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Master Thesis

L’accouchement du foetus macrosome chez la patiente multipare non diabétique. Comparaison des issues obstétricales, maternelles et néonatales par rapport au foetus eutrophe.

Abstract : Background: Nulliparity and diabetes appear to be risk factors for obstetrical, maternal and neonatal adverse outcomes when delivering a macrosomic fetus. Objectives: The aim of the study was, on the one hand, to evaluate if pregnancy’s outcomes are comparable in multiparous and non-diabetic patients either they are birthing a macrosomic newborn (≥ 4000 g) or a non-macrosomic newborn (< 4000g). On the other hand, we wanted to identify criteria suggesting a fetal macrosomia. Methods: A case-control study was performed at the maternity of Port-Royal from January 2012 to December 2013 comparing pregnancy’s outcomes between 134 low risk patients birthing a macrosomic newborn to a control group composed of 134 low risk patients birthing an eutrophic newborn. Results: Patients giving birth to macrosomic newborns had a longer labor (3h15 vs 2h35, p<0,01) and more of them received oxytocin during it (37,3% vs 26,1%, p<0,05). The mode of delivery was equal in both groups but obstetrical maneuvers were more often necessary (12,6% vs 3,8%, p<0,01) and these patients had more perineal tears (69,8% vs 8,9%, p<0,01). The third stage of labour was comparable in both groups. Newborn’s health status was also similar but two macrosomic newborns presented a brachial plexus injury. Patients giving birth to a macrosomic newborn had a history of macrosomia in 25% of cases versus 5% in control group. They also showed clinical signs (weight gain during pregnancy and uterine height) and ultrasound signs suggesting a fetal macrosomia (for all p<0,001). Conclusion: Childbirthing macrosomic fetuses increases the risk of adverse outcomes compared to eutrophic fetuses; multiparity and absence of diabetes does not enable us to be comforted about delivery’s conditions.
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  • HAL Id : dumas-01235782, version 1

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Pauline Peretout. L’accouchement du foetus macrosome chez la patiente multipare non diabétique. Comparaison des issues obstétricales, maternelles et néonatales par rapport au foetus eutrophe.. Gynécologie et obstétrique. 2015. ⟨dumas-01235782⟩

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