Trends and Outcomes of Instrumental Vaginal Deliveries at Lagos University Teaching Hospital: A 10-year Review

Abstract

Background:   Instrumental vaginal delivery (IVD) is an essential component of basic emergency obstetric care and the instruments are cheap. However, its use is declining for medico-legal reasons and over reliance on caesarean section. Objectives:  To determine prevalence, trend and feto-maternal outcomes of instrumental deliveries performed at Lagos University Teaching Hospital (LUTH). Methodology: A cross-sectional study of 97 cases of IVD conducted at LUTH from 1^st January 2010 to 31^st December 2019. Data was obtained from delivery registers and case files for scrutiny. Data analysis was done with SPSS, version 23.0. Results:   Prevalence of instrumental delivery during study period was 0.71% with no significant change in trend in the last 10 years (p=0.099). Mean age. of parturient was 29.1 ±5.1 years; most were booked (63/97, 64.9%). Delivery was performed by vacuum extraction in 63.9% and forceps in 36.1%. Perineal laceration occurred significantly more with vacuum extraction (10/11, 90.9%), p = 0.043. Neonatal unit admission rate for all IVD was 30/97 (30.9%). Birth asphyxia was significantly higher in babies of women who had forceps delivery compared to vacuum (p <0.05). Conclusion:   The low prevalence of IVD will result in loss of skills especially in tertiary institutions where specialist Obstetricians are being trained.