Adéquation entre le souhait des femmes enceintes et la prise en charge effective de l’analgésie péridurale au cours du travail obstétrical

Abstract : Background: the main objective was to describe the inadequacy between women’s initial preference for labor and its actual use at delivery. Methods: this observational prospective single-center study was conducted from January to April 2015. Women randomly identified answered to 2 written surveys about their preference for neuraxial analgesia (NA) and the analgesia finally used at delivery: one just before the preanesthetic assessment and the second after birth. Characteristics of women and childbirth were compared between women who initially prefered NA and those who did not, and then, among women who did not prefer NA, between those who had one and those who did not (inadequacy). Results: 451 women were included, 80% initially prefered NA for labor analgesia. Women who did not initially prefer NA considered being able to cope with higher levels of pain, had their follow-up more often by midwifes (60 versus 43.8%, p <0.01) and favored information from human sources than women who prefered not having a NA. Among women who delivered with NA not initially prefered (75% of them), the main reason was pain intensity. Compared with women who delivered without NA as prefered, women with inadequacy were significantly more often nulliparous, had a longer and more often operative delivery. Conclusion: factors of inadequacy are mainly related to labor. Communication about labor pain and the means available to cope with it must be improved.
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https://dumas.ccsd.cnrs.fr/dumas-01615900
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Camille Godart. Adéquation entre le souhait des femmes enceintes et la prise en charge effective de l’analgésie péridurale au cours du travail obstétrical. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01615900⟩

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