Vacuum Deliveries in Sagamu: A 10-Year Review

Abstract

Operative vaginal delivery by vacuum extraction plays a very important role in modern day obstetrics and there has been a progressive shift away from the use of forceps in favour of the vacuum extractor as the instrument of choice overtime. The objective of this study was to evaluate the indications and outcome of assisted vaginal deliveries with the aid of vacuum extraction in a Nigerian tertiary health institution. This was a retrospective study involving 376 patients who had vacuum deliveries from January 2004 to December 2013 at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. There were a total of 376 assisted vacuum deliveries out of a total of 7833 deliveries giving an overall vacuum delivery rate of 4.8%. The commonest indication was delayed second stage (81.4%) followed by foetal distress (9.3%). There were 34 perinatal deaths giving a perinatal mortality rate of 9.0%. Perinatal morbidity with foetal injury was 2.9%. Postpartum haemorrhage and perineal laceration each accounted for 2.9% of the maternal outcome while 2.4% of the parturients had cervical laceration. Vacuum deliveries are relevant in modern day obstetric practice despite the associated complications. In carefully selected patients, it is safe and has favourable outcome. It is also a means of reducing caesarean section rate.

Keywords: Instrumental vaginal delivery, Vacuum delivery, Foetal injuries, Foeto-maternal outcome.