What does this research mean for the field?

Sequential vacuum-forceps delivery confers significantly greater maternal and neonatal morbidity compared to vacuum or forceps alone, and machine learning models identify second-stage duration, decision-to-delivery time, lactate, and base excess as key predictors of instrument choice. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate maternal, intrapartum, and neonatal outcomes across different operative vaginal delivery modalities and identify predictive factors using machine learning alongside traditional statistics.

September 3, 2026The Journal of Maternal-Fetal & Neonatal MedicineOpen Access

Comparative outcomes and predictive factors in vacuum, forceps, and sequential vacuum-forceps operative vaginal deliveries

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Authors

XCXinjuan Chen JCJinhui Cui LLLing Li

Discussion

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Overview

Retrospective study reveals increased maternal and neonatal complications with sequential vacuum-forceps delivery, suggesting critical risks associated with combined instruments.

Key Points

To evaluate maternal, intrapartum, and neonatal outcomes across different operative vaginal delivery modalities and identify predictive factors using machine learning alongside traditional statistics.
Retrospectively analyzed 967 singleton deliveries at a single tertiary center across three modalities: vacuum (n = 208), forceps (n = 706), and sequential vacuum + forceps (n = 53).
Compared outcomes using ANOVA and chi-square tests, and trained a Random Forest classifier evaluated by accuracy, AUC, and Cohen’s κ to rank predictors of delivery modality.
Sequential vacuum + forceps delivery was associated with significantly longer decision-to-delivery intervals (26.9 min vs. 17.7 min for vacuum and 16.8 min for forceps, p < 0.001) and higher rates of severe perineal laceration (73.6% vs. 34.1% and 47.5%, p < 0.001).
Neonates delivered via sequential vacuum + forceps experienced worse outcomes, including lower Apgar scores, higher rates of cephalohematoma, hyperbilirubinemia, and increased neonatal transfer rates.
The Random Forest model achieved 73.7% accuracy (AUC 0.758), identifying second-stage duration, decision-to-delivery time, lactate, and base excess as the top predictors of delivery mode.

Cite This Study

Chen et al. (2026) studied this question.

synapsesocial.com/papers/6a9934ea636c6408cfa7ca42 https://doi.org/10.1080/14767058.2026.2724778

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September 3, 2026The Journal of Maternal-Fetal & Neonatal MedicineOpen Access

Comparative outcomes and predictive factors in vacuum, forceps, and sequential vacuum-forceps operative vaginal deliveries

View Full Paper

Ask AI

Bookmark

Authors

XCXinjuan Chen JCJinhui Cui LLLing Li

Discussion

Member takes

Overview

Retrospective study reveals increased maternal and neonatal complications with sequential vacuum-forceps delivery, suggesting critical risks associated with combined instruments.

Key Points

To evaluate maternal, intrapartum, and neonatal outcomes across different operative vaginal delivery modalities and identify predictive factors using machine learning alongside traditional statistics.
Retrospectively analyzed 967 singleton deliveries at a single tertiary center across three modalities: vacuum (n = 208), forceps (n = 706), and sequential vacuum + forceps (n = 53).
Compared outcomes using ANOVA and chi-square tests, and trained a Random Forest classifier evaluated by accuracy, AUC, and Cohen’s κ to rank predictors of delivery modality.
Sequential vacuum + forceps delivery was associated with significantly longer decision-to-delivery intervals (26.9 min vs. 17.7 min for vacuum and 16.8 min for forceps, p < 0.001) and higher rates of severe perineal laceration (73.6% vs. 34.1% and 47.5%, p < 0.001).
Neonates delivered via sequential vacuum + forceps experienced worse outcomes, including lower Apgar scores, higher rates of cephalohematoma, hyperbilirubinemia, and increased neonatal transfer rates.
The Random Forest model achieved 73.7% accuracy (AUC 0.758), identifying second-stage duration, decision-to-delivery time, lactate, and base excess as the top predictors of delivery mode.

Cite This Study

Chen et al. (2026) studied this question.

synapsesocial.com/papers/6a9934ea636c6408cfa7ca42 https://doi.org/10.1080/14767058.2026.2724778

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