Fetomaternal outcome in operative vaginal delivery
Keywords:Operative vaginal delivery, Instrumental delivery, Vacuum, Forceps, Assisted vaginal delivery
Background: Operative vaginal deliveries (OVD) were performed with the help of vacuum or forceps in the second stage of labor when mother and foetus condition is threatening. A successful assisted vaginal delivery avoids caesarean section and its associated morbidity and implications for future pregnancy. The aim of the study was to assess the maternal and neonatal outcome of vacuum and forceps assisted vaginal deliveries.
Methods: It was a retrospective comparative cross sectional study done in VMKVMCH, Salem in obstetrics and gynecology department, from the period of April to June 2021. All the mothers delivered by operative vaginal delivery were included. Mothers with multiple pregnancies, preterm and breech presentation were excluded. Data collected using patients information sheet and analysis was done using SPSS 23. P value <0.05 was considered significant.
Results: The most common age group was 21-25 years of age in both groups and most commonly used in primigravida. The most common indication for forceps assisted delivery in our study was the prolonged second stage labour and in vacuum delivery was poor maternal effort. In our study, common complication noted was extended episiotomy followed by perineal tear in forceps group and vice versa in vacuum group. Cephalhematoma was found to be more common in vacuum and scalp and instrumental injuries were more common in forceps assisted vaginal deliveries.
Conclusions: Operative vaginal deliveries helps in improving both maternal and foetal outcomes and reduces the caesarean delivery rate and vacuum significantly reduces maternal trauma than forceps. No difference noted in neonatal outcome.
Hubena Z, Workneh A, Siraneh Y. Prevalence and outcome of operative vaginal delivery among mothers who gave birth at Jimma university medical center, Southwest Ethiopia. J Pregnancy. 2018;2018:7423475.
Murphy DJ, Strachan BK, Bahl R, Royal College of Obstetricians Gynaecologists. Assisted Vaginal Birth. BJOG. 2020;127:70-112.
Uptodate. Fact sheet: Operative vaginal delivery. Available at: http://www.uptodate.com/contents/operative-vaginal-delivery. Accessed on 10 September 2021.
Healthline. Fact sheet: Forceps versus vacuum. Available at: https://www.healthline.com/health/pregnancy/assisted-delivery-forceps-vacuum. Accessed on 10 September 2021.
Jeon J, Na S. Vacuum extraction vaginal delivery: current trend and safety. Obstet Gynecol Sci. 2017;60(6):499-505.
Muraca GM, Sabr Y, Brant R, Cundiff GW, Joseph KS. Temporal and regional variations in operative vaginal delivery in canada by pelvic station, 2004-2012. J Obstetr Gynaecol. 2016;38(7):627-35.
Feeley C, Crossland N, Betran AP, Weeks A, Downe S, Kingdon C. Training and expertise in undertaking assisted vaginal delivery (AVD): a mixed methods systematic review of practitioners views and experiences. Reprod Health. 2021;18(1):92.
Singh S, Munikrishna M, Sheela SR. A comparative study of maternal outcome between vaccum extraction and outlet forceps delivery. Int J Reproduct Contracept Obstetr Gynaecol. 2018;7(6).
Liabsuetrakul T, Choobun T, Peeyananjarassri K, Islam QM. Antibiotic prophylaxis for operative vaginal delivery. Coch Datab Systemat Rev. 2017;8:004455.
Muraca GM, Sabr Y, Lisonkova S, Scoll A, Brant R, Cundiff GW. Morbidity and mortality associated with forceps and vaccum delivery at outlet, low and midpelvic station. J Obstetr Gynaecol. 2019;41(3):327-37.
Shetty R, Rajaratnam A. Immediate maternal and neonatal effects of forceps and vaccum-assisted deliveries. Indian J Obstetr Gynaecol. 2018;6(5).
Sharmila G, Sindhuri GK. A prospective study of immediate maternal and neonatal effects of forceps and vacuum assisted deliveries. IAIM. 2016;3(12):1-10.
Sonawane AA, Gadappa SN, Gaikwad RA. Study of feto maternal outcome in instrumental vaginal deliveries at a tertiary teaching hospital. New Indian J Ob Gyn. 2021;7(2).
Wang L, Wang H, Jia L, Qing W, Li F, Zhou J. The impact of stage of labor on adverse maternal and neonatal outcomes in multiparous women: a retrospective cohort study. BMC Pregnancy Childbirth. 2020;20(1):596.
Gebre S, Hailu A. Complications of instrumental vaginal deliveries and associated factors in Suhul general hospital, Shire, North-West Tigray, Ethiopia. J Gen Pract. 2017;5:300.
Biru S, Addisu D, Kassa S, Animen S. Maternal complication related to instrumental delivery at Felege Hiwot specialized hospital, Northwest Ethiopia: a retrospective cross-sectional study. BMC Res Notes. 2019;12(1):482.
Chaudhari P, Bansal N, Gupta V, Tandon A, Chaudhry A. A comparative study of feto-maternal outcome in instrumental vaginal delivery at tertiary health level hospital in Uttarakhand state. Int J Reprod Contracept Obstet Gynecol. 2016;5(6):3294-9.