Trend in Instrumental Vaginal Deliveries at the National Referral Hospital in Bhutan: A Review of Hospital Records

Tshering, Sangay; Dorji, Namkha; Wangden, Tshering

doi:10.5005/jp-journals-10006-1987

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…Further more than nine out of ten patients that had OVD in our cross-sectional study had vacuum (kiwi cup). Our finding is in keeping with other studies in LMICs that showed that birth attendants are likely to choose vacuum because of ease of use, and lack of expertise and supervision to perform forceps delivery [ 3 , 6 , 7 , 12 , 31 , 40 ]. Although Cochrane studies has shown that if forceps is used appropriately, it is likely to be successful.…”

Section: Discussionsupporting

confidence: 91%

“…The dramatic decline in OVD rates at CHBAH from 2014–2019 may be related to a number of factors. As previously reported, lack of requisite training, skills and supervision to perform OVD, lack of necessary equipment, and fear of litigation are some factors responsible for the declining art of OVD [ 3 , 6 , 7 , 8 , 13 , 30 , 31 ]. In South Africa, the initial guideline for the prevention of Mother to Child transmission of HIV (PMTCT) recommended that OVD, (especially Vacuum delivery) should be avoided among HIV positive women [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Consultant obstetricians tends to perform more forceps deliveries than vacuum delivery while the odds of performing vacuum delivery among registrars was about 7 folds as compared to the consultants. This findings showed lack of supervision and training of registrars in the use of forceps deliveries [ 9 , 12 , 31 ]. It is therefore pertinent to train the registrars in the use of forceps deliveries as majority of OVDs were performed by registrars.…”

Section: Discussionmentioning

confidence: 99%

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Trends and Determinants of Operative Vaginal Delivery at Two Academic Hospitals in Johannesburg, South Africa 2005–2019

Dutywa

Olorunfemi

Mbodi

2022

IJERPH

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Operative Vaginal delivery (OVD) can reduce perinatal and maternal morbidity and mortality especially in low resource setting such as South Africa. We evaluated the trends and determinants of OVD rates using join point regression at Charlotte Maxeke Johannesburg (CMJAH) and Chris Hani Baragwaneth (CHBAH) Academic Hospitals from 1 January 2005–31 December 2019 and conducted a comparative study of OVD (n = 179) and normal delivery (n = 179). Over the 15-year study period (2005–2019), 323,617 deliveries and 4391 OVDs were conducted at CHBAH giving an OVD rate of 1.36 per 100 births. In CMJAH, 74,485 deliveries and 1191 OVDs were conducted over an eleven-year period (2009–2019) with OVD rate of 1.60 per 100 births. OVD rate at CHBAH increased from 2005–2014 at 9.1% per annum and declined by 13.6% from 2014–2019, while OVD rates fluctuates at CMJAH. Of the 179 patients who had OVD, majority (n = 166,92.74%) had vacuum. Women who had OVDs were younger than those who vaginal delivery (p-value < 0.001). The prevalence of OVDs was higher among nulliparous women (p-value < 0.001), HIV negative women (p-value = 0.021), underweight (p-value < 0.001) as compared to normal delivery. The OVD rates has dramatically reduced over the study period This study heightens the need to further evaluate barriers to OVD use in our environment

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Trends and Determinants of Operative Vaginal Delivery at Two Academic Hospitals in Johannesburg, South Africa 2005–2019

Dutywa

Olorunfemi

Mbodi

2022

IJERPH

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“…1 Globally, approximately, 10-20% of the women in labor require obstetric interventions or support, with instrumental delivery accounting for 6-12% of these interventions. 2 The World Health Organization (WHO) and United Nations Population Fund (UNFPA) emphasize the importance of assisted vaginal delivery in providing comprehensive emergency obstetric and newborn care. 3 The incidence of OVD varies across countries, with rates is reported as follows: UK: 10-15%; 4 US: 3%; 5 Oman: 3.8%; 6 India: 2.7-7.7%; 7,8 in Singapore: 10%; 9 and in Ethiopia: 10%.…”

Section: Introductionmentioning

confidence: 99%

Trends in Operative Vaginal Delivery at Dubai Hospital: 5-year Retrospective Study

