Maternal and child health after assisted vaginal delivery: five-year follow up of a randomised controlled study comparing forceps and ventouse.
OBJECTIVE
To undertake a five year follow up of a cohort of women and children delivered by forceps or vacuum extractor in a randomised controlled study.


METHODS
Follow up of a randomised controlled trial.


METHODS
District general hospital in the West Midlands.


METHODS
Follow up questionnaires were sent to 306 of the 313 women originally recruited at the North Staffordshire Hospital to a randomised controlled study comparing forceps and vacuum extractor for assisted delivery. Two hundred and twenty-eight women responded (74.5%) and all were included in the study; forceps (n = 115) and vacuum extractor (n = 113).


METHODS
Bowel and urinary dysfunction, child vision assessment, and child development.


RESULTS
Maternal adverse symptoms at long term follow up were relatively common. Urinary incontinence of various severity was reported by 47%, bowel habit urgency was reported by 44% (98/225), and loss of bowel control 'sometimes' or 'frequently' by 20% of women (46/226). No significant differences between instruments were found in terms of either bowel or urinary dysfunction. Overall, 13% (20/158) of children were noted to have visual problems. There was no significant difference in visual function between the two groups: ventouse 11/86 (12.8%), compared with forceps 9/72 (12.5%); odds ratio 0.97, 95% CI 0.38-2.50. Of the 20 children with visual problems, a family history was known in 18, and 17/18 (94%) had a positive family history for visual problems. No significant differences in child development were found between the two groups.


CONCLUSIONS
There is no evidence to suggest that at five years after delivery use of the ventouse or forceps has specific maternal or child benefits or side effects.
Johanson
R B
RB
Keele University Centre for Maternal and Child Health, North Staffordshire Hospital Trust, Newcastle-under-Lyme, UK.
Heycock
E
E
Carter
J
J
Sultan
A H
AH
Walklate
K
K
Jones
P W
PW
D000328:Adult; D002657:Child Development; D002669:Child Welfare; D002675:Child, Preschool; D015331:Cohort Studies; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008429:Maternal Welfare; D009772:Obstetrical Forceps / Q000009:adverse effects*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000209:etiology; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects*; D014786:Vision Disorders / Q000209:etiology