In Practice

Failure to perform assisted deliveries is resulting in an increased neonatal and maternal morbidity and mortality: An expert opinion

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R C Pattinson, V Vannevel, D Barnard, S Baloyi, G S Gebhardt, K le Roux, N Moran, J Moodley

Abstract


The need to perform assisted vaginal delivery (AVD) has been regarded as self-evident. In high-income countries, rates of AVD range between 5% and 20% of all births. In South Africa, the rate of AVD is only 1%. This has resulted in increased neonatal morbidity and mortality due to intrapartum asphyxia, and increased maternal morbidity and mortality due to a rise in second-stage caesarean deliveries. In this article, we address the possible causes leading to a decrease in AVD and propose measures to be taken to increase the rates of AVD and subsequently reduce morbidity and mortality.


Authors' affiliations

R C Pattinson, South African Medical Research Council/University of Pretoria Maternal and Infant Health Strategies Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

V Vannevel, South African Medical Research Council/University of Pretoria Maternal and Infant Health Strategies Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

D Barnard, South African Medical Research Council/University of Pretoria Maternal and Infant Health Strategies Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

S Baloyi, Academic Head, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

G S Gebhardt, Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

K le Roux, Honorary Lecturer, Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa; Honorary Lecturer, Primary Health Care Directorate, University of Cape Town, South Africa; Zithulele Hospital, Eastern Cape, South Africa

N Moran, Head of Clinical Department: Obstetrics and Gynaecology, KwaZulu-Natal Department of Health, South Africa; Honorary Lecturer, Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, South Africa

J Moodley, Chair: National Committee for Confidential Enquiries into Maternal Deaths, South Africa

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Keywords

Obstetrics; Assisted vaginal delivery; Operative delivery

Cite this article

South African Medical Journal 2018;108(2):75-78. DOI:10.7196/SAMJ.2018.v108i2.12786

Article History

Date submitted: 2018-02-01
Date published: 2018-02-01

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