Research on the indications and complications of forceps in 2004 and 2014

Abstract

Object: Assessment of indications and complications of forceps at the National hospital of obstetrics and gynecology (NHOG) in 2004 and 2014. Subjects: 1067 patients was used forceps at NHOG in 2 years (511 patients in 2004, 556 patients in 2014) ensure the selection criteria and no exclusion criteria were taken for study. Method: Descriptive retrospective, comparing 2 phase separated 10 years. Result: In 2004, indications of forceps included: 39.1% was weak straining, 40.1% was fetal distress, 13.3% with Caesarean scar. In 2014, indications of forceps included: 55% was weak straining, 29.0% was fetal distress, 8.3% with Caesarean scar. Among pregnant women was used forceps, the difference was statistically significant between weak straining, fetal distress, and Caesarean scar in 2004 and 2014. In 2004, complications of forceps included: 10.2% was scratching the scalp, eyes and face; 1.0% was hematoma under the scalp, 2 cases witheye damage and 1.0% was nerve VII paralysis. In 2014, complications included: 20.7% was scratching the scalp, eyes and face; 1.1% was hematoma under the scalp and 3 cases with nerve VII paralysis. Among pregnant women was used forceps, the difference was statistically significant between scratching the scalp, eyes and face; hematoma under the scalp; and nerve VII paralysis in 2004 and 2014. In 2004: the rate of complications of forceps was: 5.7% was vaginal tearing, 5.3% was cervical tearing, 2.2% was degree 1 and 2 perineal tearing, 4 cases of bleeding.In 2014: the rate of complications of forceps was: 3.8% was vaginal tearing, 4.9% was cervical tearing, 2.4% was degree 1.2 and 3 perineal tearing, 6 cases of bleeding and 1 case of uterine rupture. Among pregnant women was used forceps, the difference was statistically significant between vaginal tearing, cervical tearing, uterine rupture, and bleeding in 2004 and 2014. In 2004: 3 cases of transmission from 2 units of blood or less and 1 case of transmission more than 2 units of blood. In 2014: 4 cases of transmission from 2 units of blood or less and 4 cases of transmission more than 2 units of blood; 2 cases of hysterectomy and 1 case of uterine artery, hypogastric artery ligation surgery.Among pregnant women was used forceps, the difference was statistically significant between management methods of complications with blood transfusion in 2004 and 2014. Conclusion: weak straining ( 40.1% in 2004; 61.3% in 2014) and fetal distress (46.8% in 2004; 29.0% in 2014) were the mainly indications of forceps. Maternal and neonatal complications were low, not heavy. In 2014, 1 case of uterine rupture.