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CPG Infobase: Clinical Practice Guidelines

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Record Id:
4465
Title:
Guidelines for operative vaginal birth
Fulltext:
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Author
Cargill YM, MacKinnon CJ
Publication/Review date:
2004-Aug (Reviewed 2018-Feb)
Producers:
Society of Obstetricians and Gynaecologists of Canada

Bibliographic Source

Journal Citation:
J Obstet Gynaecol Can 2018;40(2):e74-e80.
Pages/Size:
7  Page(s)
References:
33
Notes:
SOGC clinical practice guidelines no. 148 - reaffirmed 2018

Subject Information

Specialties:
Obstetrics and gynecology,
Conditions:
Cesarean Section; Obstetric Labor;
Domains:
Treatment
Target Populations:
Pregnant or Nursing Mother
Target Gender:
Female
MeSH:
Labor Stage, Second; Obstetrical Forceps; Labor, Obstetric; Vacuum Extraction, Obstetrical; Cesarean Section;

Structured Abstract:

Objective:
To provide guidelines for operative vaginal birth in the management of the second stage of labour
Opinions:
Non-operative techniques, episiotomy, and Caesarean section are compared to operative vaginal birth
Outcomes:
Reduced fetal and maternal morbidity and mortality
Evidence
MEDLINE and Cochrane databases were searched using the key words "vacuum" and "birth" as well as "forceps" and "birth" for literature published in English from January 1970 to June 2004. The level of evidence and quality of recommendations made are described using the Evaluation of Evidence from the Canadian Task Force on the Periodic Health Examination
Recommendations:
1. Non-operative interventions such as one-to-one support, partogram use, oxytocin use, and delayed pushing in women using epidurals will decrease need for operative birth (I-A)

2. Manual rotation may be used alone or in conjunction with instrumental birth with little or no increased risk to the pregnant woman or to the fetus (III-B)

3. Routine episiotomy is not necessary for an assisted vaginal birth (II-IE)

4. When operative intervention in the second stage of labour is required, the options, risks, and benefits of vacuum, forceps, and Caesarean section must be considered. The choice of intervention needs to be individualized, as one is not clearly safer or more effective than the other (II-B)

5. Failure of the chosen method, vacuum and/or forceps, to achieve delivery of the fetus in a reasonable time should be considered an indication for abandonment of the method (III-C)

6. Adequate clinical experience and appropriate training of the operator are essential to the safe performance of operative deliveries. Hospital credentialing boards should grant privileges for performing these techniques only to an appropriately trained individual who demonstrates adequate skills (III-C)
Validation:
The Clinical Practice Obstetrics Committee and Executive and Council of the Society of Obstetricians and Gynaecologists of Canada approved these guidelines

Copyright:

The copyright of this guideline and its companion documents belongs to: Society of Obstetricians and Gynaecologists of Canada

Disclaimer:
All content is provided for information and education and not as a substitute for the advice of a physician. Joule assumes no responsibility or liability arising from any error or omission or from the use of any information contained herein.

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