Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Operative Obstetrics

Poster Session 3

(704) Operative Vaginal Delivery Rates over two-decades: Instrument Choice and Neonatal Morbidity- Implications for Resident Training

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Operative vaginal delivery (OVD) rates have shown a downward trend in contemporary obstetrics, paralleling the decline in the trainee experience of forceps in some hospitals. We conducted a 20-year single-center study to explore the trajectory of OVD rates as well as assessing the trend of instrument choice and associated neonatal morbidity and mortality rates.

Study Design: This was a retrospective analysis of prospectively collected data at a single tertiary referral center from 2002-2021. All cases of OVD were included. The choice of instrument (forceps or vacuum), rate of hypoxic-ischemic-encephalopathy (HIE) and of neonatal death (NND) after OVD were also recorded. Linear regression analysis was used to determine trends.
 

Results:

During the study period, there was a total of 162,460 deliveries. The rate of OVD accounted for 17.4% (n=21,042) of all deliveries or 25.0% of all vaginal deliveries. The overall rate of OVD use showed a non-significant decrease (p=0.33, R2=0.0528, slope=-0.2299) during the 20-year study period. Forceps were used in 4.4% of all deliveries (n=7,197), while vacuum was used in 13.0% (n=21,042). In contrast to other center’s experience, the use of forceps significantly increased during the study period (p=0.006, R2=0.3491, slope=0.5908). There were no statistically significant difference in NND (p=0.067) or HIE (p=0.370) associated with OVD use.

Conclusion:

Our analysis of OVD use at a single tertiary referral center revealed noteworthy trends. While the overall rate of OVD use showed a non-significant decline, the use of forceps increased significantly. The cause of this increase is likely to be multi-factorial and may reflect institutional commitment on the part of senior clinicians to optimizing forceps training for residents. Despite these shifts in delivery methods, there was no statistically significant difference in neonatal morbidity or mortality associated with OVD use. These findings should be useful for encouraging obstetric residency training programs to either commit to, or maintain, resident exposure to forceps as a useful obstetric skillset.