Maternal and neonatal immediate effects of sequential delivery.

ABSTRACT

OBJECTIVE: To evaluate the immediate maternal and neonatal outcomes associated with sequential instrumental delivery (vacuum plus forceps) compared with the use of one instrument only (forceps or vacuum). STUDY DESIGN: A longitudinal observational study was carried out, including all instrumental deliveries performed in term singleton pregnancies, in vertex presentation, at station level 0 or +1. According to the type of the instruments, the deliveries were divided in three groups the vacuum group, the forceps group and the sequential group. Immediate maternal and neonatal outcomes were evaluated. RESULTS: A total of 275 instrumental deliveries were performed 126 (45.5%) vacuum assisted deliveries, 62 (22.6%) forceps assisted deliveries and 87 (31.6%) sequential deliveries. Regarding maternal morbidity, there was a significant difference between the three groups (p < 0.001), with a higher rate of complications in the sequential group. The type of instrument was the only factor associated with significant maternal morbidity. The rate of immediate neonatal morbidity was 4.4% and there was no significant association with the instrument type or with other identifiable factors. CONCLUSION: Sequential delivery is associated with a higher maternal morbidity and it seems not to increase neonatal morbidity.