Facteurs de risque de césarienne en cours de travail pour la nullipare avec une obésité morbide

Objectives.- Obesity is a well-known caesarean and obstetrical risk factor. However, the number of obese nulliparous women is increasing worldwide, creating an urgent need for research into the impact of obesity on the mode of delivery. Our objective was to identify caesarean risk factors in obese nulliparous women with a BMI (body mass index) greater than 40 kg/m(2).Methods. - A literature review was conducted on PubMed; including articles published between 2009 and 2019 in French and English, on caesarean risk during labor among class III obese nulliparous women.Results. - One prospective study, and 6 retrospective analyses were included. Their results suggest that the rate of caesarean delivery increases with the BMI. Maternal age, particularly after 35 years, as well as induced labor and the use of oxytocin during labor, were positively associated with cesarean delivery. Moreover, maternal BMI was linked to an increased risk of non-elective caesarean section due to non reassuring fetal heart tracing.Conclusion. - Extreme BMI, age, induced labor and oxytocin use are associated with caesarean delivery in nulliparous women with BMI > 40 kg/m(2). Further research are needed to estimate the best candidates for elective cesarean delivery. (C) 2020 Elsevier Masson SAS. All rights reserved.