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Master Thesis

Interruption médicale sélective de grossesse : quel devenir pour le jumeau sain ?

Abstract : Objective: To assess the neonatal status of the healthy twin after selective medical termination of pregnancy; to meet this objective, three sub-objectives have been defined: - Determine the median gestational age at birth of the healthy twin - Identify which neonatal complications are associated with an unfavourable prognosis - Determine the indications for medical termination of selective pregnancy for which the neonatal prognosis is more unfavourable. Methods: Literature review accompanied by a study of 14 cases of medical interruption of selective pregnancy carried out in the 2 level III public maternity units in Marseille (Conception and Hôpital Nord). Results: The median gestational age of birth depends on the technique used (radiofrequency ablation or bipolar umbilical cord coagulation) for the procedure leading to death in utero, as well as the term at which this procedure is performed. In dichorionic pregnancies, birth weight is significantly increased when the procedure was performed before 15 weeks of amenorrhea; in monochorionic pregnancies, the survival rate is increased when the procedure is performed after 18 weeks of amenorrhea. The main neonatal complications are mainly those of prematurity: respiratory distress, neurological and neurodevelopmental complications. The indications for which the prognosis is unfavourable for the healthy twin are mainly concerned with monochorionic pregnancies and vascular pathologies. Conclusion: The main objective during selective medical abortions of pregnancy is to preserve the prognosis of the healthy twin. Chorionicity is the main intrinsic factor behind the differences in management between dichorionic and monochorionic pregnancies. This element conditions the totality of the management of these selective medical abortions of pregnancy.
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https://dumas.ccsd.cnrs.fr/dumas-02389851
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Submitted on : Monday, December 2, 2019 - 4:46:56 PM
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Linda Yacoubi. Interruption médicale sélective de grossesse : quel devenir pour le jumeau sain ?. Gynécologie et obstétrique. 2019. ⟨dumas-02389851⟩

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