Spatula-assisted deliveries: a large cohort of 1065 cases

Abstract Objective To analyze neonatal and maternal complications of operative vaginal delivery using spatulas. Study design We conducted a retrospective observational study of 1065 consecutive spatula-assisted deliveries at Nice University Hospital from 2003 through 2006, excluding stillbirths and...

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Published in:European journal of obstetrics & gynecology and reproductive biology 2010-07, Vol.151 (1), p.46-51
Main Authors: Boucoiran, Isabelle, Valerio, Laure, Bafghi, Abdolreza, Delotte, Jerome, Bongain, André
Format: Article
Language:English
Subjects:
Anal Canal - injuries
Biological and medical sciences
Birth injuries
Cohort Studies
Delivery. Postpartum. Lactation
Episiotomy
Episiotomy - adverse effects
Extraction, Obstetrical - adverse effects
Extraction, Obstetrical - instrumentation
Female
Gynecology. Andrology. Obstetrics
Humans
Lacerations - etiology
Medical sciences
Obstetrical extraction
Obstetrical Forceps - adverse effects
Obstetrics and Gynecology
Perineal injury
Perineum - injuries
Pregnancy
Retrospective Studies
Spatulas
Vagina - injuries
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Summary:Abstract Objective To analyze neonatal and maternal complications of operative vaginal delivery using spatulas. Study design We conducted a retrospective observational study of 1065 consecutive spatula-assisted deliveries at Nice University Hospital from 2003 through 2006, excluding stillbirths and breech deliveries. After univariate analysis, we performed logistic regression analysis to assess risk factors for severe perineal injuries and vaginal lacerations. Results The success rate was 98.2%. Vaginal tears occurred in 23.7% of patients. The rate of third and fourth degree perineal injuries was 6.2%. No severe neonatal complication directly related to extraction was noted. Nulliparity, shoulder dystocia and absence of episiotomy were independently associated with an elevated risk of anal sphincter damage. Nulliparity and absence of episiotomy were significantly and independently associated with an increased incidence of vaginal tears. Conclusion Rates of perineal injuries, failure and neonatal complications observed with spatulas were similar to those reported in the literature with other instruments for operative vaginal delivery.
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2010.03.024