Whether epidural analgesia for labor prolongs the active-first and second labor stages and increases the risk of vacuum-assisted delivery is a controversial topic.
Risk of vacuum-assisted vaginal delivery was also significantly elevated for large FHC infants relative to average FHC infants (RR 1.55; 95% CI: 1.43, 1.69).
Large-FHC infants were at increased risk of vacuum-assisted vaginal delivery (RR 1.55; 95% CI: 1.43, 1.69), and forceps-assisted vaginal delivery (RR 1.61; 95% CI: 1.32, 1.97).
Although FHC was associated with both of these outcomes in our study as well, we observed a more modest association with risk of vacuum-assisted vaginal delivery and a stronger association with risk of primary cesarean delivery.
The relative risk of sequential vacuum and forceps use was greater than the sum of the individual relative risks of each instrument for intracranial hemorrhage, facial nerve injury, seizure, hematoma, and perineal and vaginal lacerations.
Without that, there's the risk of a vacuum at the top that is filled by disorder and by, perhaps wiser, but less accountable, unelected leaders.
In that study, nulliparous mothers with large FHC infants had elevated risk of both vacuum-assisted vaginal delivery (odds ratio [OR] 3.47; 95% CI: 3.10, 3.88) and cesarean delivery (OR 1.22; 95% CI: 1.04, 1.42).
However, the risks of or vacuum extraction did not increase prominently, which suggested that obstetricians may have a tendency for operative delivery when faced with a suspiciously large fetus and slow labor progress.
Two years ago the Leading Social skills review, commissioned by the Cabinet Office, found that civil society leaders tend to have longer careers with a single organisation, leaving the sector at risk of a leadership vacuum.
Nevertheless, women with private health insurance have more likelihood of episiotomy [ 20], a higher probability of caesarean or instrumentally assisted delivery [ 21], a higher risk of forceps or vacuum delivery and of other obstetric interventions such as epidural anaesthesia, induction or augmentation [ 7].
