Maternal and Neonatal Outcomes of Vacuum-Assisted Deliveries: A Hospital-Based Cross-Sectional Observational Study
Keywords:
Vacuum-assisted vaginal delivery, instrumental delivery, maternal outcomes, neonatal outcomes, Apgar score, perinatal complications, prolonged second stage, NICU admission, obstetric interventions, primigravidaAbstract
Background: Vacuum-assisted vaginal delivery (VAVD) is a critical obstetric intervention that offers a safe alternative to cesarean section when appropriately applied. While widely practiced, outcome variability persists based on institutional practices and operator proficiency, necessitating localized data to inform clinical decision-making.
Objectives: To evaluate maternal and neonatal outcomes of vacuum-assisted vaginal deliveries and to identify common clinical indications necessitating its use during the second stage of labor.
Methods: This hospital-based cross-sectional observational study was conducted over 12 months at the Department of Obstetrics and Gynecology, Saveetha Medical College. A total of 196 term singleton pregnancies undergoing VAVD were included. Maternal outcomes (perineal trauma, postpartum hemorrhage, retained placenta) and neonatal outcomes (Apgar scores, NICU admission, perinatal complications) were assessed using standardized clinical criteria. Data were analyzed descriptively.
Results: Most participants were aged below 26 years (70.4%), and 74.4% were primigravidas. The predominant indication for VAVD was prolonged second stage of labor (54.4%), followed by poor maternal efforts (20.2%) and fetal distress (18.3%). Maternal complications were infrequent, with vaginal wall tears in 3.8% and postpartum hemorrhage in 1.4% of cases. Neonatal outcomes were favorable, with only 1.4% of newborns scoring <4 on the Apgar scale at 1 minute and 0.9% at 5 minutes. NICU admission was required in 17.3% of cases. Perinatal complications such as birth asphyxia (4.3%) and neonatal depression (3.8%) were observed at low rates.
Conclusion: Vacuum-assisted vaginal delivery, when performed by trained providers under appropriate clinical indications, is associated with low maternal and neonatal morbidity. These findings support the continued use of VAVD in tertiary care centers as a safe and effective alternative to cesarean section, particularly for primigravidas with prolonged second-stage labor. Strengthening operator training and antenatal education can further enhance outcomes.
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