Johanson Richard, Menon Vijay
(Deceased) North Staffordshire Hospital NHS Trust, Stoke-on-Trent, UK.
Cochrane Database Syst Rev. 2010 Nov 10;2010(11):CD000224. doi: 10.1002/14651858.CD000224.pub2.
Proponents of vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother.
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.
We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: February 1999.
Acceptably controlled comparisons of vacuum extraction and forceps delivery.
Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information.
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.
真空分娩的支持者认为，对于辅助阴道分娩，应首选真空分娩，因为它对母亲造成伤害的可能性较小。
本综述的目的是评估与产钳相比，真空吸引对分娩失败以及母婴发病率的影响。
我们检索了Cochrane妊娠与分娩组试验注册库。最后检索日期：1999年2月。
对真空吸引和产钳分娩进行可接受的对照比较。
两位评价者独立评估试验质量并提取数据。与研究作者联系以获取更多信息。
纳入了10项试验。这些试验质量合理。与产钳分娩相比，使用真空吸引器进行辅助阴道分娩时，产妇创伤显著减少（比值比0.41，95%置信区间0.33至0.50），全身麻醉和区域麻醉也较少。真空吸引分娩的次数更多（比值比1.69，95%置信区间1.31至2.19）。真空吸引器组进行剖宫产的次数较少。然而，真空吸引器与新生儿头颅血肿和视网膜出血的增加有关。两种器械导致严重新生儿损伤的情况均不常见。
辅助分娩时使用真空吸引器而非产钳似乎可降低产妇发病率。产钳导致的头颅血肿和视网膜出血减少可能是一种代偿性益处。
