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Master Thesis

Ocytocine de synthèse et travail spontané. Étude avant-après la mise en place d'un protocole à l'hôpital Louis-Mourier

Abstract : Oxytocin and spontaneous labour: evaluation of a protocol. Objective: the purpose of this study was to examine the effects of a protocol for restricting oxytocin administration on maternal and newborn outcomes. Material and method: this study was a single center pre-test / post-test study. Outcomes were evaluated before and after implementation of the protocol. 2174 women with singleton cephalic foetal presentation and spontaneous labour at term without prior caesarean history were included. Results: 1235 women were included in the pre-test period and 939 in the post-test. For the pre and post-protocol group, the mean duration of labour increased from 5,2 ± 2,7 h to 6,0 ± 3,3 h (p<0,01), the rate of hyperstimulation (6,6 versus 2,7 %, OR 0,4 IC 95% 0,2-0,8, p=0,01) and pH < 7,15 (15,6 versus 8,5%, p<0,01) got lower. No difference was observed on postpartum haemorrhage. The caesarean delivery rate for dystocia seemed to be increased for primiparous women but this difference didn't reach statistical significance (ORa 1,4 IC 95% 0,9-2,2). Conclusion: implementation of this protocol resulted in decreased rate of hyperstimulations, but it seemed to increase caesarean delivery rate for labour arrest. It might be interesting to revise criteria of labour dystocia in order to reduce oxytocin use and maximize chance of vaginal delivery.
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https://dumas.ccsd.cnrs.fr/dumas-00874840
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Submitted on : Friday, October 18, 2013 - 4:34:42 PM
Last modification on : Saturday, June 25, 2022 - 8:53:50 PM
Long-term archiving on: : Friday, April 7, 2017 - 1:23:01 PM

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  • HAL Id : dumas-00874840, version 1

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Pauline Blanc-Petitjean. Ocytocine de synthèse et travail spontané. Étude avant-après la mise en place d'un protocole à l'hôpital Louis-Mourier. Gynécologie et obstétrique. 2013. ⟨dumas-00874840⟩

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