Skip to Main content Skip to Navigation
Master Thesis

Association entre la durée de latence lors du déclenchement du travail et le taux de césariennes pour échec de déclenchement : une étude ici-ailleurs

Abstract : Background: induction of labor affects more than one in five deliveries in France. Some of them end in caesarean sections for failed induction, with varying rates between French Maternities. Different practices concerning the management of the latent phase of induction of labor could be one of the explanatory elements, as there is no professional recommendation on the maximum duration of stagnation before concluding that the induction has failed.
Objective: to evaluate the effect of a more wait-and-see protocol on the duration of stagnation in the latent phase after an induction of labor on caesarean rates and perinatal outcomes.
Study population and method: we conducted a retrospective bicentric observational “hereelsewhere” study. We collected data from medical chart from June 1st, 2019 to December 31st, 2019, in two level III maternities from “Assistance Publique – Hôpitaux de Paris”: Port-Royal (group A, “6 hours latent period” after amniotomy and with oxytocin) and Louis Mourier (group B, “12 hours latent period” after amniotomy and with oxytocin). We included all women with induction of labor receiving oxytocin, with a term, cephalic, singleton fetus, and without history of caesarean section. Primary outcome was the rate of caesarean.
Results: we included 427 patients in Port-Royal and 147 patients in Louis Mourier. There were significantly fewer caesarean sections for failed induction in the more wait-and-see protocol group (20,6% in group A and 12,2% in group B (p=0,003)); but the global caesarean rate was not different (25,1% in group A and 27,9% in group B, with no significant difference). The more waitand-see protocol was associated with lower rate of postpartum haemorrhage (16,9% in group A and 7,5% in group B (p=0,01)). No difference was observed for neonatal morbidity (artery blood pH ≤ 7,20, Apgar score < 7 at 5 minutes of life, neonatal resuscitations rates, neonatal transfers rates for suspected or proven materno-foetal infection).
Conclusion: a protocol with longer duration of stagnation in the latent phase seems to reduce caesarean rates for failure of induction and allow more women to enter the active phase of labor, without reducing the global caesarean rates. However, those results merit further examination with a larger randomised study.
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03352730
Contributor : Esf Upd Connect in order to contact the contributor
Submitted on : Thursday, September 23, 2021 - 2:36:26 PM
Last modification on : Thursday, December 23, 2021 - 3:08:24 AM
Long-term archiving on: : Friday, December 24, 2021 - 8:51:41 PM

File

memoire_esfbaudelocque_Luyt Ca...
Files produced by the author(s)

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

  • HAL Id : dumas-03352730, version 1

Collections

Citation

Capucine Luyt. Association entre la durée de latence lors du déclenchement du travail et le taux de césariennes pour échec de déclenchement : une étude ici-ailleurs. Gynécologie et obstétrique. 2021. ⟨dumas-03352730⟩

Share

Metrics

Les métriques sont temporairement indisponibles