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Použití porodnických kleští patřilo po staletí k vrcholu porodnického umění. Mnohými byl dokonce nástroj nazýván „královským“, neboť od dob svého vynalezení pomáhal řešit i nejsložitější porodnické případy. Avšak v průběhu posledních dvou desetiletí získává převahu alternativní nástroj pro operační vaginální porod, a tím je vakuumextraktor. Cílem sdělení je zhodnocení dnešního postavení porodnických kleští a jejich srovnání s druhou trakční metodou, s vakuumextrakcí. Použité zdroje, zejména z Cochranovy databáze, jsou doplněny vlastními zkušenostmi.

The use of forceps delivery has been at the height of obstetric methods for centuries. They have even been described as „royal“, since from the time of their discovery they have helped solve even the most difficult delivery problems. In the past couple of decades, however, the use of alternative delivery tools, especially the vacuum extractor, have become more widespread during vaginal deliveries. The aim of this paper is to evaluate the current status of the use of forceps delivery and compare them with vacuum extraction, another tractive method. Published data, particularly from the Cochran database, are supplemented by personal experience.

Klíčová slova
operační vaginální porod, vakuumextrakce,
MeSH
extrakce porodnická kontraindikace škodlivé účinky MeSH
lidé MeSH
novorozenec MeSH
porodnické kleště MeSH
směrnice pro lékařskou praxi jako téma MeSH
těhotenství MeSH
vakuová extrakce porodnická MeSH
Check Tag
lidé MeSH
novorozenec MeSH
těhotenství MeSH
ženské pohlaví MeSH
Publikační typ
přehledy MeSH

Článek

Pubococcygeus-puborectalis trauma after forceps delivery: evaluation of the levator ani muscle with 3D/4D ultrasound

International urogynecology journal and pelvic floor dysfunction. 2009 ; 20 (10) : 1175-1181.

Int Urogynecol J Pelvic Floor Dysfunct
Medvik
Zdroj

INTRODUCTION AND HYPOTHESIS: This study seeks to assess the effects of forceps-assisted delivery on the levator hiatus. METHODS: Seventy-six women were investigated 12 months after forceps-assisted delivery. Introital three-/four-dimensional ultrasound measured volumes at rest and during the Valsalva maneuver. Morphological parameters analyzed were angle gamma, hiatal area, pubovisceral angle, and continuity between the muscle and pelvic sidewall. Avulsion was diagnosed by loss of continuity. RESULTS: Forty-eight women had avulsion injuries, 23 had bilateral, and 25 had unilateral. Bilateral avulsion increased hiatal area during straining and at rest and was associated with changes in bladder neck position at rest. Unilateral avulsion injury was associated with a higher pubovisceral angle on the side of the avulsion. CONCLUSION: Forceps-assisted vaginal delivery is associated with levator ani injury. Avulsion of the pubovisceral muscle seems more common after forceps delivery than after spontaneous vaginal delivery. Avulsion alters hiatal shape and area and influences the position and mobility of the anterior compartment.