TITLE:
Forceps Delivery at the Maternity Ward of Donka National Teaching Hospital Conakry (Guinea): Indications and Maternal-Fœtal Prognosis
AUTHORS:
M. H. Diallo, I. S. Baldé, O. Baldé, B. S. Diallo, A. Diallo, I. Sylla, B. Diallo, A. D. Diallo, Y. Hyjazi, N. Keita
KEYWORDS:
Forceps, Delivery, Complications, Conakry
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.4,
April
17,
2019
ABSTRACT: Objectives: The objectives of this work were to describe the
socio-demographic, clinical and prognostic characteristics of forceps
deliveries at the maternity ward of the Donka National Teaching Hospital of
Conakry. Parturients and Method: This was a prospective and descriptive study of all
forceps deliveries performed at the Donka National Hospital maternity ward over
a 6-month period from April 1, 2018 to September 30, 2018. Results: We performed 90 fetal extractions by forceps on 3518
deliveries i.e. a frequency of 2.55%.
The socio-demographic profile of the parturient women was that of a young primiparous
woman with an average age of 21.20 years and a full-term pregnancy with an
average gestational age of 39 weeks of amenorrhoea. Fore position
varieties were the most frequent with, in order of frequency, the fore left
occipito-iliac (61.3%) and the fore right occipito-iliac (22.22%). Posterior
varieties accounted for 15.55% of cases. Clinical pelvimetry showed that 88.89%
of parturients had a practicable pelvis, while 11.11% had a moderately narrow
pelvis. Acute fetal suffering was the most common indication (55.56%), followed
by maternal exhaustion (27.78%) and prolonged expulsion (16.67%). All forceps
were performed by doctors. We noted 8 cases of forceps failure (8.88%) that
required a cesarean section. Maternal complications were dominated by soft
tissue lesions, including 7 cases of perineal tearing (7.77%); 4 cases
of vaginal tearing (4.44%); 3 cases of cervical tearing (3.33%) and 2
cases of hemorrhage of delivery by uterine atony (2.22%). No
cases of maternal death have been recorded. The majority of newborns had a
normal birth weight (88.88%) and more than half of newborns (66.66%) had an
Apgar score below 7 out of 10 at the first minute. By the fifth minute there
was an improvement in Apgar’s score from an average of 5 to 8 out of 10. Five newborns died, or
5.55%. Conclusion: Forceps extractions are less and less practiced in our maternity wards.
Their bad reputation has something to do with it, but this is not always
justified, because complications are rare and minimal if the indications are
well laid out and the operator experienced. It therefore seems important to
reposition this instrument, which still retains its place in obstetrical
practices.