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Master Thesis

Confusion des enregistrements cardiaques fœtal et maternel au cours de l'expulsion‎ : impact sur l'état néonatal et le taux d'extraction instrumentale

Abstract : Objective: Our purpose was to describe and quantify overlap between maternal and fœtal heart rates during pushing stage of labour, and to analyse perinatal and obstetrical consequences of such situations. Methods: This prospective study was carried out in a level 3 maternity ward between January 1st and April 15, 2008. 300 single foetus vaginal deliveries were included. Maternal and foetal complications of pregnancy were excluded. For each monitoring, we quantified possible confusion between maternal and foetal heart rates as the total time of overlap between both rhythms compared to total pushing time. Mann-Whitney test was used for statistical analysis. Significance level was set at 5%. Results: Total overlap between foetal and maternal heart rates was 34.5%, and occurred on 63.3% of all monitorings. Epidural analgesia reduced occurrence of overlap, whereas maternal obesity and maternal tachycardia increased it. There were no significant neonatal consequences. Surprisingly, assisted delivery rates were significantly lower when overlapping time increased. Conclusion: Foetal heart rate recording by external monitoring is not reliable enough. There are too many overlaps between foetal and maternal heart rates, and thus too much confusion possible.
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Master Thesis
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Submitted on : Wednesday, October 12, 2011 - 3:33:59 PM
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  • HAL Id : dumas-00631512, version 1

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Séverine Buisson. Confusion des enregistrements cardiaques fœtal et maternel au cours de l'expulsion‎ : impact sur l'état néonatal et le taux d'extraction instrumentale. Médecine humaine et pathologie. 2009. ⟨dumas-00631512⟩

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