Abstract

This was a comparative study of vacuum and forceps on the usefulness and injuries caused by their application and the choice of instrument for assisted vaginal delivery, conducted in Kannur Medical College Hospital between the years 2008 and 2014. Sample size of vacuum is 767 and that for forceps is 131 out of a total of 906 instrumental deliveries conducted from 23rd October 2008 to 30th April 2014. Inclusion criteria were term fetus and vertex presentation. Exclusion criteria were cases with obstetrical and medical complications. Fetal injuries like cephalhematoma, subgaleal hematoma and intracranial hemorrhage are more with vacuum applications. Genital tract injuries like 3° perineal tear and 4° perineal tear are more with forceps, but sequelae are same till six months follow-up. Delivery time is less with forceps. Application-to-delivery time, application failure rate and hospital stay are less with forceps. Forceps is superior to vacuum in the following aspects 1) Simple and easy to handle and maintenance free. 2) Delivery time is less, statistical significance of <0.001. 3) Delivery is more effective; failure of application is less with a statistical significance <0.0001. 4) Fetal injuries are far less with forceps, statistical significance <0.0001. 5) Though genital tract injuries are slightly increased with forceps, follow-up shows no increased residual morbidity like sexual dysfunction or anal incontinence. 6) Training for forceps application should be promoted.

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