Base de données - (CIANE)

Présentation de cette base de données documentaires (site du CIANE)
Actuellement 3111 fiches
➡ Chaîne YouTube (tutoriel)

https://ciane.net/id=455

Créée le : 10 Feb 2004
Modifiée le : 02 Dec 2007

➡ Modifier cette fiche
Ne suivez ce lien que si vous possédez un mot de passe d’éditeur !

Notice bibliographique (sans auteurs) :

Dystocia in nulliparous patients monitored with fetal pulse oximetry. American Journal of Obstetrics and Gynecology 2004;190(1):113-17.

Auteur·e(s) :

Porreco RP, Boehm FH, Dildy GA, Miller HS, Wickstrom EA, Garite TJ, Swedlow D.

Année de publication :

2004

URL(s) :

http://www.sciencedirect.com/science?_ob=ArticleUR…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE :
A critical analysis of the United States randomized controlled trial of fetal pulse oximetry concluded that nonreassuring fetal heart rate patterns used for study entry may have been a marker for dystocia. We prospectively studied nulliparous women in labor whose progress was monitored with fetal pulse oximetry to examine the relationship between nonreassuring fetal heart rate patterns and operative delivery for dystocia.
STUDY DESIGN : A prospective nonrandomized observational cohort study compared two distinct classes of nonreassuring fetal heart rate patterns (class I: intermittent, mildly nonreassuring; class II: persistent, progressive, and moderate to severely nonreassuring) among nulliparous patients with the use of fetal pulse oximetry to confirm fetal well-being. Definitions of dystocia included the cessation of labor progress in the first (3 hours) or second (2 hours) stage of labor, despite adequate uterine activity that was assessed with an intrauterine pressure catheter. Independent review confirmed the classification of nonreassuring fetal heart rate patterns and study entry criteria.
RESULTS : Two hundred seventy-four patients met study criteria and had sufficient information for fetal heart rate tracing interpretation. Two hundred thirty-seven patients (86.5%) were class II, and 37 patients (13.5%) were class I. The two classes of patients were comparable in a variety of obstetric, demographic, and perinatal variables. Twelve percent of all patients were delivered for nonreassuring fetal status. Significantly more class II patients (22%) were delivered by cesarean for dystocia than were class I patients (8%). Higher doses and a longer number of hours of oxytocin were required among class II patients. Significantly more occiput posterior positions were noted among all patients who underwent cesarean delivery for dystocia compared with other modes of delivery.
CONCLUSION : Significantly nonreassuring fetal heart rate patterns predict cesarean delivery for dystocia among nulliparous patients with normally oxygenated fetuses in a setting of a standardized labor management protocol. This confirms the observations in the randomized controlled trial of fetal pulse oximetry in the United States and may provide insight into the treatment of nonprogressive labor in contemporary practice.

Sumário (português)  :

Resumen (español)  :

Remarques :

Argument (français) :

Argument (English):

Argumento (português):

Argumento (español):

Mots-clés :

➡ césarienne ; médecine factuelle ; détresse fœtale ; dystocie dystocies ; monitoring ; ocytocine (Syntocinon) ; hormones

Auteur·e de cette fiche :

Cécile Loup — 10 Feb 2004