Comparison between kiwi and standard vacuum cups in vacuum-assisted vaginal delivery

الملخص EN

Aim : to evaluate the performance and safety of the Kiwi cup and compare it to standard vacuum cups in routine clinical practice.

A retrospective observation study of Kiwi cup versus standard vacuum cups in women hospital Doha - Qatar (12000 deliveries per year, 650 beds capacity) from October 2004 to August 2005 on women requiring assisted vaginal delivery by vacuum.

Methods : data regarding maternal demographics, labor details, cup application, success and failure, maternal and neonatal outcome were collected for all the patients that vacuum extraction was indicated during their labor allocated to either Kiwi vacuum group n=105 or standard vacuum group n= 140.The standard group consisted of silastic (55 / 140, 39.3 %) or the metal cups (85 / 140, 60.7 %).

Main outcome Measures : the primary outcome was the successful completion of delivery with the allocated instrument, secondary outcomes were maternal trauma, fetal scalp trauma and duration of suction.

Results : the Kiwi cup was associated with a significantly higher failure rate than the standard cup (13.3 % vs 7.9 %) OR = 1.69 (95 % CI 1.23-2.65) and resulted in significantly more caesarean section rates (11.4 % vs 6.4 %) OR = 1.77 (95 % Cl 1.12-2.85) the forceps deliveries were similar in both groups (1.9 % vs 1.4 %) OR = 1.25 (95 % Cl 0.82-1.9).

Substantial maternal trauma was significantly less with Kiwi vacuum cup (3.8 % vs 8.6 %) OR = 0.44 (95 CI 0.150.60), rates of scalp trauma were similar in both groups, there was significantly short duration of suction time in Kiwi vacuum cup (mean 4.26 minutes compared with 6.52.

minutes in the standard cups), with 18.1 % compared with 69.3 % had more than 5 minutes suction duration OR = 0.26 (95 %C10.01- 0.45).

Conclusions: The Kiwi cup vacuum is less successful than standard vacuum cups in achieving vaginal delivery, however ; it is with less maternal trauma comp.