Vacuum-assisted birth as safe as forceps delivery

When a woman has a difficult delivery, the obstetrician may resort to forceps or a vacuum device to pull the baby through the birth canal. A new study shows that the risks involved with the two procedures are generally comparable.

In 1998, the U.S. food and Drug Administration warned that vacuum-assisted deliveries may harm the baby, causing complications such as intracranial bleeding. Nonetheless, use of the procedure has increased in recent years in the U.S., according to the authors of a report in the British Medical Journal

To compare the risks of vacuum and forceps delivery, Dr. Kitaw Demissie, from the University of Medicine and Dentistry of New Jersey in Piscataway, and colleagues analyzed data from a U.S. registry of 11.6 million births and from a New Jersey registry of 375,351 births.

In the U.S. group, the rate of newborn deaths among those delivered by either method was nearly the same - about 4.8 percent. By comparison, the neonatal death rate for unassisted deliveries was 3.7 percent.

Compared with forceps delivery, vacuum delivery was in fact associated with reduced risk of birth injury, neonatal seizures and the need for assisted ventilation.

In the New Jersey cohort, complications with the baby's shoulder during birth and the mother having serious bleeding were more likely with vacuum delivery than forceps delivery, the team found. On the other hand, intracranial bleeding, difficulty with feeding, and retinal bleeding occurred at about the same rate with either delivery method.

"Although delivery by vacuum extraction does have risks, it remains a safe alternative to forceps delivery," Demissie and colleagues conclude.

SOURCE: British Medical Journal, July 3, 2004.