Association between physician experience and obstetric outcomes after vacuum delivery

Emily S. Miller, Ashley Battarbee, Ariel Moser, Dana R. Gossett*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To estimate the association between obstetrician experience and the incidence of severe perineal lacerations and failed vacuum attempts. STUDY DESIGN: This is a retrospective cohort of vacuum deliveries performed at a tertiary-care hospital. Provider experience was examined both by attending years of practice and year of residency training (if a trainee participated in the delivery). Outcomes examined included severe perineal lacerations (3rd or 4th degree) and failed vacuum deliveries. Multilevel multivariable analyses were performed to control for both individual patient-level characteristics and the delivery provider. RESULTS: A total of 134 attending obstetricians performed 1,852 vacuum-assisted deliveries with a Kiwi or MityVac device. Of those, 248 women (13.4%) had a severe perineal laceration and 115 (6.2%) had a failed vacuum. Rates of severe perineal lacerations were not associated with any measure of provider experience. When controlling for patient-level variables such as station (low or outlet), fetal head position, indication for vacuum, and parity, we found that increasing attending years of practice (in 5-year increments) (aOR 0.80, 95% CI 0.66–0.97) and increasing resident year of training (aOR 0.60, 95% CI 0.46–0.79) were inversely associated with failed vacuum deliveries. CONCLUSION: Obstetrician experience is not associated with severe perineal lacerations. Overall obstetric attending experience and resident year of training are significantly inversely associated with failed vacuum deliveries.

Original languageEnglish (US)
Pages (from-to)131-136
Number of pages6
JournalJournal of Reproductive Medicine
Volume63
Issue number2
Publication statusPublished - Jan 1 2018

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Keywords

  • Obstetric delivery
  • Obstetrician
  • Obstetrics
  • Operative vaginal delivery
  • Perineal laceration
  • Vacuum extraction, obstetrical
  • Volume

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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