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Master Thesis

Les interventions obstétricales lors de l’accouchement des grossesses à bas risque ont-elles diminué au cours des années ? : étude de cohorte multicentrique ambispective (2011-2015-2019)

Abstract : Objective: To assess the administration of oxytocin of low-risk pregnancies during labor and delivery between three distinct periods (2011, 2015, 2019). Evaluate the rate of targeted interventions of these pregnancies in spontaneous labor and determine their impact on the maternal and neonatal state.
Method: Prospective multicenter cohort study for 2019 files, retrospective for 2011 and 2015. Data collection on AUDIPOG file in three public maternity hospitals in the Alpes Maritimes (Nice, Cannes, Grasse), from January to April. 433 patients were included in the study.
Results: With all parities taken together, when there is use of oxytocin alone, the rate of instrumental bass way is significantly higher (64.7%) than the non-instrumental way (43.8%) and 73.3 % of caesarean sections received it. Amniotomy is performed in ½ of the VBNI, 38.8% of the VBI, and 66.7% of the caesareans. The combination of oxytocin and RAPDE is mainly present during cesareans. We observed that 46.1% of 1st degree tears were significantly correlated with the use of exogenous oxytocin alone compared to 29.7% of intact perineum. And 22.1% of episiotomies were performed while using oxytocin. Regarding the neonatal state, a significant increase in newborns with lactates> 4.8 should be noted when using epidural analgesia. Finally, 9 newborns in 2019 had significantly pathological lactates compared to 6 in 2015, following the combination of oxytocin and RAPDE.
Conclusion: This study shows that there has indeed been a decrease in the rate of interventions (exogenous oxytocin, amniotomy and the combination of two or three interventions) over the years, and more particularly between 2015 and 2019. Which is total compliance with the recommendations of the Haute autorité de santé (HAS) and Collège national des gynécologues obstétriciens français (CNOGF). Additional research may be considered to examine the use of the triad of intrapartum interventions and their combination on maternal and neonatal complications versus possible confounders such as duration and progression of labor.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03202336
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Monday, April 19, 2021 - 5:21:35 PM
Last modification on : Thursday, May 13, 2021 - 3:19:09 AM

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Pauline Ivezic. Les interventions obstétricales lors de l’accouchement des grossesses à bas risque ont-elles diminué au cours des années ? : étude de cohorte multicentrique ambispective (2011-2015-2019). Médecine humaine et pathologie. 2020. ⟨dumas-03202336⟩

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