Outcomes of Operative Vaginal Delivery and Associated Factors at Aksum Saint Mary Hospital, Tigray, Northern Ethiopia

Abstract

Background: Obstetrical intervention is an option to accomplish safe delivery for a mother, if she is in need of it and technically feasible. Approximately 10-20% of all deliveries require some form of obstetrical interventions. In the current study setting, operative vaginal delivery is a frequently practiced procedure, but little is known about its outcome. Therefore, this study was aimed to assess the outcomes of operative vaginal delivery and its associated factors at Aksum Saint Mary hospital, Tigray, Northern Ethiopia. Methods: A facility-based cross-sectional study was conducted on 326 charts of mothers, selected by a systematic random sampling technique, who gave birth by operative vaginal delivery from September 1, 2013 to August 31, 2018. Data were collected using a pretested checklist and analyzed by using Statistical Package for Social Sciences software Version 20. Logistic regression analysis was conducted to identify factors associated with the maternal outcomes. A statistical significance was declared at p<0.05. Results: About 19% (95% CI: 14.7, 23.0) of the operative vaginal deliveries had unfavorable outcomes. The common type of maternal complication was post-partum hemorrhage (33.9%). Forceps delivery (AOR=2.24; 95% CI:1.14, 4.41), fetal head above the ischial spine when operative vaginal delivery was applied (AOR=3.19; 95% CI: 1.35, 7.53), neonatal birth weight greater than or equal to 4000 grams (AOR=3.34; 95% CI: 1.43, 7.78), and second stage labour greater than or equal to 3 hours duration (AOR=2.55; 95% CI: 1.03, 6.28) were factors associated with the unfavorable outcomes of operative vaginal delivery. Conclusion: Almost one in five of the operative vaginal deliveries assessed in this study had unfavorable outcome. Therefore, health professionals particularly midwives working at maternity unit of the hospital are expected to perform deliberate assessment of operative vaginal delivery needs in advance of care by considering the identified factors.
Keywords: Associated factors; Forceps delivery; Maternal outcome; Operative vaginal delivery; Vacuum delivery