Grossesses prolongées (termes dépassés) : à partir de quand doit-on surveiller et à quelle fréquence ?

Haumonté, Jean-Baptiste; d’Ercole, C.

doi:10.1016/j.jgyn.2011.09.015

Cited by 4 publications

(3 citation statements)

References 48 publications

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“…If a policy of expectant management until 42.0 weeks is chosen, regular antenatal checks in late-term pregnancy (41.0–42.0) are advised, though there is inconsistent evidence regarding the effectiveness of antenatal monitoring for the prevention of adverse perinatal outcome [9, 15, 18]. Studies are varying in timing, frequency and content of these antenatal checks [9, 10, 15, 21–23]. Some international guidelines advise to perform a transabdominal ultrasound measurement of amniotic fluid for timely detection of an oligohydramnios and to detect small-for-gestational age foetus [9, 15].…”

Section: Discussionmentioning

confidence: 99%

Management of late-term pregnancy in midwifery- and obstetrician-led care

Kortekaas

Bruinsma

Vandenbussche

et al. 2019

BMC Pregnancy Childbirth

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Management of late-term pregnancy in midwifery- and obstetrician-led care. Background Since there is no consensus regarding the optimal management in late-term pregnancies (≥41.0 weeks), we explored the variety of management strategies in late-term pregnancy in the Netherlands to identify the magnitude of this variety and the attitude towards late-term pregnancy. Methods Two nationwide surveys amongst all midwifery practices (midwifery-led care) and all hospitals with an obstetric unit (obstetrician-led care) were performed with questions on timing, frequency and content of consultations/surveillance in late-term pregnancy and on timing of induction. Propositions about late-term pregnancy were assessed using Likert scale questions. Results The response rate was 40% (203/511) in midwifery-led care and 92% (80/87) in obstetrician-led care. All obstetric units made regional protocols with their collaborating midwifery practices about management in late-term pregnancy. Most midwifery-led care practices (93%) refer low-risk women at least once for consultation in obstetrician-led care in late-term pregnancy. The content of consultations varies among hospitals. Membrane sweeping is performed more in midwifery-led care compared to obstetrician-led care (90% vs 31%, p < 0.001). Consultation at 41 weeks should be standard care according to 47% of midwifery-led care practices and 83% of obstetrician-led care units ( p < 0.001). Induction of labour at 41.0 weeks is offered less often to women in midwifery-led care in comparison to obstetrician-led care (3% vs 21%, p < 0.001). Conclusions Substantial practice variation exists within and between midwifery-and obstetrician-led care in the Netherlands regarding timing, frequency and content of antenatal monitoring in late-term pregnancy and timing of labour induction. An evidence based interdisciplinary guideline will contribute to a higher level of uniformity in the management in late- term pregnancies. Electronic supplementary material The online version of this article (10.1186/s12884-019-2294-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Management of late-term pregnancy in midwifery- and obstetrician-led care

Kortekaas

Bruinsma

Vandenbussche

et al. 2019

BMC Pregnancy Childbirth

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“…Afin de garder une valeur prédictive suffisante pour le dépis-tage de l'asphyxie antepartum, le RCF devrait être répété tous les deux à trois jours [36]. Bien que certains protocoles de surveillance soient très hétérogènes, les données issues des méta-analyses et la plupart des programmes de surveillance provenant des essais randomisés comparant une attitude d'attente d'un travail spontané à une attitude interventionniste systématique font état d'un rythme de surveillance de deux à trois fois par semaine.…”

Section: Intégration Du Rythme Cardiaque Foetal Dans Les Programmes Dunclassified

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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“…Post-term or prolonged pregnancy, defined as a pregnancy extended to or beyond 42 + 0 weeks or ≥ 294 days after the first day of last menstrual period, is associated with increased perinatal morbidity and mortality [ 1 – 10 ]. Therefore post-term pregnancy is considered as a high-risk condition which requires specialist surveillance and induction of labour at some stage, mainly because of a relative small group of undetected growth-restricted foetuses that is at risk for adverse perinatal outcome [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of induction of labour versus expectant management in women with impending post-term pregnancies: the 41 week – 42 week dilemma

Kortekaas

Bruinsma

Dillen

et al. 2014

BMC Pregnancy Childbirth

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BackgroundPost-term pregnancy, a pregnancy exceeding 294 days or 42 completed weeks, is associated with increased perinatal morbidity and mortality and is considered a high-risk condition which requires specialist surveillance and induction of labour. However, there is uncertainty on the policy concerning the timing of induction for post-term pregnancy or impending post-term pregnancy, leading to practice variation between caregivers. Previous studies on induction at or beyond 41 weeks versus expectant management showed different results on perinatal outcome though conclusions in meta-analyses show a preference for induction at 41 weeks. However, interpretation of the results is hampered by the limited sample size of most trials and the heterogeneity in design. Most control groups had a policy of awaiting spontaneous onset of labour that went far beyond 42 weeks, which does not reflect usual care in The Netherlands where induction of labour at 42 weeks is the regular policy. Thus leaving the question unanswered if induction at 41 weeks results in better perinatal outcomes than expectant management until 42 weeks.Methods/designIn this study we compare a policy of labour induction at 41 + 0/+1 weeks with a policy of expectant management until 42 weeks in obstetrical low risk women without contra-indications for expectant management until 42 weeks and a singleton pregnancy in cephalic position. We will perform a multicenter randomised controlled clinical trial. Our primary outcome will be a composite outcome of perinatal mortality and neonatal morbidity. Secondary outcomes will be maternal outcomes as mode of delivery (operative vaginal delivery and Caesarean section), need for analgesia and postpartum haemorrhage (≥1000 ml). Maternal preferences, satisfaction, wellbeing, pain and anxiety will be assessed alongside the trial.DiscussionThis study will provide evidence for the management of pregnant women reaching a gestational age of 41 weeks.Trial registrationDutch Trial Register (Nederlands Trial Register): NTR3431. Registered: 14 May 2012.

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Grossesses prolongées (termes dépassés) : à partir de quand doit-on surveiller et à quelle fréquence ?

Cited by 4 publications

References 48 publications

Management of late-term pregnancy in midwifery- and obstetrician-led care

Management of late-term pregnancy in midwifery- and obstetrician-led care

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

Effects of induction of labour versus expectant management in women with impending post-term pregnancies: the 41 week – 42 week dilemma

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