Dupuis O, Meysonnier C, Clerc J
Département d'obstétrique et de gynécologie, centre hospitalier Lyon Sud, 69310 Pierre-Bénite, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France.
Département d'obstétrique et de gynécologie, centre hospitalier Lyon Sud, 69310 Pierre-Bénite, France.
J Gynecol Obstet Biol Reprod (Paris). 2016 Apr;45(4):343-52. doi: 10.1016/j.jgyn.2015.04.011. Epub 2015 Jun 19.
The aim of this study is to describe knowledge on forceps delivery in the area of Lyon.
It is a multicentric observational study carried between January 1, 2013 and June 9, 2013. A questionnaire was sent to obstetricians and residents of the area of Lyon. It related prerequisites for operative vaginal delivery, the method used to apply forceps, practices and preferences of operators.
Seventy-five responses were obtained (47 obstetricians, 28 residents). About prerequisites: 6.4% of the obstetricians and 14.3% of the residents never do urinary catheterization. Instrumental delivery is never performed when the fetal head is not engaged. Mid-pelvic operative vaginal delivery is performed by 51.1% of obstetricians. Trans-abdominal ultrasound assessment is conducted in cases of clinical doubts about the fetal head position. For occipital anterior and left anterior positions, the left blade is first applied. A flexion of the fetal head is applied for anterior positions but not in posterior positions. Most of operators do not perform instrumental rotation. Vacuum extractor is the privileged instrument for obstetricians and forceps is often used in second line.
This study shows that most of the recommendations for forceps delivery are followed. In front of the lake of statistical power of this study, it might be interesting to improve a largest study with a comparison between obstetricians and residents' practices.
本研究旨在描述里昂地区产钳助产的相关知识。
这是一项于2013年1月1日至2013年6月9日开展的多中心观察性研究。向里昂地区的产科医生和住院医师发放了一份问卷。问卷涉及阴道助产的先决条件、应用产钳的方法、操作者的实践及偏好。
共获得75份回复（47名产科医生，28名住院医师）。关于先决条件：6.4%的产科医生和14.3%的住院医师从不进行导尿。当胎头未衔接时从不进行器械助产。51.1%的产科医生会进行中骨盆阴道助产。在临床对胎头位置存疑的情况下会进行经腹超声评估。对于枕前位和左前位，先放置左叶产钳。对于前位会使胎头俯屈，但后位则不会。大多数操作者不进行器械旋转。对于产科医生而言，真空吸引器是首选器械，产钳通常作为二线器械使用。
本研究表明，产钳助产的大多数建议都得到了遵循。鉴于本研究的统计学效力有限，开展一项纳入更多样本并比较产科医生和住院医师实践差异的更大规模研究可能会很有意思。
