[产钳助产失败：危险因素及对母婴的发病率影响]

[Failed forceps extraction: risk factors and maternal and neonatal morbidity].

作者信息

Langeron A, Mercier G, Chauleur C, Varlet M-N, Patural H, Lima S, Seffert P, Chêne G

机构信息

Département de gynécologie-obstétrique et médecine de la reproduction, hôpital Nord, CHU de Saint-Étienne, avenue Albert-Raimond, Saint-Étienne, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2012 Jun;41(4):333-8. doi: 10.1016/j.jgyn.2011.11.001. Epub 2012 Jan 9.

DOI:10.1016/j.jgyn.2011.11.001

PMID:22227232

Abstract

OBJECTIVES

To evaluate risk factors associated with failed forceps delivery and to compare the maternal and neonatal morbidity.

PATIENTS AND METHODS

In this retrospective case-control study, all failed forceps delivery cases were analyzed from January 2005 to June 2008 and were compared to a successful forceps delivery cohort.

RESULTS

The rate of failed forceps extraction was 4.4% (40/918). Specific risk factors were extraction above a fœtal station of S+2 (OR=43.03; IC 95%: 3.8-475.41), occipito-posterior position (OR=34.64; IC 95%: 4.08-293.5), and biparietal diameter higher than 95mm (OR=10.74; IC 95%: 1.4-82.41). Maternal and neonatal morbidity was few in both groups.

CONCLUSIONS

Diagnosis of presentation level and variety of presentation are necessary before instrumental extraction. A "trial of forceps" should be performed with caution in a setting where a caesarean delivery could follow. Vacuum extraction could be interesting in case of occipito-posterior position.

摘要

目的

评估与产钳助产失败相关的危险因素，并比较母婴发病率。

患者与方法

在这项回顾性病例对照研究中，分析了2005年1月至2008年6月期间所有产钳助产失败病例，并与成功的产钳助产队列进行比较。

结果

产钳助产失败率为4.4%（40/918）。具体危险因素包括胎头位置在S+2以上进行助产（比值比=43.03；95%置信区间：3.8-475.41）、枕后位（比值比=34.64；95%置信区间：4.08-293.5）以及双顶径大于95mm（比值比=10.74；95%置信区间：1.4-82.41）。两组母婴发病率均较低。