[Failed forceps extraction: risk factors and maternal and neonatal morbidity].
OBJECTIVE
To evaluate risk factors associated with failed forceps delivery and to compare the maternal and neonatal morbidity.


METHODS
In this retrospective case-control study, all failed forceps delivery cases were analyzed from January 2005 to June 2008 and were compared to a successful forceps delivery cohort.


RESULTS
The rate of failed forceps extraction was 4.4% (40/918). Specific risk factors were extraction above a fœtal station of S+2 (OR=43.03; IC 95%: 3.8-475.41), occipito-posterior position (OR=34.64; IC 95%: 4.08-293.5), and biparietal diameter higher than 95mm (OR=10.74; IC 95%: 1.4-82.41). Maternal and neonatal morbidity was few in both groups.


CONCLUSIONS
Diagnosis of presentation level and variety of presentation are necessary before instrumental extraction. A "trial of forceps" should be performed with caution in a setting where a caesarean delivery could follow. Vacuum extraction could be interesting in case of occipito-posterior position.
Département de gynécologie-obstétrique et médecine de la reproduction, hôpital Nord, CHU de Saint-Étienne, avenue Albert-Raimond, Saint-Étienne, France.
A
A
Langeron
G
G
Mercier
C
C
Chauleur
M-N
MN
Varlet
H
H
Patural
S
S
Lima
P
P
Seffert
G
G
Chêne
D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D005113:Extraction, Obstetrical / Q000009:adverse effects* / Q000379:methods / Q000534:rehabilitation / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology*; D009017:Morbidity; D009035:Mothers / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology*; D009772:Obstetrical Forceps / Q000009:adverse effects*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure