OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES IN REFERRED CASES

CORRESPONDING AUTHOR:
Dr. R. C. Prameela,
# 4544, 16th Main,
Vijaya Nagar 2nd Stage, Mysore-570017.
E-mail: rcprameela@yahoo.com

ABSTRACT: INTRODUCTION: Instrumental vaginal deliveries are important procedures. Performed in indicated cases and attending to the well laid criterias will reduce the fetal and maternal morbidity. These assisted instrumental vaginal deliveries help in reducing the caesarean section rate. AIMS AND OBJECTIVES: To determine the incidence and indications of instrumental vaginal deliveries. To know the maternal and fetal outcome in ventouse (vaccum assisted vaginal delivery) and forceps deliveries. MATERIAL AND METHOD: This was a retrospective study carried between 01/06/2014 to 31/08/2014 at Cheluvamba Hospital, Mysore Medical College and Research Institute. The hospital records of all the referred patients who had ventouse (vaccum assisted vaginal delivery) and forceps deliveries were obtained and data on age, parity, referral and type of procedure performed, APGAR score and complications were entered into a proforma and analyzed. RESULT: During the period under review there were total of 3385 deliveries, LSCS 843 cases(24.9%), Total instrumental vaginal deliveries 110 cases(3.2%). 33 Ventouse (vaccum assisted vaginal delivery) deliveries(0.9%), 57 Low forceps deliveries(1.68%) and 20 Outlet forceps deliveries(0.59%).Most common indication for instrumental deliveries being fetal distress(62 cases), Prolonged second stage of labour and maternal exhaustion (36 cases).Cut short 2^nd stage of labour- previous LSCS(8cases) and Eclampsia(2cases), RHD(1case), Sickle cell anemia with avascular necrosis femur neck(1case).Number of alive babies(103 babies), Perinatal mortality 7cases(0.20%), 8 babies required NICU admission for 3-4 days, 1 baby had subdural hematoma, 2 babies had forceps mark. Complications like vaginal tear (4 cases), episiotomy extension (18 cases). CONCLUSION: Ventouse and forceps remains appropriate tool in the armamentarium of the modern obstetrician. The major factor which determines the safety of the instrument is the operator rather than the instrument. Extreme caution, proper expertise and judicial use of these instruments are required to prevent undue risk of mother and fetus. Encouraging operative vaginal deliveries may help to reduce unwanted and raised caesarean section rates.

KEYWORDS: Assisted vaginal delivery, Forceps, Ventouse.