title: [Influence of anticoagulant therapy during pregnancy on the peripartum and anesthesia delivery terms].
abstract: OBJECTIVE
  The objective of the study was to evaluate the influence of anticoagulation on intrapartum anesthesia and delivery modalities.
  
  
  METHODS
  This ancillary study is concerned with anticoagulated patients included in the study STRATHEGE, in the Saint-Etienne and Lyon University Hospital from 2007 to 2012, which are compared to a control population. The primary endpoint is to evaluate the type of anesthesia received by women in labor, according to the center at the time of delivery compared to no treatment. The secondary endpoints are comparing the input mode to work, mode of delivery, stop management arrangements of these treatments, the rate of thromboembolic and hemorrhagic complications.
  
  
  RESULTS
  Two hundred and three cases were included and 812 controls, matched on age, body mass index and parity. 61.6% of the cases had an epidural during childbirth against 87% of controls (p<0.05), spinal rates (22.5% versus 1.85%) and general anesthesia (5.4% versus 0.7%) were higher in the case group. The delivery rate vaginally was 90% in controls, against 65% of cases. The postpartum hemorrhage rate was similar in both groups (p> 0.05). A relay of the low molecular weight heparin was performed in 63% of the cases in Lyon, but the types of anesthesia received according to the centers were similar.
  
  
  CONCLUSIONS
  Anticoagulant therapy at the time of delivery, does not limit access to effective analgesia, but with an increased rate of spinal anesthesia and general anesthesia at the expense of epidural anesthesia. The management of a parturient anticoagulant is complex and still exists today, great care disparities in the various maternity hospitals.
authors.affiliation: Département d'obstétrique et gynécologie, hôpital Nord, CHU de Saint-Étienne, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France.
authors.forename: T
authors.initials: T
authors.lastname: Boilot
authors.affiliation: Département d'obstétrique et gynécologie, hôpital Nord, CHU de Saint-Étienne, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France; EA 3065, groupe de recherche sur la thrombose, université Jean-Monnet, 42055 Saint-Étienne cedex, France.
authors.forename: T
authors.initials: T
authors.lastname: Raia-Barjat
authors.affiliation: EA 3065, groupe de recherche sur la thrombose, université Jean-Monnet, 42055 Saint-Étienne cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Ollier
authors.affiliation: EA 3065, groupe de recherche sur la thrombose, université Jean-Monnet, 42055 Saint-Étienne cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Chapelle
authors.affiliation: EA 3065, groupe de recherche sur la thrombose, université Jean-Monnet, 42055 Saint-Étienne cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Laporte
authors.affiliation: Département d'obstétrique et gynécologie, hôpital Nord, CHU de Saint-Étienne, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France; EA 3065, groupe de recherche sur la thrombose, université Jean-Monnet, 42055 Saint-Étienne cedex, France. Electronic address: celine.chauleur@chu-st-etienne.fr.
authors.forename: C
authors.initials: C
authors.lastname: Chauleur
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D058725:Peripartum Period / Q000187:drug effects*; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D054556:Venous Thromboembolism / Q000453:epidemiology
chemical_list: D000925:Anticoagulants
keywords: Accouchement; Anesthesia; Anesthésie; Anticoagulant; Delivery; Hémorragie de la délivrance; Mode d’entrée en travail; Postpartum haemorrhage; User into labor