Severe perineal morbidity of instrumental deliveries using Thierry's spatulas and vacuum extraction: A prospective observational cohort study
To evaluate the risk of severe perineal tear following instrumental vaginal delivery (IVD) performed with spatulas and vacuum extraction. Secondary objectives were to estimate the impact of episiotomy on this risk. From December 2008 to October 2012, women who underwent spatulas or vacuum were prosp...
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| Veröffentlicht in: | Journal of gynecology obstetrics and human reproduction 2017-01, Vol.46 (1), p.43 |
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| creator | Hamouda, S Mancini, J Marchand, F Bretelle, F Boubli, L D'Ercole, C Carcopino, X |
| description | To evaluate the risk of severe perineal tear following instrumental vaginal delivery (IVD) performed with spatulas and vacuum extraction. Secondary objectives were to estimate the impact of episiotomy on this risk.
From December 2008 to October 2012, women who underwent spatulas or vacuum were prospectively included. Each spontaneous vaginal delivery (SVD) following each included IVD were included as control cases (1-1 ratio). Careful perineal examination was systematically performed. Severe perineal tear was defined by the occurrence of anal sphincter rupture with or without anal mucosa tear.
A total of 761 patients were included in the current study: 248 (64%) spatulas, 137 (36%) vacuums and 381 (49%) SVDs. Severe perineal tear was diagnosed in 19 (2.5%) cases. Episiotomy had been performed in 276 (36.9%) patients. Only spatulas extraction was found to significantly increase the risk of severe perineal tear (AOR=7.66; 95% CI: 2.06-28; P=0.02). Although vacuum extraction seemed to increase this risk, it was not found to be significant (AOR=3.25; 95% CI: 0.65-16.24; P=0.15). No significant difference was observed between the risk of severe perineal tear following spatulas and vacuum (AOR=2.36; 95% CI: 0.63-8.82; P=0.202). Finally, neither foetal macrosomia, nor episiotomy, nor foetal extraction with the head in the deep pelvis, nor delivery at night had a significant impact on the probability of severe perineal tear.
Spatulas extraction is an independent risk factor for severe perineal tear. The practice of episiotomy was not shown to have any significant impact on this risk. |
| doi_str_mv | 10.1016/j.jgyn.2015.11.003 |
| format | Article |
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From December 2008 to October 2012, women who underwent spatulas or vacuum were prospectively included. Each spontaneous vaginal delivery (SVD) following each included IVD were included as control cases (1-1 ratio). Careful perineal examination was systematically performed. Severe perineal tear was defined by the occurrence of anal sphincter rupture with or without anal mucosa tear.
A total of 761 patients were included in the current study: 248 (64%) spatulas, 137 (36%) vacuums and 381 (49%) SVDs. Severe perineal tear was diagnosed in 19 (2.5%) cases. Episiotomy had been performed in 276 (36.9%) patients. Only spatulas extraction was found to significantly increase the risk of severe perineal tear (AOR=7.66; 95% CI: 2.06-28; P=0.02). Although vacuum extraction seemed to increase this risk, it was not found to be significant (AOR=3.25; 95% CI: 0.65-16.24; P=0.15). No significant difference was observed between the risk of severe perineal tear following spatulas and vacuum (AOR=2.36; 95% CI: 0.63-8.82; P=0.202). Finally, neither foetal macrosomia, nor episiotomy, nor foetal extraction with the head in the deep pelvis, nor delivery at night had a significant impact on the probability of severe perineal tear.
