Vacuum extraction and forceps deliveries; comparison of maternal and neonatal complications

To compare the maternal and neonatal complications after instrumental deliveries. Prospective study. At MH Rawalpindi. Six months from April 15,2006 to October 14,2006. Total 96 instrumental deliveries were carried out; of which 46 were ventouse and 50 were forceps deliveries. 58% of forceps deliveries were carried out in nulliparous and 42% in mulitparous patients as compared to 61% of ventouse deliveries in nulliparous and 39% in multiparous patients. Fetal distress was indication in 68% of forceps deliveries and 61% ventouse deliveries. Prolong second stage [>1 hr] was the second commonest indication i.e., in 18% of forceps deliveries and 13% of ventouse deliveries. Success rate was 90% in ventouse and 97% in forceps deliveries. Extension of episiotomy was more likely to occur with ventouse deliveries and third degree perineal tear occurred more with forceps deliveries. 14 babies were admitted to NICU and 90% of them were due to meconium staining. There was only one intrapartum death in the ventouse delivery group and that was due to intrapartum asphyxia. Forceps are more likely to be used in primigravidas and less likely to fail. Most common indication of instrumental deliveries is fetal distress followed by prolonged second stage. Cephalhaematoma and jaundice are more common in ventouse deliveries. Extension of episiotomy and low apgar score at one minute is more likely to occur with ventouse deliveries where as third degree perineal tear and subconjuctival haemorrhage are more likely to occur in forceps deliveries