Huma Naz, Muntiha Sarosh, Shabana Parveen, Azra Sultana.
Fetomaternal morbidity associated with vacuum versus forceps delivery.
Pak J Surg Jan ;28(2):126-9.

Objective: To evaluate the Foetal and maternal morbidity associated with the use of vacuum extraction and outlet forceps. Design: A comparative study, using non probability convenience sampling technique. Place and duration of study: Two year from July 2010 to june 2012, at the Department of Obstetrics & Gynaecology unit, Fatima Hospital, Baqai Medical University, Karachi Methodology: Th e study was conducted on the patients admitt ed in labour ward.One hundred consecutive patients were randomly selected either to forceps or vacuum delivery,keeping in view the indications and inclusion criteria. Th ey were divided in two groups according to parity.Group I contained 50 primigravida on which forceps were applied on 25 patients and vacuum on 25 patients. Group II contained 50 multigravida on which forceps were applied on 25 patients and vacuum on 25 patients.Information regarding gestational age, parity, booking status and any antenatal complications were noted. Th e instruments used were either the silicone rubber cup of Vaccum Extractor or the Wrigley’s obstetric forceps.Maternal outcome variables were perineal tears, haematoma, cervical tear,rectovaginal fi stula and vesicovaginal fi stula. For foetal outcome, agar score within one and fi ve minutes, cephal haematoma and jaundice were noted. Results: A total of 100 patients segregated into two groups, were analyzed for comparison of maternal and neonatal morbidity associated with two instrumental modes of the deliveries. Th e maternal morbidity associated with forceps was found to be increased i.e. perineal tear (14%) and cervical tear (6%) as compared with vacuum (10%) and (5% ) respectively. Complications of haematoma, dyspareunia and VVF were not found in either group. Neonatal morbidity complication rate in vacuum extraction group was 13% as compared to forceps group 9% (P < 0.25). Although the neonatal morbidity was on higher side in vacuum extraction group however it was not statistically signifi cant. Conclusion: Forceps delivery is associated with increased maternal birth canal trauma and blood loss. Vaccum delivery leads to increased neonatal morbidity. Either instrument can be used if a selection criterion is on standard obstetrical indication.

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