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Master Thesis

La détresse respiratoire chez le nouveau-né à terme né par césarienne avant travail et pendant travail : revue systématique de la littérature et étude rétrospective

Abstract : Objective - Study the own role of labor on the incidence of respiratory disorders in a low-risk population of term infants born by cesarean section before or during labor.
Study design - Review of literature about respiratory disorders and cesarean delivery before or during labor in term-population newborn. Retrospective exposed-non exposed study on 2280 women who delivered by cesarean section, a singleton fetus, between 2010 and 2014 at Port-Royal maternity (1104 before labor, 1176 during labor), between 37 and 40 weeks of gestation + 6 days, with and without risks factors of respiratory disorders. Data analysis from neonates admitted to special care unit for respiratory disorders have been studied.
Results - Consensus of literature about the increased respiratory morbidity in case of birth by cesarean section without labor, and the advantage to carry out an elective cesarean after 39 weeks of gestation, if it is possible, in order to reduce respiratory disorders. On 1104 women who delivered by cesarean section before labor, and 1176 during labor, the incidence of respiratory complications was respectively 3.0% and 1.8% (p-value=0.06). After removal of respiratory disorders risk-factors (diabetes mellitus, meconium-stained amniotic fluid, abnormalities of fetal heart rate), 786 women delivered by cesarean section without labor, and 319 with labor. The incidence of respiratory disorders was 2.4% in the without-labor group, and 0.6% in the with-labor group, with p-value=0.05. There was no significant difference about the respiratory complications after 39 weeks of gestation in the two groups.
Conclusion - The absence of labor is an independent risk-factor of respiratory disorders in a low-risk term newborns population. An elective cesarean section should be done after 39 weeks of gestation in order to decrease the respiratory morbidity, when it is possible.
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Submitted on : Wednesday, September 2, 2015 - 4:21:46 PM
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  • HAL Id : dumas-01191859, version 1

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Margot Lecomte. La détresse respiratoire chez le nouveau-né à terme né par césarienne avant travail et pendant travail : revue systématique de la littérature et étude rétrospective. Gynécologie et obstétrique. 2015. ⟨dumas-01191859⟩

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