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Riethmuller D, Mottet N, Guerby P, Parant O. [Spatulas: A Franco-Colombian story or the slow rise of propulsion...]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:143-152. [PMID: 36436820 DOI: 10.1016/j.gofs.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
The idea of using an instrument to assist natural childbirth is not new and it was in the 18th and 19th centuries that the forceps was developed. It is only after the Second World War that the suction cup provides an alternative to instrumental childbirth, but still based on prehension and traction. In 1950, Emile Thierry, in France, presented his spatulas based on the then original principle of propulsion. The diffusion of spatulas is almost non-existent in the Anglo-Saxon world but is not limited to France since its use was real by the Iberians and Latin Americans. There are currently three types of spatula, two of which are French and one Colombian. This review takes up the saga of this instrument for more than 70 years, develops its particularities and describes the present literature.
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Subgaleal Haematoma After Instrumental Delivery: Another Unexpected Complication of a Cost-Saving Version of Thierry's Spatulas. J Gynecol Obstet Hum Reprod 2022; 51:102356. [PMID: 35304291 DOI: 10.1016/j.jogoh.2022.102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/02/2022] [Accepted: 03/13/2022] [Indexed: 11/22/2022]
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Lebraud M, Loussert L, Griffier R, Gauthier T, Parant O, Guerby P. Maternal and neonatal morbidity after forceps or spatulas-assisted delivery in preterm birth. Eur J Obstet Gynecol Reprod Biol 2022; 271:128-131. [PMID: 35183002 DOI: 10.1016/j.ejogrb.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 02/04/2022] [Accepted: 02/11/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to assess perinatal morbidity associated with spatulas or forceps assisted delivery in preterm birth. STUDY DESIGN This is a retrospective cohort study including all women with assisted deliveries on singleton pregnancy in cephalic presentation, before 37 weeks of gestation, in two tertiary care centers. We compared forceps-assisted deliveries with spatula-assisted deliveries. The main outcome was the rate of neonatal birth trauma. Secondary outcomes included other neonatal parameters, maternal outcomes and obstetric anal sphincter injuries. RESULTS Out of 37 002 deliveries, 59 (0.2 %) preterm assisted deliveries with forceps and 111 (0.3%) preterm spatulas deliveries were included. The rate of neonatal birth trauma was low for both devices, without significant difference (3.4% in Forceps group vs 0.9% in Spatulas group, p = 0.28). The rate of episiotomy was 79.7% after forceps-assisted delivery and 48.6% for spatulas (p < 0.001). The rate of obstetric anal sphincter injuries was 1.7% and 2.7% respectively (p = 0,9). CONCLUSION The rate of birth trauma was low in both forceps-assisted deliveries and spatula-assisted deliveries and was not significantly different between the two groups.
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Affiliation(s)
- Margaux Lebraud
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, 330 avenue de Grande-Bretagne, TSA 70034 31059 Toulouse, France
| | - Lola Loussert
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, 330 avenue de Grande-Bretagne, TSA 70034 31059 Toulouse, France
| | - Romain Griffier
- Department of Public Health, CHU Bordeaux, Place Amélie Raba Léon, 33000 Bordeaux, France
| | - Tristan Gauthier
- Department of Obstetrics and Gynecology, Hôpital de la mère et de l'enfant, 8 Avenue Dominique Larrey, 87000 Limoges, France
| | - Olivier Parant
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, 330 avenue de Grande-Bretagne, TSA 70034 31059 Toulouse, France
| | - Paul Guerby
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, 330 avenue de Grande-Bretagne, TSA 70034 31059 Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases, Inserm UMR 1291 - CNRS UMR 5051 - University Toulouse III, France.
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Operative vaginal delivery in case of persistent occiput posterior position after manual rotation failure: a 6-month follow-up on pelvic floor function. Arch Gynecol Obstet 2018; 298:111-120. [PMID: 29785548 DOI: 10.1007/s00404-018-4794-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/16/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016. Maternal and neonatal outcomes of all attempted IR deliveries were compared with OP operative vaginal deliveries. Main outcomes measured were pelvic floor function at 6 months postpartum including Wexner score for anal incontinence and ICIQ-FLUTS for urinary symptoms. Perineal morbidity comprised severe perineal tears, corresponding to third and fourth degree lacerations. Fetal morbidity parameters comprised low neonatal Apgar scores, acidaemia, major and minor fetal injuries and neonatal intensive care unit admissions. RESULTS Among 5265 women, 495 presented with persistent OP positions (9.4%) and 111 delivered after manual rotation failure followed by AD delivery: 58 in the IR group and 53 in the AD in OP group. The incidence of anal sphincter injuries was significantly reduced after IR attempt (1.7% vs. 24.5%; p < 0.001) without increasing neonatal morbidity. At 6 months postpartum, AD in OP position was associated with higher rate of anal incontinence (30% vs. 5.5%, p = 0.001) and with more urinary symptoms, dyspareunia and perineal pain. CONCLUSIONS OP operative deliveries are associated with significant perineal morbidity and pelvic floor dysfunction at 6 months postpartum.
