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

Objective. - To compare maternal and fetal morbidity during forceps or Thierry spatulas operative deliveries. Methods. - Retrospective and descriptive study in a one center from 2006 to 2012. Operative deliveries were performed with forceps or spatulas, in case of no mobile fetal progression, on singleton term pregnancies with cephalic presentation, no abnormal heart rate and without any pregnancy pathology. Results. - Our studies included 65 operative deliveries with spatulas versus 77 with forceps, among a scientifically comparable population. At maternal level, when comparing spatulas versus forceps, there were more intact perineum (5.19% vs 15.38%; P = 0.04), the same rate of vaginal tears and less severe perineal injuries (0 vs 6; P = 0.05) in favor of spatulas. Extractions performed in ``unfavorable'' conditions were mostly conducted with forceps. In 50% of the case, an episiotomy was associated with severe perineal lesions. As far as fetal morbidity is concerned, there were more newborn's facial injuries using the forceps tool (18.18% vs 3.08%; P = 0.0046). The remaining data were comparable. Conclusions. - Thierry spatulas are less harmful than forceps to maternal tissues and reduce facial injuries of the newborn. Consequently, spatulas could benefit from a wider use. However, a prospective study will be needed to confirm our results. (C) 2015 Elsevier Masson SAS. All rights reserved.