Impact de l’enquête EPIPAGE 2 sur la prise en charge anténatale et postnatale entre 22 et 26 SA sur trois maternités de type III d’Ile de France

Abstract : Background : Management of extreme prematurity in France differs from other countries, with an extension of withholding care in fear of long term outcomes. In 2011, the national cohort study EPIPAGE 2 shows that improvement in survival at extremely low gestational age is possible in France. Objectives. The aim of the study was to measure the impact of EPIPAGE 2 on the management of extreme prematurity and its outcomes in terms of perinatal mortality and morbidity. Methods. This is a retrospective observational study before/after multicentric. Deliveries between 22 and 26+6 weeks of amenorrhea were included, for two periods : 2010-11 and 2015-16. Twin pregnancies were excluded. Data about antenatal management and neonatal outcomes were collected from medical files. Results. We included 84 patients in 2010-11 and 132 in 2015-16. There were no significant changes for the neonatal resuscitation rate before and after EPIPAGE 2. The antenatal decisions were more defined after EPIPAGE 2 (p<0,001). Magnesium sulfate administration increased (p=0,024). No significant differences were found for the others criterias : corticosteroids and neonatal outcomes. Conclusion. Although antenatal management seems to be more defined after EPIPAGE 2, no significant improvements in terms of morbi-mortality were found.
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Fanny Salmon. Impact de l’enquête EPIPAGE 2 sur la prise en charge anténatale et postnatale entre 22 et 26 SA sur trois maternités de type III d’Ile de France. Gynécologie et obstétrique. 2017. ⟨dumas-01591910⟩

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