Authors: Bhati Balgopal Singh


Abstract

To study the clinical Evaluation of obstetrics forceps in patients with prolonged 2nd stage of labour and evaluate its associated neonatal and maternal outcomes. It was an observational cohort study over a period of one year from July 2013 to June 2014, conducted at JLN Medical college/Hospital, Ajmer. During this study period, a total of 19082 women were delivered, of which 512 underwent forceps assisted vaginal delivery. The data were collected on the structured pro-forma with variables like parity, booking status, number of maternal death after 2nd stage intervention, major obstetric hemorrhage, number of lateral vaginal wall tear, cervical tear, complete perineal tear, number of stillborn, early neonatal death, incidence of neonatal intensive care unit and sick newborn care unit admission, APGAR score at 1min. and 5min., rate of neonatal asphyxia, number of fetal scalp hematoma and facial injury. The frequency of second stage intervention (forceps) was 2.70%. The total number of Instrumental (forceps) vaginal deliveries conducted for prolonged second stage of labour was 220(1.15%). Most of the women were booked i.e., 168 (76.36%). 116(52.72%) of cases were between 18-20 years of age. 154(70%) were Primi-gravid. Maternal morbidity with instrumental (forceps) vaginal deliveries included vaginal tear in 12(5.45%) cases, cervical tear in 3(1.36%) cases, third degree perineal tear in 3(1.36%)cases and Post-Partum Hemorrhage (PPH) occurred in 16 (7.27%) cases. Out of 46 cases (20.91%) that reported for long-term follow up, only 2 had rectal incontinence. Perinatal complications of newborn included, 14 stillbirths (6.36%), 16(7.27%) early neonatal deaths, 18(8.73%) asphyxiated and 26(12.62%) grossly asphyxiated. 42(20.39%) babies required immediate sick newborn care unit admission after delivery. Minor injuries like scalp abrasion were recorded in only 6 cases.

Keywords

Instrumental vaginal delivery, Obstetric forceps, Neonatal Intensive Care Unit, Perineal tears, Sick Newborn Care Unit.

 

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 A Clinical Evaluation of Forceps Delivery and its Associated Complications in Prolonged Second Stage of Labour