Instrumental vaginal deliveries: A review

Abstract

In contemporary obstetric practice, safety with caesarean section in developed countries has witnessed its increased application in deliveries and the decreasing use of instrumental deliveries. This trend follows the relative hazards complicating instrumental vaginal deliveries and increasing litigations arising thereof. In developing countries however, caesarean sections are not so readily available to parturients and are relatively unsafe, especially with mothers presenting late in health facilities with complicated (commonly obstructed) labors, not infrequently with fetal death. In these circumstances, instrumental vaginal deliveries serve as suitable options. It is with this background that this review considers the role of instrumental vaginal delivery and gives a critical account of current techniques of operative procedures. Important issues, including case choice, documentation, application and use, avoidance of complications, and the need for medical staff training, are included. To this end, nondestructive instrumental (vacuum and forceps), “corrective” instrumental (symphysiotomy), and destructive instrumental assisted vaginal deliveries are considered and carefully analyzed.

Keywords: Corrective instrumental delivery; destructive instrumental delivery; instrumental delivery; instrumental vaginal delivery; medical personnel training; nondestructive