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42es Journées nationales de la Société Française de Médecine Périnatale (Montpellier 17–19 octobre 2012) pp 163–169Cite as

Faut-il limiter les efforts expulsifs ?

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Résumé

En vue de réduire le risque d’asphyxie néonatale liée à la diminution du pH foetal lors des efforts expulsifs, certains recommandent de limiter la durée de la phase de poussée. Mais cette pratique s’accompagne d’une augmentation du risque d’extraction instrumentale potentiellement associée à des complications maternelles. Nous présentons ici une revue des données publiées concernant l’association entre durée des efforts expulsifs et complications maternelles et néonatales, y compris des résultats issus de données françaises.

La durée des efforts expulsifs ne semble pas associée à une augmentation de risque d’asphyxie et de morbidité néonatale lorsque la surveillance du RCF est adéquate au cours du travail. Une association entre durée prolongée des efforts expulsifs et hémorragie du post-partum a, en revanche, été retrouvée mais celle-ci est à mettre en balance avec l’augmentation de risque hémorragique lié aux extractions instrumentales plus fréquentes si on limite les efforts expulsifs.

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  1. Maternité Port Royal, 53, avenue de l’Observatoire, 75014, Paris, France

    C. Le Ray & F. Goffinet

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  1. C. Le Ray
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  2. F. Goffinet
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Le Ray, C., Goffinet, F. (2013). Faut-il limiter les efforts expulsifs ?. In: 42es Journées nationales de la Société Française de Médecine Périnatale (Montpellier 17–19 octobre 2012). Springer, Paris. https://doi.org/10.1007/978-2-8178-0385-2_14

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  • DOI: https://doi.org/10.1007/978-2-8178-0385-2_14

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0384-5

  • Online ISBN: 978-2-8178-0385-2

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