Forceps vs Vacuum. Rate of Levator Ani Muscle Avulsion: Clinical Trial.
Birth Injuries, Pelvic Floor Disorders, Instrumental; Injury, Obstetric
About this trial
This is an interventional diagnostic trial for Birth Injuries
Eligibility Criteria
Inclusion Criteria:
- Delivery with forceps or vacuum
- Cephalic presentation
- Primiparity
- At term gestation (37-42 weeks)
- No prior pelvic floor corrective surgery
- Written informed consent
Exclusion Criteria:
- Pregnancies with severe maternal or fetal pathology
Sites / Locations
- Hospital Nuestra Señora de ValmeRecruiting
Arms of the Study
Arm 1
Arm 2
Other
Other
Vacuum delivery
Forceps delivery
Deliveries completed using vacuum instrumentation were performed by obstetricians with a minimum of five years' experience in obstetric practice. In terms of analgesia, epidural analgesia was used for intrapartum analgesia. The vacuum was a metal vacuum (Bird's cup 50 mm, 80 kPa) was used to perform fetal extraction. Traction was carried out during contraction, along with maternal push, at a rate of 2-3 tractions per contraction, and without associating Kristeller maneuver. The procedure was abandoned if, after three cup slides or 15 min, fetal extraction had not been successful. Selective episiotomy was carried out in vacuum delivery following Valme's University Hospital clinical practice guideline for instrumental deliveries.
Deliveries completed using forceps instrumentation were performed by obstetricians with a minimum of five years' experience in obstetric practice. In terms of analgesia, epidural analgesia was used for intrapartum analgesia. The forceps used for the instrumentation was the forceps of Kielland. Traction was carried out during contraction, along with maternal push, at a rate of 2-3 tractions per contraction, and without associating Kristeller maneuver. The procedure was abandoned if, after three cup slides or 15 min, fetal extraction had not been successful. Selective episiotomy was carried out in VD following Valme's University Hospital clinical practice guideline for instrumental deliveries.