Maternal indications, trends, and fetal outcomes of instrument-assisted vaginal deliveries in the United Arab Emirates

Authors

  • Adhya M. Tom College of Medicine, Gulf Medical University, Ajman, United Arab Emirates
  • Chris M. Prince College of Medicine, Georgian National University SEU, Tbilisi, Georgia
  • Shameema Muhammed Department of Obstetrics and Gynecology, Thumbay University Hospital, Ajman, United Arab Emirates
  • Anusha Sreejith Department of Community Medicine, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252707

Keywords:

Cephalohematoma, Instrument assisted vaginal deliveries

Abstract

Background: Instrument-assisted vaginal deliveries (IAVDs), using vacuum or forceps, are vital for expediting childbirth in cases such as fetal distress or prolonged labor. While effective in preventing cesarean sections and reducing maternal-fetal morbidity, they carry risks including perineal trauma and neonatal injury. This study assessed the clinical indications and outcomes of IAVDs in a UAE tertiary hospital.

Methods: A retrospective review was conducted at Thumbay University Hospital, Ajman, including women who underwent IAVDs between January 2022 and January 2025. Data on maternal demographics, instrument type, clinical indications, and maternal-neonatal outcomes were collected using a validated form. Cesarean deliveries and incomplete records were excluded. Data were analyzed with SPSS v29 using descriptive statistics and Chi-square tests, with significance at p<0.05.

Results: Among 116 IAVD cases, most women were primigravida, aged 21-34, and delivered at full term. Indications included poor maternal effort (60.3%), prolonged second stage (39.7%), and fetal distress (37.9%). Vacuum was the predominant instrument. Neonatal outcomes were favorable, with 93.1% of newborns having normal birth weight. Common complications included respiratory distress (19.8%), NICU admission (14.7%), and cephalohematoma (12.9%). Maternal outcomes included episiotomy (82.8%) and vaginal tears (8.6%), with minimal serious complications.

Conclusions: IAVDs remain a safe and effective option for managing prolonged labor or fetal compromise. When guided by appropriate clinical judgment and technique, they yield favorable maternal and neonatal outcomes. Emphasis on early recognition of indications, ongoing operator training, and vigilant monitoring can further optimize safety.

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References

O'Mahony F, Hofmeyr GJ, Menon V. Choice of instruments for assisted vaginal delivery. Cochrane Database Syst Rev. 2010(11). DOI: https://doi.org/10.1002/14651858.CD005455.pub2

Patel RR, Murphy DJ. Forceps delivery in modern obstetric practice. BMJ. 2004;328(7451):1302-5. DOI: https://doi.org/10.1136/bmj.328.7451.1302

McQuivey RW. Vacuum-assisted delivery: a review. J Matern Fet Neonat Med. 2004;16(3):171-80. DOI: https://doi.org/10.1080/jmf.16.3.171.180-25

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;12:1-5. DOI: https://doi.org/10.1186/s13104-019-4530-7

Kudish B, Blackwell S, Mcneeley SG, Bujold E, Kruger M, Hendrix SL, et al. Operative vaginal delivery and midline episiotomy: a bad combination for the perineum. Am J Obstet Gynecol. 2006;195(3):749-54. DOI: https://doi.org/10.1016/j.ajog.2006.06.078

De Leeuw JW, De Wit C, Kuijken JP, Bruinse HW. Mediolateral episiotomy reduces the risk for anal sphincter injury during operative vaginal delivery. BJOG. 2008;115(1):104-8. DOI: https://doi.org/10.1111/j.1471-0528.2007.01554.x

Vasanth UP, Tambawala ZY, Saquib S, Shinko I, Mubarak M, Al Ani K. Trends in operative vaginal delivery at Dubai hospital: 5-year retrospective study. J South Asian Feder Obstet Gynaecol. 2024;16(2):74-8. DOI: https://doi.org/10.5005/jp-journals-10006-2392

Ali UA, Norwitz ER. Vacuum-assisted vaginal delivery. Rev Obstet Gynecol. 2009;2(1):5.

Salman L, Aviram A, Krispin E, Wiznitzer A, Chen R, Gabbay-Benziv R. Adverse neonatal and maternal outcome following vacuum-assisted vaginal delivery: does indication matter? Arch Gynecol Obstet. 2017;295:1145-50. DOI: https://doi.org/10.1007/s00404-017-4339-3

Zhang VR, Tan EL, Edison PE, Kanagalingam D. Operative vaginal delivery: practice patterns and outcomes at a tertiary general hospital. Singapore Med J. 2023;64(5):313-8. DOI: https://doi.org/10.11622/smedj.2022069

Aliyu LD, Kadas AS, Hauwa MA. Instrumental vaginal delivery in Bauchi, northeast Nigeria. J West Afr Coll Surg. 2011;1(4):18.

Prapas N, Kalogiannidis I, Masoura S, Diamanti E, Makedos A, Drossou D, et al. Operative vaginal delivery in singleton term pregnancies: short-term maternal and neonatal outcomes. Hippokratia. 2009;13(1):41.

Ghanchi FM, Mansuri MI, Doshi HU, Kharod Patel PH. Maternal and perinatal outcome in instrumental vaginal deliveries over 5 years: a retrospective study. Int J Reprod Contracept Obstet Gynecol. 2023; 12(4):934-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20230790

Singh A, Rathore P. A comparative study of feto-maternal outcome in instrumental vaginal delivery. J Obstet Gynecol India. 2011;61:663-6. DOI: https://doi.org/10.1007/s13224-011-0119-3

Bradley MS, Kaminski RJ, Streitman DC, Dunn SL, Krans EE. Effect of rotation on perineal lacerations in forceps-assisted vaginal deliveries. Obstet Gynecol. 2013;122(1):132-7. DOI: https://doi.org/10.1097/AOG.0b013e31829752fc

Handa VL, Danielsen BH, Gilbert WM. Obstetric anal sphincter lacerations. Obstet Gynecol. 2001;98(2):225-30. DOI: https://doi.org/10.1097/00006250-200108000-00008

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Published

2025-08-28

How to Cite

Tom, A. M., Prince, C. M., Muhammed, S., & Sreejith, A. (2025). Maternal indications, trends, and fetal outcomes of instrument-assisted vaginal deliveries in the United Arab Emirates. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(9), 2840–2845. https://doi.org/10.18203/2320-1770.ijrcog20252707

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Original Research Articles