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Master Thesis

Siège à terme et tentative de voie basse : quelles issues en cas de bassin transversalement rétréci « compensé » ?

Abstract : Objective: compare delivery mode, maternal and perinatal morbidity after attempting a vaginal delivery in case of term breech presentation according to the maternal pelvis type : transversely narrowed pelvis called “compensated” (TNP) versus normal pelvis. Material and methods: unicentric retrospective observational study related to 437 patients with a monofoetal pregnancy in breech presentation at least 37 wk. 143 patients were eligible for an attempted vaginal delivery : 107 (74,8%) patients had a normal pelvis and 36 (25,2%) patients a TNP. The primary outcome was the rate of caesarean. Secondary endpoints were difficulty during vaginal childbirth, maternal and perinatal morbidity. Results: the rate of caesarean of TNP pelvis group was similar to normal pelvis one in univariate and multivariate analysis 30,6% (n=11/36) vs 25,2% (27/107). Compared to normal pelvis, TNP do not increase the risk of caesarean during labor after adjustment (aOR=1,10 ; CI95% [0,46-2,66]). With TNP vaginal childbirth could lead to more difficulties compared to childbirth with a normal pelvis (OR=4,08 ; CI95% [1,16-14,30] and aOR=4,00 ; CI95% [1,09-14,71]). Maternal and perinatal morbidity were similar whatever the type of pelvis, respectively aOR=1,82 ; CI95% [0,72-4,62] and aOR=1,16 ; CI95% [0,28-4,75]. Conclusion: compared to normal pelvis the vaginal delivery of term breech presentation with a TNP does not seem to be associated with an increased risk of caesarean. However, compared to a normal pelvis TNP vaginal childbirth could lead to more difficulties.
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https://dumas.ccsd.cnrs.fr/dumas-03279115
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Submitted on : Tuesday, July 6, 2021 - 11:40:22 AM
Last modification on : Friday, July 9, 2021 - 3:48:02 AM
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  • HAL Id : dumas-03279115, version 1

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Xavier Ah-Kit. Siège à terme et tentative de voie basse : quelles issues en cas de bassin transversalement rétréci « compensé » ?. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03279115⟩

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