scholarly journals Maternal Complication Related To Instrumental Delivery At Felege Hiwot Specialized Hospital, Northwest Ethiopia. A Retrospective Cross-Sectional Study

2019 ◽  
Author(s):  
shimeles biru zewudie ◽  
Dagne Addisu sewyew ◽  
Simachew kassa limenh ◽  
Simachew animen bante

Abstract ABSTRACT Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98]. Keywords: maternal complication, instrumental delivery, northwest, Ethiopia

2019 ◽  
Author(s):  
shimeles biru zewudie ◽  
Dagne Addisu sewyew ◽  
Simachew kassa limenh ◽  
Simachew animen bante

Abstract ABSTRACT Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98]. Keywords: maternal complication, instrumental delivery, northwest, Ethiopia


2019 ◽  
Author(s):  
shimeles biru zewudie ◽  
Dagne Addisu sewyew ◽  
Simachew kassa limenh ◽  
Simachew animen bante

Abstract Abstract Objective: the aim of the study was to assess the proportion of maternal complication related to instrumental vaginal delivery and its associated factors among mothers who gave birth in Felege Hiwot comprehensive specialized hospital, northwest Ethiopia. Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of reviewed card had complete documentation. The proportion of maternal complications due instrumental vaginal delivery was found to be 12.1%. A mother who had an episiotomy [AOR=0.14, 95%CI=0.07-0.3], Forceps assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and primiparity [AOR=3.5, 95%CI=1.26-9.98] were found to be associated with maternal complications related to instrumental vaginal delivery. Keywords: maternal complication, instrumental delivery, Felege hiwot, Bahir Dar


Author(s):  
Vijayalakshmi Gnanasekaran ◽  
Shantha Kanamma ◽  
Shanthi Dhinakaran ◽  
Jikki Kalaiselvi

Objective: To determine the instrument preference among obstetricians practicing operative vaginal deliveries and to determine the prevalence and risks of vacuum or forceps Assisted Vaginal Delivery (AVD). Methods: This cross-sectional study was carried out in ACS Medical and Hospital, Chennai. A total of 520 obstetricians were included in the study. An online questionnaire was sent to all obstetricians in Chennai. The choice of procedure for specific circumstances, instrument preference [use of vacuum or forceps] and views on the complications encountered in both vacuum and forceps use at vaginal delivery were explored. For the replies, we computed means and percentages for the entire group and distinct subgroups. Risk assessment of outcome with exposure as suitable p-value was included in the statistical analysis. Results: Response rate for the questionnaire was 97% (504/520). The findings suggest that obstetricians preference was more towards vacuum due to their ease of usage.   Baseline characteristics were similar between the two groups. Failed vacuum due to slipping of the cup was the most common complication faced - 62%, followed by caput succedaneum 25%, both were statistically significant. The most significant finding was that maternal injuries in the vacuum group were only 2% which was way less than those who had forceps delivery (68%) with a p-value of < 0.001. Conclusion: In this research, physician instrument choice is a significant predictor of results that should be taken into account. Use of vacuum for delivery seemed to be the choice of majority of obstetricians [334 (66%)]. Vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity, whereas neonatal injuries were more common in newborns delivered by vacuum. The choice of instrument should be personalized based on the patient's condition and the obstetrician's experience and expertise.


2021 ◽  
pp. 1-3
Author(s):  
Triza Kumar Lakshman ◽  
Ekta Chhabra ◽  
Ravindra S. Pukale

Introduction: Giving birth can be a long and painful process and is not always a perfect one. Instrumental vaginal delivery is an art and provides a 1 temporal advantage over cesarean delivery. It is also an alternative procedure for delivery in emergency obstetrics. Instrumental vaginal delivery is an integral part of Obstetrics care world wide. The present study was carried out to evaluate the maternal and neonatal outcome in operative/assisted vaginal delivery. Method: We performed a retrospective observational study of women with singleton term pregnancies who underwent operative vaginal delivery at Adichunchanagiri Institute of Medical Sciences. The study was conducted between August 2019 to August 2020 for the duration of 1 year and the data was accrued from patient database retrospectively and was entered in Microsoft Excel (Version 16.4) for Windows. Results: During the study period, 95 patients underwent Instrumental Vaginal Delivery, of which 74 were vacuum assisted and 21 were forceps nd delivery. The most common indication for Operative vaginal delivery was failure of maternal efforts followed by prolong 2 stage of labour in vacuum group and severe pre-eclampsia in forceps group. Vacuum was used more often than forceps for most of the deliveries. Maternal st nd complication like 1 and 2 degree perineal tear were seen more often with the use of forceps. Instrument marks and bruising were found in the neonates delivered by forceps and a greater incidence of cephalohaematomas and caput in the neonates delivered with vacuum. Conclusion: A successful instrumental vaginal delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labour and skilled operator. The overall rate of perinatal and maternal morbidity and mortality vary by indication and operative instrument. Women who underwent forceps-assisted delivery had greater rates of maternal complications than those who underwent vacuum-assisted delivery


Author(s):  
Jeyamani B. ◽  
Nashreen Dhasleema A.

