A 10‑year review of instrumental vaginal delivery at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Background: Instrumental vaginal deliveries are conducted for either maternal or fetal indications to shorten the second stage of labour. Global trends show a diminished instrumental delivery rates.
Objectives: To determine the prevalence, indications, complications, and the trend of instrumental vaginal deliveries at the University of Port Harcourt Teaching Hospital.
Materials and Methods: This was a retrospective study of 164 women who had an instrumental vaginal delivery over a 10‑year period at the University of Port Harcourt Teaching Hospital from January 1, 2008, to December 31, 2017. Data obtained from the labour ward registers and case notes of patients were entered into a proforma and analyzed using EPI‑info ver. 7. P value of 0.05 was set as significant at 95% confidence interval.
Results: The incidence of instrumental vaginal delivery was 0.67% of all deliveries. Vacuum delivery accounted for 0.63% whereas forceps delivery was 0.04%. Delayed second stage of labour (56; 34.15%) and severe pre‑eclampsia/eclampsia (42; 25.61%) were the most common indications. Senior resident trainees conducted majority (121; 73.78%) of the deliveries. The most common maternal complications were perineal tears (13; 50%) and primary postpartum haemorrhage (11; 42.31%). These maternal complications significantly occurred more with vacuum delivery (P value = 0.001). About half of the babies (80; 47.62) had birth asphyxia.
Conclusion: The instrumental vaginal delivery rate in this study is very low despite being an alternative to caesarean section. Therefore, efforts should be made toward training and retraining of doctors on this skill to reduce maternal and fetal morbidity associated with the procedure, and also reduce the caesarean section rate.
Keywords: Forceps delivery; instrumental vaginal delivery; Port Harcourt; trend; vacuum delivery