TITLE:
Emergency Neonatal Obstetric Cares at Cocody University Hospital: Overview of Instrumental Extraction
AUTHORS:
Kakou Charles, Kasse Raoul, Kouame Arthur, Koime Hervé, Effoh Denis, Gondo Diomandé, Boni Serge
KEYWORDS:
Instrumental Extraction, Forceps, Vacuum Extractor, Availability, Stillbirth
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.11,
October
18,
2017
ABSTRACT: Objectives: The aim of this study was
to show an overview of situation of instrumental
extraction at the maternity of Cocody University Hospital by determining
availability and assessing the maternal and fetal prognosis. Patients and
method: it was a retrospective study with a descriptive purpose on 6 months
from January 1 to June 31, 2015. It concerned all patients admitted in the
expulsive phase of labor delivery room and with an indication of fetal instrumental
extraction and the state of their newborns at birth. Results: We saved
2288 vaginal deliveries; including 28 instrumental deliveries on 104 indications
of instrumental extraction is an implementation rate of 26.9% (16 by vacuum
extractor and 12 forceps). Among
patients with indication but without instrumental extraction (n = 76), there is
42.3% vaginal delivery (n = 44) and 30.8% of cesarean section (n = 32). 44 have given birth vaginally (42.3%) and 32 by
caesarean section (30.8%). It’s young patient (28 years), nulliparous (42.3%). Average time between instrumental extraction indication and the delivery
of the baby was 58 min in the case of instrumental extraction and 1 hour 41 minutes
in the case of spontaneous delivery in anticipation of the c-section.
Motherhood had 3 instrumental extractors (2 vacuum extractors and 1 forceps)
recycled after each use. The Apgar score was good in 85.7% in children born by
instrumental extraction and bad in 54.5% in children born vaginally without
instrumental extraction. We found 20 stillborn in intra partum occurred only in
children born vaginally without instrumental extraction. Twelve (12) cases of
bleeding of the issue by uterine atony (27.3%) were recorded in patients
pregnant without instrumental extraction. No maternal deaths were observed. Conclusion: The realization of instrumental extraction rate remains
low at the maternity of the UH-C. In the event, the fetal prognosis was better.