[Thierry's spatulas or forceps--a comparison between maternal-fetal morbidities].

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Surgical Instruments

Background:

• Operative vaginal delivery is employed when fetal progression is impeded.
• Forceps and Thierry spatulas are common instruments used in such deliveries.
• Understanding the comparative maternal and fetal morbidity associated with these instruments is crucial for clinical decision-making.

Purpose of the Study:

• To compare maternal and fetal morbidity outcomes between operative deliveries utilizing forceps and Thierry spatulas.
• To evaluate the safety and efficacy of Thierry spatulas versus forceps in specific obstetric scenarios.

Main Methods:

• A retrospective, single-center study was conducted from 2006 to 2012.
• Included were singleton, term pregnancies with cephalic presentation, normal fetal heart rate, and no pregnancy pathology, requiring operative delivery due to lack of fetal progression.
• Data were collected for deliveries performed with either forceps or Thierry spatulas.

Main Results:

• Maternal outcomes favored spatulas, showing a higher rate of intact perineum (15.38% vs 5.19%) and fewer severe perineal injuries (0 vs 6) compared to forceps.
• Fetal morbidity revealed significantly more newborn facial injuries with forceps use (18.18% vs 3.08%).
• Extractions in unfavorable conditions were more common with forceps; episiotomy was associated with severe perineal lesions in 50% of cases.

Conclusions:

• Thierry spatulas appear to be less harmful to maternal tissues and reduce neonatal facial injuries compared to forceps.
• The findings suggest that Thierry spatulas could be utilized more broadly in operative vaginal deliveries.
• Further prospective studies are recommended to validate these comparative outcomes.