Perinatal outcome of delivery completed by vacuum extraction

Cilj rada: retrospektivna analiza perinatalnog ishoda poroda dovršenih VE u Klinici za ginekologiju i porodništvo Rijeka te usporedba poroda dovršenih metalnom čašom Malmström i Kiwi Omnicup-om od 1. siječnja 2018. do 31. prosinca 2020. godine. Materijali i metode: Od ukupno 7190 poroda 106 je dovršeno VE. Ispitanice smo podijelili u dvije skupine. Kod prvih je porod dovršen Malmström čašom, a drugih Kiwi Omnicup-om. Rodiljama smo analizirali dob, paritet, gestaciju, komplikacije u trudnoći, način početka, trajanje poroda, upotrebu analgezije te komplikacije u III. i IV. porodnom dobu. Novorođenčadi smo analizirali spol, porodnu masu, Apgar score u prvoj i petoj minuti, komplikacije i pH pupkovine. Statistička obrada učinjena je u programu Microsoft Excel. Skupine smo uspoređivali uz pomoć Studentovog t-testa gdje su signifikantne vrijednosti ukoliko je p < 0,05. Rezultati: Učestalost poroda dovršenih VE u KBC Rijeka iznosi 1,47%. Statistički značajnu razliku između dviju skupina pronašli smo u trajanju poroda (značajno kraći u skupini Malmström) te u distribuciji spola (više muške novorođenčadi skupini Kiwi Omnicup). Nuliparitet i EPA predstavljaju rizik za dovršenje poroda VE. Preacidoza i pupkovina omotana oko vrata imaju utjecaj na niži Apgar score u prvoj i petoj minuti. Od komplikacija III. i IV. porodnog doba kod poroda dovršenih Malmström čašom češće nalazimo laceracije vagine, a kod poroda dovršenih Kiwi Omnicup-om nalazimo teže povrede kao što su zastoj ramena i ruptura međice III. i IV.stupnja te adherirana placenta. Zaključci: Porod dovršen VE utječe na morbiditet majki i novorođenčadi. Postoje minimalne razlike u ishodu poroda dovršenih metalnom čašom i Kiwi Omnicup-om. Porod VE treba koristiti uz dobru procjenu, pravilnu indikaciju, treba ju izvoditi iskusni porodničar uz pravilnu tehniku izvođenja te uvijek treba uzeti u obzir moguće komplikacije.
Objective: retrospective analysis of perinatal outcome of births completed by VE at the Clinic for Gynecology and Obstetrics Rijeka and comparison of births completed with a metal cup Malmström and Kiwi Omnicup from 1 January 2018 to 31 December 2020. Materials and methods: From 7190 births, 106 are completed via VE. We divided women into two groups. The 1st where the birth was completed with a Malmström cup, and the 2nd with a Kiwi Omnicup. We analyzed the age, parity, gestation, complications in pregnancy, duration of childbirth, use of analgesia and complications in III. and IV. childbearing age. In newborns, we analyzed sex, birth weight, Apgar score in the first and fifth minutes, complications, and umbilical cord pH. Finally, we compared the groups using student's t-test. Results: The frequency of births completed by VE in KBC Rijeka is 1.47%.We found a statistically significant difference between the two groups in the duration of labor (significantly shorter in the Malmström group) and in the sex distribution (more male infants in the Kiwi Omnicup group). Nulliparas and EPA pose a risk for the vacuum assisted delivery. Preacidosis and umbilical cord wrapped around the neck have an effect on lower Apgar score in the first and fifth minutes. From complication III. and IV. of childbearing age in births completed with a Malmström cup more often we find lacerations of the vagina, and in births completed with Kiwi Omnicup we find more serious injuries such as shoulder stagnation and rupture of the perineum III. and IV degree and adherent placenta Conclusions: VE birth affects the morbidity of mothers and newborns. There are minimal differences in the outcomes of births completed with a metal cup and Kiwi Omnicup. Vacuum assisted delivery should be used with a good assessment, the correct indication, it should be performed by an experienced obstetrician with the correct technique, and possible complications should always be taken into account.