Influence d’un traitement anticoagulant pendant la grossesse sur l’anesthésie per-partum et les modalités d’accouchement

Conclusion La présence d’un traitement anticoagulant héparinique au moment de l’accouchement ne limite pas l’accessibilité à une analgésie efficace, avec cependant une augmentation du taux de rachianesthésie et d’anesthésie générale au détriment de l’anesthésie péridurale. Par ailleurs, un relais par héparine non fractionnée en fin de grossesse semble inutile. Objectives The objective of the study was to evaluate the influence of anticoagulation on intrapartum anesthesia and delivery modalities. Methods This ancillary study is concerned with anticoagulated patients included in the study STRATHEGE, in the Saint-Etienne and Lyon University Hospital from 2007 to 2012, which are compared to a control population. The primary endpoint is to evaluate the type of anesthesia received by women in labor, according to the center at the time of delivery compared to no treatment. The secondary endpoints are comparing the input mode to work, mode of delivery, stop management arrangements of these treatments, the rate of thromboembolic and hemorrhagic complications. Results Two hundred and three cases were included and 812 controls, matched on age, body mass index and parity. 61.6% of the cases had an epidural during childbirth against 87% of controls (p <0.05), spinal rates (22.5% versus 1.85%) and general anesthesia (5.4% versus 0.7%) were higher in the case group. The delivery rate vaginally was 90% in controls, against 65% of cases. The postpartum hem...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research