MATERNAL AND NEONATAL OUTCOMES OF FORCEPS-ASSISTED VAGINAL DELIVERIES: A RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL

Abstract

Background:
Forceps-assisted vaginal delivery remains an essential component of operative obstetrics, particularly in low- and middle-income countries where cesarean access may be limited. This study aimed to evaluate maternal and neonatal outcomes associated with forceps use in a tertiary care setting.

Methods:
A retrospective observational study was conducted at Saveetha Hospital, Chennai, over a 12-month period (November 2023 to October 2024). Medical records of 50 singleton pregnancies delivered using Wrigley’s outlet forceps were reviewed. Maternal outcomes included episiotomy extension, genital tract trauma, postpartum hemorrhage, and length of hospital stay. Neonatal outcomes included Apgar scores, NICU admission, birth injuries, and perinatal mortality. Data were analyzed descriptively.

Results:
The primary indication for forceps delivery was non-reassuring fetal heart rate (54%), followed by maternal exhaustion (18%). Maternal morbidities included episiotomy extension (14%), genital tract injuries (12%), postpartum hemorrhage (6%), and one uterine rupture. Neonatal complications included Apgar score <7 at 1 minute in 24% of cases, NICU admissions in 12%, and minor birth trauma in 10%. There were two stillbirths and one early neonatal death, yielding a perinatal mortality rate of 6%.

Conclusions:
When appropriately indicated and skillfully performed, forceps-assisted vaginal delivery is associated with acceptable maternal and neonatal outcomes and serves as a valuable alternative to cesarean section in the second stage of labor. Continued emphasis on training and clinical protocols is essential to safely preserve this obstetric skill.