Title: Comparision of Maternal and Neonatal Outcomes in Outlet Forceps and Vacuum Extraction Deliveries
Authors: Dr Chaitra Ramachandra, Dr Roopa, Dr Rekha, Dr Shankaregowda, Dr Nirupama.Y.S
DOI: http://dx.doi.org/10.18535/jmscr/v4i5.15
Abstract
Aims: To compare the maternal and neonatal out come between forceps and vacuum extractions deliveries.
Methods and materials: A total of 100 patients were retrospectively analysed to compare the outcome between forceps (N=50) and vacuum application(N=50) between January 2015 to December 2015 in a tertiary care hospital. The indications for instrumental delivery were fetal distress, failure of descent of head, to cut short second stage of labor, poor maternal efforts. Maternal outcomes were analysed in terms of genital tract injuries (vaginal tears, cervical tears) perineal hematoma, paraurethral tears, postpartum hemorrhage. Neonatal outcomes were analysed in terms of APGAR scores), neonatal trauma (bruise marks, clavicular fractures), Cephalhematoma, Respiratory Distress Syndrome, NICU admissions. and neonatal mortality. The 2 groups were compared using paired T test with p<0.05 is statistically significant. The data were analysed using SPSS soft ware version 16.
Results: The most common age group in both the groups were between 21-29 years. Primigravida women with gestational age between 37-40 weeks more commonly required instrumental delivery in both the groups. Fetal Distress was the most common indication(42%) for vaccum application and poor maternal efforts (36%) is the most common indication for forceps. The maternal morbidity was higher in forceps compared to vacuum (58% Vs .40%). Amongst maternal morbidities seen, genital tract injuries (perineal laceration, episiotomy extension and cervical tears) were most common both arms but more in forceps arm which is statistically significant. Amongst the fetal morbidity noted, Neonatal Trauma (Bruises, abrasion, clavicular fracture) was more common in forceps application comparative to vacuum (16% Vs 2%). Cephalhematoma was noted only with vacuum applications (12% Vs 0 %). NICU admission was significantly more in forceps application compare to vacuum (32 % Vs 24%).
Conclusion: Vaccum application has a better maternal and neonatal outcome compared to forceps delivery, except cephalhematoma in the neonate which is increasing seen with vaccum application.
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