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Master Thesis

Prise en charge des nouveau-nés asymptomatiques à risque infectieux en maternité. Évaluation d’un algorithme incluant la procalcitonine au cordon ombilical

Abstract : Introduction – Objective: facing the challenge of early diagnosis of neonatal infection and nonspecific clinical signs and the C-reactive protein (CRP), a more powerful biological marker protein seemed necessary. According to several authors, the procalcitonin (PCT) measured in cord blood would be a scorer of early onset neonatal sepsis than the CRP. Our main goal was to evaluate an algorithm including the PCT measured in cord blood in the diagnosis and management of early onset neonatal sepsis in children at risk. Material and methods: we conducted a study monocentric before - after the implementation of this new algorithm in November 2014. All asymptomatic children born from 35 gestational weeks, at risk of early onset neonatal sepsis, at the Port-Royal maternity in 2013 and 2015 were included. Our main criterion was the number of CRP levied in these infants. Our criteria for secondary judgment was the number of hospitalizations for antibiotics. Results: 2794 newborns were included for the year 2013 and 2499 for 2015. We observed a significant decrease in the number of CRP (p < 0.01), as well as the average number of analysis per child (1.36 ± 0.65 versus 1.29 ± 0.60; p = 0.02). The number of hospitalizations for suspected infection in neonates at risk has also significantly reduced (3.29% versus 2.13%; p < 0.01). But this decline was more pronounced for symptomatic newborns (2, 10% versus 1.30%; p = 0.02) than asymptomatic children (1.19% versus 0.83%; p = 0.19). Conclusion: blood cord PCT in neonates at risk of early infection allow a reduction in analysis of CRP and hospitalizations for antibiotics, without the risk of under-diagnosis.
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  • HAL Id : dumas-01587412, version 1

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Gwenaëlle Bontemps. Prise en charge des nouveau-nés asymptomatiques à risque infectieux en maternité. Évaluation d’un algorithme incluant la procalcitonine au cordon ombilical . Gynécologie et obstétrique. 2017. ⟨dumas-01587412⟩

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