{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:47:27Z","timestamp":1777870047259,"version":"3.51.4"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether metal cup size influences maternal and neonatal morbidity in vacuum\u2010assisted deliveries (VAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Retrospective cohort at a single tertiary center (2011\u20132022) comparing 60\u2010mm versus 50\u2010mm Malmstr\u00f6m cups. A 1:1 matched cohort analysis balanced maternal and obstetric variables. Primary neonatal outcomes were a birth trauma composite outcome (brachial plexus injury, cephalohematoma, subgaleal or subdural hematoma) and a severe neonatal composite outcome (neonatal intensive care unit admission, 5\u2010min Apgar score less than 7, umbilical artery pH less than 7.1, intraventricular hemorrhage, hypoxic ischemic encephalopathy, or neonatal convulsions). The primary maternal composite outcome included postpartum hemorrhage, third\u2010 or fourth\u2010degree perineal tears or need for postpartum blood products.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 1564 patients were included (782 per group). The 60\u2010mm cup was associated with fewer cup detachments (22 [2.8%] versus 41 [5.2%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.015), a shorter interval to delivery (4.3\u2009\u00b1\u20091.9 versus 4.7\u2009\u00b1\u20092.4\u2009min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003) and a comparable failure rate leading to cesarean delivery (5 [0.6%] versus 7 [0.9%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.56). The neonatal birth trauma composite outcome was less prevalent with 60\u2010mm cups (51 [6.5%] versus 72 [9.2%]; odds ratio [OR] 0.69, 95% confidence interval [CI] 0.47\u20130.99,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.049) whereas the severe neonatal composite outcome did not differ (83 [10.6%] versus 96 [12.3%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.302). Maternal composite outcome was similar between groups; however, perineal tears were less common with 60\u2010mm cups (306 [39.1%] vs 369 [47.2%]; OR 0.72, 95% CI 0.59\u20130.88;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In VAD, use of a larger Malmstr\u00f6m cup (60\u2009mm) is associated with fewer cup detachments and a reduced risk of neonatal birth trauma without increasing maternal morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70667","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T09:01:35Z","timestamp":1763197295000},"page":"757-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of metal cup size on neonatal and maternal morbidity in vacuum\u2010assisted deliveries"],"prefix":"10.1002","volume":"173","author":[{"given":"Matan","family":"Anteby","sequence":"first","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tally","family":"Pinchas\u2010Cohen","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoav","family":"Baruch","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anat","family":"Lavie","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Maslovitz","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liran","family":"Hiersch","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yariv","family":"Yogev","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health, Tel Aviv Sorasky Medical Center, Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"issue":"8","key":"e_1_2_9_2_1","first-page":"1","article-title":"Births: final data for 2017","volume":"67","author":"Martin JA","year":"2018","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_9_3_1","unstructured":"NHS Digital.NHS Maternity Statistics England 2022\u201323. 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