[Unexpected out-of-hospital deliveries: Management and risk factors].
OBJECTIVE
To estimate the frequency of accidental out-of-hospital deliveries (OHDs), to describe the home care and the complications occurred, and to identify risk factors.


METHODS
A retrospective case-control study from 1st January 2012 to 31 December 2012 in Lyon urban area. Cases were identified from the Emergency Medical Aid Service 69 (SAMU 69) registry and control from the birth registry of the maternity corresponding to the case, recruiting two controls per case.


RESULTS
The frequency of the OHDs was 0.3% [0.2-0.4]. At home, the prophylactic administration of oxytocin was performed in 18.3% [9.31-27.3] of cases and prevention of neonatal hypothermia was performed in 45.7% [34.1%-57.3%] of cases. Multiparity [OR: 3.43 (1.65-7.23)], a precarious situation [OR: 37.63 (5.02-7.81)], and lack of antenatal care [OR: 3.36 (2.72-4.15)] were OHDs' risk factors.


CONCLUSIONS
The practical prevention of postpartum hemorrhage, and that of the home neonatal hypothermia could be improved. Points of vigilance for the medical teams to look for during the pregnancy monitoring are precariousness and less than 3 consultations scheduled.
Hôpital Femme-Mère-Enfant, 69500 Bron, France.
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M
Billon
SAMU 69, 69437 Lyon cedex 03, France.
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G
Bagou
Hôpital Femme-Mère-Enfant, 69500 Bron, France.
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L
Gaucher
SAMU 69, 69437 Lyon cedex 03, France.
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G
Comte
Faculté de médecine et de maïeutique, Lyon Sud-Charles-Mérieux, 69921 Oullins, France.
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M
Balsan
Réseau périnatal Aurore, laboratoire « santé, individu, société », faculté de médecine Laennec, université Lyon-Est, EA 4129, 69372 Lyon cedex 08, France.
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RC
Rudigoz
Réseau périnatal Aurore, laboratoire « santé, individu, société », faculté de médecine Laennec, université Lyon-Est, EA 4129, 69372 Lyon cedex 08, France. Electronic address: Corinne.dupont@chu-lyon.fr.
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C
Dupont
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods / Q000592:standards; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
Accouchement extrahospitalier; Delivery out-of-hospital; Management; Prise en charge