Author(s)

Omar Gassama, Babacar Biaye^*, Boura Taoufiki, Ndeye Astou Faye, Djibril Diallo, Aminata Niass, Abdou Ndiaye, Alassane Diouf, Jean Charles Moreau

Gynecological and Obstetric Clinic of Aristide Hospital Le Dantec of Dakar, Dakar, Senegal.

Introduction: An instrumental extraction is performed in order to shorten the phase of expulsion of the fetus outside the maternal pelvic pathway, when there is a suspected fetal state or a defect in progression of the fetal mobile. It can be responsible for immediate or late maternal complications, which are not specific because they can occur after a normal delivery. The objectives of this work are to describe the epidemiological-clinical and prognosis aspects of deliveries assisted by instrumental extractions in a reference maternity unit in Dakar. Materials and Methods: This was a retrospective, descriptive and analytical study between January 1, 2017 and December 31, 2017, a period of 12 months at the maternity ward of the Nabil Choucair Health Center. The collection was carried out using the survey form completed on the basis of the analysis of the files, the delivery register and the anaesthesia register of the operating room. The parameters studied were about socio-demographic characteristics, indications and prognosis. The data entry was carried out using the Sphinx version 5 software and the data analysis using the Epi info version 3.5 software. Results: During the period of our study, we collected 94 instrumental extractions. The frequency of instrumental extractions was 1.7%. The average age of the patients was 25 years with extremes of 16 to 43 years old. The average parity was 1 with extremes 1 to 6. Among parturient women, 12 patients (12.8%) had a history of suction cup, two (2.1%) had received forceps and three (3.2%) had a cesarean section. The average gestational age was 39 Weeks of Amenorrhea (WA), the average uterine height was 32 cm, fetal heart sounds were normal in 98% parturient’ cases. The vaginal touch had found a fully dilated cervix, a rupture of the amniotic sac with clear amniotic fluid in 98% of parturient women and a fetus with an anterior left iliac occipito topin 69.4% of cases. The pelvis was clinically normal in all parturient women. The indications were dominated by maternal fatigue (65.9%). The spatula was the most commonly used instrument (82.7%). Episiotomy was performed in 97.3% of cases. The average weight of the newborn was 3058 grams and an Apgar score of 8/10 was noted in 96% of newborns. We noted 3 cases of maternal complications with perineal tear type (3.2%) and 1 case of perineal tear associated with postpartum hemorrhage (1.06%). The neonatal prognosis was dominated by 2 caput succedaneum cases (2.1%). Newborns were alive and well in 97.8%. We noted 2 cases of death, i.e. 2.1% in unsolved circumstances. All the mothers were alive and well at (100%). Conclusion: Instrumental extractions must be integrated into our structures to significantly reduce the number of abusive cesarean sections. The perfect mastery of extraction techniques and indications makes it possible to reduce fetal suffering while avoiding the morbidity associated with instrumental extractions.

Instrumental Extraction, Suction Cup, Spoonbill, Forceps

Gassama, O. , Biaye, B. , Taoufiki, B. , Faye, N. , Diallo, D. , Niass, A. , Ndiaye, A. , Diouf, A. and Moreau, J. (2020) Fetal Instrumental Extractions at the Maternity Section of the Dakar Nabil Choucair Health Centre (Senegal) in 2017: Epidemio-Clinical Aspects, Indications and Prognosis. Open Journal of Obstetrics and Gynecology, 10, 390-399. doi: 10.4236/ojog.2020.1030035.