{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T12:03:30Z","timestamp":1757592210388,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"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":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare maternal and fetal outcomes between early (&lt;2\u2009h) and delayed (&gt;2\u2009h) vacuum extraction (VE) deliveries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study in a single, university\u2010affiliated medical center (2014\u20132021). We included term singleton pregnancies delivered by VE, allocated into one of two groups according to second stage duration: &lt;2\u2009h or &gt;2\u2009h. Primary outcome was maternal composite adverse outcome (included chorioamnionitis, 3\u20134 degree lacerations, and postpartum hemorrhage [PPH]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 2521 deliveries: 2261 (89.6%) with early VE and 260 (10.4%) with delayed VE. Study groups' characteristics were not different, except of parity. Maternal composite outcome almost reached a significance (<jats:italic>P<\/jats:italic>\u2009=\u20090.054) comparing between the groups. Comparing second stage length up to 2\u2009h versus more, there was similar rate of advance maternal lacerations. However, extending the second stage to more than 3\u2009h was associated with third degree lacerations compared to 2\u20133\u2009h (9.8% vs 3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.011). There were significantly more PPH events in the later VE group (<jats:italic>P<\/jats:italic>\u2009=\u20090.004), but the need for blood transfusions was similar. The rates of 5\u2009min Apgar score\u2009\u22647 (<jats:italic>P<\/jats:italic>\u2009=\u20090.001) and umbilical artery pH\u2009&lt;7.0 were significantly higher in group 2 compared with group 1. The effect was much more pronounced when second stage was &gt;3\u2009h. After conducting multiregression analysis, the results became insignificant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that VE performed in the late second stage of labor, up to 3\u2009h, is safe as VE performed in the early stages regarding maternal and neonatal outcomes. Extra caution is needed with extended second stage to more than 3\u2009h.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15374","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T07:15:53Z","timestamp":1705562153000},"page":"397-403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Does delayed vacuum\u2010assisted delivery harbor greater maternal or neonatal complications?"],"prefix":"10.1002","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-2945","authenticated-orcid":false,"given":"Gal","family":"Bachar","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiba","family":"Abu\u2010Rass","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa 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