EL USO DE VACUUM EXTRACTOR DISMINUYE LA TASA DE LESIONES MATERNAS SEVERAS ASOCIADAS AL FÓRCEPS SIN AUMENTAR LAS COMPLICACIONES FETALES SEVERAS

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Antecedentes: Existe evidencia que sugiere que el método de elección para resolver un parto operatorio es el vacuum extractor, sin embargo, esta recomendación no se ha incorporado a la práctica habitual en América Latina. Objetivos: Comparar los resultados materno-fetales de la aplicación del vacuum o fórceps. Métodos: Revisamos los 12 estudios controlados y randomizados que comparan los resultados materno-fetales del uso de vacuum y fórceps, publicados hasta julio de 2006. Resultados: El vacuum como método primario es menos efectivo que fórceps en conseguir partos vaginales, sin embargo dado que permite el uso de fórceps secundario, presenta una menor tasa global de cesáreas. El vacuum extractor se asocia a una menor tasa de lesiones maternas severas, y a un aumento en la tasa de céfalo hematomas. No existen diferencias en la tasa de mortalidad perinatal ni de otras complicaciones fetales. Conclusión: El uso de vacuum se asocia a una menor morbilidad materna y a una mayor incidencia de céfalo hematoma, sin aumentar la mortalidad perinatal ni las complicaciones fetales severas

Translated abstract

Background: Today's evidence suggests the use of the vacuum extractor as the better method for assisted vaginal delivery; nevertheless, this recommendation has not impacted the usual practice in Latin America. Objectives: To compare the maternal-fetal outcomes associated to vacuum or forceps. Methods: We reviewed the 12 randomized controlled trials comparing the maternal-fetal outcomes of vacuum and forceps, published until July 2006. Results: The vacuum as a primary method is less effective than forceps in obtaining vaginal delivery; nevertheless, since secondary use of forceps is possible, vacuum exhibits a smaller global rate of caesarean section. The vacuum extractor is associated to a smaller rate of severe maternal injuries, and to an increased rate of cephalic hematomas. There are no differences in perinatal mortality or the rates of other fetal morbidity. Conclusion: The vacuum extractor is associated to a lower maternal morbidity and to a greater incidence of cephalic hematoma, without increasing perinatal morbidity and mortality

Related collections

Most cited references 30

Record: found
Abstract: found
Article: not found

The relative risks of caesarean section (intrapartum and elective) and vaginal delivery: a detailed analysis to exclude the effects of medical disorders and other acute pre-existing physiological disturbances.

Geoffrey P. Bingham, R. J. Lilford, David Moore … (1990)

To compare maternal mortalities attributable to vaginal delivery, elective caesarean section (CS) and intrapartum CS. The number of deaths associated with each method of delivery was ascertained among unselected and among low-risk women by detailed retrospective review of the case-notes of women who died after delivery. The frequency of each method of delivery throughout the study period was ascertained from the computer database and enhanced by analysis of the case-notes of unselected groups of women. The Peninsula Maternity Services (Cape Town) during the years 1975-1986 inclusive. A total of 108 maternal deaths arising from 263,075 maternities provided accurate information. The relative frequency of vaginal and abdominal delivery was determined from the computer database. The ratio of elective CS to emergency prepartum CS to intrapartum CS was obtained by review of the first 200 operations in the years 1975, 1977, 1979, 1982 and 1984. (i) Mortality rates associated with the different methods of delivery in unselected women and in women who were healthy before surgery; (ii) mortality rates apparently attributable to the method of delivery. The overall relative risk of mortality associated with caesarean section compared with vaginal delivery was 7 decreasing to 5 after the exclusion of women with medical or life-threatening antenatal complications (eg, haemorrhage, hypertension). The relative risk associated with intrapartum compared with elective sections was 2.3 decreasing to 1.4 after the exclusion of women with medical disorders or life-threatening complications. The relative risk of maternal mortality which was apparently attributable to intrapartum compared with elective sections was 1.7. However, the 95% confidence intervals of these values, even from this large data-set, are wide. Nevertheless, these rates are in broad agreement with an approximation derived from the British confidential enquiries into maternal deaths. The attributable relative mortalities of caesarean section compared with vaginal delivery and intrapartum compared with elective caesarean section are lower than the overall relative mortalities of these modes of delivery and are approximately 5:1 and 1.5:1 respectively. These data are crucially important in the decision to recommend elective caesarean section compared with trial of labour.