A Comparative Study Of Short Term Maternal And Neonatal Outcome Of Operative Vaginal Delivery And Spontaneous Vaginal Delivery

Background: Off late there have been a gradual decline in instrumental delivery and a rise in cesarean births. This may reflect a perception of the practitioner that caesarean section has less morbidity. However this has not been supported by evidence. Instrumental delivery could potentially reduce not only the risks associated with caesarean delivery but reduce the cost of obstetric care. Aims and Objectives: The present study was aimed at to compare short term maternal and neonatal outcome of operative vaginal delivery and spontaneous vaginal delivery. Material and Method: The present study was conducted on 256 subjects admitted in labour ward of tertiary care teaching institute KNH Shimla. Subjects were divided in two groups. Group-I included subjects who underwent operative vaginal delivery, either forceps or ventouse and Group-II included subjects who underwent spontaneous vaginal delivery. The Maternal outcome measures were extension of episiotomy, 3rd or 4th degree perineal tears, cervical tears, multiple vaginal lacerations and vulval haematomas, post partum hemorrhage. Neonatal outcome measures were APGAR at 1and 5 minute, any injuries, admission to neonatal intensive care unit. Statistical measures: Results were analyzed with Chi square and Student’t test and odd ratios and confidence intervals were calculated using SPSS v16 and open epi softwares. Results: Maternal complications, extension of episiotomy (X2 5.69 P value 0.01 OR 2), multiple vaginal lacerations (X2 5.48 P value 0.01 OR 5.32 ,cervical tears, post partum hemorrhage were significantly more in group-I. APGAR less than 7 at five minute was observed in 2.3% in group-I and 0.79% in group-II. Neonatal injuries, scalp abrasion, facial bruises, cephalhematoma were significantly more in group-I (p < 0.05). Conclusion: Operative vaginal delivery appears to cause more complications in neonates and mothers, but most of these complications were minor in nature. The experienced operator can anticipate many satisfying occasions when the forceps and ventouse may solve some of his/her perplexing problems. Obstetrician must, therefore, make every effort to retain these skills, to modify and improve them in every possible way.