Comparison of outcomes between operative vaginal deliveries and spontaneous vaginal deliveries in southeast Nigeria

Abstract Objective To evaluate the incidence of, indications for, and outcome of operative vaginal deliveries compared with spontaneous vaginal deliveries in southeast Nigeria. Methods A retrospective cohort study was conducted involving cases of operative vaginal delivery performed at Ebonyi State University Teaching Hospital over a 10-year period. Data on the procedures were abstracted from the operation notes of the medical records of parturients. Results An incidence of 4.7% (n = 461) was recorded. The most common indications for vacuum and forceps delivery were prolonged second stage of labor (44.9%) and poor maternal effort (27.8%). The only indication for destructive operation was intrauterine fetal death (3.7%). The risk ratio (RR) for hemorrhage/vulvar hematoma was 1.14 (95% confidence interval [CI], 0.53–2.48) for vacuum-assisted delivery and 5.49 (95% CI, 0.82–36.64) for forceps delivery. The RR for genital laceration was 1.21 (95% CI, 0.44–3.30) for vacuum-assisted delivery and 9.41 (95% CI, 1.33–66.65) for forceps delivery. The risk of fetal scalp bruises and caput succedaneum was higher for operative vaginal delivery than for spontaneous vaginal delivery, with no significant difference in maternal morbidity. The perinatal mortality rate was 0.9 per 1000 live births. Conclusion Operative vaginal delivery by experienced healthcare providers is associated with good obstetric outcomes with minimal risk.