Maternal and child health after assisted vaginal delivery: five-year follow up of a randomised controlled study comparing forceps and ventouse

Br J Obstet Gynaecol. 1999 Jun;106(6):544-9. doi: 10.1111/j.1471-0528.1999.tb08322.x.


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.

Design: Follow up of a randomised controlled trial.

Setting: District general hospital in the West Midlands.

Population: 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).

Main outcome measures: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child Development
  • Child Welfare
  • Child, Preschool
  • Cohort Studies
  • Fecal Incontinence / etiology
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Maternal Welfare
  • Obstetrical Forceps / adverse effects*
  • Pregnancy
  • Surveys and Questionnaires
  • Urination Disorders / etiology
  • Vacuum Extraction, Obstetrical / adverse effects*
  • Vision Disorders / etiology