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A prospective observational study to evaluate the maternal and neonatal outcome of forceps delivery in a tertiary care government hospital

Introduction: The art of forceps delivery is a practice that dates back several centuries. Modern obstetrics practice has witnessed an increase in the caesarean section rates. The goal of forceps delivery is to mimic spontaneous vaginal birth, thereby expediting delivery with a minimum of maternal or neonatal morbidity. Its safe and proper use can reduce the rising cesarean section rates. This study is aimed to see the outcome of its use in a teaching hospital over a 1 year period. Materials and Methods: In this Prospective observational study, 158 cases of forceps delivery were studied for maternal outcome such as injuries, failue of forceps, postpartum hemorrhage, need of blood transfusion and neonatal outcome such as birth weight, Apgar scores, neonatal intensive care unit admissions or any fetal morbidity or mortality. Results: Out of the 158 patients, 76.58% of patients requiring forceps application were primigravida. The most common indication was fetal distress (55.69%) followed by maternal exhaustion. The most common maternal complication was maternal injuries such as vaginal lacerations. (9.49%), 3 cases of failure of forceps delivery (1.89%), vulvovaginal hematoma in 2 cases, 6 cases of complete perineal tears with 6 cases of Postpartum hemorrhage requiring blood transfusion. There was 1 case of uterine rupture which was in a previous lower segment caesarean section case. Out of total of 15 babies (9.49%) who had poor Apgar scores 14 recovered after resuscitation with 1 case of stillbirth where fetal distress was indication of forceps delivery. Conclusion: Forceps is a considerable and safe option for the obstetrician to reduce the caesarean section rates; however, extreme caution, proper expertise and judicial use of this instrument is required to prevent undue risk to mother and fetus.