Instrumental Deliveries And Outcome In A British General Hospital

SUMMARY

Objectives: To assess the trends in instrumental delivery in the centre of study, relating them to maternal and neonatal outcome and comparing them with the existing literature, both from Nigeria and abroad. .

Methods: The notes of all the women who had instrumental deliveries in the Central Middlesex Hospital between January and March 1996 were reviewed.

Results: Four hundred and twenty women were delivered during the period of study and 46 of them (11 %) had instrumental deliveries. 69.5% were vacuum deliveries while 30.5% were forceps deliveries. Thirty-five women (76%) were nulliparous and all but 4 of the women were fully dilated before delivery. The commonest indication for delivery was fetal distress/poor cardiotocograph readings - 32 women (69%), followed by prolonged second stage - 15 women (33%). Thirty-nine of the women (85%) had episiotomies, 2 of which became extended. 1 woman (2%) and 6 women (13%) had first and second degree perineal tears respectively. There were no third degree tears. Only eight out of the 46 babies (17%) had Apgar score at 1 minute less than 7, and none of them had Apgar at 5 minutes less than 8. Five babies (11%) were admitted to the Special Care Baby Unit but only 2 (4%) stayed for more than 24 hours.

Conclusion: Instrumental delivery appears to be a relatively safe procedure in the Central Middlesex Hospital. There was no significant neonatal or maternal morbidity, and no mortality in any of the cases.