Complications of instrumental vaginal deliveries and associated factors in hospitals of Western Oromia, Ethiopia

Abstract

Objective: In developing countries like Ethiopia, there is lack of evidence that shows the magnitude and factors affecting complications of instrumental delivery. Most of the research done in Ethiopia was secondary data and lacks variables like socio-demographic factors, availability of cardiotocograph, number of traction, and who conducted delivery (qualification of health workers). So, this study tried to fill the gaps by conducting primary research with secondary data and adding those variables stated above. Methods: Health facility-based cross-sectional study was conducted from 20 February 20 June 2020 in five public hospitals in East Wollega Zone. Single population proportion formula used to calculate sample size. Systematic random sampling was employed. Interviewer-administered structured questionnaire, checklist, and document review were used to collect data from 282 respondents. Data entered to Epi Data version 3.01 and exported to a statistical package of social sciences version 21 for analysis. Those variables with p < 0.25 in the bivariate analyses were a candidate for multivariable logistic regression and multivariable logistic regression was done to identify factors associated with complications of instrumental vaginal delivery using 95% confidence interval and p < 0.05. Results: Complications of instrumental vaginal delivery were 37.2%. Out of all neonates delivered by operative vaginal delivery, 69 (24.5%) developed complications. Vacuum-assisted delivery (adjusted odd ratio = 0.245, 95% confidence interval 0.092–0.658), 120–160 fetal heartbeats per minute (adjusted odd ratio = 0.298, 95% confidence interval 0.114–0.628), birthweight > 4000 g (adjusted odd ratio = 4.09, 95% confidence interval 1.729–9.499) and outlet instrumentation (adjusted odd ratio = 0.139, 95% confidence interval 0.057–0.339) were associated with complications of instrumental vaginal delivery. Conclusion: Magnitude of complications of instrumental vaginal delivery was high in the study area. So, health professionals should give due attention on instrument selection and application. Instrumental delivery requires a careful assessment of clinical circumstances to identify the indications and contraindications for the application of the instruments.

Fetomaternal Outcome of Instrumental Vaginal Delivery at Nepalgunj Medical College Teaching Hospital Kohalpur

“…In our study maximum participants were of age group 20-24 years (41.6%) which is similar to study done by Shimalis et al 4 In their study mean age was 24.94 years and in Hubena Z7 mean age was 24.7 years. Our mean age was 24.93 ± 0.99.…”

“…Fetal indication is fetal distress, after coming head in breech presentation. 4 Being a tertiary care centre of this region, complicated cases are referred to our hospital. Many of these need cesarean section or instrumental delivery.…”

Neonatal mortality and associated factors among newborns in Mogadishu, Somalia: a multicenter hospital-based cross-sectional study

“…Research conducted in Ethiopia indicated that mothers who delivered via C-section had a 66% lower risk of newborn mortality compared to those who underwent SVD, primarily due to prolonged labor and other complications associated with SVD [27]. These findings were substantiated by studies conducted in Western Oromia, Ethiopia [75], Canada [76], and Southern Ethiopia [27].…”

“…This study found that neonates born to mothers who underwent instrumental deliveries were at a higher risk of neonatal mortality in comparison to those born via spontaneous vaginal delivery (SVD). A study in Ethiopia discovered that 45.7% of neonates delivered through instrumental methods experienced complications and had low APGAR scores, which are known risk factors for neonatal mortality [ 75 ]. The use of instruments during delivery, such as forceps or vacuum extraction, was associated with an increased risk of neonatal mortality.…”

Instrumental deliveries and its outcome in tertiary care center

“…A neonate who is assisted by vacuum deliveries had a greater proportion of NICU admissions compared to spontaneous deliveries and the mortality rate was higher in the vacuum. 6 The obstetrician prefer vacuum than forceps due to its apparent increased safety and easy to use. Studies done in Europe and USA indicate showed similar commonest indication for vacuum delivery as our study, which includes prolonged second stage of labour, fetal distress, followed by prolonged second stage and poor maternal effort.…”