The Experts below are selected from a list of 699 Experts worldwide ranked by ideXlab platform
Richard Johanson - One of the best experts on this subject based on the ideXlab platform.
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Vacuum extraction versus forceps for assisted vaginal delivery
Cochrane Database of Systematic Reviews, 2010Co-Authors: Richard Johanson, Vijay MenonAbstract:Background Proponents of Vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother. Objectives The objective of this review was to assess the effects of Vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity. Search strategy We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: February 1999. Selection criteria Acceptably controlled comparisons of Vacuum extraction and forceps delivery. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Main results Ten trials were included. The trials were of reasonable quality. Use of the Vacuum Extractor for assisted vaginal delivery when compared to forceps delivery was associated with significantly less maternal trauma (odds ratio 0.41, 95% confidence interval 0.33 to 0.50) and with less general and regional anaesthesia. There were more deliveries with Vacuum extraction (odds ratio 1.69, 95% confidence interval 1.31 to 2.19). Fewer caesarean sections were carried out in the Vacuum Extractor group. However the Vacuum Extractor was associated with an increase in neonatal cephalhaematomata and retinal haemorrhages. Serious neonatal injury was uncommon with either instrument. Reviewer's conclusions Use of the Vacuum Extractor rather than forceps for assisted delivery appears to reduce maternal morbidity. The reduction in cephalhaematoma and retinal haemorrhages seen with forceps may be a compensatory benefit.
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withdrawn Vacuum extraction versus forceps for assisted vaginal delivery
Cochrane Database of Systematic Reviews, 2010Co-Authors: Richard JohansonAbstract:BACKGROUND Proponents of Vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother. OBJECTIVES The objective of this review was to assess the effects of Vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: February 1999. SELECTION CRITERIA Acceptably controlled comparisons of Vacuum extraction and forceps delivery. DATA COLLECTION AND ANALYSIS Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS Ten trials were included. The trials were of reasonable quality. Use of the Vacuum Extractor for assisted vaginal delivery when compared to forceps delivery was associated with significantly less maternal trauma (odds ratio 0.41, 95% confidence interval 0.33 to 0.50) and with less general and regional anaesthesia. There were more deliveries with Vacuum extraction (odds ratio 1.69, 95% confidence interval 1.31 to 2.19). Fewer caesarean sections were carried out in the Vacuum Extractor group. However the Vacuum Extractor was associated with an increase in neonatal cephalhaematomata and retinal haemorrhages. Serious neonatal injury was uncommon with either instrument. AUTHORS' CONCLUSIONS Use of the Vacuum Extractor rather than forceps for assisted delivery appears to reduce maternal morbidity. The reduction in cephalhaematoma and retinal haemorrhages seen with forceps may be a compensatory benefit.
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soft versus rigid Vacuum Extractor cups for assisted vaginal delivery
Cochrane Database of Systematic Reviews, 2010Co-Authors: Richard Johanson, Vijay MenonAbstract:Background The original cups used for Vacuum extraction delivery of the fetus were rigid metal cups. Subsequently, soft cups of flexible materials such as silicone rubber or plastic were introduced. Soft cups are thought to have a poorer success rate than metal cups. However they are also thought to be less likely to be associated with scalp trauma and less likely to injure the mother. Objectives The objective of this review was to assess the effects of soft versus rigid Vacuum Extractor cups on perineal injury, fetal scalp injury and success rate. Search strategy We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: February 2000. Selection criteria Acceptably controlled comparisons of soft versus rigid Vacuum Extractor cups. Data collection and analysis Two reviewers assessed trial quality and extracted data. Study authors were contacted for additional information. Main results Nine trials involving 1375 women were included. The trials were of average quality. Soft cups are significantly more likely to fail to achieve vaginal delivery (odds ratio 1.65, 95% confidence interval 1.19 to 2.29). However, they were associated with less scalp injury (odds ratio 0.45, 95% confidence interval 0.15 to 0.60). There was no difference between the two groups in terms of maternal injury. Authors' conclusions Metal cups appear to be more suitable for 'occipito-posterior', transverse and difficult 'occipito-anterior' position deliveries. The soft cups seem to be appropriate for straightforward deliveries.
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soft versus rigid Vacuum Extractor cups for assisted vaginal delivery
Birth-issues in Perinatal Care, 2000Co-Authors: Richard Johanson, Vijay MenonAbstract:Reason for withdrawal from publication This review has been withdrawn because it has been updated by a new review entitled 'Choice of instruments for assisted vaginal delivery'. To view the published versions of this article, please click the 'Other versions' tab.
