Maternal and Child Health After Assisted Vaginal Delivery: Five-Year Follow Up of a Randomised Controlled Study Comparing Forceps and Ventouse

Abstract

This 5-year follow-up study contrasted the effects on maternal and child health of two forms of assisted delivery: forceps and vacuum extraction. Of 313 women randomized into the study, 306 were sent follow-up questionnaires and 228 of them (nearly 75 percent) responded. The group included 115 women having forceps-assisted deliveries and 113 undergoing vacuum extraction. Either a third-degree perineal tear or an extended upper vaginal tear occurred in 5 percent of the ventouse group and 10 percent of the forceps group. Just over 40 percent of women in each group had had another child when followed up 5 years after the index delivery. Urinary incontinence was described by 47 percent of all women, and bowel urgency by 44 percent. One in five women reported losing bowel control sometimes or frequently. None of these symptoms correlated significantly with one or the other form of assisted delivery. Visual problems were reported for 12 to 13 percent of children in each group; all but one of 18 of these children had a family history of vision problems. Development did not differ significantly in the two groups of children; the overall incidence of developmental problems was low. This study, the first long-term follow-up of mothers and their children after assisted delivery, revealed no substantial differences in morbidity between the vacuum extraction and forceps techniques. Br J Obstet Gynaecol 1999;106:544–549