[Failed forceps extraction: risk factors and maternal and neonatal morbidity]. / Facteurs de risque et morbidité maternelle et néonatale des échecs d'extraction instrumentale par forceps.

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.