Threatened late miscarriage. French guidelines. Menace de fausse couche tardive. Recommandations françaises

Archive ouverte

Carcopino, Xavier | Barde, K. | Petrovic, Melinda | Beucher, Gaël | Capmas, Perrine | Huchon, Cyrille | Deffieux, Xavier | D’ercole, C. | Bretelle, Florence

Edité par CCSD ; Elsevier Masson -

International audience. Objectives-To define guidelines for the management of women diagnosed with threatenedlate miscarriage (TLM).Materials and Methods-A systematic review of the literature was performed using Pubmedand the Cochrane library databases and the guidelines from main international societies.Results-Management of women diagnosed with threatened LM requires a complete history-taking searching for a previous history of LM and/or of premature delivery (Grade B). Speculumexamination is required to diagnose membrane prolapse (Grade B) and vaginal ultrasound scanis recommended to measure the cervical length (Grade B). Finally, initial management shouldallow to rule out chorioamniotitis (Grade B). Vaginal progesterone therapy (90-200 mg daily) isrecommended for women diagnosed with a sole shortened cervix (< 25 mm) in mid-pregnancy(Grade A). Cerclage is only recommended in women with both history of previous prematuredelivery and/or previous LM and shortened cervical length diagnosed before 24 weeks of ges-tation (Grade A). Finally, cervical cerclage (Mc Donald technique) associated with systematictocolytic therapy (indometacine) and antibiotics are to be recommended in women diagnosedwith TLM with dilated cervical os eventually associated with membrane prolapse (Grade C).

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Mémoire et thèse
• Gestion