A comparative study of neonatal and maternal outcome between forceps delivery and vacuum extraction

Authors

  • Subhabrata Ghosh Department of Obstetrics and Gynaecology, Midnapore Medical College, Midnapore, West Bengal, India
  • Pranab K. Biswas Department of Obstetrics and Gynaecology, Calcutta National Medical College, Kolkata, West Bengal, India
  • Manik Mani Department of Obstetrics and Gynaecology, Midnapore Medical College, Midnapore, West Bengal, India
  • Snehamay Chaudhuri Department of Obstetrics and Gynaecology, Midnapore Medical College, Midnapore, West Bengal, India
  • Nirupam K. De Department of Obstetrics and Gynaecology, Midnapore Medical College, Midnapore, West Bengal, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20233150

Keywords:

Vacuum extraction, Forceps, Maternal injuries, Foetal complications

Abstract

Background: Aims and objectives of the study were to compare maternal and neonatal outcomes of forceps versus vacuum application in assisted vaginal delivery.

Methods: This prospective study was conducted in a tertiary care hospital of West Bengal over one year. Women in labor with vertex presentation were delivered by vacuum and forceps. A total of 100 cases were included of which 50 patients selected for forceps delivery and 50 patients for vacuum extraction. The instruments were either silastic cup vacuum extractor or Wrigley`s outlet forceps. Maternal morbidity was studied in terms of cervical tears, vaginal lacerations, episiotomy extension, perineal tears, PPH, and retention of urine. Neonatal morbidity was studied in terms of Apgar score, instrumental injuries, cephalhematoma, NICU admission and the outcome was compared. Chi square test was used to analyze the data.

Results: Observations maternal morbidity viz. episiotomy extension, traumatic PPH were significant in the forceps group (p=0.01). With regards to neonatal morbidity, SNCU admission were significantly higher in forceps delivery (p=0.02) and incidence of cephalohematomas were more in ventouse delivery (p=0.02).

Conclusions: Vacuum and forceps should remain appropriate tools in the armamentarium of the modern obstetrician. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother.

 

References

Patel RR, Murphy DJ. Forceps delivery in modern obstetric practice. BMJ. 2004;328(7451):1302-5.

Johanson R, Menon V, Cochrane Pregnancy and Childbirth Group. Vacuum extraction versus forceps for assisted vaginal delivery. Cochrane database of systematic reviews. 1996;2010(1).

Dell DL, Sightler SE, Plauché WC. Soft cup vacuum extraction: a comparison of outlet delivery. Obstet Gynecol. 1985;66(5):624-8.

Mesleh RA, Al-Sawadi HM, Kurdi AM. Comparison of maternal and infant outcomes between vacuum extraction and forceps deliveries. Saudi Med J. 2002;23(7):811-3.

Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. The Lancet. 2001;358(9289):1203-7.

Johanson RB. Instrumental vaginal delivery. London: Royal College of Obstetricians and Gynaecologists. 2000.

Johanson R, Menon V, Cochrane Pregnancy and Childbirth Group. Vacuum extraction versus forceps for assisted vaginal delivery. Cochrane database of systematic reviews. 1996;2010(1).

Singh A, Rathore P. A comparative study of feto-maternal outcome in instrumental vaginal delivery. J Obstet Gynecol India. 2011;61:663-6.

Johanson RB, Rice C, Doyle M, Arthur J, Anyanwu L, Ibrahim J, et al. A randomised prospective study comparing the new vacuum extractor policy with forceps delivery. BJOG: Int J Obstet Gynaecol. 1993;100(6):524-30.

Vacca A, Grant A, Wyatt G, Chalmers I. Portsmouth operative delivery trial: a comparison vacuum extraction and forceps delivery. BJOG: Int J Obstet Gynaecol. 1983;90(12):1107-12.

Shekhar S, Rana N, Jaswal RS. A prospective randomized study comparing maternal and fetal effects of forceps delivery and vacuum extraction. J Obstet Gynecol India. 2013;63:116-9.

Khalid N, Sumaira A. Comparison of maternal and foetal outcome in instrumental delivery. PJMMS. 2013;7(1).

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(10):3294-300.

Downloads

Published

2023-10-06

Issue

Section

Original Research Articles