Not surprisingly, the risk
of operative vaginal delivery and the risk of emergency cesarean section are much higher in the hospital.
Yet, comparison of the outcomes
of operative vaginal deliveries and unplanned cesarean deliveries shows no difference in serious neonatal morbidity (eg, intracerebral hemorrhage or death).
Not exact matches
Nurse - midwives demonstrated with a high grade level
of evidence a lower rate
of cesarean sections, lower apgar scores, lower labor augmentation, lower episotomy rates, equivalent low birthrates, lower
vaginal operative deliveries, less use
of labor analgesia and epidurals, and lower rates
of third - and fourth - degree perineal lacerations.
Training in, and ongoing maintenance
of, practical skills related to
operative vaginal delivery should be encouraged.
In addition to greater expectant management
of the second stage, two other practices could potentially reduce cesarean
deliveries in the second stage: 1)
operative vaginal delivery and 2) manual rotation
of the fetal occiput for malposition.
Manual rotation
of the fetal occiput in the setting
of fetal malposition in the second stage
of labor is a reasonable intervention to consider before moving to
operative vaginal delivery or cesarean
delivery.
Neuraxial analgesia or anaesthesia was provided in 84 %, 89 % and 95 %
of spontaneous
vaginal,
operative vaginal and caesarean
deliveries, respectively.
Just as a point
of comparison, most OB / GYN residencies by contrast require Drs to perform 250 - 300 spontaneous
vaginal deliveries as primaries, as well as 150 C - sections and 25 - 50
operative vaginal deliveries by the time they are done with their residency.
The contribution
of bacteria through
vaginal delivery followed by exclusive breastfeeding promotes specific microbial profiles that facilitate optimal nutrient metabolism and early systemic immune training.23 The potential short - and long - term effects
of perturbations
of the gut microbiome
of infancy, as influenced by
operative delivery or formula feeding, are beginning to be examined.
This dramatic increase was a result
of several changes in the practice environment, including the introduction
of electronic fetal monitoring and a decrease in
operative vaginal deliveries and attempts at
vaginal breech
deliveries (8 — 11).
Planned out -
of - hospital birth also had a statistically significant association with higher rates for 5 - minute Apgar scores
of less than 7, neonatal seizures, neonatal ventilator support, maternal blood transfusion, and unassisted
vaginal delivery but with lower rates
of both admission to neonatal intensive care units and obstetrical interventions, including induction and augmentation
of labor,
operative vaginal delivery, cesarean
delivery, and severe perineal lacerations.
«There have been no randomized trials
of the total package
of active management or
of the use
of strict diagnostic criteria alone, but trials
of early amniotomy, early oxytocin, and these interventions combined do not suggest that these interventions are effective in reducing rates
of cesarean sections or
operative vaginal deliveries.
The researchers assessed maternal complications according to the incidence
of cesarean sections (CS),
operative vaginal deliveries (OVD), retained placentas or post-partum hemorrhages.