Spatulas extraction is an independent risk factor for severe perineal tear. The practice of episiotomy was not shown to have any significant impact on this risk.</description><identifier>EISSN: 2468-7847</identifier><identifier>DOI: 10.1016/j.jgyn.2015.11.003</identifier><identifier>PMID: 28403956</identifier><language>eng</language><publisher>France</publisher><subject>Adult ; Anal Canal - injuries ; Case-Control Studies ; Cohort Studies ; Episiotomy - statistics & numerical data ; Female ; Humans ; Intestinal Mucosa - injuries ; Obstetrical Forceps - adverse effects ; Perineum - injuries ; Perineum - surgery ; Pregnancy ; Rupture ; Vacuum Extraction, Obstetrical - adverse effects</subject><ispartof>Journal of gynecology obstetrics and human reproduction, 2017-01, Vol.46 (1), p.43</ispartof><rights>Copyright © 2015 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28403956$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamouda, S</creatorcontrib><creatorcontrib>Mancini, J</creatorcontrib><creatorcontrib>Marchand, F</creatorcontrib><creatorcontrib>Bretelle, F</creatorcontrib><creatorcontrib>Boubli, L</creatorcontrib><creatorcontrib>D'Ercole, C</creatorcontrib><creatorcontrib>Carcopino, X</creatorcontrib><title>Severe perineal morbidity of instrumental deliveries using Thierry's spatulas and vacuum extraction: A prospective observational cohort study</title><title>Journal of gynecology obstetrics and human reproduction</title><addtitle>J Gynecol Obstet Hum Reprod</addtitle><description>To evaluate the risk of severe perineal tear following instrumental vaginal delivery (IVD) performed with spatulas and vacuum extraction. Secondary objectives were to estimate the impact of episiotomy on this risk.
From December 2008 to October 2012, women who underwent spatulas or vacuum were prospectively included. Each spontaneous vaginal delivery (SVD) following each included IVD were included as control cases (1-1 ratio). Careful perineal examination was systematically performed. Severe perineal tear was defined by the occurrence of anal sphincter rupture with or without anal mucosa tear.
A total of 761 patients were included in the current study: 248 (64%) spatulas, 137 (36%) vacuums and 381 (49%) SVDs. Severe perineal tear was diagnosed in 19 (2.5%) cases. Episiotomy had been performed in 276 (36.9%) patients. Only spatulas extraction was found to significantly increase the risk of severe perineal tear (AOR=7.66; 95% CI: 2.06-28; P=0.02). Although vacuum extraction seemed to increase this risk, it was not found to be significant (AOR=3.25; 95% CI: 0.65-16.24; P=0.15). No significant difference was observed between the risk of severe perineal tear following spatulas and vacuum (AOR=2.36; 95% CI: 0.63-8.82; P=0.202). Finally, neither foetal macrosomia, nor episiotomy, nor foetal extraction with the head in the deep pelvis, nor delivery at night had a significant impact on the probability of severe perineal tear.
Spatulas extraction is an independent risk factor for severe perineal tear. The practice of episiotomy was not shown to have any significant impact on this risk.</description><subject>Adult</subject><subject>Anal Canal - injuries</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Episiotomy - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Intestinal Mucosa - injuries</subject><subject>Obstetrical Forceps - adverse effects</subject><subject>Perineum - injuries</subject><subject>Perineum - surgery</subject><subject>Pregnancy</subject><subject>Rupture</subject><subject>Vacuum Extraction, Obstetrical - adverse effects</subject><issn>2468-7847</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kMtOwzAURC0kRCvoD7BA3rFKuI5dx2FXVbykSizovnLi69ZVXrKdiHwE_0wQsBqNzugshpBbBikDJh_O6fk4tWkGbJ0ylgLwC7LMhFRJrkS-IKsQzgDAVCYll1dkkSkBvFjLJfn6wBE90h69a1HXtOl86YyLE-0sdW2IfmiwjTMxWLt56zDQIbj2SPcnh95P94GGXseh1oHq1tBRV8PQUPyMXlfRde0j3dDed6HHuY5IuzKgH_UPmrVVd-p8pCEOZrohl1bXAVd_eU32z0_77Wuye3952252Sc9AxcRIDornWAhmLcgSwHLBs1wXDPLCqswKlFzIGZa8AGslzwyIkpm1rVTFr8ndr7YfygbNofeu0X46_N_CvwExLWja</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Hamouda, S</creator><creator>Mancini, J</creator><creator>Marchand, F</creator><creator>Bretelle, F</creator><creator>Boubli, L</creator><creator>D'Ercole, C</creator><creator>Carcopino, X</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>201701</creationdate><title>Severe