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Chapter 40 - Failed Operative Vaginal Delivery

Minimising Maternal and Fetal Morbidity

from Section 8 - Management of Anticipated and Non-anticipated Emergencies in Pregnancy

Published online by Cambridge University Press:  06 May 2021

By
Naheed Tahir  and
Edwin Chandraharan
Edited by
Edwin Chandraharan  and
Sir Sabaratnam Arulkumaran
Edwin Chandraharan
Affiliation:
St George's University of London
Sir Sabaratnam Arulkumaran
Affiliation:
St George's University of London
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Summary

Operative vaginal birth rate has been stable in the United Kingdom at about 10%–13% [3, 4]. The caesarean section at full dilation as an alternative approach to instrument delivery has a high maternal and neonatal morbidity, but failed instrument vaginal deliveries (FID), which lead to caesarean sections, are associated with potentially serious maternal and fetal complications such as angular tears, postpartum haemorrhage, difficulty in delivery of the fetal head, fetal ischaemic-hypoxic injuries, birth trauma and perinatal deaths. Therefore, it is important to identify factors which can help to predict successful operative vaginal delivery.

There are various established risk factors which increase the chances of instrument delivery, including advanced maternal age, high body mass index (BMI; >30), high birth weight (>4.0 kg) and epidural analgesia.

Type
Chapter
Information
Obstetric and Intrapartum Emergencies
A Practical Guide to Management
 , pp. 292 - 296
Publisher: Cambridge University Press
Print publication year: 2021

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References

Schiff, E, Friedman, SA, Zolti, M, et al. A matched controlled study of Kielland’s forceps for transverse arrest of the fetal vertex. J Obstet Gynaecol. 2001;21(6):576–9.Google ScholarPubMed
Majoko, F, Gardener, G. Trial of instrumental delivery in theatre versus immediate caesarean section for anticipated difficult assisted births. Cochrane Database Syst Rev. 2012;10:CD005545.Google Scholar
Royal College of Obstetricians and Gynaecologists Clinical Effectiveness Support Unit. National Sentinel Caesarean Section Audit Report. London: RCOG Press; 2001 www.rcog.org.uk/files/rcog-corp/uploadedfiles/nscs_audit.pdf. 2. Information and Statistics.Google Scholar
Division, Scottish Health Statistics. Births in Scotland report 2002. Births and babies (Births 1976–2008). www.isdscotland.org/isd/1612.htmlGoogle Scholar
Melamed, N, Segev, M, Hadar, E, Peled, Y, Wiznitzer, A, Yogev, Y. Outcome of trial of labor after cesarean section in women with past failed operative vaginal delivery. Am J Obstet Gynecol. 2013;209(1):49.e1–7.CrossRefGoogle ScholarPubMed
O’Mahony, F, Hofmeyr, GJ, Menon, V. Choice of instruments for assisted vaginal delivery. Cochrane Database Syst Rev. 2010;(11):CD005455.CrossRefGoogle ScholarPubMed
Royal Australian and New Zealand College of Obstetricians and Gynaecologists. College Statement C-Obs 16: Instrumental vaginal delivery. Melbourne, Australia: RANZCOG; 2009. www.ranzcog.edu.au/publications/statements/C-obs16.pdfGoogle Scholar
Royal Australian and New Zealand College of Obstetricians and Gynaecologists. College Statement C-Obs 13: Guidelines for use of rotational forceps. Melbourne, Australia: RANZCOG; 2009, www.ranzcog.edu.au/publications/statements/CGoogle Scholar
Murphy, DJ, Liebling, RE, Patel, R, Verity, L, Swingler, R. Cohort study of operative delivery in the second stage of labour and standard of obstetric care. BJOG. 2003;110(6):610–15.CrossRefGoogle ScholarPubMed
Murphy, DJ, Liebling, RE, Verity, L, Swingler, R, Patel, R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet. 2001;358(9289):1203–7.Google Scholar
McDonnell, S, Chandraharan, E. Determinants and outcomes of emergency caesarean section following failed instrumental delivery: 5-Year observational review at a tertiary referral centre in London. J Pregnancy. 2015;2015:627810.CrossRefGoogle Scholar
Tahir, N, Chandraharan, E. Emergency caesarean sections following a failed instrumental delivery: maternal and perinatal outcomes. In Book of Abstracts. European Congress on Intrapartum Care. Stockholm, 2017.Google Scholar
Ramphul, M, Ooi, PV, Burke, G, Kennelly, MM, Said, SA, Montgomery, AA, Murphy, DJ. Instrumental delivery and ultrasound: a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery. BJOG. 2014;121(8):1029–38.CrossRefGoogle Scholar

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