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Master Thesis

Procidence du cordon ombilical : prise en charge obstétricale et analyse de l'issue néonatale à la maternité de Port-Royal

Abstract : Background: umbilical cord prolapse (UCP) is a medical emergency that may compromise the safety of both the mother and fetus. The management of umbilical cord prolapse must be immediate and systematic to ensure security and health for the mother and her newborn. Objectives: to evaluate the impact of diagnosis to delivery time upon neonatal outcome. To evaluate the obstetrical features conditioning the management of umbilical cord prolapse associated with the diagnosis to delivery time. Method: we conducted a retrospective study on 12 years of activity in the maternity Port-Royal and studied 57 cases of umbilical cord prolapse on low risks patients. We analyzed the influence of a 15minute and a 12-minute diagnosis to delivery time upon neonatal outcome. Results: the incidence of umbilical cord prolapse was 1.2 per 1000 births in our population. Regardless of the diagnosis to delivery time, about 50% of the newborns had a birth arterial pH lower than 7.20. Only 5% of the newborns, all diagnosis to delivery time combined had an Apgar score lower than 7 at 5 minutes of life. The birth arterial pH was not correlated to the 5-minute Apgar score. Regardless of the diagnosis to delivery time, 20% of the newborns were admitted to the intensive care ward. The management of UCP within 15 and 12 minutes after the diagnosis was associated with higher rates of artificial rupture of membranes, cervical dilation between 6 and 10 cm and severe fetal heart rate abnormalities. The caesarean section was the most frequent mode of delivery. Conclusion: the diagnosis to delivery time did not prove to have an impact on the newborns’ conditions at birth. Umbilical cord prolapse is an emergency which requires a systematic management in order to improve neonatal outcome.
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https://dumas.ccsd.cnrs.fr/dumas-03022087
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Submitted on : Tuesday, November 24, 2020 - 4:12:41 PM
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  • HAL Id : dumas-03022087, version 1

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Agathe Barbara. Procidence du cordon ombilical : prise en charge obstétricale et analyse de l'issue néonatale à la maternité de Port-Royal. Gynécologie et obstétrique. 2020. ⟨dumas-03022087⟩

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