Table 1.
Demographic characteristics by attempted mode of delivery
| First Operative Attempt |
||||
|---|---|---|---|---|
| Characteristics, n (%) unless otherwise indicated |
Vaginal trial of vacuum n=1382 |
Vaginal trial of forceps n=1018 |
Cesarean n=131 |
P-value* |
| Age , years | <.001 | |||
|
| ||||
| <25 | 502 (36.3) | 331 (32.5) | 27 (20.6) | |
|
| ||||
| 25-29.9 | 385 (27.9) | 252 (24.8) | 37 (28.2) | |
|
| ||||
| 30-34.9 | 346 (25.0) | 299 (29.4) | 43 (32.8) | |
|
| ||||
| ≥35 | 149 (10.8) | 136 (13.4) | 24 (18.3) | |
|
| ||||
| Race/ethnicity | <.001 | |||
|
| ||||
| Non-Hispanic white | 776 (56.2) | 602 (59.1) | 74 (56.5) | |
|
| ||||
| Non-Hispanic black | 198 (14.3) | 80 (7.9) | 8 (6.1) | |
|
| ||||
| Hispanic | 201 (14.5) | 171 (16.8) | 25 (19.1) | |
|
| ||||
| Other | 207 (15.0) | 165 (16.2) | 24 (18.3) | |
|
| ||||
| Diabetes (pre-gestational or gestational) |
68 (4.9) | 46 (4.5) | 10 (7.6) | .30 |
|
| ||||
| Smoking | 116 (8.4) | 57 (5.6) | 6 (4.6) | .02 |
|
| ||||
| PROM | 34 (2.5) | 28 (2.8) | 4 (3.1) | .87 |
|
| ||||
| Hypertension (chronic or preeclampsia) |
139 (10.1) | 109 (10.7) | 14 (10.7) | .86 |
|
| ||||
| BMI, kg/m2 | .02 | |||
|
| ||||
| <25 | 240 (17.5) | 169 (16.8) | 9 (7.0) | |
|
| ||||
| 25-29.9 | 583 (42.6) | 465 (46.3) | 56 (43.8) | |
|
| ||||
| 30-34.9 | 364 (26.6) | 252 (25.1) | 42 (32.8) | |
|
| ||||
| 35-39.9 | 126 (9.2) | 70 (7.0) | 14 (10.9) | |
|
| ||||
| ≥40 | 56 (4.1) | 48 (4.8) | 7 (5.5) | |
|
| ||||
| Cocaine/meth | 5 (0.4) | 5 (0.5) | 1 (0.8) | .48 |
|
| ||||
| Prior cesarean | 42 (3.0) | 32 (3.1) | 5 (3.8) | .89 |
|
| ||||
| Intrapartum chorioamnionitis |
162 (11.7) | 188 (18.5) | 32 (24.4) | <.001 |
|
| ||||
| Gestational age, weeks | .10 | |||
|
| ||||
| 370-376 | 94 (6.8) | 67 (6.6) | 6 (4.6) | |
|
| ||||
| 380-386 | 222 (16.1) | 143 (14.1) | 17 (13.0) | |
|
| ||||
| 390-396 | 417 (30.2) | 269 (26.4) | 42 (32.1) | |
|
| ||||
| 400+ | 649 (47.0) | 539 (53.0) | 66 (50.4) | |
|
| ||||
| Length of second stage, hours† |
2.2 ± 1.6 | 2.5 ± 1.6 | 3.8 ± 1.7 | <.001 |
|
| ||||
| Birthweight ≥4000 grams | 83 (6.0) | 71 (7.0) | 21 (16.0) | <.001 |
|
| ||||
| Birthweight, grams, mean ± sd |
3338 ± 422 | 3370 ± 426 | 3537 ± 442 | <.001 |
|
| ||||
| Rotation >450 when vacuum or forceps applied† |
53 (4.1) | 61 (6.5) | .01‡ | |
|
| ||||
| Episiotomy | 514 (37.2) | 288 (28.3) | 2 (1.5) | <.001 |
|
| ||||
| Cystotomy | 1 (0.1) | 1 (0.1) | 0 (0.0) | 1.00 |
|
| ||||
| Bowel injury | 0 (0.0) | 1 (0.1) | 0 (0.0) | § |
|
| ||||
| Ureteral injury | 0 (0.0) | 0 (0.0) | 0 (0.0) | § |
|
| ||||
| Accreta | 1 (0.1) | 0 (0.0) | 0 (0.0) | § |
|
| ||||
| Attending years since graduation |
<.001 | |||
|
| ||||
| < 10 | 320 (23.5) | 174 (17.2) | 46 (35.9) | |
|
| ||||
| 10.0-14.9 | 273 (20.0) | 219 (21.6) | 26 (20.3) | |
|
| ||||
| 15.0-19.9 | 239 (17.5) | 179 (17.7) | 13 (10.2) | |
|
| ||||
| 20.0-9.9 | 224 (16.4) | 142 (14.0) | 16 (12.5) | |
|
| ||||
| ≥ 25.0 | 307 (22.5) | 298 (29.5) | 27 (21.1) | |
PROM, premature rupture of membranes; BMI, body mass index
*
based on chi-square, Fisher’s exact or Kruskal-Wallis
†
length of second stage missing in 2.8%; rotation >450 missing in 6.7% of vaginal operative attempts
‡
p-value comparing vaginal trial of vacuum and vaginal trial of forceps as this was not applicable in cesarean as first operative attempt
§
p-value not computed due to zero observations in two or more groups