{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T11:19:00Z","timestamp":1770549540593,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between fetal head position during prevacuum assessment and adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This retrospective cohort study included all vacuum\u2010assisted deliveries using the Kiwi Omnicup over 5\u2009years. Primary outcomes were third\u2010 or fourth\u2010degree perineal tear, pH\u2009&lt;\u20097.1, and subgaleal hematoma (SGH). AGAR, neonatal intensive care unit admission, cephalohematoma, Erb's palsy, third\u2010stage duration, and postpartum hemorrhage were secondary. Outcomes were compared between the occiput posterior (OP) and occiput anterior (OA) positions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 1960 patients. OP position was more likely to involve epidural analgesia (311 [82.5%] vs. 1216 [77%], <jats:italic>P<\/jats:italic>\u00a0=\u20090.020), higher fetal head station (<jats:italic>P<\/jats:italic>\u00a0=\u20090.001), higher percentage of cup detachments (121 cases [32.1%] vs. 307 [19.4%], <jats:italic>P<\/jats:italic>\u00a0=\u20090.001), and longer procedure (5.5\u2009\u00b1\u20093.7\u2009min vs. 4.7\u2009\u00b1\u20092.8\u2009min, <jats:italic>P<\/jats:italic>\u00a0=\u20090.001). OP was associated with umbilical cord pH\u00a0&lt;\u20097.1 (21 [5.5%] vs. 52 [3.9%], <jats:italic>P<\/jats:italic>\u00a0=\u20090.032), NICU admissions (16 [4.2%] vs. 38 [2.4%], <jats:italic>P<\/jats:italic>\u00a0=\u20090.049), SGH (18 [4.8%] vs. 38 [2.4%], <jats:italic>P<\/jats:italic>\u00a0=\u20090.013), and high\u2010degree perineal tears (12 [3.2%] vs. 26 [1.7%], with borderline significance, <jats:italic>P<\/jats:italic>\u00a0=\u20090.051). SGH and high\u2010grade tears remained significantly associated with OP position (<jats:italic>P<\/jats:italic>\u00a0=\u20090.008 and <jats:italic>P<\/jats:italic>\u00a0=\u20090.016, respectively) after adjusting for maternal age, nulliparity, diabetes, epidural anesthesia, preprocedure head station, and birth weight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>OP position is an independent risk\u2010factor for anal sphincter injury and SGH during vacuum\u2010assisted delivery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14367","type":"journal-article","created":{"date-parts":[[2022,7,23]],"date-time":"2022-07-23T15:00:47Z","timestamp":1658588447000},"page":"836-841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Head position and vacuum\u2010assisted delivery using the Kiwi Omnicup"],"prefix":"10.1002","volume":"160","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5224-0813","authenticated-orcid":false,"given":"Hanoch","family":"Schreiber","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gal","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gil","family":"Shechter Maor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Einat","family":"Haikin Herzberger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tal","family":"Biron\u2010Shental","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ofer","family":"Markovitch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv 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