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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Currently 3059 records
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Created on : 19 Aug 2018
Modified on : 03 Nov 2018

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Bibliographical entry (without author) :

Neonatal complications among 596 infants delivered by vacuum extraction (in relation to characteristics of the extraction). J Matern Fetal Neonatal Med. 2018

Author(s) :

Ekéus C, Wrangsell K, Penttinen S, Åberg K

Year of publication :

2018

URL(s) :

https://www.ncbi.nlm.nih.gov/pubmed/28629251
https://doi.org/10.1080/14767058.2017.1344631

Résumé (français)  :

OBJECTIF :
Étudier l’association entre les accouchements par les extractions par ventouses difficiles et les complications néonatales.

METHODES :
Étude observationnelle y compris les données sur la gestion des LV-596 accouchements consécutifs à 6 différentes cliniques de naissance en Suède en 2013. Nous avons utilisé la régression logistique pour examiner l’association entre les extractions par ventouses difficiles et : céphalhématome, complication néonatale sévère (hémorragie intra-crânienne et / ou l’asphyxie / faible score d’Apgar et / ou convulsions et / ou encéphalopathie) et lésions du plexus brachial. a été dépassé LV considéré compliqué si la durée 15 min, et / ou plus de six tractions ont été utilisés, et / ou plus d’un détachement de la coupe a eu lieu. VE non compliqué a servi de groupe de référence.

RÉSULTATS :
Dix pour cent des nourrissons ont été diagnostiqués avec au moins une des complications étudiées. Le céphalhématome est survenu chez 5,2% des nourrissons et 1,5% présentait un hématome sous-dural. Au total, 24 nourrissons (4,0%) ont été diagnostiqués avec une complication grave; faible score d’Apgar, convulsions néonatales, encéphalopathie ou hémorragies intracrâniennes. Une lésion du plexus brachial est survenue chez huit nourrissons (1,3%). Le odds ratio brut pour extracrâniens était de 2,6 hémorragies (IC à 95% 1,17 à 5,77) 7,4 (1,67 à 9,92) pour les complications néonatales graves, et 4,63 (1,08 à 19,76) est lésion du plexus brachial.

CONCLUSIONS :
Le temps d’extraction > 15 minutes, > 6 tentatives et un lâchage de la cupule > 1 sont associés à un risque accru de complications néonatales. Ces résultats soutiennent le respect des directives et des recommandations pour les accouchements par ventouse.

Abstract (English)  :

OBJECTIVE:
To investigate the association between complicated vacuum extraction (VE) deliveries and neonatal complications.

METHODS:
Observational study including data on the management of 596 consecutive VE-deliveries at 6 different birth clinics in Sweden in 2013. We used logistic regression to examine the association between a complicated VE and: extracranial bleeding, severe neonatal complication (intracranial hemorrhage and/or asphyxia/low Apgar score and/or convulsions, and/or encephalopathy), and brachial plexus injury. VE was considered complicated if duration exceeded 15 min, and/or more than six pulls were used, and/or more than one cup detachment occurred. Uncomplicated VE served as the reference group.

RESULTS:
Ten percent of the infants were diagnosed with at least one of the investigated complications. Cephalohematoma occurred in 5.2% of the infants and 1.5% had a subgaleal hematoma. Altogether 24 (4.0%) infants were diagnosed with a severe complication; low Apgar score, neonatal convulsions, encephalopathy or intracranial hemorrhages. Brachial plexus injury occurred in eight (1.3%) infants. The crude odds ratio for extracranial hemorrhages was 2.6 (95% CI 1.17-5.77), 4.07 (1.67-9.92) for severe neonatal complications, and 4.63 (1.08-19.76) for brachial plexus injury.

CONCLUSIONS:
Extraction time >15 min, >6 pulls and >1 cup detachment is associated with increased risk of neonatal complications. These results support compliance with guidelines and recommendations for VE deliveries.

Sumário (português)  :

OBJETIVO:
Investigar a associação entre extrações complicadas de vácuo (VE) e complicações neonatais.

MÉTODOS:
estudo observacional incluindo dados sobre a gestão de 596 consecutivo VE-entregas em 6 clínicas de nascimento diferentes na Suécia em 2013. Foi utilizada a regressão logística para examinar o entre associação e complicado VE: hemorragia extracraniana, complicações neonatais graves (hemorragia e / ou asfixia intracraniana / Apgar baixo e / ou convulsões, e / ou encefalopatia), e lesão do plexo braquial. Mais de seis blusas foram usadas, e / ou mais de uma xícara de descolamento ocorreu. A VE não complicada serviu como o grupo de referência.

RESULTADOS:
Dez por cento dos lactentes foram diagnosticados com pelo menos uma das complicações investigadas. Cefaloematoma ocorreu em 5,2% das crianças e 1,5% tiveram um hematoma subgaleal. No total, 24 (4,0%) lactentes foram diagnosticados com uma complicação grave; baixo índice de Apgar, convulsões neonatais, encefalopatia ou hemorragias intracranianas. A lesão do plexo braquial ocorreu em oito (1,3%) lactentes. O odds ratio bruto para hemorragias extracranianas foi de 2,6 (IC de 95% 1,17-5,77), 4,07 (1,67-9,92) para complicações graves neonatais, e 4,63 (1,08-19,76) para lesão do plexo braquial.

CONCLUSÕES:
O tempo de extracção> 15 min> 6 blusas e> um copo desprendimento está associada com risco aumentado de complicações neonatais. Esses resultados suportam a conformidade com diretrizes e recomendações para entregas de VE.

Comments :

Argument (français) :

Le temps d’extraction > 15 minutes, > 6 tentatives et un lâchage de la cupule > 1 sont associés à un risque accru de complications néonatales. Ces résultats soutiennent le respect des directives et des recommandations pour les accouchements par ventouse.

Argument (English):

Extraction time >15 min, >6 pulls and >1 cup detachment is associated with increased risk of neonatal complications. These results support compliance with guidelines and recommendations for ventouse deliveries.

Argumento (português):

O tempo de extracção> 15 min> 6 blusas e> um copo desprendimento está associada com risco aumentado de complicações neonatais. Esses resultados suportam a conformidade com diretrizes e recomendações para entregas de vácuo.

Keywords :

➡ fundal pressure ; vacuum extraction (ventouse)

Author of this record :

Alison Passieux — 19 Aug 2018
➡ latest update : Bernard Bel — 03 Nov 2018

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