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Guerby P, Allouche M, Simon-Toulza C, Vayssiere C, Parant O, Vidal F. Management of persistent occiput posterior position: a substantial role of instrumental rotation in the setting of failed manual rotation. J Matern Fetal Neonatal Med 2017; 31:80-86. [DOI: 10.1080/14767058.2016.1275552] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paul Guerby
- Gynecology and Obstetrics Department, Paule de Viguier Hospital, CHU Toulouse, France
| | - Mickael Allouche
- Gynecology and Obstetrics Department, Paule de Viguier Hospital, CHU Toulouse, France
| | - Caroline Simon-Toulza
- Gynecology and Obstetrics Department, Paule de Viguier Hospital, CHU Toulouse, France
| | - Christophe Vayssiere
- Gynecology and Obstetrics Department, Paule de Viguier Hospital, CHU Toulouse, France
- UMR 1027 INSERM, University Paul Sabatier Toulouse III, Toulouse, France
| | - Olivier Parant
- Gynecology and Obstetrics Department, Paule de Viguier Hospital, CHU Toulouse, France
- UMR 1027 INSERM, University Paul Sabatier Toulouse III, Toulouse, France
| | - Fabien Vidal
- Gynecology and Obstetrics Department, Paule de Viguier Hospital, CHU Toulouse, France
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Hamouda S, Mancini J, Marchand F, Bretelle F, Boubli L, D’Ercole C, Carcopino X. Severe perineal morbidity of instrumental deliveries using Thierry's spatulas and vacuum extraction: A prospective observational cohort study. J Gynecol Obstet Hum Reprod 2017; 46:43-51. [DOI: 10.1016/j.jgyn.2015.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 10/25/2015] [Accepted: 11/04/2015] [Indexed: 11/24/2022]
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Évaluation des spatules de Teissier dans l’accouchement assisté des fœtus prématurés. ACTA ACUST UNITED AC 2016; 45:592-8. [DOI: 10.1016/j.jgyn.2015.06.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 06/04/2015] [Accepted: 06/18/2015] [Indexed: 11/17/2022]
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Durand-Maison O, Mangin-Meyniel M, Tabard F, Bulot P, Cottenet J, Gobenceaux AS. Spatules de Thierry ou forceps : comparaison des morbidités materno-fœtales. ACTA ACUST UNITED AC 2016; 44:17-22. [DOI: 10.1016/j.gyobfe.2015.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/15/2015] [Indexed: 11/16/2022]
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Tsoyem Mouafou AC, Morel O, Lamy C, Monceau E, Judlin P, Muhlstein J. Morbidité materno-fœtale des extractions instrumentales : forceps versus spatules. À propos d’une série de 77 cas. ACTA ACUST UNITED AC 2014; 42:144-8. [DOI: 10.1016/j.gyobfe.2012.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Accepted: 02/15/2011] [Indexed: 10/28/2022]
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Vidal F, Simon C, Cristini C, Arnaud C, Parant O. Instrumental rotation for persistent fetal occiput posterior position: a way to decrease maternal and neonatal injury? PLoS One 2013; 8:e78124. [PMID: 24205122 PMCID: PMC3799777 DOI: 10.1371/journal.pone.0078124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 09/09/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate immediate perineal and neonatal morbidity associated with instrumental rotations performed with Thierry's spatulas for the management of persistent posterior occiput (OP) positions. METHODS Retrospective study including all persistent occiput posterior positions with vaginal OP delivery, from August 2006 to September 2007. Occiput anterior deliveries following successful instrumental rotation were included as well. We compared maternal and neonatal immediate outcomes between spontaneous deliveries, rotational and non rotational assisted deliveries, using χ(2) and Anova tests. RESULTS 157 patients were enrolled, comprising 46 OP spontaneous deliveries, 58 assisted OP deliveries and 53 deliveries after rotational procedure. Instrumental rotation failed in 9 cases. Mean age and parity were significantly higher in the spontaneous delivery group, while labor duration was shorter. There were no significant differences in the rate of severe perineal tears and neonatal adverse outcomes between the 3 groups. CONCLUSION Instrumental rotation using Thierry's spatulas was not associated with a reduced risk of maternal and neonatal morbidity for persistent OP deliveries. Further studies are required to define the true interest of such procedure in modern obstetrics.
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Affiliation(s)
- Fabien Vidal
- CHU Toulouse, Pole de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, France
| | - Caroline Simon
- CHU Toulouse, Pole de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, France
| | | | - Catherine Arnaud
- CHU Purpan Unité de soutien à la recherche, Toulouse, France
- INSERM, U.1027, France
- Université Paul-Sabatier, Toulouse, France
| | - Olivier Parant
- CHU Toulouse, Pole de Gynécologie Obstétrique, Hôpital Paule de Viguier, Toulouse, France
- INSERM, U.1027, France
- Université Paul-Sabatier, Toulouse, France
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Genre L, Tanchoux F, Parant O. Hématome puerpéral pelvien : étude sur cinq années de suivi. ACTA ACUST UNITED AC 2012; 41:290-7. [DOI: 10.1016/j.jgyn.2011.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Revised: 12/27/2011] [Accepted: 12/30/2011] [Indexed: 10/14/2022]
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Lésions périnéales sévères liées à une extraction fœtale par spatules. Quels facteurs de risques ? ACTA ACUST UNITED AC 2012; 41:69-75. [DOI: 10.1016/j.jgyn.2011.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 06/14/2011] [Accepted: 06/17/2011] [Indexed: 11/23/2022]
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Grisot C, Mancini J, de Troyer J, Rua S, Boubli L, d’Ercole C, Carcopino X. Morbidité périnéale des extractions instrumentales par spatules et ventouses : qu’en est-il réellement ? ACTA ACUST UNITED AC 2011; 40:348-58. [DOI: 10.1016/j.jgyn.2011.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Revised: 03/19/2011] [Accepted: 03/24/2011] [Indexed: 11/16/2022]
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