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maternal and child health after assisted vaginal delivery five year follow up of a randomised controlled study comparing forceps and ventouse
British Journal of Obstetrics and Gynaecology, 1999Co-Authors: Richard Johanson, E Heycock, J E Carter, K Walklate, Abdul H Sultan, Peter J. H. JonesAbstract:Objective To undertake a five year follow up of a cohort of women and children delivered by forceps or Vacuum Extractor in a randomised controlled study. Design Follow up of a randomised controlled trial. Setting District general hospital in the West Midlands. Population Follow up questionnaires were sent to 306 of the 313 women originally recruited at the North Staffordshire Hospital to a randomised controlled study comparing forceps and Vacuum Extractor for assisted delivery. Two hundred and twenty-eight women responded (74.5%) and all were included in the study; forceps (n= 115) and Vacuum Extractor (n= 113). Main outcome measures Bowel and urinary dysfunction, child vision assessment, and child development. Results Maternal adverse symptoms at long term follow up were relatively common. Urinary incontinence of various severity was reported by 47%, bowel habit urgency was reported by 44% (98/225), and loss of bowel control ‘sometimes’ or ‘frequently’ by 20% of women (46/226). No significant differences between instruments were found in terms of either bowel or urinary dysfunction. Overall, 13% (20/158) of children were noted to have visual problems. There was no significant difference in visual function between the two groups: ventouse 11/86 (12.8%), compared with forceps 9/72 (12.5%); odds ratio 0.97,95% CI 0.38–2.50. Of the 20 children with visual problems, a family history was known in 18, and 17/18 (94%) had a positive family history for visual problems. No significant differences in child development were found between the two groups. Conclusions There is no evidence to suggest that at five years after delivery use of the ventouse or forceps has specific maternal or child benefits or side effects.
Vijay Menon - One of the best experts on this subject based on the ideXlab platform.
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Vacuum extraction versus forceps for assisted vaginal delivery
Cochrane Database of Systematic Reviews, 2010Co-Authors: Richard Johanson, Vijay MenonAbstract:Background Proponents of Vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother. Objectives The objective of this review was to assess the effects of Vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity. Search strategy We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: February 1999. Selection criteria Acceptably controlled comparisons of Vacuum extraction and forceps delivery. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Main results Ten trials were included. The trials were of reasonable quality. Use of the Vacuum Extractor for assisted vaginal delivery when compared to forceps delivery was associated with significantly less maternal trauma (odds ratio 0.41, 95% confidence interval 0.33 to 0.50) and with less general and regional anaesthesia. There were more deliveries with Vacuum extraction (odds ratio 1.69, 95% confidence interval 1.31 to 2.19). Fewer caesarean sections were carried out in the Vacuum Extractor group. However the Vacuum Extractor was associated with an increase in neonatal cephalhaematomata and retinal haemorrhages. Serious neonatal injury was uncommon with either instrument. Reviewer's conclusions Use of the Vacuum Extractor rather than forceps for assisted delivery appears to reduce maternal morbidity. The reduction in cephalhaematoma and retinal haemorrhages seen with forceps may be a compensatory benefit.
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soft versus rigid Vacuum Extractor cups for assisted vaginal delivery
Cochrane Database of Systematic Reviews, 2010Co-Authors: Richard Johanson, Vijay MenonAbstract:Background The original cups used for Vacuum extraction delivery of the fetus were rigid metal cups. Subsequently, soft cups of flexible materials such as silicone rubber or plastic were introduced. Soft cups are thought to have a poorer success rate than metal cups. However they are also thought to be less likely to be associated with scalp trauma and less likely to injure the mother. Objectives The objective of this review was to assess the effects of soft versus rigid Vacuum Extractor cups on perineal injury, fetal scalp injury and success rate. Search strategy We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: February 2000. Selection criteria Acceptably controlled comparisons of soft versus rigid Vacuum Extractor cups. Data collection and analysis Two reviewers assessed trial quality and extracted data. Study authors were contacted for additional information. Main results Nine trials involving 1375 women were included. The trials were of average quality. Soft cups are significantly more likely to fail to achieve vaginal delivery (odds ratio 1.65, 95% confidence interval 1.19 to 2.29). However, they were associated with less scalp injury (odds ratio 0.45, 95% confidence interval 0.15 to 0.60). There was no difference between the two groups in terms of maternal injury. Authors' conclusions Metal cups appear to be more suitable for 'occipito-posterior', transverse and difficult 'occipito-anterior' position deliveries. The soft cups seem to be appropriate for straightforward deliveries.
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soft versus rigid Vacuum Extractor cups for assisted vaginal delivery
Birth-issues in Perinatal Care, 2000Co-Authors: Richard Johanson, Vijay MenonAbstract:Reason for withdrawal from publication This review has been withdrawn because it has been updated by a new review entitled 'Choice of instruments for assisted vaginal delivery'. To view the published versions of this article, please click the 'Other versions' tab.
John C Morrison - One of the best experts on this subject based on the ideXlab platform.
