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Master Thesis

Indications et délai optimal de la corticothérapie anténatale dans le contexte de grossesse gémellaire : une étude rétrospective dans les maternités de niveau III de Marseille

Abstract : Introduction: The administration of 2 injections of 12 mg betamethasone intramuscularly, 24 hours apart, when delivery appears imminent before 34 weeks of amenorrhea it’s recommended. The therapeutic window was established when delivery takes place 24 hours to 7 days after the complete cure. Currently, the protocol is the same for single and multiple pregnancies. Objectives: The main objective was to identify the indications for antenatal corticosteroid therapy in twin pregnancies and the time between treatment and delivery. The secondary objective was to calculate the frequency of respiratory distress syndrome in twins. Materials and method: A retrospective quantitative study was conducted in the level 3 maternity hospitals in Bouches-du-Rhône between August 1, 2016 and August 31, 2018. A total of 120 twin pregnant patients who received a complete course of corticosteroids between 24 SA and 34 SA were studied. Results: Only 16.7% of patients who received a full course of corticosteroids gave birth within the therapeutic window. For the vast majority of patients, steroid therapy was administered too early. There is a significant difference between the indication for corticosteroid therapy and the time between treatment and delivery. The indication "symptomatic short cervix" could be associated with patients who received corticosteroid therapy suboptimally since the majority of them gave birth more than 7 days after the full course of treatment. About respiratory distress syndrom, there is a significant difference between the two groups of twins. Conclusion: For the majority of patients who received a full course of corticosteroids between 24 SA and 34 SA, corticosteroid therapy is given too early. These patients deliver beyond the established therapeutic window and this difference is significant in the case of hospitalized patients with symptomatic short cervix.
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https://dumas.ccsd.cnrs.fr/dumas-02389392
Contributor : École Universitaire de Maïeutique Marseille Méditerranée (eu3m) <>
Submitted on : Monday, December 2, 2019 - 2:58:40 PM
Last modification on : Monday, July 6, 2020 - 4:04:38 PM
Long-term archiving on: : Tuesday, March 3, 2020 - 6:00:43 PM

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Valentine Vaxelaire. Indications et délai optimal de la corticothérapie anténatale dans le contexte de grossesse gémellaire : une étude rétrospective dans les maternités de niveau III de Marseille. Gynécologie et obstétrique. 2019. ⟨dumas-02389392⟩

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