A prospective study of immediate maternal and neonatal effects of forceps and vacuum assisted deliveries

Introduction: The unaided human birth process is not perfect. All round the world 10% to20% of all pregnant women receive assistance with their delivery. Aim: This present study was to analyze and study the contribution use of operative forceps with vacuum extractor. Materials and methods: The present prospective study was undertaken in the department of OBG for a period of 2 years. Cases were chosen at random 50 cases of vacuum extraction and 50 cases of forceps delivery were taken and the maternal and fetal outcomes were studied. Results: In the present study, it was observed that 66% of forceps deliveries were primipara and 34% were multipara. In the present study it was observed that occipito anterior position was most common (64%) position observed in forceps. Occurrence of OA position in forceps deliveries was significantly higher p<0.001 when compared to vacuum deliveries. it was observed that 100% of patients in forceps group delivered with 10 cm of cervical dilatation. Majority of forceps deliveries 96% occurred when head was at station +3, 4% forceps deliveries occurred when head was at +2 station. Application of vaccum was significantly more with no caput 58% compared to forceps 32 %. Fetal distress was the indication for 40% in forceps and 38% in vacuum. In the present study it was observed that the number of pulls required to extract the baby was significantly high in vacuum group p<0.001. 46% of forceps delivered babies had a birth weight of 2.6-3.0 kg, 36% of vacuum deliveries had a birth weight between 3.1-3.5 kg. The mean APGAR score at birth for forceps deliveries was 6.54 + 1.47 and vacuum deliveries was 6. 74 + 1.33. There was no significant difference in mean APGAR score at birth in either of the groups p=0.47. The mean APGAR score at 5 min for forceps deliveries was 8.06+1.33 and vacuum deliveries was 8.16+1.34. There was no significant difference in mean APGAR score at 5 min in either of the groups p= 0.71. In the present study there was not much of a variation in terms of maternal or perinatal out come with both the groups. While scalp lacerations, face marks were more common in the forceps groups, vacuum extraction had a slightly higher incidence of cervical laceration and cephalhematoma, though not statistically significant. The incidence of perineal injuries was comparatively higher in the forceps group though significant difference did not exist in terms of maternal outcome. Conclusions: The advantage of vacuum was its ease of application and hence an apparently safe alternative in the hands of poorly trained personnel.