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Master Thesis

Non engagement de la présentation foetale à dilatation complète : issue obstétricale, morbidité maternelle et néonatale - étude prospective sur 261 patientes - NEDiC

Abstract : Objective: study the obstetric practices at a tertiary care university hospital in case of engagement dystocia. Material and methods: observational, prospective and unicentric study for two years about 261 patients with live singleton term fetuses in vertex presentation presenting with engagement dystocia. The first part is about 233 patients who benefit from an attempted vaginal delivery in order to study the obstetric outcome and the maternal and neonatal morbidity and identify risk factors of failed vaginal deliveries. The second part is about the 261 patients presenting with engagement dystocia. We compared the maternal characteristics and the maternal and neonatal morbidity between two groups of patients: women who underwent an attempted vaginal delivery and those who benefit from a caesarian section at once. Results: when a vaginal delivery is attempted, 78,5% of women have a vaginal birth with 44,6% of operative vaginal deliveries. Risk factors of failed vaginal delivery that we identified are nulliparity, gestational age at delivery ≥ 41 WG, prenatal suspicion of macrosomia and persistent occiput posterior. We do not find any significative statistical difference between the groups “caesarian section” and “attempted vaginal delivery” regarding maternel and neonatal severe morbidity. Conclusion: in case of engagement dystocia, it would seem that attempting pushing efforts allows, most of the time, a vaginal delivery. Specific risk factors of failed vaginal delivery should be taken into consideration before attempting pushing efforts. Performing a cesarean section from the outset do not seem to reduce maternal or neonatal morbidity.
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https://dumas.ccsd.cnrs.fr/dumas-03411653
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Submitted on : Tuesday, November 2, 2021 - 2:20:47 PM
Last modification on : Wednesday, December 8, 2021 - 3:55:31 AM
Long-term archiving on: : Thursday, February 3, 2022 - 7:06:42 PM

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  • HAL Id : dumas-03411653, version 1

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Philippine Marie Stéphanie Sabarros. Non engagement de la présentation foetale à dilatation complète : issue obstétricale, morbidité maternelle et néonatale - étude prospective sur 261 patientes - NEDiC. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03411653⟩

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