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Master Thesis

La prise en charge de l’élévation de température maternelle pendant le travail

Abstract : Objective: on the one hand to describe and evaluate the management of maternel hyperthermia during labor and to show the differences in practice, on the other hand to identify the determinants of the establishment of antibiotic treatment in the mothers and describe the neonatal outcomes related to this antibiotic therapy. Patients and methods: single center retrospective study of 252 patients who gave birth in 2017 in Port-Royal maternity unit. We performed a two steps study : first, descriptive and second, a case control study where the cases were the patients who had been treated by antibiotics and the others were the untreated women. Resultats: the majority of patients had a temperature under 38.5°C (79%). An infectious assessment was performed on 221 patients (87.7%). Antibiotic therapy was initiated in 191 patients (75.8%) and antipyretic in 188 patients (74.6%). Patients treated with antibiotics had a higher temperature (p <0.001), had more shivering (23.2% vs 5.7%, p <0.01), but no more tachycardia (9.6% vs 4.9%, p = 0.25). Fetal tachycardia was more found (34.6% vs 15.1%, p <0.005) as well as stained amniotic fluid and meconium (respectively, 19.9% and 14.7% vs 11.5% and 4.9% ; p <0.05). The length of rupture of membranes was comparable in both groups. Neonatal outcomes were similar. A probable infection occurred in 7 newborns when the mother was treated and none in the other groupe of mother, but this difference is not significant. Conclusion: there are differences in practice in the management of these patients. Patients treated with antibiotics have more clinical signs of infection, which justifies antibiotic prophylaxis.
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Submitted on : Thursday, July 11, 2019 - 3:58:23 PM
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  • HAL Id : dumas-02180729, version 1


Soraya Bhalil. La prise en charge de l’élévation de température maternelle pendant le travail. Gynécologie et obstétrique. 2019. ⟨dumas-02180729⟩



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