Instrumental Vaginal Delivery in a District Hospital in North Central Nigeria; A 10-year review

Background: Instrumental vaginal delivery (IVD) is a long-standing obstetric practice used to expedite vaginal delivery and avoid cesarean section, along with its associated fetal and maternal morbidity and mortality. Recent trends have shown that IVD, especially the use of forceps, has declined, as the rate of caesarean deliveries continues to increase. Methods: This was a retrospective descriptive study to determine the rate of instrumental vaginal deliveries, the common indications, and to compare fetomaternal outcomes between forceps and vacuum deliveries in a District Hospital in North Central Nigeria. The labour ward registers were used to compile a list of parturients who had instrumental vaginal deliveries between 2013 and 2019, and in 2021-2023 in the facility. Sociodemographic data, indications for IVD, and fetomaternal outcomes were retrieved from the electronic medical database. Data analysis was conducted using SPSS version 25. Results: During the study period, there were 15,338 deliveries, with 190 (1.23%) being instrumental vaginal deliveries. Among these, forceps and vacuum deliveries accounted for 20 (10.5%) and 170 (89.5%), respectively. The most common indication was prolonged second stage of labour (27.8%). Babies delivered by vacuum were more likely to have birth asphyxia (P 0.03) and be admitted to the neonatal intensive care unit (P 0.04). There was no significant association between the type of instruments and maternal complications. Conclusion: The rate of instrumental vaginal deliveries in our institution is low, with a shift from forceps to vacuum-assisted deliveries. Babies delivered by vacuum were more likely to have birth asphyxia and be admitted to the neonatal intensive care unit, and there is no significant difference in maternal outcomes.