Kiwi omnicup handheld versus Mityvac M-style conventional vacuum system: a retrospective observational study. (2nd December 2018)

• Record Type: Journal Article
• Authors: Weissbach, Tal; Hag-Yahia, Nasreen; Ovadia, Michal; Tzadikevitch Geffen, Keren; Weitzner, Omer; Biron-Shental, Tal
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 31:Number 23(2018)
• Page Start: 3178
• Page End: 3182
• Publication Date: 2018-12-02
• Subjects: Conventional vacuum system -- hand-held vacuum system -- Kiwi omnicup -- M-style Mityvac cup -- vacuum assisted delivery; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1366443
• Languages: English
• ISSNs: 1476-7058

Abstract

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.