Instrumental delivery may lead to which of the following?

Instrumental delivery, involving the use of tools such as forceps or vacuum to assist in childbirth, does come with potential complications for the newborn. Among the possible outcomes, emissary vein rupture is particularly relevant. Emissary veins are small veins that drain blood from the superficial layers of the skull. During instrumental delivery, especially with the use of forceps, there can be increased pressure in the fetal head, leading to rupture of these veins. This can result in cephalhematoma or other cranial injuries.

In contrast, perinatal stroke, umbilical cord prolapse, and fetal heart rate abnormalities are also complications that can arise with instrumental deliveries, but they typically do not directly relate to the physical mechanics or anatomical considerations as emissary vein rupture does. While these complications are serious and warrant attention, they are not as specifically associated with the direct impact of the instruments used in delivery. Emissary vein rupture reflects the vascular compromise that can occur due to the mechanical forces at play during an assisted delivery, making it a directly relevant complication in this context.