Sièges prématurés avant 35 semaines d’aménorrhée : quelle influence de la voie d’accouchement sur l’état néonatal ?

Conclusion Ce travail montre un risque accru de complications traumatiques en cas d’accouchement par voie basse, sans augmentation des autres complications néonatales. Il paraît raisonnable dans ce contexte particulier d’autoriser une tentative de voie basse sous couvert du respect strict des règles de sécurité entourant l’accouchement par le siège. Objective The mode of delivery for preterm breech is still controversial, while no randomized study has been completed. The question of a protective effect of cesarean section on neonatal outcome arises. The objective of this study was to compare mortality and neonatal morbidity for children born before 35 weeks of gestation in breech presentation, depending on the route of delivery. Methods This was a retrospective study done in University Hospital type 3 over five years, comparing neonatal mortality and different neonatal morbidity criteria for children born between 25 weeks of gestation and 34 weeks+6 days spread into two groups according to their mode of delivery: elective caesarean section before labor and vaginal delivery. Statistical analysis was performed with an adjustment for gestational age and weight of the newborn. Results No significant difference between the two groups was found with regard to neonatal mortality. Among the various morbidity criteria studied, only the head entrapment rate and serious traumatic injury occurrence were significantly increased in the “intent to vaginal delivery” gro...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research