Assisted Vaginal Deliveries in Far South of Jordan

Objective: To determine the rate, indications and complications of instrumental deliveries at Prince Hashim Ben Abdullah The Second Hospital (former name Princess Haya Bent Al-Hussein), Aqaba, Jordan. Methods: This retrospective observational study has been carried out over a four-year period between 1st January 2012 and 31st December 2015. The medical records of all patients who underwent instrumental deliveries were reviewed and analyzed. Results: During this four-year period 238 successful instrumental deliveries were performed out of 9,767 deliveries with a rate of 2.56%. The commonest instrument used was vacuum (202/240) and 36 patients were delivered by forceps. The indications were; presumed fetal distress (132), prolonged 2nd stage of labor (85) and maternal exhaustion (21). Maternal complications reported were postpartum hemorrhage (18) and different degrees of genital tract tears (28). Fetal complications registered consisted of 34 cases of which (11) were cases of Erbs palsy, (12) were cases admitted to NICU for observation and one case was diagnosed with cerebral palsy. Conclusion: Our study showed a lower rate of operative vaginal delivery in comparison to the international figures. This may be attributed to the lack of epidural anesthesia which increases the incidence of instrumental deliveries, in addition to the simple experience of the attending residents who fear possible complications of applying these instruments and the potential subsequent litigation. The complications reported in our study were expected in assisted vaginal deliveries (AVD) and mimic those mentioned in the literature.