Prise en charge des patientes obèses morbides en salle d’accouchement : étude cas-témoin concernant l’utilisation d’ocytocine durant le travail
Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: Objective : To analyze the use of oxytocin in morbidly obese patients by comparing the mean total dose received during labor compared with normal-weight patients. Methods : Retrospective case-control study at the Bordeaux University Hospital from January to July 2015. Were included all patients with BMI≥40kg/m², a singleton pregnancy with cephalic presentation and vaginal labor attempt at term (≥37SA). Normal weight controls were matched by age, parity and labor induction. Results : 34 morbidly obese women and 68 normal weight controls were included. In group "spontaneous onset of labor" mean total dose of oxytocin received was 2.976UI vs 2.084UI (p= 0.37). For the group "labor after induction" it was 5.064UI vs 3.021UI (p= 0.007). This difference persisted in multivariate analysis (p= 0.0102 ; IC95 = 0.175-0.810). The mean duration of induction was prolonged (p= 0.038 ; IC95 = 0.003-0.525). There was no difference in the total duration of labor but the duration of expulsive efforts was shorter for obese after induction (p= 0.0231). The epidural failure rate ranged from 30 to 41.7 % vs 0 to 8.3 % (p= 0.017 and 0.0004). Conclusion : Use and doses of oxytocin were higher in morbidly obese women after onset of labor. This practice does not lead to more maternal and fetal complications. New recommendations and protocols appear necessary to unify and improve obese management.
Source: HAL
Author: Julie Commeny
Institution: Université de Bordeaux
Language: French
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2198878428