title: [Materno-fetal morbidity of instrumental deliveries: forceps versus spatulas. About a series of 77 cases].
abstract: OBJECTIVE
  To compare the early feto-maternal morbidity after assisted vaginal delivery using forceps versus spatulas.
  
  
  METHODS
  It is a retrospective comparative study conducted in a third level maternity carrying on cephalic instrumental non premature deliveries by forceps or spatulas, on singleton pregnancies. Forty assisted vaginal deliveries using forceps and 40 others using spatulas were registered, over a period of 4.5 months. Feto-maternal lesions were analyzed.
  
  
  RESULTS
  Characteristics of the population of forceps and spatulas groups were alike (Body Mass Index: 25.9 versus 26.7kg/m(2), P=0.79; parity: 0.6 versus 0.4, P=0.20; fetal weight: 3306g versus 3295g, P=0.91). The characteristics of labor were also similar, except for the left transverse fetal position more important in spatulas group (10.8% - 4/37 - versus 0%; P=0.03). More fetus had no lesion in the spatulas group (85.7% - 30/35 - versus 60.5% - 23/38), P=0.02). The episiotomy rate was higher in the forceps group: 32/40 (80.0%) versus 13/37 (35.1%); P=0.0001.
  
  
  CONCLUSIONS
  These results are similar to those from the literature, which evoke a fetal protection by spatulas. However, this is biased by the fact that the two instruments are not always used in the same conditions. Besides, spatulas do not appear to be more deleterious to maternal perinea. Therefore, perpetuation and teaching the use of these two instruments seem essential.
authors.affiliation: Pôle de gynécologie-obstétrique et reproduction, maternité régionale universitaire de Nancy, université Nancy-I H.-Poincaré, 10, rue du Dr.-Heydenreich, CS 74213, 54042 Nancy cedex, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Tsoyem Mouafou
authors.affiliation: Pôle de gynécologie-obstétrique et reproduction, maternité régionale universitaire de Nancy, université Nancy-I H.-Poincaré, 10, rue du Dr.-Heydenreich, CS 74213, 54042 Nancy cedex, France.
authors.forename: O
authors.initials: O
authors.lastname: Morel
authors.affiliation: Pôle de gynécologie-obstétrique et reproduction, maternité régionale universitaire de Nancy, université Nancy-I H.-Poincaré, 10, rue du Dr.-Heydenreich, CS 74213, 54042 Nancy cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Lamy
authors.affiliation: Pôle de gynécologie-obstétrique et reproduction, maternité régionale universitaire de Nancy, université Nancy-I H.-Poincaré, 10, rue du Dr.-Heydenreich, CS 74213, 54042 Nancy cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Monceau
authors.affiliation: Pôle de gynécologie-obstétrique et reproduction, maternité régionale universitaire de Nancy, université Nancy-I H.-Poincaré, 10, rue du Dr.-Heydenreich, CS 74213, 54042 Nancy cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Judlin
authors.affiliation: Pôle de gynécologie-obstétrique et reproduction, maternité régionale universitaire de Nancy, université Nancy-I H.-Poincaré, 10, rue du Dr.-Heydenreich, CS 74213, 54042 Nancy cedex, France. Electronic address: joel.muhlstein@free.fr.
authors.forename: J
authors.initials: J
authors.lastname: Muhlstein
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology; D015992:Body Mass Index; D036861:Delivery, Obstetric / Q000295:instrumentation* / Q000379:methods; D004841:Episiotomy / Q000706:statistics & numerical data; D005113:Extraction, Obstetrical / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D020567:Fetal Weight; D006801:Humans; D007743:Labor, Obstetric; D009772:Obstetrical Forceps / Q000009:adverse effects*; D010298:Parity; D010502:Perineum / Q000293:injuries; D011247:Pregnancy; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects*