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Master Thesis

Les issues périnatales sont-elles différentes selon le mode du début de travail en cas d’utérus unicicatriciel ?

Abstract : Objectives: to evaluate perinatal outcomes according to the mode of labor in women with a previous cesarean delivery and to determine factors of successful trial of labor. Population and methods: an observational retrospective study was conducted in a maternity hospital in Ile de France. 453 women with on previous cesarean delivery who gave birth at or after 37 weeks of a single live-born infant, in cephalic presentation between 1January 2013 and 26 October 2016. Findings: 337 (74.4%) women had a trial of labor. Of these, 228 went into spontaneous labor (67.7%) and 109 underwent an induction of labor (32.3%). Previous vaginal birth (p<0.001), spontaneous labor (p=0.006) and epidural anesthesia (p<0.001) were associated with vaginal delivery. By contrast, BMI >30kg/m² (p=0.005), previous indication as dystocia (p=0.03), prostaglandins E2 induction of labor (p<0.001) and male fetus (p=0.02) were associated with emergency cesarean section. The rate of cesarean section was higher in women undergoing induced labor than in women undergoing spontaneous labor (44% vs 27.6%, p=0.003). No differences were found in the maternal and neonatal complications studied. Conclusion: this work shows that there are factors associated with successful trial of labor after previous cesarean delivery. Furthermore, the rate of vaginal delivery decreased when the labor is induced.
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Submitted on : Tuesday, September 19, 2017 - 11:32:09 AM
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  • HAL Id : dumas-01589951, version 1

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Emma Vecchioli. Les issues périnatales sont-elles différentes selon le mode du début de travail en cas d’utérus unicicatriciel ?. Gynécologie et obstétrique. 2017. ⟨dumas-01589951⟩

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