[Contraceptive prescriptions following repeated volontary induced abortions]. / Prescriptions contraceptives après interruptions volontaires de grossesses à répétition.

OBJECTIVES: The main objective of this study was to evaluate if the increasing number of repeated abortions in France is linked to a failure to reassess post-abortion contraceptive methods. METHODS: This is a multicentered, descriptive, retrospective study of post-abortion contraceptive practices of patients who underwent a repeated volontary abortion between September one and December 31, 2017, in four abortion centers, in public hospitals in the Alpes-Maritimes and East Var. RESULTS: Of the 217 patients who participated to the study, 78.8% used a different contraceptive method post-abortion vs. the method used during the conception. Only 51.8% of long-acting reversible contraception (LARC) prescribed have been used at the post abortion consultation. DISCUSSION AND CONCLUSION: The repeated abortion may be partly explained by a transient or prolonged absence of contraception. Screening for breaks in the contraceptive history is therefore essential to adapt and maintain contraception at each stage of the patient's life. Some of the professional practices which do not favour an early placement of LARC devices prescribed at the time of abortion, contrary to the new recommendations. The evolution of professional practices still seems necessary to try to help reduce the repeated use of abortion.

[Thierry's spatulas or forceps--a comparison between maternal-fetal morbidities]. / Spatules de Thierry ou forceps : comparaison des morbidités materno-fœtales.

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.