The impact of delivery mode on the risk of neonatal intracranial haemorrhage
a prospective population-based cohort study
DOI:
https://doi.org/10.14528/snr.2019.53.3.751Keywords:
labour, caesarean delivery, vacuum extraction, intracranial haemorrhageAbstract
Introduction: The objective of the study was to examine the association between the mode of delivery and the incidence of neonatal intracranial haemorrhage.
Methods: Slovenian National Perinatal Information System (NPIS) data for the period 2002 through 2016 were analysed. Nulliparous women delivering singleton neonates in cephalic presentation weighting 2,500 to 4,000g were included. Incidence of neonatal intracranial haemorrhage in vacuum delivery vs. other modes of delivery was compared using the Chi-square test (p < 0.05 significant).
Results: 125,393 deliveries were included: 5,438 (4 %) planned caesarean deliveries, 9,7764 (78 %) spontaneous vaginal deliveries, 15,577 (12 %) emergency caesarean deliveries, and 6,614 (5 %) vacuum extractions. 17 (0.14/1000) neonatal intracranial haemorrhages were recorded: 12 occurred in spontaneous vaginal deliveries, two in emergency caesarean deliveries, and three in vacuum extractions. In comparison to infants born by spontaneous vaginal delivery, those delivered by vacuum extraction had higher rates of intracranial haemorrhage (odds ratio (OR) 3.70; 95% confidence interval (CI) 1.04−13.10). Risk estimates did not reach statistical significance when comparing infants born by vacuum extraction and those born by emergency caesarean delivery (OR 3.54; 95% CI 0.59−21.16).
Discussion and conclusion: Infants born by vacuum extraction have significantly higher rates of intracranial haemorrhage than those born by spontaneous vaginal delivery although the absolute risk is small. There are no significant differences in the rates of intracranial haemorrhage in vacuum extraction vs. emergency caesarean delivery.
Downloads
Metrics
References
American College of Obstetricians and Gynecologists (ACOG),2013. Cesarean delivery on meternal request. Committee Opinion No. 559. obstetrics & Gynecology, 121, pp. 904–907. https://doi.org/10.1097/01.AOG.0000428647.67925.d3 PMid:23635708
Cardwell, C.R., Stene, L.C., Joner, G., Cinek, O., Svensson, J., Goldacre, M.J., et al., 2008. Caesarean section is associated with an In creased risk of childhood - onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia, 51, pp. 726–735. https://doi.org/10.1007/s00125-008-0941-z PMid:18292986
Castillo, M. & Fordham, L.A., 1995. MR of neurologically symptomatic newborns after vacuum extraction delivery. American Journal of Neuroradiology, 16, pp. 816–818. PMid: 7611047
Cohn, M., Barclay, C., Fraser, R., Zaklama, M., Johanson, R., Anderson, D., et al., 1989. A multicentre randomized trial comparing delivery with a silicone rubber cup and rigid metal vacuum extractor cups. British Journal of Obstetrics and Gynaecology, 96, pp. 545–551. https://doi.org/10.1111/j.1471-0528.1989.tb03253.x PMid:2667629
Ecker, J., 2013. Elective cesarean delivery on maternal request. Journal of American Medical Association, 309, pp. 1930–1936. https://doi.org/10.1001/jama.2013.3982 PMid:23652524
EURO-PERISTAT Project., 2010. The European Perinatal Health Report. Available at: www.europeristat.com [16. 8. 2018].
