Treffers P E
Verloskunde en Gynaecologie Universiteit van Amsterdam, Henriëtte Bosmansstraat 4, 1077 XH Amsterdam.
Ned Tijdschr Geneeskd. 2001 Aug 18;145(33):1581-5.
The author was asked to provide an expert assessment of the case histories of 28 patients delivered by vacuum extraction. At the start of the extraction the foetal head level was at station 0 or above in 25 of the patients. In 12 cases the duration of extraction exceeded 14 min and in 7 of the cases it exceeded 19 minutes with a maximum of 45 minutes. Nine of the infants died, 11 suffered cerebral damage, 4 had brachial plexus injury and 1 had both cerebral damage and plexus injury. In 17 cases a causal relation between the unfavourable outcome and the vacuum extraction seemed plausible. During the past 40 years several studies of patients who have undergone high pelvic vacuum extractions have been published; cerebral damage of the infants often occurred. The risk of shoulder dystocia resulting in brachial plexus injury is considerably increased in case of a large infant and mid pelvic or high pelvic delivery. In the paediatric literature a number of authors describe cerebral lesions caused by high pelvic vacuum extraction. High pelvic vacuum extraction is still occasionally practiced in the Netherlands; it is a hazardous technique and should be replaced by caesarean section.
作者受邀对28例经真空吸引分娩的患者病历进行专家评估。在开始吸引时，25例患者的胎头位置在0级或以上。12例患者的吸引持续时间超过14分钟，7例超过19分钟，最长达45分钟。9例婴儿死亡，11例遭受脑损伤，4例有臂丛神经损伤，1例既有脑损伤又有臂丛神经损伤。在17例病例中，不良结局与真空吸引之间的因果关系似乎是合理的。在过去40年里，已经发表了几项关于接受高位骨盆真空吸引的患者的研究；婴儿脑损伤经常发生。如果婴儿体型较大且在中骨盆或高位骨盆分娩，肩难产导致臂丛神经损伤的风险会显著增加。在儿科文献中，许多作者描述了高位骨盆真空吸引导致的脑损伤。荷兰仍偶尔进行高位骨盆真空吸引；这是一种危险的技术，应由剖宫产取代。
