Aspects médico-légaux de l'extraction instrumentale

The aim of this data analysis on medical liability in professional guidelines on instrumental delivery, is to point out the most common difficulties to which obstetricians are exposed, and to discuss some aspects confronted to literature. Firstly, instrumental delivery is replaced in whole labour ward activity by unpublished results of a national enquiry on instrumental delivery concerning 239 337 deliveries during the year 2007. Then, the analysis of 61 data from legal claims in relation with instrumental deliveries between 1995 and 2007, to allow educational lessons. At last, few specific aspects of judicial expert opinion are confronted to literature and discussed: the effects of debriefing after operative childbirth; discussion on decision making and decision-to-delivery intervals. This chapter is concluded by different points on risk management in labour ward, mainly with potential interest of auditable standards and training with computer assisted simulation.