perineal morbidity of instrumental deliveries using Thierry's spatulas and vacuum extraction: A prospective observational cohort study</title><author>Hamouda, S ; Mancini, J ; Marchand, F ; Bretelle, F ; Boubli, L ; D'Ercole, C ; Carcopino, X</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p108t-d630837e941ff06b00f34327a91079f82f4e6346ff0b390ff632d04b1d5fc8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Anal Canal - injuries</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>Episiotomy - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Intestinal Mucosa - injuries</topic><topic>Obstetrical Forceps - adverse effects</topic><topic>Perineum - injuries</topic><topic>Perineum - surgery</topic><topic>Pregnancy</topic><topic>Rupture</topic><topic>Vacuum Extraction, Obstetrical - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamouda, S</creatorcontrib><creatorcontrib>Mancini, J</creatorcontrib><creatorcontrib>Marchand, F</creatorcontrib><creatorcontrib>Bretelle, F</creatorcontrib><creatorcontrib>Boubli, L</creatorcontrib><creatorcontrib>D'Ercole, C</creatorcontrib><creatorcontrib>Carcopino, X</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Journal of gynecology obstetrics and human reproduction</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamouda, S</au><au>Mancini, J</au><au>Marchand, F</au><au>Bretelle, F</au><au>Boubli, L</au><au>D'Ercole, C</au><au>Carcopino, X</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe perineal morbidity of instrumental deliveries using Thierry's spatulas and vacuum extraction: A prospective observational cohort study</atitle><jtitle>Journal of gynecology obstetrics and human reproduction</jtitle><addtitle>J Gynecol Obstet Hum Reprod</addtitle><date>2017-01</date><risdate>2017</risdate><volume>46</volume><issue>1</issue><spage>43</spage><pages>43-</pages><eissn>2468-7847</eissn><abstract>To evaluate the risk of severe perineal tear following instrumental vaginal delivery (IVD) performed with spatulas and vacuum extraction. Secondary objectives were to estimate the impact of episiotomy on this risk.
From December 2008 to October 2012, women who underwent spatulas or vacuum were prospectively included. Each spontaneous vaginal delivery (SVD) following each included IVD were included as control cases (1-1 ratio). Careful perineal examination was systematically performed. Severe perineal tear was defined by the occurrence of anal sphincter rupture with or without anal mucosa tear.
A total of 761 patients were included in the current study: 248 (64%) spatulas, 137 (36%) vacuums and 381 (49%) SVDs. Severe perineal tear was diagnosed in 19 (2.5%) cases. Episiotomy had been performed in 276 (36.9%) patients. Only spatulas extraction was found to significantly increase the risk of severe perineal tear (AOR=7.66; 95% CI: 2.06-28; P=0.02). Although vacuum extraction seemed to increase this risk, it was not found to be significant (AOR=3.25; 95% CI: 0.65-16.24; P=0.15). No significant difference was observed between the risk of severe perineal tear following spatulas and vacuum (AOR=2.36; 95% CI: 0.63-8.82; P=0.202). Finally, neither foetal macrosomia, nor episiotomy, nor foetal extraction with the head in the deep pelvis, nor delivery at night had a significant impact on the probability of severe perineal tear.
Spatulas extraction is an independent risk factor for severe perineal tear. The practice of episiotomy was not shown to have any significant impact on this risk.</abstract><cop>France</cop><pmid>28403956</pmid><doi>10.1016/j.jgyn.2015.11.003</doi></addata></record> |
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| identifier | EISSN: 2468-7847 |
| ispartof | Journal of gynecology obstetrics and human reproduction, 2017-01, Vol.46 (1), p.43 |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Anal Canal - injuries Case-Control Studies Cohort Studies Episiotomy - statistics & numerical data Female Humans Intestinal Mucosa - injuries Obstetrical Forceps - adverse effects Perineum - injuries Perineum - surgery Pregnancy Rupture Vacuum Extraction, Obstetrical - adverse effects |
| title | Severe perineal morbidity of instrumental deliveries using Thierry's spatulas and vacuum extraction: A prospective observational cohort study |
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