Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 6: Fetal, neonatal and pediatric risks and adverse effects of using oxytocin augmentation during spontaneous labor

International audienc

Risque d'intubation trachéale en salle de naissance des grands prématurés nés par césarienne avant travail (influence du type d'anesthésie maternelle)

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Grande prématurité (un accouchement par voie basse a-t-il le même impact chez les singletons et le jumeaux ?)

Résumé françaisDIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 5: Maternal risk and adverse effects of using oxytocin augmentation during spontaneous labor

International audienc

Recommandations pour l’administration d’oxytocine au cours du travail spontané. Chapitre 6 : risques et effets indésirables fœtaux, et pédiatriques de l’administration de l’oxytocine au cours du travail spontané

International audienceLes risques et effets indésirables fœtaux, et pédiatriques de l’utilisation de l’oxytocine au cours du travail spontané, s’ils existent, sont globalement de cinq types : (1) difficultés d’adaptation à la vie extra-utérine, (2) ictère néonatal, (3) hyponatrémie néonatale, (4) perturbations de la succion en période néonatale et (5) troubles envahissant du développement (autisme) chez l’enfant. De nombreuses difficultés méthodologiques interdisent l’établissement d’un lien causal entre l’exposition à l’oxytocine et ces cinq effets indésirables : manque de puissance des essais randomisés, sélection dans les essais randomisés de parturientes qui ne correspondent pas à celles observées dans les enquêtes en population, et inversement mise en évidence dans les enquêtes en population d’effets indésirables dans des conditions d’administration de l’oxytocine (indication, posologie, préparation) qui ne sont pas forcément celles établies dans les recommandations. Néanmoins, compte tenu de la forte fréquence actuelle de l’administration de l’oxytocine au cours du travail spontané en France, notre groupe d’experts attire l’attention des prescripteurs sur la nécessité d’une grande vigilance : cette vigilance doit s’articuler notamment autour de la rédaction de protocole d’administration de l’oxytocine au cours du travail spontané dans chaque maternité, autour de l’analyse de l’administration de l’oxytocine lors des reprises de cas ou revue de morbi-mortalité des nouveau-nés ayant présenté une mauvaise adaptation à la vie extra-utérine, et du taux d’administration de l’oxytocine au cours du travail spontané dans chaque maternité

CARACTERISTIQUES DES GRANDS PREMATURES SOIGNES AU CHU DE BESANCON DE 1989 A 1997

BESANCON-BU Médecine pharmacie (250562102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Neonatal outcome associated with singleton birth at 34 to 41 weeks of gestation.: outcome of late-preterm and early-term neonates

International audienceBackground: Approximately 75% of preterm births are late-preterm (340/7 to 366/7 weeks' gestation). This group has usually been considered as a whole in studies assessing the outcome of these preterm infants by comparison with term infants. However, the respective contribution to prognosis of each week of gestation has not been fully clarified. Methods: A population-based study of 150,426 live-born singleton neonates with gestational ages ranging from 34 to 41 weeks of gestation. Results: The rate of severe respiratory disorders (treated by mechanical ventilation and/or nasal continuous positive airway pressure) markedly declined with gestational age from 19.8% at 34 weeks to 0.28% at 39-41 weeks. Between 34 to 38 weeks, each additional week diminished the relative risk (crude or adjusted) of severe respiratory disorders by a factor varying from 2 to 3. The rate of poor prognosis (death and/or severe neurological condition) significantly declined between 34 to 38 weeks and remained stable thereafter. A multivariate analysis showed that antepartum hemorrhage and hypertensive disorders during pregnancy were significantly associated with severe respiratory disorders and poor outcome. Diabetes was an additional factor associated with severe respiratory disorders. Conclusions: Future studies should delineate more precisely the respective contribution of gestational age, maternal complication and induced delivery in the prognosis of infants born between 33 and 39 weeks' gestation

Correction: Maternal Haemoglobin and Short-Term Neonatal Outcome in Preterm Neonates.

[This corrects the article DOI: 10.1371/journal.pone.0089530.]

Maternal haemoglobin and short-term neonatal outcome in preterm neonates.

To determine whether there is a significant association between maternal haemoglobin measured before delivery and short-term neonatal outcome in very preterm neonates.We included prospectively all live births occurring from 25 to 32+6 weeks of gestation in a tertiary care centre between January 1(st) 2009 and December 31(st) 2011. Outborn infants and infants presenting with lethal malformations were excluded. Three hundred and thirty-nine mothers and 409 infants met the inclusion criteria. For each mother-infant pair a prospective record of epidemiologic data was performed and maternal haemoglobin concentration recorded within 24 hours before delivery was retrospectively researched. Maternal haemoglobin was divided into quartiles with the second and the third one regarded as reference as they were composed of normal haemoglobin values. Short-term outcome was defined as poor in case of death during hospital stay and/or grades III/IV intraventricular haemorrhage and/or periventricular leukomalacia and/or necessity of ventriculoperitoneal shunt.The global rate of poor short-term neonatal outcome was 11.4% and was significantly associated with low maternal haemoglobin values. This association remained significant after adjustment for antenatal corticosteroids therapy, gestational age, parity, mechanism of preterm birth, mode of delivery and birth weight (aOR = 2.97 CI 95% [1.36-6.47]). There was no relation between short-term neonatal outcome and high maternal haemoglobin concentration values.We show that low maternal haemoglobin concentration at delivery is an independent risk factor for poor short-term neonatal outcome in very preterm neonates. This study is one of the first to show such an association within the preterm population

Probability of poor short-term neonatal outcome in relation to gestational age and maternal haemoglobin quartile (Hb m Q).

<p>The results are adjusted for birth weight, mechanism of preterm birth, antenatal corticosteroid therapy, maternal age, parity and mode of delivery.</p