Tambawala,

Vasanth,

Saquib

et al. 2024

Journal of South Asian Federation of Obstetrics and Gynaecology

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Background: Operative vaginal delivery (OVD) refers to the use of forceps or a vacuum during vaginal delivery, a fundamental component of emergency obstetric and newborn care. But, worldwide, there is a declining trend in the instrumental delivery and increase in cesarean delivery.Objective: This study aims to assess the current trends, risks, and complications associated with OVD at Dubai Hospital, United Arab Emirates (UAE). Study design: Retrospective observational study of all women who delivered by OVD over a 5-year period from 2018 to 2022. We collected data on maternal demographics, maternal, and neonatal outcomes and total deliveries. Results: During the study period, 2.8% of women had successful operative vaginal deliveries. Our incidence remained the same during the study period. We had a total of 273 instrumental deliveries during the study period; out of this, 54.6% were delivered by metal cup, 42% by Kiwi, and 3.3% by forceps. We also noticed the preference of Kiwi over the years as compared with metal vacuum. The most common indication for OVD was fetal distress, accounting for 85.7% of cases. We also noticed a significant increase in OVD for patients on epidural analgesia (14.7% in 2018 vs 43.6% in 2022). Among the patients who underwent instrumental deliveries, 13 cases (4.8% of the total) were identified with 3rd-degree perineal tears. Multiple vaginal lacerations and cervical tears were observed in 25% of the cases. Major perineal tears, the need for suturing in operation theater, and the need for blood transfusion were seen more in women delivered by metal cups as compared with Kiwi and forceps, but not statistically significant. About 13% babies developed neonatal jaundice, and 18.3% babies needed admission to the neonatal intensive care unit (NICU). Shoulder dystocia is more common in babies delivered by metal cups (4.6%). Conclusion: Operative vaginal delivery remains a crucial component of obstetric care, with stable incidence. We observed a shifting preference toward the Kiwi vacuum extractor over metal cups while fetal distress remained the primary indication.

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Join point trends of instrumental vaginal deliveries and cesarean sections at the Lagos University Teaching Hospital, Lagos, Nigeria (2002–2017)

Olamijulo,

Aliyu,

Olorunfemi

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo determine the trends of instrumental vaginal delivery (IVD) and cesarean section (CS) at the Lagos University Teaching Hospital (LUTH), Nigeria, over 16 years, from 2002 to 2017.MethodsA retrospective cross‐sectional study. The case records of all women who had IVD and CS during the study period were reviewed. The trends in the IVD and CS rates were evaluated using join point regression modeling. The average annual percent change (AAPC) and annual percent change (APC) with associated 95% confidence interval of segmental trends were calculated.ResultsThe overall IVD rate was 1.36%. Vacuum delivery rate was higher than forceps (0.79% vs 0.57%). The CS rate was 44.9 per 100 deliveries; the rate increased by about 3.7% per annum. CS rates were 7.1–89.9 times the IVD rates within the study period. The number of IVDs performed in the hospital declined by about 83.02%, from 53 cases in 2002 to nine cases in 2017. Forceps delivery declined at a faster rate than vacuum delivery between 2002 and 2017 (AAPC for forceps: −12.6% [−17.5 to −7.5], P < 0.001 vs AAPC for vacuum: −6.2% [−14.3 to 2.7], P = 0.200). The commonest indication for IVD was prolonged second stage of labor (47/162, 29.01%) and shortening of the second stage of labor for maternal conditions (47/162, 29.01%).ConclusionIVD rates are low and declining at LUTH. There is need to train accoucheurs on the safe use of IVDs to potentially reduce the CS rate.

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Trend in Instrumental Vaginal Deliveries at the National Referral Hospital in Bhutan: A Review of Hospital Records

Cited by 3 publications

References 31 publications

Trends and Determinants of Operative Vaginal Delivery at Two Academic Hospitals in Johannesburg, South Africa 2005–2019

Trends and Determinants of Operative Vaginal Delivery at Two Academic Hospitals in Johannesburg, South Africa 2005–2019

Trends in Operative Vaginal Delivery at Dubai Hospital: 5-year Retrospective Study

Join point trends of instrumental vaginal deliveries and cesarean sections at the Lagos University Teaching Hospital, Lagos, Nigeria (2002–2017)

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