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

Description of this bibliographical database (AFAR website)
Currently 3059 records
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Created on : 08 Jul 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis. The British Medical Journal 2004;329:24.

Author(s) :

Demissie K, Rhoads GG, Smulian JC, Balasubramanian BA, Gandhi K, Joseph KS, Kramer M.

Year of publication :


URL(s) :;32…

Résumé (français)  :

Abstract (English)  :


To compare the risk of neonatal and infant adverse outcomes between vacuum and forceps assisted deliveries.


Population based study.


US linked natality and mortality birth cohort file and the New Jersey linked natality, mortality, and hospital discharge summary birth cohort file.


Singleton live births in the United States (n = 11 639 388) and New Jersey (n = 375 351).

Main outcome measures

Neonatal morbidity and mortality.


Neonatal mortality was comparable between vacuum and forceps deliveries in US births (odds ratio 0.94, 95% confidence interval 0.79 to 1.12). Vacuum delivery was associated with a lower risk of birth injuries (0.69, 0.66 to 0.72), neonatal seizures (0.78, 0.68 to 0.90), and need for assisted ventilation (< 30 minutes 0.94, 0.92 to 0.97; 30 minutes 0.92, 0.88 to 0.98). Among births in New Jersey, vacuum extraction was more likely than forceps to be complicated by postpartum haemorrhage (1.22, 1.07 to 1.39) and shoulder dystocia (2.00, 1.62 to 2.48). The risks of intracranial haemorrhage, difficulty with feeding, and retinal haemorrhage were comparable between both modes of delivery. The sequential use of vacuum and forceps was associated with an increased risk of need for mechanical ventilation in the infant and third and fourth degree perineal tears.


Although vacuum extraction does have risks, it remains a safe alternative to forceps delivery.

Sumário (português)  :

Comments :

Argument (français) :

Autant de mortalité néonatale avec les forceps et la ventouse.

Argument (English):

Argumento (português):

Keywords :

➡ evidence-based medicine/midwifery ; dystocy ; forceps delivery ; vacuum extraction (ventouse) ; postpartum hemorrhage ; perinatal death rates ; morbidity ; instrumental delivery

Author of this record :

Cécile Loup — 08 Jul 2004

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