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Master Thesis

Comparaison de méthodes de maturation cervicale en situation de fœtus de petit poids : ballon intracervical versus dispositif intravaginal de Dinoprostone, une étude prospective randomisée à propos de 69 patientes

Abstract : Introduction: induction of labor (IOL) is often prefered in case of Small for gestational age (SGA) because of the association of this condition with stillbirth. There is a lack of consensus about the most appropriated cervical ripening method to use in case of SGA. Nevertheless, Prostaglandins are associated with more hyperstimulation and fetal heart rate changes. The primary outcome was cesarean section rate between two cervical ripening methods: dinoprostone insert and foley catheter. The secondary outcomes were maternal, neonate outcomes and the pain. Study design: open-label randomized controlled trial 1 : 1, between Nov 1st, 2015 and Jan 20, 2017, Center Aliénor d'Aquitaine. Enrollment: women with a pregnancy affected by SGA with decision of IOL after 32 weeks, with an unfavorable cervix. Results: 69 women were included and 68 women were analyzed, 34 in the Foley catheter group (BIC) and 34 in the dinoprostone group (PIV). Cesarean rate were much the same between the two groups, 23,5% in the BIC group versus 35.3% in the PIV group (p=0.43). Less hyperstimulation and fetal heart changes occurred in the BIC group (p=0.005 and 0.013 respectively). Using balloon catheter was less painful (p=0.001). Use of ocytocin and instrumental delivery were higher in the BIC group (p=0.02). Serious maternal or neonatal morbidity in the trial were infrequent and comparable. Conclusion: balloon catheter is a interesting and safe cervical ripening method in case of SGA.
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Master Thesis
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Submitted on : Thursday, June 22, 2017 - 1:07:34 PM
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Marion Desoutter. Comparaison de méthodes de maturation cervicale en situation de fœtus de petit poids : ballon intracervical versus dispositif intravaginal de Dinoprostone, une étude prospective randomisée à propos de 69 patientes. Médecine humaine et pathologie. 2017. ⟨dumas-01544987⟩

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