Delay in the second stage of labour – instrument to be used (soft ventouse versus hard ventouse)

Bibliographic reference Study type Evidence level Number of patients Patient characteristics Intervention Comparison Length of follow-up Outcome measures Effect size Source of funding Additional comments
Johanson R;Menon V; 2005561Systemati c review - meta- analysisEvidence level: 1++9 trials involving 1375 womenPrimiparous and multiparous women who have required assisted delivery with a vacuum extractorIntervention: Use of soft (silicone, plastic or rubber) vacuum extractor cupsComparison: rigid (metal or plastic) vacuum extractor cupsFollow-up period: N/AOutcome Measures: perineal injury fetal scalp injury short and long term pain success rateFail to deliver with selected instrument
9 trials
1368 women
Peto Odds Ratio 1.65 [1.19, 2.29]

Significant maternal injury
6 trials
1137 women
Peto Odds Ratio 0.85 [0.57, 1.27]

Apgar score <7 at 1 minute
4 trials
866 women
Peto Odds Ratio 1.21 [0.80, 1.83]

Apgar score <7 at 5 minutes
5 trials
765 women
Peto Odds Ratio 0.68 [0.35, 1.33]

4 trials
538 women
Peto Odds Ratio 0.70 [0.34, 1.44]

Phototherapy or jaundice
6 trials
1137 women
Peto Odds Ratio 0.73 [0.50, 1.07]

Significant scalp trauma
8 trials
1337 women
Peto Odds Ratio 0.45 [0.34, 0.60]

Severe retinal/intracranial haemorrhage
2 trials
218 women
Peto Odds Ratio 0.84 [0.27, 2.64]

Umbilical artery pH <7.20
1 trial
100 women
Peto Odds Ratio 1.00 [0.45, 2.22]

72 women
Peto Odds Ratio 1.26 [0.08, 20.85]
No sources of support suppliedOK

From: Evidence tables

Cover of Intrapartum Care
Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth.
NICE Clinical Guidelines, No. 55.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Sep.
Copyright © 2007, National Collaborating Centre for Women’s and Children’s Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK []. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.