{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:38:22Z","timestamp":1791596302182,"version":"4.3.4"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD21410"],"award-info":[{"award-number":["HD21410"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD27869"],"award-info":[{"award-number":["HD27869"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD27915"],"award-info":[{"award-number":["HD27915"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD27917"],"award-info":[{"award-number":["HD27917"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD34116"],"award-info":[{"award-number":["HD34116"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD34208"],"award-info":[{"award-number":["HD34208"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD36801"],"award-info":[{"award-number":["HD36801"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD40500"],"award-info":[{"award-number":["HD40500"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD40512"],"award-info":[{"award-number":["HD40512"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD40544"],"award-info":[{"award-number":["HD40544"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD40545"],"award-info":[{"award-number":["HD40545"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD40560"],"award-info":[{"award-number":["HD40560"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD40485"],"award-info":[{"award-number":["HD40485"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD53097"],"award-info":[{"award-number":["HD53097"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD53118"],"award-info":[{"award-number":["HD53118"]}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"crossref","award":["UL1 RR024989"],"award-info":[{"award-number":["UL1 RR024989"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"crossref","award":["5UL1 RR025764"],"award-info":[{"award-number":["5UL1 RR025764"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Objective\u2003This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes.<\/jats:p>\n                  <jats:p>Study Design\u2003This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls.<\/jats:p>\n                  <jats:p>Results\u2003Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application.<\/jats:p>\n                  <jats:p>Conclusion\u2003The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.<\/jats:p>","DOI":"10.1055\/s-0039-1683439","type":"journal-article","created":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T22:45:51Z","timestamp":1553121951000},"page":"503-510","source":"Crossref","is-referenced-by-count":16,"title":["Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes"],"prefix":"10.1055","volume":"37","author":[{"given":"Emily S.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinglei","family":"Lai","sequence":"additional","affiliation":[{"name":"Biostatistics Center, The George Washington University, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Bailit","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma M.","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J.","family":"Wapner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Varner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"John M.","family":"Thorp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Leveno","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve N.","family":"Caritis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan T. N.","family":"Tita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George R.","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoram","family":"Sorokin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dwight J.","family":"Rouse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean C.","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Children's Memorial Hermann Hospital, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Tolosa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network*","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,3,20]]},"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1683439.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T18:40:41Z","timestamp":1585593641000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1683439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,20]]},"references-count":0,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,3,30]]},"published-print":{"date-parts":[[2020,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1683439","relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,20]]}}}