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]

Cephalhaematoma
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]

Death
1trial
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.

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