Is ethnicity a risk factor for maternal complications in operative vaginal delivery?

Abstract

Objective: To evaluate ethnic-based differences in maternal complications following operative vaginal deliveries. Study design: Retrospective, case-controlled analysis of obstetric deliveries over a fourteen year period in a single urban hospital, enrolled in a computerized database. Results: Of 18285 deliveries, 8948 (49.0%) occurred in non-Hispanic (WNH) women, and 7611 (41.6%) occurred in non-Hispanic (BNH) women. Operative vaginal deliveries included vacuum, outlet forceps, low forceps and mid-forceps. Maternal outcomes included incidence of third and fourth degree lacerations and calculated blood loss. The WNH population had 1349 (15%) operative vaginal deliveries and 277 (20.5%) had third and fourth degree lacerations, while in the BNH population there were 807 (10.6%) operative vaginal deliveries and 114 (14%) third and fourth degree lacerations (p ≤ 0.001). In the WNH group, calculated blood loss in operative vaginal deliveries was 1057 ml for midforceps and 907 ml for low forceps deliveries; the BNH group had 828 ml blood loss in midforceps and 660cc in low forceps group (p < 0.001 for midforceps and p < 0.001 for low forceps). Conclusion: WNH women had more operative vaginal deliveries, maternal morbidity, third and fourth degree lacerations and greater blood loss compared to the BNH women.