Maternal and neonatal outcomes following vacuum assisted vaginal delivery in a tertiary care hospital in North-East India

Abstract

Introduction: Operative vaginal birth remains an important part of modern obstetric care and is used to achieve or expedite safe vaginal birth for maternal or foetal indications avoiding unnecessary caesarean birth. However, the use of obstetric forceps or vacuum extractor requires an obstetrician to be familiar with the proper use of the instruments and the risks involved. Objective: To evaluate the maternal and neonatal outcomes following vacuum assisted vaginal delivery. Materials and Methods: A hospital based cross-sectional study was conducted among 250 pregnant women (125 delivered by ventouse assisted vaginal delivery and 125 delivered by normal vaginal delivery) for a period of one and half years in the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal. Maternal outcomes like atonic PPH, Traumatic PPH, extension of episiotomy, 3rd degree perineal tear; and neonatal outcomes like birth weight, Apgar scores, NICU admission were compared between the two groups. Descriptive statistics like mean, standard deviation and percentage were used. The data was analyzed using SPSS version 21.0 IBM. Data analysis was done using Chi square test and t-test and p- value < 0.05 was taken as significant. Results:The average age among vacuum delivered women was 28 years. Most of the women who underwent vacuum assisted vaginal deliveries were primigravida accounting for 46.4% of the cases. The most common reason for vacuum delivery was poor maternal effort (31.2%) followed by prolonged 2nd stage of labour (28%) and foetal distress (26.4%). Maternal complications rate among the vacuum delivery was 8.8% in this study, the most common complication being atonic post-partum haemorrhage (4%). Apgar score below 4 at 1min and 5 min was also seen only in few cases of vacuum assisted delivery (2.4% and 0.8% respectively). And NICU admission was also seen among vacuum assisted vaginal deliveries only (4.8%). Conclusion: Vacuum-assisted vaginal delivery is a valuable and generally safe obstetric procedure when used for appropriate indications and under recommended clinical conditions.