Analyse de la délivrance dirigée par oxytocine dans les interruptions médicales de grossesse au deuxième trimestre : étude prospective randomisée d’octobre 2015 à octobre 2017 à la maternité du Centre Aliénor d’Aquitaine - CHU de Bordeaux

Abstract : Introduction: the placental retention rate is 30 to 40% in second trimester medical pregnancy termination. Placental retention may be associated with increased manual or surgical evacuation of the placenta, increased blood loss and a higher infectious morbidity. Our objective was to compare two methods for third-stage management after medical pregnancy termination between 14 and 28 weeks of gestation in order to decrease placental retention. Study design: a prospective randomized trial compared two deliverance techniques: 10 units of intra-venous oxytocin and no additional medication after fetal expulsion. It concerned pregnancies between 14 and 28 weeks of gestation at Aliénor d’Aquitaine maternity of Bordeaux. The principal criteria of evaluation was the incidence of placental retention defined by the absence of spontaneous expulsion of the placenta within 30 minutes or the necessity of manual evacuation of the placenta. Results: 91 women were randomly assigned to the groups from October 2015 to October 2017. 47 were assigned to oxytocin group and 44 to non-additional medication group. The placental retention rate was significantly lower in oxytocin group (11% versus 30%, p=0;03). Blood loss was significantly lower in oxytocin group (50ml (50-150) versus 100 (50-200), p=0,02). Conclusion: intra-venous administration of 10 units of oxytocin after fetal delivery in medical pregnancy termination between 14 and 28 weeks of gestation could decrease placental retention and blood loss.
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Master Thesis
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Submitted on : Friday, January 18, 2019 - 3:50:39 PM
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Sophie Levrier. Analyse de la délivrance dirigée par oxytocine dans les interruptions médicales de grossesse au deuxième trimestre : étude prospective randomisée d’octobre 2015 à octobre 2017 à la maternité du Centre Aliénor d’Aquitaine - CHU de Bordeaux. Médecine humaine et pathologie. 2018. ⟨dumas-01986229⟩

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