Complications fœtales et néonatales des grossesses prolongées

Chantry, Anne; López, E.

doi:10.1016/j.jgyn.2011.09.007

Cited by 23 publications

(7 citation statements)

References 46 publications

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“…Post-term pregnancy, defined as a pregnancy extended to or beyond 42 weeks, or 294 days or more, is associated with increased perinatal morbidity and mortality. 1 2 3 4 5 6 7 8 9 10 The World Health Organization and various guidelines throughout the world therefore recommend induction of labour after 42 weeks. 10 11 12 13 14 15 Although the overall probability of favourable perinatal outcomes between 40 and 42 weeks is good in high resource settings, the risk of adverse perinatal outcome increases gradually after 40 weeks.…”

Section: Introductionmentioning

confidence: 99%

Induction of labour at 41 weeks versus expectant management until 42 weeks (INDEX): multicentre, randomised non-inferiority trial

Keulen

Bruinsma

Kortekaas

et al. 2019

BMJ

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Objective To compare induction of labour at 41 weeks with expectant management until 42 weeks in low risk women. Design Open label, randomised controlled non-inferiority trial. Setting 123 primary care midwifery practices and 45 hospitals (secondary care) in the Netherlands, 2012-16. Participants 1801 low risk women with an uncomplicated singleton pregnancy: randomised to induction (n=900) or to expectant management until 42 weeks (n=901). Interventions Induction at 41 weeks or expectant management until 42 weeks with induction if necessary. Primary outcome measures Primary outcome was a composite of perinatal mortality and neonatal morbidity (Apgar score <7 at five minutes, arterial pH <7.05, meconium aspiration syndrome, plexus brachialis injury, intracranial haemorrhage, and admission to a neonatal intensive care unit (NICU). Secondary outcomes included maternal outcomes and mode of delivery. The null hypothesis that expectant management is inferior to induction was tested with a non-inferiority margin of 2%. Results Median gestational age at delivery was 41 weeks+0 days (interquartile range 41 weeks+0 days-41 weeks+1 day) for the induction group and 41 weeks+2 days (41 weeks+0 days-41 weeks+5 days) for the expectant management group. The primary outcome was analysed for both the intention-to-treat population and the per protocol population. In the induction group, 15/900 (1.7%) women had an adverse perinatal outcome versus 28/901 (3.1%) in the expectant management group (absolute risk difference −1.4%, 95% confidence interval −2.9% to 0.0%, P=0.22 for non-inferiority). 11 (1.2%) infants in the induction group and 23 (2.6%) in the expectant management group had an Apgar score <7 at five minutes (relative risk (RR) 0.48, 95% CI 0.23 to 0.98). No infants in the induction group and three (0.3%) in the expectant management group had an Apgar score <4 at five minutes. One fetal death (0.1%) occurred in the induction group and two (0.2%) in the expectant management group. No neonatal deaths occurred. 3 (0.3%) neonates in the induction group versus 8 (0.9%) in the expectant management group were admitted to an NICU (RR 0.38, 95% CI 0.10 to 1.41). No significant difference was found in composite adverse maternal outcomes (induction n=122 (13.6%) v expectant management n=102 (11.3%)) or in caesarean section rate (both groups n=97 (10.8%)). Conclusions This study could not show non-inferiority of expectant management compared with induction of labour in women with uncomplicated pregnancies at 41 weeks; instead a significant difference of 1.4% was found for risk of adverse perinatal outcomes in favour of induction, although the chances of a good perinatal outcome were high with both strategies and the incidence of perinatal mortality, Apgar score <4 at five minutes, and NICU admission low. Trial registration Netherlands Trial Register NTR3431.

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Section: Introductionmentioning

confidence: 99%

Induction of labour at 41 weeks versus expectant management until 42 weeks (INDEX): multicentre, randomised non-inferiority trial

Keulen

Bruinsma

Kortekaas

et al. 2019

BMJ

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“…Nous verrons dans les chapitres suivants des RPC (questions Chantry et al) que d'un point de vue physiopathologique, il n'existe pas réelle-ment de seuil mais plutôt un continuum à en fin de grossesse concernant les risques maternels, foetaux et néonataux, rendant difficile la définition de ces deux termes [27,28].…”

Section: Définitions De La Grossesse Prolongée Et Du Dépassement De Tunclassified

“…Le Tableau [27,28]. Cette définition a été reprise par différentes sociétés savantes, entre autres l'ACOG, la SOGC et la FIGO [1][2][3][4].…”

Section: Définitions De La Grossesse Prolongée Et Du Dépassement De Tunclassified

“…Le terme peut donc être considéré d'après les données de la littérature comme l'intervalle de temps situé entre le « pré-terme » et le « dépassement de terme » soit allant de 37 +0 SA à 41 +6 SA inclus. Cependant, lorsque la grossesse se poursuit au-delà de 41 +0 SA, il semble que les risques foetaux et maternels augmentent significativement, comme le montrent les auteurs des différents chapitres des RPC (questions Chantry et al) [27,28]. Une surveillance spécifique de fin de grossesse doit donc être mise en place afin de limiter ces risques.…”

Section: Définitions De La Grossesse Prolongée Et Du Dépassement De Tunclassified

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Comment définir la date présumée de l’accouchement et le dépassement de terme ?

Ray

Anselem

2011

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…Il est clairement établi que la grossesse prolongée repré-sente une situation obstétricale où il existe un risque accru de morbi-mortalité, non seulement maternelle mais aussi et surtout foetale (asphyxies et décès périnataux), chez les femmes à bas risque présentant par ailleurs une grossesse sans complications [1,2]. Les différents moyens de surveillance disponibles sont avant tous basés sur le dépis-tage des signes d'hypoxie foetale.…”

Section: Introductionunclassified

Place du rythme cardiaque fœtal et de son analyse informatisée dans la surveillance de la grossesse prolongée

Coatleven

2011

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Complications fœtales et néonatales des grossesses prolongées

Cited by 23 publications

References 46 publications

Induction of labour at 41 weeks versus expectant management until 42 weeks (INDEX): multicentre, randomised non-inferiority trial

Induction of labour at 41 weeks versus expectant management until 42 weeks (INDEX): multicentre, randomised non-inferiority trial

Comment définir la date présumée de l’accouchement et le dépassement de terme ?

Place du rythme cardiaque fœtal et de son analyse informatisée dans la surveillance de la grossesse prolongée

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