Evaluation of Suzor forceps training by studying obstetric anal sphincter injuries: a retrospective study.

BACKGROUND: Instrumental deliveries are an unavoidable part of obstetric practice. Dedicated training is needed for each instrument. To identify when a trainee resident can be entrusted with instrumental deliveries by Suzor forceps by studying obstetric anal sphincter injuries. METHODS: A French retrospective observational study of obstetric anal sphincter injuries due to Suzor forceps deliveries performed by trainee residents was conducted from November 2008 to November 2016 at Limoges University Hospital. Perineal lesion risk factors were studied. Sequential use of a vacuum extractor and then forceps was also analyzed. RESULTS: Twenty-one residents performed 1530 instrumental deliveries, which included 1164 (76.1%) using forceps and 89 (5.8%) with sequential use of a vacuum extractor and then forceps. Third and fourth degree perineal tears were diagnosed in 82 patients (6.5%). Residents caused fewer obstetric anal sphincter injuries after 23.82 (+/- 0.8) deliveries by forceps (p = 0.0041), or after 2.36 (+/- 0.7) semesters of obstetrical experience (p = 0.0007). No obese patient (body mass index> 30) presented obstetric anal sphincter injuries (p = 0.0013). There were significantly fewer obstetric anal sphincter injuries after performance of episiotomy (p <  0.0001), and more lesions in the case of the occipito-sacral position (p = 0.028). Analysis of sequential instrumentation did not find any additional associated risk. CONCLUSION: Training in the use of Suzor forceps requires extended mentoring in order to reduce obstetric anal sphincter injuries. A stable level of competence was found after the execution of at least 24 forceps deliveries or after 3 semesters (18 months) of obstetrical experience.

Mobile phone use during pregnancy: Which association with fetal growth?

INTRODUCTION: Few studies have investigated the effect of electromagnetic waves on the human fetus whereas nowadays mobile phone use is ubiquitous. The aim of this study was to evaluate the association between mobile phone use by pregnant women and fetal development during pregnancy in the general population. MATERIAL AND METHODS: Data came from the NéHaVi cohort ("prospective follow-up, from intrauterine development to the age of 18 years, for children born in Haute-Vienne"), a prospective, longitudinal, multicenter (three maternity units in Haute-Vienne) observational cohort focusing on children born between April 2014 and April 2017. Main objective was to investigate the association of mobile phone use on fetal growth. Univariate and multivariate models were generated adjusted for the socioprofessional category variables of the mother, and other variables likely to influence fetal growth. RESULTS: For the analysis 1378 medical charts were considered from which 1368 mothers (99.3 %) used their mobile phones during pregnancy. Mean phone time was 29.8 min (range: 0.0-240.0 min) per day. After adjustment, newborns whose mothers used their mobile phones for more than 30 min/day were significantly more likely to have an AUDIPOG score ≤ 10th percentile than those whose mothers used their mobile phones for less than 5 min/day during pregnancy (aOR = 1.54 [1.03; 2.31], p = 0.0374). For women using their cell phones 5-15 min and 15-30 min, there wasn't a significant association with an AUDIPOG score ≤ 10th, respectively aOR = 0.98 [0.58; 1.65] and aOR = 1.68 [0.99; 2.82]. CONCLUSION: Using a mobile phone for calls for more than 30 min per day during pregnancy may have a negative impact on fetal growth. A prospective study should be performed to further evaluate this potential link.