Krispin E, et al. -The perinatal outcome related to cup detachment amid vacuum-assisted vaginal delivery (VAVD) is ascertained in this study. The outcome of this study suggests cup detachment is related to a higher rate of adverse neonatal outcome. Cup reapplication ought to be considered carefully.

Methods

• For this research, they designed a retrospective cohort study.
• Between 2012–2014, women attempting VAVD in a tertiary hospital were enrolled in this study.
• In this study, singleton–term pregnancies were included.
• Antepartum fetal death and major fetal structural or chromosomal abnormalities were excluded.
• Primary outcome was neonatal birth trauma (subgaleal hematoma, subarachnoid hematoma, subdural hematoma, skull fracture, and/or erb’s palsy).
• Secondary outcomes were maternal complications or other neonatal morbidities. Results were compared between women after ≥ 1 cup detachment (study group) and the rest (control group).
• Logistic regression analysis was used to adjust results to potential confounders.

Results

• Overall, 1779 women attempted VAVD amid study period.
• Of them, in 146 (8.2%), the cup detached prior to delivery; 130/146 (89%) had a single detachment.
• After detachment, 4 (2.7%) delivered by cesarean section, 77 (52.7%) delivered after cup reapplication, and 65 (44.6%) delivered spontaneously.
• Women in the study group will probably undergo VAVD because of prolonged second stage, and were portrayed by lower rates of metal cup use.
• Neonates in the detachment group had higher rates of subarachnoid hematoma and composite neonatal birth trauma (2.7 vs. 0.1% and 4.8 vs. 1.8%, respectively, p < 0.05).
• This remained important after adjustment to potential confounders (subarachnoid hematoma aOR = 45.44, 95% CI 6.42–321.62 and neonatal birth trauma aOR = 2.62, 95% CI 1.1–6.22, p < 0.05 for all).
• Other neonatal and maternal morbidities were similar between groups.