Kiwi omnicup handheld versus Mityvac M-style conventional vacuum system: a retrospective observational study |
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Authors: | Tal Weissbach Nasreen Hag-Yahia Michal Ovadia Keren Tzadikevitch Geffen Omer Weitzner Tal Biron-Shental |
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Affiliation: | 1. Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel;2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel |
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Abstract: | Introduction: To improve the choice of vacuum-assisted delivery (VAD) system, we compared the outcomes of Kiwi handheld system and Mityvac M-style conventional system (both use disposable plastic cups).Materials and methods: Retrospective observational study with data collection from electronic medical records. The study was conducted at a tertiary medical center, with approximately 7000 deliveries annually. Categorical and continuous variables were analyzed using chi-square test and t-test, respectively. p value?.05 was considered significant. The main outcomes assessed were the overall failure rate of each system, failure rates for occipito-anterior (OA) versus occipito-transverse/occipito-anterior (OT/OP) positions, +1 versus +2 fetal stations, and early maternal/neonatal outcomes.Results: During a 10-month period, there were 507 (8.4%) attempted VADs, 36 failed (7.1%), and eight (1.5%) converted to cesarean section. Of these, 364 were Kiwi-assisted and 143 Mityvac-assisted. Background characteristics were similar. The handheld system had more failures overall (9.6 versus 0.7%), at OA (7.6 versus 0.9%), and non-OA positions (17.3% versus none), at +1 (13.25 versus 0.96%) and at +2/3 stations (6.1% versus none), than the conventional system did, respectively. There was a higher rate of early post-partum hemorrhage (15.3 versus 7.4%) in the conventional group. Both systems had similar rates of third/fourth degree perineal tears, shoulder dystocia and adverse neonatal outcomes.Conclusions: Our results suggest more failures with Kiwi compared to Mityvac, overall and at any fetal position/station, without a significant difference in adverse outcome profile. |
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Keywords: | Conventional vacuum system hand-held vacuum system Kiwi omnicup M-style Mityvac cup vacuum assisted delivery |
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