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Indications, Patterns and Correlates of Immediate Adverse Maternal Outcome Following Instrumental Assisted Vaginal Delivery in Leku Primary Hospital, Sidama Zone, Ethiopia

Getinet Kassahun*, Teshome Melese, Metsnanat Getachew, Abenezer Alemu

Background: Instrumental vaginal delivery involves either vacuum extractor or obstetric forceps to facilitate delivery of the fetus for maternal and fetal benefit. However, instrumental delivery could be associated with substantial maternal injuries and even death.
Objective: The aim of the study was to assess the patterns and correlates of immediate adverse outcome of assisted vaginal births in Leku primary hospital, Sidama Zone, Ethiopia.
Methods: This retrospective hospital based study was employed done among 406 instrumental births between January 2014 and January 2019. Study cases were traced using systematic sampling technique while data was extracted using pretested-structured questioner. Epi data version 3.1 was used for data entry and Statistical Package for Social Science (SPSS) version 22 was used for analysis.
Results: The overall rate of maternal adverse outcome was 17.6% and 24.9%. The rates of assisted vaginal births were 56.6% in vacuum extractors and 43.4% in forceps. The most frequent indications for instrumental deliveries were prolonged second stage of labour while the most common adverse maternal outcome was perineal tears. After adjustments for potential confounders in multivariate regression analysis, parity [AOR=8.654, 95% CI 3.382-22.147], prolonged second stage of labor [AOR=3.713, 95% CI 1.540-8.953], obstetric complication [AOR=3.418, CI 1.315- 8.880], type of IVD [AOR=4.130, 95% CI 1.667-10.235] use of episiotomy [AOR=4.175, 95% CI 1.525-11.428], type of labor [AOR=4.214, 95% CI 1.860-9.548] and birth weight [AOR=1.345, 95% CI 1.558-3.240] were also determinants of maternal adverse outcome.
Conclusion: The overall rate of adverse maternal outcome was high. Episiotomy application, referred from other facility type of IVD, obstetric complication and type of labor were determinants of outcome variable. Thus, focusing on risk factors for adverse maternal outcome during instrumental vaginal delivery is mandatory in order to improve quality of care and improve maternal outcome.