Birthing experience and quality of life after vacuum delivery and second-stage caesarean section: a prospective cohort study in Uganda
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Medicine and International Health
Abstract
objective To assess perceptions of women undergoing vacuum extraction or second-stage caesarean
section (SSCS) in a tertiary referral hospital in sub-Saharan Africa.
methods Prospective cohort study, with six-month follow-up, of women who gave birth to a term
singleton in cephalic presentation by vacuum extraction (n = 289) or SSCS (n = 357) between 25
November 2014, to 8 July 2015, in Mulago Hospital, Uganda. Excluded were women who had failed
vacuum extraction, severe birth complications and those whose babies had died. Outcome measures
were birthing experience satisfaction, physical component summary (PCS) and mental component
summary (MCS) of the SF-12 quality-of-life questionnaire, pain scores and dyspareunia.
results One day after vacuum extraction, 63.7% (181/284) of women were feeling well vs. 48.1%
(167/347) after SSCS (OR 1.89; 95%CI 1.37–2.61) and mean pain sores were 2.70 vs. 3.87
(P < 0.001). In both groups, >90% of women were satisfied with their birthing experience. At six
weeks, in vacuum extraction vs. SSCS, mean pain sores were 0.40 vs. 0.89 (P < 0.001); mean PCS
was 48.67 vs. 44.03 (P < 0.001); mean MCS was 52.80 vs. 51.23 (P = 0.203); 40% (70/175) vs.
28.3% (70/247) of women had resumed sexual intercourse (OR 1.69; 95%CI 1.12–2.54) and 21.4%
(15/70) vs. 28.6% (20/70) had dyspareunia (OR 0.68; 95%CI 0.32–1.47). No differences were found
at six months after birth.
conclusion One day and six weeks after birth, outcomes were better in women who had vacuum
extraction. At six months, outcomes were similar. To promote quick recovery, vacuum extraction
should be the first intervention considered in the second stage of labour.
Description
Keywords
vacuum extraction, caesarean section, quality of life, pain, dyspareunia, birthing experience