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Master Thesis

Impact d’une estimation de poids fœtal échographique à 36 SA sur les issues obstétricales et néonatales dans une population à bas risque

Abstract : Objective
The purpose of our study is to assess the impact of a fetal weight estimation, through an ultrasound at 36 weeks of amenorrhea, on the obstetric and neonatal outcomes, within a low obstetrical risk group.
Methods
We achieved a retrospective cohort, observational and unicentric study in the department of obstetrics gynecology in the hospital of Poissy-Saint-Germain-en-Laye, between the 1st of January 2013 and the 31st of December 2013. An additional ultrasound has been achieved at 36 weeks of amenorrhea among 357 low-risk patients. We excluded the patients who were requiring a 36 weeks ultrasound for maternal, obstetrical or fetal pathology. We also selected a control group of 357 patients meeting the same requirements and who have not gone through an additional sonogram after the third one. The main evaluation criterion was the caesarean rate, and the secondary criteria were the labour induction rate and the evaluation of neonatal morbidity, assessed with a pH test, an APGAR score, and a neonatal intensive care admission rate.
Results and conclusion
Both groups were similar except regarding age and parity of the patients. The caesarean rate was higher within the patients who underwent a 36 weeks of amenorrhea ultrasound (26,3% vs 19,3%, p=0,032). We observed no significant difference comparing the labour induction rate and the neonatal morbidity (pH, APGAR and intensive care admission rate). A multivariate analysis considering age and parity did not showed a significant difference in caesarean rate. The 36 weeks additive ultrasound did not directly influence the caesarean rate. Furthermore, respectively for the macrosomic and the SGA, our sonogram has a sensibility of 32,14% and 62,5%, and a specificity of 96,76% and 97,49%. The reliability of this 36 weeks sonogram is hence limited.
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https://dumas.ccsd.cnrs.fr/dumas-01225120
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Submitted on : Thursday, November 5, 2015 - 3:48:18 PM
Last modification on : Monday, April 26, 2021 - 11:45:05 AM
Long-term archiving on: : Saturday, February 6, 2016 - 11:22:49 AM

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  • HAL Id : dumas-01225120, version 1

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Citation

Ombeline Kauffer. Impact d’une estimation de poids fœtal échographique à 36 SA sur les issues obstétricales et néonatales dans une population à bas risque. Gynécologie et obstétrique. 2015. ⟨dumas-01225120⟩

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