A prospective randomized study comparing maternal and fetal effects of forceps delivery and vacuum extraction

Abstract

Objective: To compare maternal and neonatal effects of assisted vaginal delivery by forceps and vacuum extraction.

Methods: A prospective randomized study. One hundred eligible women requiring assisted vaginal delivery in the second stage of labor were randomized to deliver by forceps or vacuum extraction.

Results: All of those allocated to forceps delivery actually delivered with the allocated instrument (100 % delivery rate in forceps vs. 90 % in VE); however, maternal trauma (40 % in forceps vs. 10 % in VE, p < 0.001), use of analgesia (p < 0.001), and blood loss at delivery (234 ml in VE vs. 337 ml in forceps group, p < 0.05) were significantly less in the group allocated to deliver by vacuum extraction. Vacuum extraction, however, appears to predispose to an increase in neonatal jaundice and incidence of cephalhematoma. More serious neonatal morbidity was rare in both groups.

Conclusion: Extrapolation of the data from the study reveals that there is a significant reduction in maternal injuries. However, vacuum extraction has the potential to injure babies more.

Keywords: Comparative morbidity; Obstetric forceps; Outcome; Vacuum extractor.