Abstract
Background: There is a progressive shift away from the use of forceps in favour of the vacuum extractor as the instrument of choice for operative vaginal deliveries. The overall objective of this is to improve safe motherhood by reducing the contribution of second stage of labour complications to maternal mortality and morbidity. Objective: This study was carried out to determine the incidence, indications, outcome and complications of Ventouse delivery in Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: This was a retrospective study carried out at the Aminu Kano Teaching Hospital. The case notes of all parturients who had vacuum deliveries in the hospital within January 2008 to December 2012 were retrieved from the statistics unit of the hospital and analysed using SPSS. Results: 22,680 patients delivered in the hospital over this 5-year period. Ventouse was used on 210 occasions giving an incidence rate of 0.9%. One hundred and eighty (85.7%) had successful vacuum delivery. The failed extractions (14.3%) were delivered by caesarean sections. The mean age of the patients was 29.4 years. The mean parity was 2.2. Ninety (42.9%) were primipara while 120 (57.1%) were multipara. The commonest indication for the vacuum delivery was prolonged second stage of labour in 45.2% of cases. The commonest maternal complication was primary postpartum haemorrhage (9.5%). Foetal complication occurred in about 31% of vacuum deliveries, the commonest (18.1%), being cephalhaematoma. Conclusion: The incidence rate of vacuum delivery is low. Thus, active training in the art of vacuum assisted vaginal delivery is clearly needed during residency.
Highlights
The past 20 years have seen a progressive shift away from the use of forceps in favour of the vacuum extractor as the instrument of choice [1] [2]
The outcome measures were the socio-demographic characteristics of the patients, indication for the vacuum delivery, complications and failed vacuum that resulted in caesarean section
The incidence rate of vacuum deliveries in this review was 0.9%. This is higher than 0.6% in Jos, but significantly lower than vacuum delivery rates of 1.5%, 1.67% and 2.9% reported from Enugu, Maiduguri, Lagos and AGE RANGE 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 TOTAL
Summary
The past 20 years have seen a progressive shift away from the use of forceps in favour of the vacuum extractor as the instrument of choice [1] [2]. The ventouse can be used in the late first stage of labour at 8 cm cervical dilatation and above for foetal distress or cord prolapsed [4] This is a very significant advantage over the forceps in African setting. There is a progressive shift away from the use of forceps in favour of the vacuum extractor as the instrument of choice for operative vaginal deliveries. Objective: This study was carried out to determine the incidence, indications, outcome and complications of Ventouse delivery in Aminu Kano Teaching Hospital, Kano, Nigeria. Active training in the art of vacuum assisted vaginal delivery is clearly needed during residency
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