Though this is certainly more convenient for the doctor and the hospital, once you do one intervention, the woman now needs continuous fetal monitoring, she'll have to be hooked to an IV for extra fluids, she'll probably want an epidural -- and earlier rather than later -- and the risk of Caesarean or instrument delivery is greater.
Both groups were compared with respect to the incidence of cesarean delivery or instrument delivery and the incidence of transfer to the neonatal ward.
There were no significant differences in preferred future mode of delivery for women who had a caesarean delivery after a failed instrument delivery and those who were delivered by immediate caesarean delivery.
At the same time, we found limited evidence of the absolute increase in risk of low cognitive function rising to 15%35%% if Apgar score <7 was accompanied by very young maternal age, growth restriction, or instrument delivery.
Greater differences from the expected distribution were seen among those who had five-minute Apgar score <7 coupled with maternal age 20 years or younger (60.0%); with preterm birth (40.9%); with SGA (50.0%); or with instrument delivery (48.1%).
A large majority (93.4%) of the men had Apgar score of 10 at 5 minutes of age; 136 (0.7%) had Apgar score below 7, and 1143 (5.9%), a score in the range from 7 to 9. Five-minute Apgar score was inversely associated with prevalence of maternal nulliparity and unmarried status; and with prevalence of preterm birth, low birth weight, and Cesarean or instrument delivery (table 1).
Procedural issues will be recorded in terms of place of delivery, need for senior obstetric support, transfer to theatre, use of sequential instruments, failure of instrumental delivery or proceeding directly to caesarean section and the decision to delivery interval.
The sample Goodman et al. [ 16] used was limited to low-risk postpartum women with uneventful vaginal deliveries, whereas our sample extends the scope to women with instrument deliveries.
Eighteen per cent of the patients had an instrumented delivery, which differs slightly from a previous study showing that 5.8% of deliveries were instrumented in a population of 243 women from Taiwan [ 37].
An established prevalence of poor technique in instrumental delivery was apparent in a CESDI review of cases where babies died.[ 8] In this review it was clear that many basic rules with regard to instrumental delivery had not been adhered to, as some of the deaths were related to multiple attempts at delivery with different instruments.
