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Master Thesis

L'histoire de la césarienne : les raisons d'un succès

Abstract : Introduction: Over the last few centuries, the caesarean section has seen an increase about the number of indication due to an easier technique and the reduction of immediate complications intra and postoperative. Objective: To describe and analyze the development of indications and caesarean section care management to Hôpital Nord from 1996 to 2013. Method: retrospective, descriptive and mono centric study on 389 medical records of caesarean deliveries patients Results: the caesarean section rates in Hôpital Nord 625%) did not increase significantly between 1996 and 2013 (p=0,919). The three main indications for emergency caesarean section were the ARCF (29%), preeclampsia (6%) and cephalopelvic disproportion (5%). For planned caesarean section, the three major were bi scarred uterus (22%), the breech presentation (20%) and scarred uterus with maternal rejection of the vaginal delivery (18%).Comparison of data collected between 1996 and 2013 showed an increase in planned cesarean (p = 0,0011), increased caesareans performed outside of labor (p = 0,0421), a reduction of anesthesia general (p = 0.0096) and increased spinal epidural combined (p = 0,0071). Regarding the surgical technique, the technique of Cohen Stark is favored (p = 0,0001). The use of the drain has become scarce (p 8,929E-7). Was found a generalization of the directed delivery (p 0,00003), the intraoperative antibiotic prophylaxis (p 1,629 E -8) and the wearing of compression stockings (p=O.0001). The length of stay was significantly decreased (p =3,8390 E-5) and breastfeeding has spread. (p = 0.0114) Conclusion: The overall caesarean section rate according to WHO should not exceed 15% significantly exceeded this figure to Hôpital Nord. (Around the French national rate of 21%) This increase is related to changes in medical practice and sociocultural factors. The evolution of the care management of the caesarean deliveries patient was part of an early rehabilitation program.
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https://dumas.ccsd.cnrs.fr/dumas-01218593
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Submitted on : Tuesday, December 6, 2016 - 2:38:29 PM
Last modification on : Monday, July 6, 2020 - 4:04:37 PM
Long-term archiving on: : Monday, March 20, 2017 - 6:46:06 PM

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  • HAL Id : dumas-01218593, version 1

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Grazia Sabatino. L'histoire de la césarienne : les raisons d'un succès. Gynécologie et obstétrique. 2015. ⟨dumas-01218593⟩

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