Vacuum deliveries at the University of Nigeria Teaching Hospital, Enugu

Abstract

Context: A timely instrumental vaginal delivery can help to avert a caesarean section. A recent study at the University of Nigeria Teaching Hospital (UNTH) Enugu, found that women with dystocia in the second stage who had caesarean delivery because of the absence of functional vacuum aspirators or inexperience on the part of birth attendants constituted 35% of avoidable caesarean sections. Objective: To determine the rate, indications and outcome of vacuum deliveries at the University of Nigeria Teaching Hospital Enugu over a five year period (1999-2003). Methods: A retrospective review of the case notes of all parturients who had vacuum deliveries in the hospital within the study period (January 1999 to December 2003). Results: There were 87 vacuum deliveries out of 5742 total births giving a vacuum delivery rate of 1.5%. The commonest indication for vacuum extraction was poor maternal effort in the second stage of labour (32.2%). Postpartum haemorrhage was the commonest maternal complication and chignon, the commonest fetal complication. The overall perinatal mortality rate was 6.9% while the corrected perinatal mortality rate (excluding stillbirths) was 2.3%. Conclusion: The current rate of vacuum delivery at the UNTH is low. The indications are similar to what had been recorded previously. The outcome of the procedure for both mother and baby was good. In order to increase its use and, perhaps, contribute in reducing the currently high caesarean section rate in the hospital, the vacuum equipment should always be in a functional state and the skills taught to younger residents early in their training. Keywords: vacuum delivery, Enugu, Nigeria Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 23-26