La première consultation de grossesse en cabinet de médecine générale

Abstract : Introduction: HAS frames the first pregnancy consultation. Some elements challenge, as the time for this consultation or elements that differ foreign recommendations or other medical societies. We were interested in the practice of general practitioner to look for areas of improvement. Materials and Methods: This quantitative prospective observational study, conducted from April to June 2016, concerned the general practitioner in Val de Marne. Results: 82 physicians responded. Those who have had a gynecological training follow more pregnancies (p = 0.023). 57 (69.5%) consultations lasted 15 to 30 minutes, and 13 (15.9%) over 30 minutes. 12 (14.6%) physicians have not spoken of toxic and 1 (1.2%) to 3 (3.7%) of sexually transmitted infections, being sure of the absence of risk behavior. 43 (52.4%) were prescribed fasting glucose, 67 (81.7%) a toxoplasmosis serology, 31 (37.8%) screening markers for trisomy 21. 44 (53.7%) gave folate. Discussion: the training of General practitioners is crucial to promote monitoring of pregnancy and its components (technical moves, screening for trisomy 21 and risk behaviors). The first consultation is dense. It seems that an adaptation of the time dedicated is necessary for completeness, revaluing financially or splitting it. Several thinking points appear. Doctors are likely to detect gestational diabetes, highlighting a missing element of the HAS while attitudes practiced abroad pose question: the abandonment of routine screening for toxoplasmosis and food folate supplementation could be tracks interesting.
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Pauline Glevarec. La première consultation de grossesse en cabinet de médecine générale. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01615892⟩

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