Instrumental Vaginal Delivery versus Second-Stage Cesarean Section: A Cross-Sectional Analysis of Outcomes in a Sudanese Tertiary Hospital

Abstract

Second-stage cesarean section (CS) rates are rising globally, often replacing instrumental vaginal delivery (IVD) due to reduced reliance on forceps or vacuum in prolonged second stage of labor. However, regional data from Sudan is sparse. The Study aimed to evaluate maternal and neonatal outcomes of second-stage CS versus IVD at Al-Damer Teaching Hospital, River Nile State, Sudan.

This prospective, descriptive, cross section hospital-based study involved 106 women (53 CS, 53 IVD) conducted between February 2022 and August 2022. Data were analyzed using SPSS version 25.0.

The demographic profiles were similar across groups, except for a significantly higher rate of rural residency in the IVD group (p = 0.043). Antenatal booking, gestational diabetes, and PROM were slightly more frequent in the CS group but not statistically significant. No maternal mortality occurred. Maternal complications were higher with IVD (13.2%) versus CS (9.7%) but not significant (p = 0.366). Neonatal survival rates were high in both groups (94.3% IVD, 98.1% CS), with minimal complications. Neonatal mortality occurred only in the IVD group (1.9%, p = 0.253). Length of hospital stay over 3 days was slightly higher in the IVD group for both mothers and neonates, without significance.

When appropriately indicated and executed, instrumental vaginal delivery remains a safe and viable alternative to second-stage cesarean section, with comparable maternal and fetal outcomes.