AU - Tita, Alan T.N.

AU - Saade, George R.

AU - Sorokin, Yoram

AU - Rouse, Dwight J.

AU - Blackwell, Sean C.

AU - Tolosa, Jorge E.

AU - Grobman, W.

AU - Mallett, G.

AU - Ramos-Brinson, M.

AU - Roy, A.

AU - Stein, L.

AU - Campbell, P.

AU - Collins, C.

AU - Jackson, N.

AU - Dinsmoor, M.

AU - Senka, J.

AU - Paychek, K.

AU - Peaceman, A.

AU - Talucci, M.

AU - Zylfijaj, M.

AU - Reid, Z.

AU - Leed, R.

AU - Benson, J.

AU - Forester, S.

AU - Kitto, C.

AU - Davis, S.

AU - Falk, M.

AU - Perez, C.

AU - Hill, K.

AU - Sowles, A.

AU - Postma, J.

AU - Alexander, S.

AU - Andersen, G.

AU - Scott, V.

AU - Morby, V.

AU - Jolley, K.

AU - Miller, J.

AU - Berg, B.

AU - Dorman, K.

AU - Mitchell, J.

AU - Kaluta, E.

AU - Clark, K.

AU - Spicer, K.

AU - Timlin, S.

AU - Wilson, K.

AU - Moseley, L.

AU - Santillan, M.

AU - Price, J.

AU - Buentipo, K.

AU - Bludau, V.

AU - Thomas, T.

AU - Fay, L.

AU - Melton, C.

AU - Kingsbery, J.

AU - Benezue, R.

AU - Simhan, H.

AU - Bickus, M.

AU - Fischer, D.

AU - Kamon, T.

AU - Deangelis, D.

AU - Mercer, B.

AU - Milluzzi, C.

AU - Dalton, W.

AU - Dotson, T.

AU - McDonald, P.

AU - Brezine, C.

AU - McGrail, A.

AU - Latimer, C.

AU - Guzzo, L.

AU - Johnson, F.

AU - Gerwig, L.

AU - Fyffe, S.

AU - Loux, D.

AU - Frantz, S.

AU - Cline, D.

AU - Wylie, S.

AU - Iams, J.

AU - Wallace, M.

AU - Northen, A.

AU - Grant, J.

AU - Colquitt, C.

AU - Andrews, W.

AU - Moss, J.

AU - Salazar, A.

AU - Acosta, A.

AU - Hankins, G.

AU - Hauff, N.

AU - Palmer, L.

AU - Lockhart, P.

AU - Driscoll, D.

AU - Wynn, L.

AU - Sudz, C.

AU - Dengate, D.

AU - Girard, C.

AU - Field, S.

AU - Breault, P.

AU - Smith, F.

AU - Annunziata, N.

AU - Allard, D.

AU - Silva, J.

AU - Gamage, M.

AU - Hunt, J.

AU - Tillinghast, J.

AU - Corcoran, N.

AU - Jimenez, M.

AU - Ortiz, F.

AU - Givens, P.

AU - Rech, B.

AU - Moran, C.

AU - Hutchinson, M.

AU - Spears, Z.

AU - Carreno, C.

AU - Heaps, B.

AU - Zamora, G.

AU - Seguin, J.

AU - Rincon, M.

AU - Snyder, J.

AU - Farrar, C.

AU - Lairson, E.

AU - Bonino, C.

AU - Smith, W.

AU - Beach, K.

AU - Van Dyke, S.

AU - Butcher, S.

AU - Thom, E.

AU - Rice, M.

AU - Zhao, Y.

AU - McGee, P.

AU - Momirova, V.

AU - Palugod, R.

AU - Reamer, B.

AU - Larsen, M.

AU - Spong, C.

AU - Tolivaisa, S.

AU - Vandorsten, J. P.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Objective: This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design: This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results: Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion: The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.

AB - Objective: This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design: This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results: Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion: The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.

KW - duration

KW - forceps

KW - operative vaginal delivery

KW - pop-offs

KW - pulls

KW - vacuum

UR - http://www.scopus.com/inward/record.url?scp=85082563409&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85082563409&partnerID=8YFLogxK

U2 - 10.1055/s-0039-1683439

DO - 10.1055/s-0039-1683439

M3 - Article

C2 - 30895577

AN - SCOPUS:85082563409

SN - 0735-1631

VL - 37

SP - 503

EP - 510

JO - American Journal of Perinatology

JF - American Journal of Perinatology

IS - 5

ER -

Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

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