Chongqing Red Cross Society Hospital (Jiangbei People's Hospital), Chongqing, China.
Dalian Medical University, Dalian, China.
Int J Gynaecol Obstet. 2024 Feb;164(2):699-707. doi: 10.1002/ijgo.15037. Epub 2023 Aug 16.
To discuss the effect of the Kiwi OmniCup system on reducing adverse maternal and neonatal outcomes and provide a reference for assisted vaginal delivery methods.
Women who gave birth to singleton term neonates in a cephalic presentation and underwent assisted vaginal delivery from 2017 to 2021 were eligible for inclusion in the study; they were divided into a Kiwi OmniCup system group and a forceps group. Binary logistic regression analysis was used to observe and compare maternal and neonatal outcomes. The primary outcomes were severe maternal and neonatal morbidity. Severe maternal morbidity was defined as the occurrence of at least one of the following outcomes: third- or fourth-degree perineal lacerations, refractory postpartum hemorrhage, thrombotic events, amniotic fluid embolism, admission to the intensive care unit, and maternal death. Severe neonatal morbidity was defined as the occurrence of at least one of the following outcomes: neonatal asphyxia requiring resuscitation or intubation, neonatal head and face injuries, neonatal fracture, and admission to the neonatal intensive care unit for longer than 24 h.
The rate of severe neonatal morbidity in the forceps group was significantly higher than that in the Kiwi OmniCup system group, the differences between the two groups were significant (27.2% vs. 42.3%, P < 0.001), and there was no significant difference in the rate of severe maternal morbidity between the two groups (30% vs. 30%, P > 0.05). Binary logistic regression analysis showed that Kiwi OmniCup system-assisted delivery reduced severe neonatal morbidity (adjusted odds ratio 0.49; 95% confidence interval 0.33-0.73) and did not increase severe maternal morbidity compared with forceps-assisted delivery.
The Kiwi OmniCup system, which can reduce the incidence of severe neonatal morbidity without increasing the incidence of serious adverse maternal outcomes, is worthy of clinical promotion.
探讨 Kiwi OmniCup 系统对降低母婴不良结局的影响，为辅助阴道分娩方法提供参考。
纳入 2017 年至 2021 年行头位足月单胎产妇的辅助阴道分娩病例，分为 Kiwi OmniCup 系统组和产钳组。采用二项逻辑回归分析观察比较母婴结局。主要结局为严重母婴不良结局。严重母婴不良结局定义为至少发生以下一种结局：Ⅲ度或Ⅳ度会阴裂伤、难治性产后出血、血栓事件、羊水栓塞、入住重症监护病房和产妇死亡。严重新生儿不良结局定义为至少发生以下一种结局：新生儿需要复苏或气管插管的窒息、新生儿头部和面部损伤、新生儿骨折和入住新生儿重症监护病房超过 24 h。
产钳组严重新生儿不良结局发生率明显高于 Kiwi OmniCup 系统组，两组差异有统计学意义（27.2%比 42.3%，P<0.001），两组严重母婴不良结局发生率差异无统计学意义（30%比 30%，P>0.05）。二项逻辑回归分析显示，Kiwi OmniCup 系统辅助分娩降低了严重新生儿不良结局的发生风险（调整优势比 0.49；95%置信区间 0.33~0.73），与产钳辅助分娩相比，不增加严重母婴不良结局的发生风险。
Kiwi OmniCup 系统可降低严重新生儿不良结局的发生率，且不增加严重母婴不良结局的发生风险，值得临床推广。
