Maternal and neonatal effects of forceps versus vacuum operative vaginal delivery

Abstract

The purpose of this study was to assess the differences in immediate maternal and neonatal morbidity of vacuum and forceps assisted deliveries.A retrospective analysis of parturients files with singleton vertex presentation who underwent an instrumental delivery during a period of 40 months was performed. The rate of forceps delivery versus vacuum extraction in Wolfson Medical Center is approximately 1:6. In order to obtain a meaningful and capable number of instrumental deliveries for assessment, all vacuum deliveries within a 2 year period were included but the recruitment of forceps delivery was extended to 40 months. Institutional criteria for instrumental delivery were present in all women. The deliveries were performed by a senior physician or by a resident under the supervision of a senior physician. The decision whether to perform vacuum or forceps delivery was made by the senior obstetrician who was present at the time of delivery. For vacuum extraction a 5-cm metal cup was used and a vacuum force of up to 800 mmHg was applied. The time limit of traction was 20 min. For forceps assisted delivery, the Simpson forceps was used and only outlet forceps was performed.A total of 215 vacuum assisted deliveries and 106 forceps assisted deliveries was assessed. The clinical data on women and neonates in the study groups are given in Tables 1 and 2, respectively.Vacuum assisted deliveries were performed more frequently in cases of prolonged second stage and forceps assisted deliveries more frequently in cases of suspected fetal distress. This is probably because of the notion that forceps delivery might be much quicker to accomplish than vacuum assisted delivery. Maternal soft tissues injury rates and immediate neonatal complications were similar in vacuum and forceps assisted deliveries. This finding contrasts with most previous studies that revealed that maternal soft tissue injuries are more common in 0020-7292/$ -see front matter D

A comparative study of feto-maternal outcome in instrumental vaginal delivery at tertiary health level hospital in Uttarakhand state

“…16 Currently there is tendency to rely on vacuum extraction which may be because of recent evidence of decreased maternal trauma with vacuum extraction compared to forceps deliveries in randomized trials and by a substantial improvement in the technique of vacuum extraction, especially in the material used for vacuum cups. 17 In our study we also found the ratio of 1/6 between forceps and vacuum application, which is in accordance with findings derived from Lurie S et al 18 In our study 74% of forceps delivery and 58% of ventouse deliveries were carried out in primigravida, which is in accordance with prior study done by Akhtar S. 19 For vacuum delivery, common indications were to cut short the second stage of labour (42.85%) followed by prolonged second stage of labour (25.7%), poor maternal efforts (14.3%) and fetal distress (12.9%). For forceps delivery main indication was to cut short the second stage of labour (41.2%) followed by fetal distress (32.9%).…”

Forceps Delivery at the Maternity Ward of Donka National Teaching Hospital Conakry (Guinea): Indications and Maternal-Fœtal Prognosis

“…In our series, maternal traumatic complications related to forceps use were dominated by perineal, vaginal and cervical tearings. This finding is found in the Open Journal of Obstetrics and Gynecology literature; however our prevalence of tearins is slightly higher than those reported in other studies [11]- [16]. These complications are generally related to a poor appreciation of dilation, with forceps being applied while cervical dilation is incomplete.…”

Morbidité materno-fœtale liée à l’extraction instrumentale par spatules de Teissier. Étude comparative à la ventouse obstétricale de type Minicup®

“…Dans notre série, un nouveau-né avait un score d'Apgar inférieur sept à cinq minutes de vie après extraction par ventouse mais sans aucune différence entre les deux groupes, ce résultat a été également retrouvé dans la comparaison forceps-ventouse dans la méta-analyse de Johanson et al [23] Le taux de transfert en réanimation néonatale était de 4,3 % dans le groupe ventouse et de 8,7 % dans le groupe spatules mais sans différence significative, ces données sont comparables aux données de la littérature [25,26]. Ces taux de transfert sont le résultat des indications même des extractions instrumentales.…”