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a randomized prospective trial of the obstetric forceps versus the m cup Vacuum Extractor
American Journal of Obstetrics and Gynecology, 1996Co-Authors: James A Bofill, Orion A Rust, Stephen J Schorr, Robert C Brown, Rick W Martin, James N Martin, John C MorrisonAbstract:Abstract OBJECTIVE: Our purpose was to determine the efficacy of the obstetric forceps versus the M-cup, a new Vacuum Extractor cup, and maternal-neonatal complication rates. STUDY DESIGN: Over a 10-month period operative vaginal deliveries were randomized between the obstetric forceps and the M-cup Vacuum Extractor cup. Maternal demographics, indication for intervention, analgesia, position, station, degree of asynclitism, fetal caput-molding, and time from application to delivery were prospectively recorded. Episiotomy and extensions, lacerations, and the reason for abandonment of the randomized instrument were noted in both groups. Fetal weight, Apgar scores, cord arterial gases, hyperbilirubinemia, phototherapy, and any evidence of fetal trauma were documented at delivery or in the nursery. RESULTS: Six hundred thirty-seven women were randomized, 315 in the forceps group and 322 in the M-cup group. There were no differences in maternal demographic variables. The station, position, degree of asynclitism, or requirement for rotation was not different between the groups. The corrected efficacy rates were forceps 92% and M-cup 94% ( p = 0.217). The M-cup deliveries were accomplished more rapidly than forceps deliveries ( p p p p = 0.002) lacerations, but blood loss as clinically estimated ( p = 0.232) or as measured by hemoglobin levels ( p = 0.166) was not significantly different. Forceps deliveries were associated with fewer clinically diagnosed cephalhematomas ( p = 0.015) than M-cup deliveries were, but there were no differences in the number of neonates diagnosed with hyperbilirubinemia ( p = 0.377) or in the number of infants treated with phototherapy ( p = 0.660). CONCLUSIONS: The M-cup Vacuum Extractor cup appears to be as efficient (and faster) than the obstetric forceps but is associated with significantly more fetal cephalhematomas, whereas maternal injuries are more common with the forceps. (Am J Obstet Gynecol 1996;175:1325-30.)
James A Bofill - One of the best experts on this subject based on the ideXlab platform.
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a randomized prospective trial of the obstetric forceps versus the m cup Vacuum Extractor
American Journal of Obstetrics and Gynecology, 1996Co-Authors: James A Bofill, Orion A Rust, Stephen J Schorr, Robert C Brown, Rick W Martin, James N Martin, John C MorrisonAbstract:Abstract OBJECTIVE: Our purpose was to determine the efficacy of the obstetric forceps versus the M-cup, a new Vacuum Extractor cup, and maternal-neonatal complication rates. STUDY DESIGN: Over a 10-month period operative vaginal deliveries were randomized between the obstetric forceps and the M-cup Vacuum Extractor cup. Maternal demographics, indication for intervention, analgesia, position, station, degree of asynclitism, fetal caput-molding, and time from application to delivery were prospectively recorded. Episiotomy and extensions, lacerations, and the reason for abandonment of the randomized instrument were noted in both groups. Fetal weight, Apgar scores, cord arterial gases, hyperbilirubinemia, phototherapy, and any evidence of fetal trauma were documented at delivery or in the nursery. RESULTS: Six hundred thirty-seven women were randomized, 315 in the forceps group and 322 in the M-cup group. There were no differences in maternal demographic variables. The station, position, degree of asynclitism, or requirement for rotation was not different between the groups. The corrected efficacy rates were forceps 92% and M-cup 94% ( p = 0.217). The M-cup deliveries were accomplished more rapidly than forceps deliveries ( p p p p = 0.002) lacerations, but blood loss as clinically estimated ( p = 0.232) or as measured by hemoglobin levels ( p = 0.166) was not significantly different. Forceps deliveries were associated with fewer clinically diagnosed cephalhematomas ( p = 0.015) than M-cup deliveries were, but there were no differences in the number of neonates diagnosed with hyperbilirubinemia ( p = 0.377) or in the number of infants treated with phototherapy ( p = 0.660). CONCLUSIONS: The M-cup Vacuum Extractor cup appears to be as efficient (and faster) than the obstetric forceps but is associated with significantly more fetal cephalhematomas, whereas maternal injuries are more common with the forceps. (Am J Obstet Gynecol 1996;175:1325-30.)
Jeanne P Spencer - One of the best experts on this subject based on the ideXlab platform.
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assisted vaginal delivery using the Vacuum Extractor
American Family Physician, 2000Co-Authors: Lakshmidevi V Putta, Jeanne P SpencerAbstract:Vacuum Extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup Vacuum Extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Vacuum Extractors can cause neonatal injury. These devices should be employed when indicated, usually for a nonreassuring fetal heart tracing or failure to progress in the second stage of labor. Complications may be minimized if the physician recognizes contraindications to the use of Vacuum extraction. Complete documentation is essential.