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Master Thesis

Maturation cervicale par PGE1 ou PGE2 au sein d’une population de femmes obèses : comparaison de la voie d’accouchement et indication de césarienne

Abstract : Introduction and objective : Obesity is increasing among parturient women. Physiopathologics phenomenons could explain the rise of prolonged pregnancies in this population, causing these patients to be insensitive to natural prostaglandins, type E2. Our objective was to evaluate the response to different prostaglandins allowing cervical maturation and labouring, PGE1 or PGE2, in a population of obese women with prolonged pregnancies. Material and methods : A bi-centric retrospective study was performed in the CHIPS and Port Royal maternity unit. It collected data from 189 patients from 2013 to 2016. The analysis compares the results of the two groups using different types of prostaglandins, PGE1 for CHIPS or PGE2 for Port-Royal. Results : A reduction in the cesarean section rate in the PGE1 group (33.9% versus 49.3%) was observed in our study. The distribution of cesarean section indications was similar. Oxytocin or artificial rupture of membranes prior to labour was more often required in the PGE2 group (p=0.02). Hypercontractility and pathologic heart rates were also increased (p=0.03 and p=0.04). Despite the increase in cesarean section, with fetal indication being the primary indication, we did not see an increase in adverse neonatal outcomes in the PGE2 group. Conclusion : The use of PGE1 for labour induction in a population of obese patients with prolonged pregnancy had a positive impact on their delivery and obstetrical prognosis. Maternal and neonatal prognosis are not affected by the type of prostaglandins.
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https://dumas.ccsd.cnrs.fr/dumas-01909566
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Clara Lavau. Maturation cervicale par PGE1 ou PGE2 au sein d’une population de femmes obèses : comparaison de la voie d’accouchement et indication de césarienne. Gynécologie et obstétrique. 2018. ⟨dumas-01909566⟩

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