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Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this bibliographical database (AFAR website)
Currently 3032 records
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https://afar.info/id=2018

Created on : 17 Mar 2007
Modified on : 26 Nov 2018

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Bibliographical entry (without author) :

Pregnancy outcome beyond 41 weeks gestation. {Chine}. Int J Gynaecol Obstet. 1997 Oct;59(1):19-24.

Author(s) :

Roach VJ, Rogers MS.

Year of publication :

1997

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=p…

Résumé (français)  :

OBJECTIF : Déterminer la morbidité maternelle et périnatale et le taux de travail spontané au-delà de 41 semaines de gestation.

MÉTHODE : Les patientes ayant une grossesse simple ont été recrutées à 41 semaines et soumises à un dépistage du bien-être fœtal ou maternel. Après observation entre 41 et 42 semaines, les patients ont été randomisés pour effectuer une surveillance en série par cardiotocographie et mesure de l’indice de liquide amniotique ou pour une induction immédiate. Les comparaisons ont été effectuées à l’aide du test chi (2). Les résultats après 42 semaines ont été analysés selon l’intention lors de la randomisation.

RESULTATS : La morbidité n’a pas augmenté avant 42 semaines. Après 42 semaines, le taux de césariennes et l’incidence du méconium sous les cordes vocales ont augmenté chez les patients suivis. L’âge gestationnel médian chez les patientes suivies était de 298, 5 (294 à 321) jours. Parmi les patients observés à partir de 41 semaines, 91, 6% ont travaillé spontanément.

CONCLUSION : Il est raisonnable d’observer une grossesse sans complications jusqu’à 42 semaines avec une surveillance adéquate. Après 42 semaines, le déclenchement du travail est préféré.

Abstract (English)  :

OBJECTIVE: To determine maternal and perinatal morbidity and the spontaneous labor rate beyond 41 weeks of gestation.

METHOD: Patients with uncomplicated pregnancy were recruited at 41 weeks and screened for fetal or maternal well-being. Following observation between 41 and 42 weeks, patients were randomized to either serial monitoring by cardiotocography and measurement of amniotic fluid index, or to immediate induction. Comparisons were made using the chi (2) test. Results after 42 weeks were analyzed according to intention at randomization.

RESULTS: Morbidity was not increased before 42 weeks. After 42 weeks, the cesarean section rate and incidence of meconium below the vocal cords were increased in monitored patients. The median gestational age in patients who were monitored was 298.5 (294-321) days. In patients observed from 41 weeks, 91.6% labored spontaneously.

CONCLUSION: It is reasonable to observe uncomplicated pregnancy until 42 weeks with adequate monitoring. After 42 weeks, induction of labor is preferred.

Sumário (português)  :

OBJETIVO: Determinar a morbidade materna e perinatal e a taxa de parto espontâneo após 41 semanas de gestação. MÉTODO: Pacientes com gravidez não complicada foram recrutados em 41 semanas e selecionados para o bem-estar fetal ou materno. Após a observação entre 41 e 42 semanas, os pacientes foram randomizados para monitorização seriada por cardiotocografia e medida do índice de líquido amniótico, ou para indução imediata. As comparações foram feitas usando o teste chi (2). Os resultados após 42 semanas foram analisados ​​de acordo com a intenção na randomização.

RESULTADOS: A morbidade não aumentou antes de 42 semanas. Após 42 semanas, a taxa de cesárea e a incidência de mecônio abaixo das cordas vocais foram aumentadas em pacientes monitorados. A mediana da idade gestacional nos pacientes monitorados foi 298,5 (294-321) dias. Nos pacientes observados a partir das 41 semanas, 91,6% trabalhavam espontaneamente.

CONCLUSÃO: É razoável observar a gravidez sem complicações até 42 semanas com monitoramento adequado. Após 42 semanas, a indução do parto é preferida.

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Comments :

Le résultat aurait été inverse si l’on n’avait compté que les femmes qui ont réellement subi un déclenchement et non celles à qui le tirage au sort avait attribué un déclenchement…
Voir la discussion de cette méthodologie sur la page http://ciane.net/wiki/pmwiki.php?n=Ciane.DeclenchementSystematiqueBiais

Argument (français) :

Il est raisonnable d’observer une grossesse sans complications jusqu’à 42 semaines avec une surveillance adéquate. Après 42 semaines, le déclenchement du travail est préféré.

Argument (English):

It is reasonable to observe uncomplicated pregnancy until 42 weeks with adequate monitoring. After 42 weeks, induction of labor is preferred.

Argumento (português):

É razoável observar a gravidez sem complicações até 42 semanas com monitoramento adequado. Após 42 semanas, a indução do parto é preferida.

Keywords :

➡ c-section/caesarean ; guidelines ; induction of labor ; post-term pregnancy ; informed consent

Author of this record :

Cécile Loup — 17 Mar 2007
➡ latest update : Bernard Bel — 26 Nov 2018

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