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RCOG Green-top Guideline No. 26 e79 of e112

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What is the risk of significant vulvo-vaginal tear with vacuum extraction compared to forceps?

10%

Which instrument usage combination resulted in the highest risk among babies?

Sequential vacuum and forceps

What is the incidence of postpartum haemorrhage with vacuum and forceps?

10–20%

Which instrument is associated with a higher incidence of retinal hemorrhage?

<p>Vacuum extraction</p> Signup and view all the answers

What is the range of incidence for cephalhaematoma predominantly associated with vacuum extraction?

<p>5–10%</p> Signup and view all the answers

Which instrument is mainly responsible for skull fractures?

<p>Non-rotational forceps</p> Signup and view all the answers

What is the risk of OASI (Obstetric Anal Sphincter Injury) with vacuum extraction?

<p>&gt;4%</p> Signup and view all the answers

Which instrument demonstrates a higher incidence of facial or scalp lacerations?

<p>&gt;10%</p> Signup and view all the answers

What is the likelihood of failed assisted vaginal birth being associated with maternal worries about the baby?

<p>2.2</p> Signup and view all the answers

According to the study, what is the increased likelihood of failed assisted vaginal birth being associated with cephalhaematoma?

<p>2.4</p> Signup and view all the answers

What is the likelihood that failed assisted vaginal birth is associated with retinal hemorrhage?

<p>2.0</p> Signup and view all the answers

In the study, how likely is failed assisted vaginal birth to be associated with significant maternal perineal and vaginal trauma?

<p>0.4</p> Signup and view all the answers

According to the findings, what is the increased likelihood of failed assisted vaginal birth being linked to low 5 min Apgar scores?

<p>1.7</p> Signup and view all the answers

What was the likelihood that failed assisted vaginal birth was related to the need for phototherapy?

<p>-1.1</p> Signup and view all the answers

How much more likely was failure of vacuum birth with a fetal malposition?

<p>= 3 times</p> Signup and view all the answers

Compared to conventional cup birth, what was the relative risk (RR) associated with anterior births in vacuum births?

<p>&gt; 1.55</p> Signup and view all the answers

What was the association between episiotomy and postpartum hemorrhage?

<p>Episiotomy increased postpartum hemorrhage by 10%</p> Signup and view all the answers

What was the risk of obstetric anal sphincter injuries (OASIS) in ventouse deliveries without episiotomy compared to forceps deliveries without episiotomy?

<p>6.53 times greater</p> Signup and view all the answers

According to the Danish group, what did the data show about mediolateral or lateral episiotomy in nulliparous women?

<p>It is protective against OASIS</p> Signup and view all the answers

What was the relationship between mediolateral episiotomy and OASIS in parous women?

<p>Increased risk of OASIS</p> Signup and view all the answers

What did the Israeli group report about the use of episiotomy in vacuum birth?

<p>It has no benefit and may increase maternal morbidity</p> Signup and view all the answers

In nulliparous women, what was the odds ratio for obstetric anal sphincter injuries (OASIS) associated with mediolateral episiotomy?

<p>$0.68$</p> Signup and view all the answers

What is the risk of OASIS in ventouse deliveries without episiotomy compared to primiparous vaginal deliveries?

<p>$1.74-2.05$ fold greater</p> Signup and view all the answers

Based on the large UK-based retrospective cohort study, which delivery method had the highest risk of OASIS without episiotomy?

<p>$6.53$ times greater in forceps deliveries</p> Signup and view all the answers

"Should prophylactic antibiotics be given?" What is this question referring to?

<p>&quot;Aftercare following vacuum birth&quot;</p> Signup and view all the answers

Which study recommended considering mediolateral or lateral episiotomy as protective against OASI in nulliparous women?

<p>The Danish group study</p> Signup and view all the answers

What is the effect of continuous support for women during childbirth on the likelihood of spontaneous vaginal birth?

<p>Increase</p> Signup and view all the answers

How does epidural analgesia compared with non-epidural methods impact the incidence of assisted vaginal birth?

<p>Increases</p> Signup and view all the answers

What is the effect of using epidural analgesia in the latent phase of labor compared to the active phase on the risk of assisted vaginal birth in nulliparous women?

<p>No increase in risk</p> Signup and view all the answers

How does continuous support during childbirth influence the likelihood of assisted vaginal birth?

<p>Decrease</p> Signup and view all the answers

What did a post hoc subgroup analysis reveal about the increase in assisted vaginal births related to epidural analgesia?

<p>Not replicated</p> Signup and view all the answers

Which method provides better pain relief than non-epidural analgesia during childbirth?

<p>Epidural analgesia</p> Signup and view all the answers

What is the impact of using lower concentrations of local analgesic or patient-controlled epidural analgesia on assisted vaginal birth outcomes?

<p>No impact</p> Signup and view all the answers

What is one of the reasons why complex decision-making is required when choosing between assisted vaginal birth and second-stage caesarean birth?

<p>Significant maternal and perinatal morbidity with assisted vaginal birth</p> Signup and view all the answers

Which position should women using epidural analgesia adopt in the second stage of labor according to the guideline?

<p>Lying down lateral position</p> Signup and view all the answers

What effect does adopting an upright or lateral position in the second stage of labor have for women not using epidural analgesia?

<p>Reduces the need for assisted vaginal birth</p> Signup and view all the answers

What is recommended for nulliparous women with epidural analgesia to reduce the need for rotational and midpelvic assisted vaginal birth?

<p>Delayed pushing for 12 hours</p> Signup and view all the answers

What can be challenging and result in significant maternal and perinatal morbidity late in the second stage of labor?

<p>Assisted vaginal birth</p> Signup and view all the answers

Which type of birth is more likely to lead to perinatal death according to the guideline?

<p>Midpelvic assisted vaginal birth</p> Signup and view all the answers

What is encouraged for women not using epidural analgesia in the second stage of labor?

<p>Delayed pushing for 12 hours</p> Signup and view all the answers

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