title: [Assessment of vacuum-assisted vaginal delivery in a frank breech presentation].
abstract: OBJECTIVE
  After verification of the eligibility criteria and with an obstetrician familiar with the specific maneuvers likely to be needed, vaginal delivery of breech presentations is possible. If problems arise during the active pushing phase of labor, vacuum extraction has been described in the literature for this uncommon condition with limited series. The aim of this study is to assess retrospectively vacuum extraction in frank breech presentation in our center.
  
  
  METHODS
  This retrospective study of trials of vaginal delivery of fetuses in breech presentation at term compares cases according to whether they did or did not use a vacuum extraction.
  
  
  RESULTS
  During a two-year period, 83 patients, whom had trials of vaginal delivery in breech presentations, reached the active pushing/bearing down stage after complete cervical dilatation. Vacuum assistance was applied in six of these (7.2 %). The failure rate for vaginal delivery was significantly higher in the group with compared to without vacuum extraction (33.3 % versus 6.5 %, P<0.05). Moreover, the mean pH at birth was significantly lower in the group with vacuum extraction (7.12±0.11 versus 7.20±0.08, P<0.05), and these infants more frequently had deep cutaneous injuries (66.7 % versus 26.0 %, P<0.05).
  
  
  CONCLUSIONS
  In fetuses in breech presentation, when vaginal delivery failed, it seems to be safer for the fetuses to perform caesarean section rather than attempt vacuum extraction.
authors: Pôle femme-mère-nouveau-né, hôpital Jeanne-de-Flandre, université Lille Nord de France, 1, rue Eugène-Avinée, 59037 Lille cedex, France. Electronic address: geraldine.bleu@gmail.com.
authors: G
authors: G
authors: Bleu
authors: Pôle femme-mère-nouveau-né, hôpital Jeanne-de-Flandre, université Lille Nord de France, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4489, IMPRT, faculté de médecine Henri-Warembourg, université Lille Nord de France, 59000 Lille, France.
authors: P
authors: P
authors: Deruelle
authors: Pôle femme-mère-nouveau-né, hôpital Jeanne-de-Flandre, université Lille Nord de France, 1, rue Eugène-Avinée, 59037 Lille cedex, France.
authors: J
authors: J
authors: Demetz
authors: Maternité Paul-Gellé, 91, avenue Julien-Lagache, 59100 Roubaix, France.
authors: S
authors: S
authors: Michel
authors: Pôle femme-mère-nouveau-né, hôpital Jeanne-de-Flandre, université Lille Nord de France, 1, rue Eugène-Avinée, 59037 Lille cedex, France.
authors: P
authors: P
authors: Dufour
authors: Pôle femme-mère-nouveau-né, hôpital Jeanne-de-Flandre, université Lille Nord de France, 1, rue Eugène-Avinée, 59037 Lille cedex, France.
authors: S
authors: S
authors: Depret
authors: Pôle femme-mère-nouveau-né, hôpital Jeanne-de-Flandre, université Lille Nord de France, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 2694, université Lille Nord de France, 59000 Lille, France.
authors: D
authors: D
authors: Subtil
mesh_terms: D000328:Adult; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D011247:Pregnancy; D012189:Retrospective Studies; D012867:Skin / Q000293:injuries; D014620:Vacuum Extraction, Obstetrical
keywords: Accouchement; Breech presentation; Complications; Siège; Vacuum extractor; Vaginal delivery; Ventouse obstétricale; Voie basse