Destructive Operative Vaginal Delivery in a Tertiary Health Institution in Northwestern Nigeria : A Ten Year Review

Umar AG, Maiahu AI, Panti AA, Hassan M, Tunau K, Sulaiman B, Saidu AD

A. BACKGROUND: Destructive operations are a group of obstetric procedures that are performed via the vaginal route by reducing the size of the head, shoulder girdle, or trunk of the dead foetus to allow vaginal deliveryto avert caesarean section and its complications. B. AIMS AND OBJECTIVES:TO determining the incidence rate, indications, complications and outcome of destructive operations in UDUTH, Sokoto. C. MATERIALS AND METHODS: This was a 10 year retrospective study of destructive operations performed at UDUTH. Sokoto, from 1st January 2005 to 31st December 2014. Information was extracted from patient’s case files retrieved from the medical records department. D.RESULTS: There were 28,422 deliveries during the period under review. The incidence of destructive operation was 0.31% and the mean age of the patients was 20 ± 4.7 years. Majority are in their 2nd decades of life and they presented mainly as emergencies. The mean gestational age at presentation was 38.55 ± 1.401 weeks and the procedures were successful in all the cases. The most common procedure was craniotomy in 76/84 (90.50%) and the main indication was prolonged and obstructed labour in 76/84 (90.5%) of cases. The most frequent complication encountered was anaemia in 52/84 (61.9%) of the patients and there were four cases of maternal deaths (4.76%). E.CONCLUSION: Destructive operations still have a role in the management of obstructed labour particularly if the foetus is dead. However, the trend is on a decrease due to risk of complications that may lead to litigation.

https://doi.org/10.31871/WJRR.6.1.11