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Master Thesis

Issues périnatales à terme après succès d’une version par manœuvres externes pour présentation du siège

Abstract : Objectives. To study the mode of delivery and neonatal outcomes in women after a successful external cephalic version (ECV). Material and methods. We conduct a retrospective matched cohort study in a teaching hospital between January 1996 and June 2015. Delivery and neonatal outcomes of women with a successful ECV after 37 SA were compared with those of women with spontaneously occurring cephalic presentations (1:2), controlling for the date of birth, maternal age, parity, body mass index and previous cesarean section. The primary outcome was the prevalence of cesarean section and instrumental vaginal delivery. Univariate analysis and adjusted OR were calculated with multivariate logistic regression analyse for predictive factors for cesarean section. Results. Among 643 patients who attempted ECV, 198 with successful ECV were compared with 396 patient control. Cesarean section and instrumental vaginal delivery were higher after successful ECV (respectively 20, 2% versus 7, 07% and 16, 7% versus 12, 4% p<0, 01). After an adjustment for matching and confounding variables (time variance, gestational maternal complications, ante partum fœtal complications, induction of labor, use of ocytocin for dystocia, term of delivery, neonatal cephalic perimeter), a successful ECV was associated with an increased rate of cesarean delivery (OR 3,17 IC [1,86-5,46] p<0,0001). Multiparity was a protective factor (OR 0, 75 IC [0, 58-0, 94] p=0, 02). No difference was observed for neonatal outcomes. When we considered outcomes after ECV attempt, neonatal care unit admission for nulliparous rate was higher after successful ECV than spontaneous breech delivery (23, 6% versus 13, 2%, p<0.05). Conclusion. Women who have had a successful ECV have increased risk for cesarean and instrumental vaginal delivery as compared with women with a spontaneous cephalic presentation.
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  • HAL Id : dumas-01335160, version 1

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Camille Fleury. Issues périnatales à terme après succès d’une version par manœuvres externes pour présentation du siège. Gynécologie et obstétrique. 2016. ⟨dumas-01335160⟩

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