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Master Thesis

Diagnostic clinique des variétés de présentation pendant le travail : existe-il une différence entre les variétés postérieures et antérieures ? Étude de cohorte prospective uni-centrique dans une maternité hospitalo-universitaire de type lll

Abstract : Objective: compare the variety of presentation associated with cervical dilation and the level of engagement of posterior and anterior presentations and determine how to manage the rotation of posterior varieties. Material and method: this was a single site trial, prospective observational study consisting of 2 cohorts: pregnancies with a foetus in a persistent or non-persistent variety and a control group consisting of occiput anterior position. It included full-term singleton pregnancies ≥ 37 weeks of amenorrhea, with a live and viable foetus with cephalic presentation. Maternal, foetal, labour characteristics associated with occiput posterior varieties were identified and compared to the control group. For neonatal maternal complications, only persistent occiput posterior varieties were considered. Results: a total of 122 patients with a fetus in occiput posterior variety during labor, including 44 of whom were persistent presentations, compared with a control group constituted of 122 previous varieties. The presentation variety was diagnosed at 8 cm of presentation of cervical dilation, in both cohorts. Concerning the level of engagement, the OP were diagnosed with equal percentages with a floating above the brim/ applied presentation (35%), or a fixed presentation (35%), and the OA group, diagnosed with a fixed presentation (48%). Regarding to corrective measurements, positioning was achieved in 91% in the 2 cohorts with an 11% incidence for the 4-legged position for the posterior varieties. Manual rotation was carried out in 38% of cases with 48% success. The use of oxytocin did not show any differences between the two cohorts. Conclusion: this study could not demonstrate a difference in the diagnosis of the presentation variety associated with dilation between occiput posterior position and occiput anterior position. There was a difference regarding the level of engagement with equal percentages as regards floating above the brim/ applied presentation in OP group and in the OA groupe, diagnosed with fixing presentation. This late diagnosis leads to a delay in patient care conducting of preventable fetal and maternal complications. The corrective measures taken during the work were positioning or manual rotation. No differences were observed about the installation of oxytocin. Further studies are needed to confirm our results and to highlight the actual effects of corrective measures on the occiput posterior position.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03558277
Contributor : Bibliothèque Universitaire de Médecine Nice Connect in order to contact the contributor
Submitted on : Friday, February 4, 2022 - 4:38:24 PM
Last modification on : Saturday, March 26, 2022 - 3:26:21 AM
Long-term archiving on: : Thursday, May 5, 2022 - 7:39:07 PM

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2021NICEMSF05.pdf
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  • HAL Id : dumas-03558277, version 1

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Juliette Clion. Diagnostic clinique des variétés de présentation pendant le travail : existe-il une différence entre les variétés postérieures et antérieures ? Étude de cohorte prospective uni-centrique dans une maternité hospitalo-universitaire de type lll. Médecine humaine et pathologie. 2021. ⟨dumas-03558277⟩

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