title: [Instrumental delivery with perineum-fetal head distance >55 MM on ultrasound].
abstract: OBJECTIVE
  Compare the issue of an operative vaginal delivery associated to the fetal presentation diagnosed by transperineal ultrasound. Three groups were formed: ≥55 mm, between 45 and 55 mm, and <45 mm.
  
  
  METHODS
  A monocentric prospective study on 108 patients has been conducted between April 2011 and August 2014. The distance between perinea and skull has been analyzed to compare the success of operative vaginal delivery considering the level of the fetal presentation in the pelvic cavity.
  
  
  RESULTS
  The failed operative vaginal deliveries are more frequent while the fetal head is above 55 mm (16.7%) or while the fetal head is between 45 and 55 mm (9.1%) than while the fetal skull is under 45 mm (1.8%) (P=0.04). However there is no significant difference for the fetal shoulder dystocia (5.6% vs 3.0% vs 3.5%, P=0.5), nor for the newborn outcomes (16.7 vs 15.2 vs 14; P=0.9).
  
  
  CONCLUSIONS
  Despite the high rate of failed operative vaginal delivery above 55 mm, it should be considered not to prohibit but send free to the obstetrician appreciation.
authors: Département de gynécologie-obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France.
authors: C
authors: C
authors: Magnard
authors: Département de gynécologie-obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France.
authors: M
authors: M
authors: Perrot
authors: Département de gynécologie-obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France.
authors: C
authors: C
authors: Fanget
authors: Département de santé publique, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France.
authors: B
authors: B
authors: Paviot-Trombert
authors: Département de gynécologie-obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France; INSERM UMR1059 Saint-Étienne, université Jean-Monnet, 42023 Saint-Étienne, France. Electronic address: raia.tiphaine@gmail.com.
authors: T
authors: T
authors: Raia-Barjat
authors: Département de gynécologie-obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France; Département de santé publique, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42055 Saint-Étienne, France.
authors: C
authors: C
authors: Chauleur
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000295:instrumentation* / Q000379:methods; D004420:Dystocia / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005333:Fetus; D006257:Head; D006801:Humans; D007746:Labor Presentation; D010502:Perineum; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
keywords: Extraction instrumentale; Operative vaginal delivery; Presentation above 55mm; Présentation au-delà de 55mm; Transperineal ultrasound; Échographie transpérinéale