Second stage expedite delivery of low birth weight neonates: Emergent cesarean delivery versus vacuum assisted delivery

Gabriel Levin, Amihai Rottenstreich, Tal Cahan, David Mankuta, Simcha Yagel, Yoav Yinon, Raanan Meyer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: To determine maternal and neonatal outcomes among women undergoing second stage emergent cesarean delivery (ECD) versus vacuum-assisted delivery (VAD) of low birthweight neonates. Materials and methods: A retrospective cohort study from two tertiary medical centers. We included women who underwent either ECD or VAD during the second stage of labor, and delivered neonates with a birthweight of <2500 g during 2011–2019. Characteristics and outcomes were compared between the groups. The primary outcome was the rate of a composite adverse neonatal outcome, defined as the presence of ≥1 of the following: Apgar 5 min < 7, respiratory distress syndrome, neonatal intensive care unit admission, mechanical ventilation and intrapartum fetal death. Results: The study cohort included 611 patients, of whom 46 had ECD and 565 had VAD. Baseline characteristics did not differ between the groups. The rate of Apgar score < 7 at 1 min was higher among the ECD group]10 (22%) vs. 29 (5%), OR (95% CI) 5.1 (2.3–11.3), p < 0.001[. Other neonatal and maternal outcomes were similar in both groups. Conclusions: Neonatal and maternal outcomes do not differ substantially between ECD and VAD of neonates weighing <2500 g. This information may be useful when contemplating the preferred mode of delivery in this setting.

Original languageAmerican English
Article number102136
JournalJournal of Gynecology Obstetrics and Human Reproduction
Issue number8
StatePublished - Oct 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Masson SAS


  • Cesarean delivery
  • Low birthweight
  • Perinatal outcome
  • Second stage
  • Vacuum extraction


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