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Master Thesis

Déclenchement pour malformation congénitale grave diagnostiquée en anténatal et nécessitant une prise en charge immédiate à la naissance : étude rétrospective sur 5 ans à la maternité du CHU de Bordeaux

Abstract : Objective: induction of labor for severe congenital anomalies diagnosed in antenatal period aims for a birth in optimal condition for the neonatal care, attended by the appropriate medical professionals, necessary for an immediate care of the infant. In France, there is no standardised care regarding birth organisation in this context, to our knowledge. The main purpose of this study is to evaluate the rate of birth that have happened during non-working hours, i.e 6:30 pm to 8:00 am or during the weekend after induction of labor, in case of serious birth defects, diagnosed in antenatal period. Secondary objectives are to compare healthcare delay, maternal and neonatal infant morbidity, and to evaluate potential risk factors of a delivery between non-working and working hours. Study design: Retrospective and monocentric study, realised between 1st January 2016 and 1st January 2021, at Centre Aliénor d’Aquitaine maternity, within Bordeaux CHU. Every one of the patient induced because of severe birth defects diagnosed in antenatal period and requiring immediate care at birth is included in this study. The main judgment criterion is the birth rate during non-working hours, while secondary criteria are healthcare delay and maternal and neonatal infant morbidity, analysed with regard to birth time. A multivariate analysis is then realised on the potential risk factors that would result in a birth during non-working periods. Results: in this study, 42.3% (44/104) of the patients have given birth during the weekend, public holidays or between 6:30 pm and 8am during the week. There is a statistically significant difference between the two groups, in favour of a delivery during working hours, when patient are induced for serious prenatal fetal pathology, diagnosed in prenatal period (p=0.03). Birth occurring during non-working hours does not induce an increased risk of maternal or neonatal infant morbidity. No statistically significant difference regarding neonatal healthcare delay have been proven, whatever the birth time. Among the studied potential risk factors, there appears to be no maternal characteristics likely to induce an increased risk of a delivery during non-working hours in case of fetal pathology induced labor, when the latter begins before 12pm. Conclusion: when a delivery induction is organised because of severe congenital anomalies, diagnosed in antenatal period and requiring an immediate care, 42.3% of the birth happen during non-working hours, against 57.7% during working hours (p=0.03). Maternal and neonatal infant morbidity and neonatal healthcare delay are not increased when birth occurs during non-working hours.
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https://dumas.ccsd.cnrs.fr/dumas-03390623
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Submitted on : Thursday, October 21, 2021 - 2:41:11 PM
Last modification on : Wednesday, December 8, 2021 - 3:55:31 AM

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  • HAL Id : dumas-03390623, version 1

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Camille Coupet. Déclenchement pour malformation congénitale grave diagnostiquée en anténatal et nécessitant une prise en charge immédiate à la naissance : étude rétrospective sur 5 ans à la maternité du CHU de Bordeaux. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03390623⟩

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