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Master Thesis

Les issues maternelles et néonatales des crash césariennes

Abstract : Objective : The purpose of this study was to analyze maternal and neonatal outcomes of crash cesarean deliveries. Methods : We analyzed retrospectively collected singleton maternal and neonatal data from January 1, 2008 to December 31, 2012 of crash cesarean in Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye. We excluded the elective cesarean sections and the emergency cesarean sections. We only kept the crash cesarean sections and classified them in two categories : certain crash cesarean sections and probable crash cesarean sections. The maternal morbidity was studied according to five parameters : general anesthesia ; postpartum hemorrhage ; transfusion ; hysterectomy and re-operation. The neonatal morbidity was analyzed according to four parameters : the cord pH strictly less than 7.20 ; low 1-minute Apgar scores (<7) ; low 5-minute Apgar scores (<7) ; and the admission to neonatal intensive care unit. Results and conclusion : 261 cases were classified as crash cesarean sections : 215 certain crash cesarean sections and 46 probable crash cesarean sections. The results were studied in 3 groups : crash cesarean sections ; certain crash cesarean and probable cesarean sections. In the first group, 35.2% of the mothers had a general anesthesia ; 5.7% had a postpartum hemorrhage ; 1.1% had a hysterectomy ; 1.1 % had a transfusion ; 0.4 % had a re-operation and 0.4% died. In the second group, 27.4% of the mothers had a general anesthesia ; 6% had a postpartum hemorrhage ; 1.4 % had a hysterectomy ; 0.9 % had a transfusion ; 0.5 % had a re-operation ; 0.5 % died. In the third group, 71.1% of the mothers had a general anesthesia ; 4.3% had a postpartum hemorrhage ; 2.1 % had a transfusion. In the first group, 37.9% of the newborns had a pH lower than 7.20 ; 40.6% had a low 1-minute Apgar score (<7) ; 8% had a low 5-minute Apgar score (<7) ; 33.7% had an admission to neonatal intensive care unit. In the second group, 40.5% of the newborns had a pH lower than 7.20 ; 38.6% had a low 1-minute Apgar score (<7) ; 7.9% had a low 5-minute Apgar score (<7) and 33% had an admission to neonatal intensive care unit. In the third group, 26% of the newborns had a pH lower than 7.20 ; 50% had a low 1-minute Apgar score (<7) ; 10.8% had a low 5-minute Apgar score (<7) and 36.9 % had an admission to neonatal intensive care unit.
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Submitted on : Friday, June 6, 2014 - 4:36:19 PM
Last modification on : Monday, April 26, 2021 - 10:38:10 AM
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  • HAL Id : dumas-01002794, version 1

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Hélène Lalo. Les issues maternelles et néonatales des crash césariennes. Gynécologie et obstétrique. 2014. ⟨dumas-01002794⟩

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