Shahida Akhtar.
Comparison of maternal and infant outcome between vacuum extraction and forceps deliveries.
Pak Armed Forces Med J Jan ;56(1):12-5.

Objective: To analyze the instrumental deliveries carried out at the Gynae Department during the year 1996 and compare the outcome of ventouse and forceps deliveries. Patients and Methods: Retrospective case notes review of all instrumental deliveries; carried out during the year 1996. Results: Three hundred and four instrumental deliveries; of which 258 were ventouse and 46 were forceps deliveries; were assisted. Seventy percent of forceps deliveries were carried out in primigravida as compared to 49% of ventouse deliveries. Fetal distress was the indications in 81.4% of ventouse deliveries as compared to 76% forceps deliveries (p<0.05). Prolonged 2nd stages of labor were indications in 6(13%) of forceps and 16(6.2%) of ventouse deliveries. Consultants and senior Gynecologists were more likely to use forceps while registrars use ventouse as their preferred instrument for delivery. Attempted ventouse delivery was successful in 91.4% as compared to 95.7% in forceps (p<0.05). Extension of an episiotomy was more likely to occur with ventouse than forceps deliveries while 3rd degree perineal tears occurred more with forceps deliveries. Babies who had attempted ventouse deliveries have lower apgar score at one minute than attempted forceps. No babies required admission to neonatal intensive care unit. There was only one stillbirth in the ventouse delivery group due to intrapartum asphyxia and true knot in the umbilical cord. Conclusion: Forceps is more likely to be used in the primigravids and prolonged 2nd stage of labor and less likely to fail. Ventouse is more likely to be used by registrars. Extension of an episiotomy and low apgar score at one minute is more likely to occur with ventouse deliveries.

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