Clinical Case Database / Category: Patient Management

Operative vaginal delivery

Publication details

Saira Sadiq MBBS BSc MCPS, S O Anifowoshe, MBBS, MRCOG, Fadi Alfhaily, MBChB, MSc, DFFP, MRCOG, MA Khaled, FRCOG, PhD
Foundation Years Journal, volume 5, issue 5, p.20 (123Doc Education, London, June 2011)

Abstract

Operative vaginal deliveries expedite the delivery of a baby who is believed to be at risk of compromise or when the mother is unable to push it out herself. In the UK, operative vaginal delivery rates have remained stable at 10%–15%. These varying rates reflect different clinical practices and different attitudes in each unit. However, operative vaginal delivery remains an integral and crucial part of the obstetrician’s duties. Low operative vaginal delivery rates may reflect high caesarean section rates, including those performed at full dilatation because of a reluctance to perform operative vaginal deliveries. Although operative vaginal delivery can be hazardous and should be undertaken with care, the difficulty of caesarean section at full dilatation should not be underestimated; it can be extremely difficult and is associated with high maternal morbidity. But, there has been an increasing awareness of the potential for morbidity for both the mother and the baby, following operative vaginal deliveries. Therefore, when offering women the option of a safe operative vaginal delivery, we need to improve our approach to clinical care to minimize the risk of mortality and morbidity; hence minimizing the likelihood of litigation, without limiting maternal choice.

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Authors

Saira Sadiq MBBS BSc MCPS

Specialty Trainee in Obstetrics and Gynaecology, Colchester Hospital University
NHS Foundation Trust

S O Anifowoshe, MBBS, MRCOG

Staff Grade/Associate Specialist in Obstetrics and Gynaecology
Colchester Hospital University
NHS Foundation Trust

Fadi Alfhaily, MBChB, MSc, DFFP, MRCOG

Consultant Obstetrician and Gynaecologists,
Colchester Hospital University
NHS Foundation Trust

MA Khaled, FRCOG, PhD

Consultant Obstetrician and Gynaecologist, Director of Education
Colchester Hospital University
NHS Foundation Trust

References

1. Royal College of Obstetricians and Gynaecologists. Operative Vaginal Delivery. Green-Top Guideline 26. London: RCOG Press, 2005.
2. Patterson-Brown S. Ventouse and forceps delivery. In Howell C, Grady K, Cox C, eds. Managing Obstetric emergencies and trauma. London: RCOG Press; 2007.
3. Cohen W.R. Influence of the duration of second stage labor on perinatal outcome and puerperal morbidity. Obstet Gynecol 1977; 49:266–69.
4. Myles T.D., Santolaya J. Maternal and neonatal outcomes in patients with a prolonged second stage of labor. Obstet Gynecol 2003; 102:52–8.
5. Johanson R.B., Menon B.K.V. Vacuum extraction versus forceps delivery for assisted vaginal delivery (Cochrane Review). In: The Cochrane Library - Issue 1, 2001. Oxford: Update Software.
6 Okunwobi-Smith Y., Cooke I., MacKenzie I.Z. Decision to delivery intervals for assisted vaginal vertex delivery. Br J Obstet Gynaecol 2000; 107: 467–71.
7. Kolderup L.B., Laros L.K., Musci T.J. Incidence of persistent birth injury in macrosomic infants: association with mode of delivery. Am J Obstet Gynecol 1997; 177: 37–41.
8. Fortune P.M., Thomas R.M. Sub-aponeurotic haemorrhage: A rare but life-threatening neonatal complication associated with ventouse delivery. Br J Obstet Gynaecol 1999; 106: 868–70.
9. Kudish B., Blackwell S., Mcneeley S.G., et al. Operative vaginal delivery and midline episiotomy: a bad combination for the perineum. Am J Obstet Gynecol 2006; 195:749–54.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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