Complications of Instrumental Vaginal Deliveries and Associated Factors in Suhul General Hospital, Shire, North-West Tigray, Ethiopia

Abstract

Instrumental vaginal delivery is a key element of essential obstetric care, and scaling up its use in resource poor countries through training and supply of appropriate equipment is likely to contribute significantly to reduce maternal and newborn morbidity and mortality and objective of the study was to assess complications of instrumental vaginal delivery and associated factors. A two years retrospective cross sectional analytical study was conducted from July 2013 to June 2015 in the obstetric department of Shire, Suhul General Hospital, North-West zone, Tigray Ethiopia. Records of 357 mothers managed with operative vaginal delivery were retrieved, 224 (62.7%) were rural residents. Low instrumental vaginal delivery was the most common type of practiced station (208, 58.3%) but mid instrumental delivery is highly associated with complications [AOR 95% CI 12.2 (4.79-31, 4)]. Fetal distress was the most common indication of operative vaginal deliveries, 158 (44.3%) as well as the commonest cause of low 1st minute Apgar score, 97 (54.8%). More than half of mothers were assisted with forceps, 187 (52.4%), and it was the, commonest cause for perineal tear (67.4%) and significantly associated with feto maternal complications [AOR 95% CI 1.73 (1.07-2.80)]. Even though forceps had higher maternal complications, vacuum extraction has higher fetal complications. We conclude that obstructed labor (OL), mid pelvic instrument application, increases in birth weight and forceps application were significantly associated with feto maternal complications.