[Thierry's spatulas or forceps--a comparison between maternal-fetal morbidities].
OBJECTIVE
To compare maternal and fetal morbidity during forceps or Thierry spatulas operative deliveries.


METHODS
Retrospective and descriptive study in a one center from 2006 to 2012. Operative deliveries were performed with forceps or spatulas, in case of no mobile fetal progression, on singleton term pregnancies with cephalic presentation, no abnormal heart rate and without any pregnancy pathology.


RESULTS
Our studies included 65 operative deliveries with spatulas versus 77 with forceps, among a scientifically comparable population. At maternal level, when comparing spatulas versus forceps, there were more intact perineum (5.19% vs 15.38%; P=0.04), the same rate of vaginal tears and less severe perineal injuries (0 vs 6; P=0.05) in favor of spatulas. Extractions performed in "unfavorable" conditions were mostly conducted with forceps. In 50% of the case, an episiotomy was associated with severe perineal lesions. As far as fetal morbidity is concerned, there were more newborn's facial injuries using the forceps tool (18.18% vs 3.08%; P=0.0046). The remaining data were comparable.


CONCLUSIONS
Thierry spatulas are less harmful than forceps to maternal tissues and reduce facial injuries of the newborn. Consequently, spatulas could benefit from a wider use. However, a prospective study will be needed to confirm our results.
Service de gynécologie-obstétrique, CHU de Dijon, 14, rue Paul-Gaffarel, 21079 Dijon, France. Electronic address: olivia.durand.maison@gmail.com.
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Durand-Maison
Service de gynécologie-obstétrique de Chalon-sur-Saône, centre hospitalier de William-Morey, 7, quai de l'Hôpital, 71321 Chalon-sur-Saône, France.
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M
Mangin-Meyniel
Service de gynécologie-obstétrique, CHU de Dijon, 14, rue Paul-Gaffarel, 21079 Dijon, France.
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Tabard
Service de gynécologie-obstétrique de Chalon-sur-Saône, centre hospitalier de William-Morey, 7, quai de l'Hôpital, 71321 Chalon-sur-Saône, France.
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Bulot
Équipe d'accueil E7 41S4 épidémiologie des populations, université de Bourgogne, 21000 Dijon, France.
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Cottenet
Service de gynécologie-obstétrique, centre hospitalier intercommunal de Fréjus-Saint-Raphael, 240, avenue de Saint-Lambert, BP 110, 83608 Frejus, France.
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Gobenceaux
D001720:Birth Injuries / Q000453:epidemiology* / Q000209:etiology; D036861:Delivery, Obstetric / Q000295:instrumentation* / Q000379:methods; D005151:Facial Injuries / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009772:Obstetrical Forceps / Q000009:adverse effects*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014621:Vagina / Q000293:injuries*
Episiotomy; Extraction instrumentale; Fetal and maternal morbidities; Forceps; Morbidité materno-fœtale; Operative vaginal delivery; Spatules de Thierry; Thierry's spatulas; Épisiotomie