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Master Thesis

État des lieux du mode d’accouchement des femmes ayant un indice de masse corporelle pré-conceptionnel supérieur ou égal à 40 au sein de 5 maternités de l’Assistance Publique – Hôpitaux de Paris (AP-HP)

Abstract : Objectives: the main objective was to assess the delivery mode of women with a pre-conceptional body mass index (BMI) greater than or equal to 40 within the Paris Public Hospital Assistance (AP-HP), the secondary objective was to assess maternal and neonatal morbidity at the end of childbirth for women with a pre-conceptional BMI greater than or equal to 40 within the AP-HP. Method: retrospective, observational and multicenter study between January 1, 2017 and December 31, 2017 including all women with pre-conceptional BMI ≥ 40 who gave birth at term ≥ 22 weeks of amenorrhea in the AP-HP. A descriptive analysis was carried out. Results: this is the first part of this study conducted in 5 AP-HP maternity hospitals. 0.8% (n=135) of women with a pre-conceptional BMI ≥ 40 gave birth in all 5 centres. The vaginal delivery rate was 55.6% and the cesarean section rate was 44.4%. Among patients who had a vaginal attempt, the vaginal delivery rate was 70%. The distribution of C-sections before labour (20.7%) and during labour (23.7%) was approximately the same. No pre-labor cesarean section has been performed for obesity alone. Maternal and neonatal morbidity at the end of childbirth is low, although it appears to be higher than the general population. There was a significant proportion of severe postpartum hemorrhage (3.5%), complete perineum (5.3%), postpartum complications (30%), prematurity (14%), low pH (2.3%), neonatal transfer (17.6%) and almost as many new-born macrosomes as low birth weight.
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https://dumas.ccsd.cnrs.fr/dumas-02302568
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Léna Dhimine. État des lieux du mode d’accouchement des femmes ayant un indice de masse corporelle pré-conceptionnel supérieur ou égal à 40 au sein de 5 maternités de l’Assistance Publique – Hôpitaux de Paris (AP-HP). Gynécologie et obstétrique. 2019. ⟨dumas-02302568⟩

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