Abstract
Context: Instrumental vaginal delivery is one of the lifesaving functions of emergency obstetric care to reduce perinatal and maternal morbidity and mortality. Objective: To determine the instrumental vaginal delivery rate, the trends, and the status of their operators in Jos University Teaching Hospital, Nigeria (JUTH) over a 7‑year period (1997–2003). Study Design: A 7‑year cross‑sectional study of obstetric service data from 1 st January 1997 to 31 st December 2003. Patients and Methods: A register was kept for all cases of instrumental deliveries at JUTH from 1 st January 1997 to 31 st December 2003. This register with the patient case notes and neonatal ward records was used to conduct this study. Results: During the study period, there were a total of 17,888 deliveries and 349 instrumental vaginal deliveries, giving a rate of 1.95%. Out of these, 238 (68.2%) were vacuum extraction and 111 (31.8%) were forceps delivery. There was a 67% decline in the use of these instruments from 84 (3.18%) in 1997 to 34 (1.05%) in 2003. Majority 313 (90%) of the procedures were performed by residents (Registrars 49%, Senior Registrars 41%). Consultants performed 10%, and all were in the first four years of the study. Forceps delivery rate 0.62% and vacuum delivery rate was 1.33%. There was a strong negative correlation with the performance of IVD in JUTH. At the current trend, no forceps delivery ( R = −0.93008) will be performed in JUTH in 2005 while only 4 vacuum deliveries ( R = −0.80015) will be conducted in in the same period. Discussion: There is a low instrumental vaginal delivery rate in JUTH with a strong negative correlation in the performance of these procedures. Most procedures are performed by residents, and vacuum is the preferred procedure. Conclusions: Instrumental vaginal delivery in JUTH is a dying art. Training and re‑training of resident doctors on this lifesaving function is recommended. Keywords: Instrumental vaginal delivery; Jos; Nigeria
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