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Master Thesis

Tentative d’accouchement voie basse : les présentations céphaliques après version par manœuvre externe réussie accouchent-elles mieux que les présentations podaliques ? : étude de cohorte multicentrique, ambispective, sur une période de 12 ans

Abstract : Introduction: the breech delivery can be associated with a higher risk of neonatal morbidity and mortality. External cephalic version (ECV) uses to be an alternative to convert breech presentation (BP) into cephalic presentation (CP). Literature shows significant increase in caesarean section rate after successful ECV (ECV+) versus spontaneous cephalic presentation (SCP). The literature compares childbirth outcomes between BP and SCP and, SCP and ECV+. No studies, to our knowledge, compare maternal and neonatal outcomes between ECV+ and BP deliveries. The aim is to compare the caesarean section rate between the ECV+ and BP cohorts, and characteristics of labour and delivery patterns. Material and methods: multicentric retrospective cohort study comparing patients who gave birth in cephalic presentation after ECV + to patients who gave birth in BP between 01.01.07 and 30.09.19 in 3 public maternities of Alpes-Maritimes (France). All were paired on maternal age, parity, date and place of birth and gave birth in a gynecological position from 37 weeks of an alive singleton. In total 258 patients were included: 271 in the case group and 87 in the control-group. Results: no significant rate of per-partum caesarean section was demonstrated between the two cohorts. The “ECV +” cohort presents: a laster delivery term (p <0.001), an extended total duration of labour (p <0.001), and higher rates of foetal malpositions (p = 0.02), operative deliveries (p <0.038) and postpartum hemorrhages (p = 0.026). A less good adaptation to extra-uterine life at 1 and 5 minutes (p <0.001 and p <0.02) without significant increase in morbidity and mortality associated with obstetrical maneuvers was identified in the « BP » cohort. Conclusion: the vaginal breech attempt is no more dystocic than childbirth after VME +. And even if the neonatal outcomes show a slight excess of neonatal morbidity, they are nonetheless comparable to those of newborns born after version.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03197769
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Wednesday, April 14, 2021 - 10:55:12 AM
Last modification on : Tuesday, July 20, 2021 - 3:25:53 AM

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  • HAL Id : dumas-03197769, version 1

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Élodie da Silva Teixeira. Tentative d’accouchement voie basse : les présentations céphaliques après version par manœuvre externe réussie accouchent-elles mieux que les présentations podaliques ? : étude de cohorte multicentrique, ambispective, sur une période de 12 ans. Médecine humaine et pathologie. 2020. ⟨dumas-03197769⟩

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