Abstract
Background :-Instrumental deliveries are conducted to assist or expediate the delivery of the baby in second stage of labour. Ventouse deliveries are on rise due to its preferance over obstetric forceps.Relative safety and requirement of less technical skill ,could be the two main reasons for its preferance over forceps. Results :-The incidence of ventouse deliveries was 0.73%.Common indications of ventouse application were maternal exhaustion,previous caesarean section, fetal distress and eclampsia. Six percent cases had ventouse related complications.One case had third degree perineal tear and one baby had cephal hematoma and intracranial hemorrhage.Failure of ventouse, requiring caesarean section was observed in 4% of cases. Apgar score of babies delivered by ventouse, performed for prolonged second stage was lower, than when it was performed for prophylactic indication.Overall neonatal outcome was satisfactory. Duration of hospital stay was not affected by ventouse delivery. Conclusion :-Careful selection of cases and adequate training of postgraduate students during residency under direct supervision of senior experienced obstetrician can reduce the rate of failed ventouse and related complications.Ventouse remains a good alternative to obstetric forceps in situation like proloned second stage and those situations which demand shortening of second stage of labour like maternal hypertensive diseases and rheumatic heart diseases.
Highlights
Instrumental or assisted vaginal birth is commonly used to expedite birth, for the benefit of either mother, baby or both.[1]
Episiotomy may be reduced, but additional pulls and stronger traction force may be required to deliver a baby through an intact perineum, if the mother is having her first baby 7
Subgaleal haematoma, which is quoted as occurring in 14% of babies born with vacuum extraction 7, is the most important life-threatening complication of this mode of delivery 10
Summary
Instrumental or assisted vaginal birth is commonly used to expedite birth, for the benefit of either mother , baby or both.[1]. There are widespread procedural variations in assisted vaginal birth that depend on many factors. IJBR 3[05] [2012]253‐258 indications for an assisted birth take into account maternal and fetal wellbeing. Maternal indications include exhaustion following prolonged labour, failure to progress in the second stage of labour, and medical conditions such as pre-eclampsia, placental abruption, or acquired or congenital heart disease. Fetal indications are fetal distress in the second stage of labour due either to the maternal condition or occurring independently of it. Other factors which must be taken into account are the station and position of the presenting part, moulding of the fetal head, comfort, morale and co-operation of the mother, as well as experience of the operator and the availability of Research Article the necessary equipments 1. Last few decades have witnessed rise in the number of ventouse deliveries among instrumental deliveries.[3,4,5] Present study was aimed at critically analyzing the ventouse deliveries in regards to its incidence, indications and maternal and neonatal outcome at tertiary care teaching hospital
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