S Vanlieferinghen1, G Girard, L Mandelbrot. 1. Service de gynécologie-obstétrique, hôpital Louis-Mourier, AP-HP, université Paris-Diderot, 92700 Colombes, France.
Abstract
OBJECTIVE: To compare short-term maternal and fetal morbidities between Thierry's spatules and the vacuum extractor. MATERIAL AND METHODS: A retrospective study of all assisted vaginal deliveries using spatules or the vacuum extractor between January 1, 2005 and December 31, 2007 in a single, university hospital maternity. RESULTS: There were 385 deliveries with the vacuum extractor and 332 with spatulas, among a total number of 6941 deliveries. The obstetrical conditions did not differ between the two groups (indication, level or type of presentation, duration of the second stage before extraction). The rate of episiotomy was higher in the spatules than in the vacuum extractor group (80.3 % vs 54.8 %, p < 0.0001), whereas there was a lower rate of first-to-second degree perineal lacerations (18.8 % vs 35.2 %, p < 0.0001). There was no statistically significant difference in the rate of third-to-fourth degree perineal lacerations (2.1 % vs 0.7 %, respectively, p = 0.31). Neonatal outcomes did not differ significantly between the two groups (5-minute Apgar score < 7 in 0.3 % vs 1.8 %, respectively, p = 0.75). CONCLUSION: There were few differences in maternal and neonatal outcomes according to the type of instrument used, except for a lower episiotomy rate with vacuum extraction.
OBJECTIVE: To compare short-term maternal and fetal morbidities between Thierry's spatules and the vacuum extractor. MATERIAL AND METHODS: A retrospective study of all assisted vaginal deliveries using spatules or the vacuum extractor between January 1, 2005 and December 31, 2007 in a single, university hospital maternity. RESULTS: There were 385 deliveries with the vacuum extractor and 332 with spatulas, among a total number of 6941 deliveries. The obstetrical conditions did not differ between the two groups (indication, level or type of presentation, duration of the second stage before extraction). The rate of episiotomy was higher in the spatules than in the vacuum extractor group (80.3 % vs 54.8 %, p < 0.0001), whereas there was a lower rate of first-to-second degree perineal lacerations (18.8 % vs 35.2 %, p < 0.0001). There was no statistically significant difference in the rate of third-to-fourth degree perineal lacerations (2.1 % vs 0.7 %, respectively, p = 0.31). Neonatal outcomes did not differ significantly between the two groups (5-minute Apgar score < 7 in 0.3 % vs 1.8 %, respectively, p = 0.75). CONCLUSION: There were few differences in maternal and neonatal outcomes according to the type of instrument used, except for a lower episiotomy rate with vacuum extraction.