Recent efforts to reduce the rate of cesarean section births has been associated with increased operative vaginal deliveries (forceps, vacuum or both; OVD). We evaluated the frequency of several neonatal morbidities in 3888 live births (1994) of which 863 (22.2%) were by C-section and 407 (10.5%) by OVD. As has been previously reported, significant birth trauma occurred in 26/407 (6.3%) of OVD and 11/26 (42%) had low Apgar scores (<3 at 1 min). ICN observation was required in 94/407 (23%) babies. Nearly 196/407 (48.2%) OVD newborns were exclusively breast fed. It is in this group, significant jaundice (bili >14 mg/dl) was observed in 135/407 (33%); 13/135 (9.6%) went on to develop bili values >17 mg/dl and were administered phototherapy. This value was twice that observed in normal vaginal or C-section groups. The incidence of breast feeding in phototherapy group was 11/13 (83%). This small particularly high risk group of newborns represented those born to primigravida mothers with OVD and were susceptible to breast feeding difficulties. Concurrent extravascular hemolysis from birth trauma secondary to OVD and delayed enterohepatic circulation secondary to inappropriate/delayed breast feeding appears to potentiate significant hyperbilirubinemia. Thus, though generally OVD may be conducted safely, there remains the risk of transferring morbidity to the newborn. A high risk group that requires specialized follow-up, lactational support and attention is the primigravida mother delivered by OVD.
About this article
Cite this article
Cieplinski, J., Bhutani, V. LACTATIONAL AND NEONATAL MORBIDITIES ASSOCIATED WITH OPERATIVE VAGINAL DELIVERIES. 1191. Pediatr Res 39, 201 (1996). https://doi.org/10.1203/00006450-199604001-01213