[Instrumental extractions using Thierry's spatulas: evaluation of the risk of perineal laceration according to occiput position in operative deliveries].

Objective: Risk factors for severe perineal lacerations are nowadays well-known and they include operative vaginal deliveries and extractions in occiput posterior (OP) positions. The aim of this study was to assess whether OP position increases the risk for anal sphincter injury when compared with occiput anterior (OA) positions in operative deliveries using Thierry's spatulas.

Methods: Retrospective study of 163 extractions with Thierry's spatulas over a five-year period (January 2000 to December 2005) performed in a general hospital.

[Thierry's spatula instrumental extraction: a study of foetal-maternal morbidity].

Objective: Assisted delivery is necessary in many obstetrical conditions but is involved in maternal and foetal complications. The legal pressure and the commendable aim consisting in less neonatal morbidity and mortality have called forth a reflection about the type and the way of instrumental foetal extraction. In 1950, Thierry had already felt this problem and he invented spatula to replace obstetrical forceps.

[Update on delayed births].

Sixteen (16) cases of delayed births have been reported in the literature. All of these patients obtained at least one live child. This method can, therefore, be suggested in cases of premature birth after less than 28 weeks of amenorrhea for patients who present with a multiple, pluriamniotic pregnancy.

[Antenatal diagnosis of achondrogenesis. Two successive cases in the same family].

Achondrogenesis is a rare case of fetal skeletal dysplasia. Achondrogenesis in lethal. That is a autosomal recessive fetal skeletal dysplasia.

[Deferred deliveries in multiple pregnancies. Discussion on a new case report].

The authors report a new case of a triplet pregnancy in which an abortion occurred in the second trimester and twins were delivered at the 33rd week of gestation. The authors point out that it is possible to carry out a cerclage when a fetus and placenta are retained without necessarily causing an infection with clinical symptoms; but the authors do point out that there is always the possibility of infecting the mother and the fetus. As to the prognosis for the fetus, it is better it is given an opportunity to grow further in spite of the risk of infection.

[Neonatal alloimmune thrombocytopenia following immunization against the platelet antigen ZWA (PLA/1). 3 case reports in the same family and analysis of the literature].

Allo-immune neonatal thrombopenia is to platelets what rhesus hemolytic disease is to red blood cells. There is a risk of haemorrhage when fetal platelets decreases below 50,000 per mm3. Such haemorrhage may occur at any time during the thrombopenia period.

[Non-Hodgkin's malignant lymphoma with primary localization in the breast. Apropos of 2 cases: review of the literature].

The malignant non-hodgkinian lymphoma (M.N.H.

[The procedure to be adopted in cases of breech presentation: use of the vacuum extractor].

The authors review the advantages of a non-standard method of extraction in cases of breech presentation, the vacuum extractor. This method should not only replace total extraction in cases of frank breech, but should also find much wider applications. In fact the technique, which is easily applied and always effective, permits extraction in cases of frank breech by the vaccum cup at the stage of complete dilatation, preferably when the breech is well engaged, without serious complications.

[A sensory screening test in neonatal pathology].

Systematic investigation of auditory reactions in newborn babies has been started three years ago at the Centre Hospitalier Regional of Besançon. However, deafness screening at the Maternity has been used for a wider purpose by the authors, who investigated more especially the correlations between the response to auditory stimulus and antenatal and perinatal pathology. Their preliminary study was conducted on 340 newborn infants.