title: [Accidental out-of-hospital deliveries].
abstract: Unexpected out-of-hospital delivery accounts for 0.5% of the total number of delivery in France. The parturient is placed under constant multiparametric monitoring. Fetus heart rate is monitored thanks to fetal doppler. A high concentration mask containing a 50-to-50 percent mix of O(2) and NO performs analgesia. Assistance of mobile pediatric service can be required under certain circumstances such as premature birth, gemellary pregnancy, maternal illness or fetal heart rate impairment. Maternal efforts should start only when head reaches the pelvic floor, only if the rupture of the membranes is done and the dilation is completed. The expulsion should not exceed 30 min. Episiotomy should not be systematically performed. A systematic active management of third stage of labour is recommended. Routine care such as warming and soft drying can be performed when the following conditions are fulfilled: clear amniotic liquid, normal breathing, crying and a good tonus. Every 30 seconds assessment of heart rate, breathing quality and muscular tonus then guide the care. The redaction of birth certificate is a legal obligation and rests with the attending doctor.
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: pierreemmanuelbouet@yahoo.fr.
authors.forename: P-E
authors.initials: PE
authors.lastname: Bouet
authors.affiliation: Service de pédiatrie et réanimation néonatales, Smur pédiatrique (Samu 92), hôpital Antoine-Béclère (AP-HP), 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France. Electronic address: jean-louis.chabernaud@abc.aphp.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Chabernaud
authors.affiliation: Service d'anesthésie et réanimation médicale, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: duc_flavy@yahoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Duc
authors.affiliation: Service d'anesthésie et réanimation médicale, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: tarikkhouri@hotmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Khouri
authors.affiliation: Service de réanimation néonatale, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: BeLeboucher@chu-angers.fr.
authors.forename: B
authors.initials: B
authors.lastname: Leboucher
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier universitaire, CHU de Besançon, avenue du 8-Mai-1945, 25030 Besançon cedex, France. Electronic address: didier.riethmuller@ufc-chu.univ-fcomte.fr.
authors.forename: D
authors.initials: D
authors.lastname: Riethmuller
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: phdescamps@chu-angers.fr.
authors.forename: P
authors.initials: P
authors.lastname: Descamps
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: losentilhes@chu-angers.fr.
authors.forename: L
authors.initials: L
authors.lastname: Sentilhes
mesh_terms: D001719:Birth Certificates; D036861:Delivery, Obstetric / Q000592:standards / Q000706:statistics & numerical data; D004632:Emergency Medical Services; D004841:Episiotomy; D005260:Female; D005602:France / Q000453:epidemiology; D006340:Heart Rate, Fetal; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D012307:Risk Factors; D013997:Time Factors
keywords: Accouchement; Childbirth; Delivery; Emergency; Extrahospitalier; Nouveau-né; Out-of-hospital; Urgence