Instrumental Vaginal Delivery in Abuja Northcentral Nigeria

Instrumental Vaginal Delivery

Abstract

ABSTRACT

Background: Instrumental vaginal delivery (IVD) is an important intervention in obstetrics practice. Its main goal is to expedite vaginal delivery with minimal feto-maternal morbidity while obviating the need for caesarean section (CS). There has been a steady decline in the art of IVD worldwide for a number of reasons including over reliance on CS and lack of training of practitioners in the art. Regular audit of this important intrapartum intervention in health institutions is key to improving its practice and outcome.

Aim: The aim of the study was to evaluate the practice and outcome of IVD in a secondary healthcare facility in Abuja.

Materials and Method: This was a retrospective analysis of cases of IVD conducted in Maitama District Hospital Abuja, over a 5-year period, between January 1^st 2018 to December 31^st 2022.

Results: The IVD rate in this study was 0.65%. Vacuum delivery was the commonest type of IVD accounting for 96.2 % of cases. Majority, 34(65.4%), were primigravidae. Delayed second stage of labour (76.9%) and fetal distress in the second stage (11.3%) were the commonest indications for IVD. Maternal and perinatal complications were rare and overall feto-maternal outcome was good.

Conclusion:  IVD rate is low in our facility with a preponderance of vacuum delivery. Periodic training, with facilitative supervision by Obstetricians experienced in the art, is key to ensuring sustenance of the practice of IVD and is therefore recommended.

Key words: Instrumental vaginal delivery, vacuum delivery, forceps delivery, fetal outcome, maternal complications, Abuja.