Background: Operative vaginal deliveries (OVD) were performed with the help of vacuum or forceps in the second stage of labor when mother and foetus condition is threatening. A successful assisted vaginal delivery avoids caesarean section and its associated morbidity and implications for future pregnancy. The aim of the study was to assess the maternal and neonatal outcome of vacuum and forceps assisted vaginal deliveries.Methods: It was a retrospective comparative cross sectional study done in VMKVMCH, Salem in obstetrics and gynecology department, from the period of April to June 2021. All the mothers delivered by operative vaginal delivery were included. Mothers with multiple pregnancies, preterm and breech presentation were excluded. Data collected using patients information sheet and analysis was done using SPSS 23. P value <0.05 was considered significant.Results: The most common age group was 21-25 years of age in both groups and most commonly used in primigravida. The most common indication for forceps assisted delivery in our study was the prolonged second stage labour and in vacuum delivery was poor maternal effort. In our study, common complication noted was extended episiotomy followed by perineal tear in forceps group and vice versa in vacuum group. Cephalhematoma was found to be more common in vacuum and scalp and instrumental injuries were more common in forceps assisted vaginal deliveries.Conclusions: Operative vaginal deliveries helps in improving both maternal and foetal outcomes and reduces the caesarean delivery rate and vacuum significantly reduces maternal trauma than forceps. No difference noted in neonatal outcome. 


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tariku Gebre Haile ◽  
Eshetu Haileselassie Engeda ◽  
Abdella Amano Abdo

Background. In many studies, compliance with standard precautions among healthcare workers was reported to be inadequate.Objective.The aim of this study was to assess compliance with standard precautions and associated factors among healthcare workers in northwest Ethiopia.Methods.An institution-based cross-sectional study was conducted from March 01 to April 30, 2014. Simple random sampling technique was used to select participants. Data were entered into Epi info 3.5.1 and were exported to SPSS version 20.0 for statistical analysis. Multivariate logistic regression analyses were computed and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors.Results.The proportion of healthcare workers who always comply with standard precautions was found to be 12%. Being a female healthcare worker (AOR [95% CI] 2.18 [1.12–4.23]), higher infection risk perception (AOR [95% CI] 3.46 [1.67–7.18]), training on standard precautions (AOR [95% CI] 2.90 [1.20–7.02]), accessibility of personal protective equipment (AOR [95% CI] 2.87 [1.41–5.86]), and management support (AOR [95% CI] 2.23 [1.11–4.53]) were found to be statistically significant.Conclusion and Recommendation.Compliance with standard precautions among the healthcare workers is very low. Interventions which include training of healthcare workers on standard precautions and consistent management support are recommended.


2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Budi I. Santoso ◽  
Suskhan Djusad ◽  
Surahman Hakim ◽  
Fernandi Moegni ◽  
Alfa P. Meutia ◽  
...  

Background: Perineal tear is the most common complication after vaginal delivery. Pill-rolling test is a widely used clinical evaluation method to determine the degree of perineal tear. However, the evaluation results of anal sphincter complex (ASC) differ between clinical examination and 2D/multislice transperineal ultrasonography (TPUS). This study aims to describe measurement variation between these modalities.Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2015 to May 2016. Subjects were primiparous women after vaginal delivery. Clinical examination using pill-rolling test was performed to determine the degree of perineal laceration. Suture was conducted accordingly. The subjects were subjected to 2D/multislice TPUS 72 hours after delivery to evaluate the integrity of internal and external anal sphincters. Data were collected and analyzed to determine compatibility between these examinations.Results: Among 70 prospective primiparous women, five were excluded due to unavailability to undergo 2D/multislice TPUS 72 hours after delivery. The mean duration to perform 2D/multislice TPUS was 4.5 minutes, and pain was tolerable during the examination. The compatibility values of clinical examination with 2D and multislice TPUS were 0.98 and 0.93, respectively, with Cohen’s kappa of 0.92 (95% CI 0.81–1.00) and 0.79 (95% CI 0.58–0.99), respectively.Conclusion: Clinical examination is compatible with 2D/multislice TPUS for determining the degree of perineal tear after vaginal delivery.


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