New Systematic Review and Meta-Analysis: Comparative Risk of Neonatal Ischemic Encephalopathy in Operative Vaginal Delivery vs. Cesarean at Complete Dilation – Now Online in AJP!

January 29, 2026OBGYNBy Maria Sainz

We are excited to announce our latest publication is now available online ahead of print in the American Journal of Perinatology! “Comparative Risk of Neonatal Ischemic Encephalopathy in Operative Vaginal Delivery Versus Cesarean Section at Complete Dilation: A Systematic Review and Meta-Analysis.” is now available online at this link: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2796-1349 This systematic review and meta-analysis examines critical neonatal outcomes in second-stage delivery decisions, comparing the risk of neonatal hypoxic-ischemic encephalopathy (HIE) between operative vaginal delivery (including forceps and vacuum subtypes) and cesarean section performed at complete cervical dilation. Key insights include elevated HIE risk with operative vaginal delivery compared to spontaneous vaginal delivery, but comparable overall risk to cesarean at complete dilation—with subgroup findings suggesting forceps-assisted delivery may carry lower risk in certain scenarios. This work underscores the importance of weighing risks and benefits in intrapartum management to optimize neonatal safety. Full text available via the journal (DOI link above). Congratulations to the research team on this important contribution to obstetric evidence!

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“I delivered both my beautiful babies with Dr. Marchand and I wouldn’t have it any other way! Every doctor visit up until I was in labor was great, he took all the time to answer all my questions. I didn’t feel rushed in and rushed out of the office. The office was always very clean! The staff were always very friendly. When I was in labor he made sure my birth plan was the most important thing! He always had my best interest in hand! My first delivery I was induced and it took 3 long days and Marchand kept checking on me all hours of the night!! If I did it all over again I’d definitely use Marchand as my OB again!”

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Alex S.
“We congratulate Dr. Greg J. Marchand as SRC’s first Surgeon of Excellence in Minimally Invasive Surgery (SOEMIS) in the United States. To achieve SOEMIS accreditation, Dr. Marchand invited SRC to complete a rigorous onsite inspection and thorough chart review to illustrate his compliance with the program. Dr. Marchand and his practice exemplify SRC’s commitment to patient safety and care.”

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Ashley DuBray, Senior Director of the Surgical Review Corporation
“I initially met Dr. Marchand upon an emergency room visit due to complications during my first pregnancy. My husband and I had recently moved from out of state. Not knowing many people here, in a scary situation and finding myself hospitalized was made a lot easier once we met Dr. Marchand who we decided would be the best doctor to see my care through the pregnancy and ultimate c-section. He always had time for our questions even when we knew he had many other patients. He did a great job with the surgery and follow up care and was very pleasant, patient and professional throughout the process. When we decided to have another baby, he saw us through another pregnancy and c-section and continues to be my OB of choice. I would recommend him in a heartbeat to any girlfriends I know.”

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Megan E. of Gilbert, AZ
“Growing up I have had my fair share of woman health issue from Endometriosis, PCOS, Severe Pelvic Pain, Loss of Pregnancy and Infertility and more pelvic surgeries than I can count. I have seen many different doctors till about 6-7 years ago when I needed emergency surgery and met Dr. Marchand and now I refuse to go to any one else. With the many issues I have had both Dr. Marchand as well as his whole office staff have been so helpful I couldn’t be more grateful. It’s very hard to find an honest, trustworthy doctor these days but rest assured you can’t go wrong with Dr. Greg Marchand. They are open late and almost always can fit you into the schedule for emergencies and you can always reach him no matter what time it is if you have questions. Dr. Marchand is an amazing surgeon and loves what he does. He has delivered many friends and family’s children and hope that one day he will be able to deliver mine as well.”

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