Prevalence, out come and factors associated with Operative vaginal delivery among women who gave Birth in tercha general hospital, snnpr regional state, Dawro zone, ethiopia. A three year retrospective study

Abstract

Background: Assisted vaginal delivery, with the use of forceps and vacuum extraction, offers the option to accomplish safe delivery for the mother and the clinician. A successful assisted vaginal delivery avoids caesarean section, its attendant uterine scar and its implications for future pregnancy. The present study was designed to determine prevalence and feto maternal outcome by comparing vacuum with forceps. Objectives: To determine prevalence, outcome and factor associated among mothers who gave birth by operative vaginal delivery in Tercha General Hospital during the study period January 1, 2014 to December 31, 2016. Methods: Facility based cross-sectional retrospective study was conducted by reviewing available data or hospital records of mothers who gave birth from January1, 2014 to 31 December 2016. The data was checked for its completeness. Then it was coded, entered, cleaned and analyzed using SPSS version 22.0. Descriptive statistics was run to explore the data and multiple logistic regressions were used to see the association and strength between dependent & independent variables. A p-value of less than 0.05 was considered statistically significant in all tests of association. Results: During the 3 years’ study period, the prevalence of operative vaginal delivery was 6.2 % from the total of 2,647 deliveries, and proportion of vacuum and forceps delivery was 4.2%and 2% respectively. Operative vaginal deliveries were more commonly employed on primi gravida 67.1%compared to multiparas and the most common indication was delayed second stage of labor for vacuum, 70.5% and non-reassuring fetal heart rate in the forceps group 57. 7%. Forceps and vacuum-assisted deliveries were both associated with maternal and newborn complications. Vaginal laceration, 11.6% for mothers, and cephalhematoma, 10.9%for newborns were the commonest complication of operative vaginal delivery. Mothers were from rural are high risk to develop complication than those mothers came from urban with, (AOR,4.4;95%CI: 1.52,12.7 ). Newborn who had birth weight >4000gram 38.5 times more likely to have unfavorable outcome as compared to newborn who had birth weight 2500-3999gram with 95%CI of 4.1,362.3 . Conclusion: Operative vaginal delivery rates in this center are comparable to other centers as are the possible complications. Furthermore, in this study maternal complication has shown to be significantly higher in those who come from rural area and lack of antenatal care. Additionally, birth weight 4000gram and above were associated with unfavorable maternal and neonatal outcome. A trial of labor and careful use of forceps or vacuum extraction are acceptable for most fetuses suspected to be macrosomic because there is no precise method for determining which mothers have macrosomic infants prior to delivery