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Master Thesis

Évaluation des pratiques professionnelles concernant l’utilisation de l’ocytocine chez les primipares en travail spontané à la maternité de Port Royal

Abstract : Introduction lens: At the Port-Royal maternity unit, the first phase of the clinical audit showed that the protocol on the use of oxytocin was not followed for more than 50% of patients. The objective of this study was to perform the second and third phases of this clinical audit.
Materials and Methods: This is a single-center study evaluating the implementation of awareness-measure compliance with the protocol on the use of oxytocin and maternal and neonatal outcomes.
Results: Clinical audit has led to improved practices. The protocol is better respected (p<0,001) for the indication of use of oxytocin (p=0,005), the duration of increased levels (p<0,001) and the duration between amniotomy and laying the oxytocin infusion (p=0,03). The implementation of the awareness measures was associated with a reduction in the use of oxytocin (p=0,04).
However, the impact of these changes on maternal and neonatal outcomes is controversial. The rate of caesarean section and instrumental delivery decreased (p=0,11) but the postpartum hemorrhage rate increased (p=0,002). Abnormalities of the fetal heart rate decreased (p<0,001) but the arterial pH at birth decreased (p=0,005).
Conclusion: Adhesion to the protocol increased during the clinical audit. However, maternal and neonatal outcomes were not improved. The evaluation of the use of oxytocin during labor should still be studied.
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Submitted on : Tuesday, September 15, 2015 - 4:12:05 PM
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  • HAL Id : dumas-01195772, version 1

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Julie Sailly. Évaluation des pratiques professionnelles concernant l’utilisation de l’ocytocine chez les primipares en travail spontané à la maternité de Port Royal. Gynécologie et obstétrique. 2015. ⟨dumas-01195772⟩

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