Hofmeyr, G.J., Gobetz, L., Sonnendecker, E.W. & Turner, M.J., 1990. New design rigid and soft vacuum extractor cups: a preliminary comparison of traction forces. British Journal of Obstetrics and Gynaecology, 97, pp. 681–685. https://doi.org/10.1111/j.1471-0528.1990.tb16238.x PMid:2205287
Huang, L.T. & Lui, C.C., 1995. Tentorial hemorrhage associated with vacuum extraction in a newborn. Pediatric Radiology, 25, pp. S230–S231. PMid:8577537
Johanson, R., Pusey, J., Livera, N. & Jones, P., 1989. North Staffordshire/Wigan assisted delivery trial. British Journal of Obstetrics and Gynaecology, 96, pp. 537–544. https://doi.org/10.1111/j.1471-0528.1989.tb03252.x PMid:2667628
Johanson, R.B., Rice, C., Doyle, M., Arthur, J., Anyanwu, L., Ibrahim, J., et al., 1993. A randomised prospective study comparing the new vacuum extractor policy with forceps delivery. British Journal of Obstetrics and Gynaecology, 100, pp. 524–530. https://doi.org/10.1111/j.1471-0528.1993.tb15301.x PMid:8334086
Kuit, J.A., Eppinga, H.G., Wallenberg, H.C. & Huikeshoven, F.J., 1993. A randomized comparison of vacuum extraction delivery with a rigid and pliable cup. Obstetrics and Gynecology, 82, pp. 280–284. PMid:8336878
Liu, S., Liston, R.M., Joseph, K.S., Heaman, M., Sauve, R. & Kramer, M.S., 2007. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. Canadian Medical Association Journal, 176, pp. 455–460. https://doi.org/10.1503/cmaj.060870 PMid:17296957; PMCid:PMC1800583
Loghis, C., Pyrgiotis, E., Panayotopoulos, N., Batalias, L., Salamalekis, E. & Zourlas, P.A., 1992. Comparison between metal cup and silicone rubber cup vacuum extractor. European Journal of Obstetrics & Gynecology and Reproductive Biology, 45, pp. 173–176. https://doi.org/10.1016/0028-2243(92)90079-E
Lučovnik, M., 2016. Operativno dokončanje poroda. In: I. Takač & K. Geršak, eds. Ginekologija in perinatologija. Maribor: Medicinska fakulteta, pp. 614–626.
National Institute of Health (NIH), 2006. NIH State-of-the-Science Conference Statement on cesarean delivery on maternal request. NIH consensus and state-of-the-science statements, 23, pp. 1-29.
Odita, J.C. & Hebi, S., 1996. CT and MRI characteristics of intracranial haemorrhage complicating breech and vacuum delivery. Pediatric Radiology, 26, pp. 782–785. https://doi.org/10.1007/BF01396201 PMid:8929377
Perrin, R.G., Rutka, J.T., Drake, J.M., Meltzer, H., Hellman, J., Jay, V., et al., 1997. Management and outcomes of posterior fossa subdural hematomas in neonates. Neurosurgery, 40, pp. 1190–1199. https://doi.org/10.1097/00006123-199706000-00016 PMid:9179892
Plauché, W.C., 1979. Fetal cranial injuries related to delivery with the Malmström vacuum extractor. Obstetrics and Gynecology, 53, pp. 750–757. PMid:377161
Rossen, J., Lucovnik, M., Eggebø, T.M., Tul, N., Murphy, M., Vistad, I., et al., 2017. A method to assess obstetric outcomes using the 10-Group Classification System: a quantitative descriptive study. British Medical Journal Open, 7, art. ID e016192. https://doi.org/10.1136/bmjopen-2017-016192 PMid:28706102; PMCid:PMC5726112
Rijhsinghani, A. & Belsare, T.J., 1997. Neonatal intracerebellar hemorrhage after forceps delivery: report of a case without neurologic damage. Journal of reproductive medicine, 42, pp. 127–130. PMid:9058351
Thavagnanam, S., Fleming, J., Bromley, A., Shields, M.D. & Cardwell, C.R., 2008. A meta-analysis of the association between Caesarean section and childhood asthma. Clinical & Experimental Allergy, 38, pp. 629–633. https://doi.org/10.1111/j.1365-2222.2007.02780.x PMid:18352976
Towner, D., Castro, M.A., Wilkens, E.E. & Gilbert, M.W., 1999. Effect of mode of delivery in nullparous women on neonatal intracranial injury. New England Journal of Medicine, 341, pp. 1709–1714. https://doi.org/10.1056/NEJM199912023412301 PMid:10580069
Vidic, Z., Blickstein, I., Štucin Gantar, I., Verdenik, I. & Tul, N., 2016. Timing of elective cesarean section and neonatal morbidity: a population-based study. Journal of Maternal-Fetal & Neonatal Medicine, 29, pp. 2461–2463. https://doi.org/10.3109/14767058.2015.1087500 PMid:26444222
Williams, M.C., Knuppel, R.A., O'Brien, W.F., Weiss, A. & Kanarek, K.S., 1991. A randomized comparison of assisted vaginal delivery by obstetrical forceps and polyethylene vacuum cup. Obstetrics and Gynecology, 78, pp. 789–794. https://doi.org/10.1097/MD.0000000000006355 PMid:28296771; PMCid:PMC5369926
Wen, S.W., Liu, S., Kramer, M.S., Marcoux, S., Ohlsson, A., Sauvé, R., et al., 2001. Comparison of maternal and infant outcomes between vacuum extraction and forceps deliveries. American Journal of Epidemiology, 153, pp. 103–107. https://doi.org/10.1093/aje/153.2.103 PMid:11159152
Downloads
Published
How to Cite
Issue
Section
License
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.
