Trends in instrument preference for operative vaginal delivery in a tertiary referral center: 2008-2021

OBJECTIVE

To examine temporal trends in operative vaginal deliveries as well as the ratio between vacuum and forceps deliveries over 15 years in a large tertiary hospital.

METHODS

This retrospective study assessed prospectively collected data from 2008 to 2021. Women with greater than 37 weeks of gestation who underwent an operative vaginal delivery were included. The rate and ratio of instrumental deliveries and perineal trauma were recorded.

RESULTS

From 2008 to 2021 there was a total of 109 230 term deliveries, of which 20 151 were an operative vaginal delivery. The rate of operative vaginal delivery as a proportion of all term deliveries decreased from 21.9% (1547 of 7069) in 2008 to 17.1% in 2021 (1428 of 8338, P < 0.001). The ratio between vacuum and forceps-assisted deliveries decreased significantly over the study period, from 7.06 in 2008 to 2.39 in 2021 (P < 0.001). Perineal trauma remained unchanged during the study period.

CONCLUSION

Operative vaginal delivery rates declined over the 15-year study period. While vacuum-assisted vaginal deliveries remain the favored instrument, forceps-assisted deliveries are becoming more prevalent. The cause for this change in practice is unclear but is likely multifactorial.

The Redelberger antigen: a family study, a family story

The Redelberger antigen (Rba) was first discovered in 1974 on the RBCs of a blood donor who was an employee of the Community Blood Center in Dayton, Ohio. The discovery was made as a result of the investigation of a reagent contamination problem. Two examples of the Rba antigen were subsequently identified in the United Kingdom,but no "new"examples have been identified in the United States or Europe. Anti-Rba is a commonly occurring antibody, often found in combination with other antibody specificities, especially in combination with other antibodies to low-incidence antigens.

Case reports: Use of a polyethylene glycol additive to enhance eluate sensitivity

The use of polyethylene glycol additives to enhance the detection of clinically significant alloantibodies in serum has been widely described. This report outlines several cases in which polyethylene glycol additives were added to eluate test systems to enhance the detection of alloantibodies in recently transfused patients.