Forceps deliveries and fetomaternal outcome in modern obstetrics

Background: In modern obstetrics practice has witnessed an increase in the caesarean section rates everywhere. The incidence of instrumental deliveries varies between 10-12% in UK. The incidence of instrumental deliveries varies between 2.7-5% in India. There is an urgent need to reintroduce instrumental need in the modern obstetrics. Instrumental delivery is one of the basic functions of emergency care according to WHO. This study was done to know the prevalence, indications and fetal outcomes of forceps deliveries.Methods: A retrospective study was conducted at a tertiary teaching hospital, India from January 2014 to December 2018. All cephalic singleton pregnant mothers who underwent forceps delivery after 28 weeks were included. All the forceps delivery done in twins and breech vaginal delivery were excluded. Demographic data, Indication of forceps delivery, maternal complications of forceps delivery like episiotomy extension, cervical tear, vaginal wall tear, PPH and neonatal outcome like low birth weight, NICU admissions, stillbirth, APGAR score at 1 and 5 minutes were recorded. Equal number of mothers of reproductive age group 20-45 ages who underwent normal non breech vaginal deliveries were randomly selected as control.Results: The prevalence of forceps delivery was 5.25%. The most common indication was fetal distress (55%). Most of the mothers were primigravidas in age group 20-30 years (p2.5 kgs.  APGAR <7 at 1 and 5 min was not significant.Conclusions: As fetal distress is the most common indication, every obstetrician should learn the skill of forceps delivery and it should not be a dying art

Prevalence of teenage pregnancy and pregnancy outcome at a rural teaching hospital in India

Background: Teenage pregnancy accounts for 11% of births worldwide and 95% of these occur in low middle income countries. Pregnancy and its complications are leading cause of death among these girls. This study was done to know the prevalence and to determine whether teenage mothers are at risk of adverse pregnancy outcome.Methods: A retrospective study was conducted at a tertiary teaching hospital, India between July 2015 to Dec, 2017. All teenage mothers delivered after 28 weeks of gestation were included. Women with Diabetes mellitus, renal disease, thyroid disorders were excluded. Demographic data, maternal complications like anaemia, hypertensive disorders of pregnancy, preterm birth, mode of delivery, low birth weight, NICU admissions, stillbirth and early neonatal death were recorded.Results: In the present study, the prevalence was 7% which is less than that of other studies. Incidence of caesarean-Section in the present study was 31%. Amongst the complications oligohydramnious was found to be significantly associated with teenage pregnancy. NICU admissions were needed for 43% of the cases and 31% were LBW.Conclusions: High NICU admission and high LBW in newborns of teenage mothers were noted in the current study. Hence, there is urgent need to focus on the teenage pregnancy