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Master Thesis

Évitabilité de l’asphyxie per-partum : impact d’une formation e-learning à l’analyse du RCF. Étude multicentrique, avant-après

Abstract : Introduction: intra-partum asphyxia is a rare event but occurrence can have serious immediate and long term consequences. So that, progress are necessary to improve screening and diagnostic. The aim of our study is to test the impact of an e-learning program on the rate of avoidable intra-partum asphyxia, after 37 weeks of gestation, according to a committee of experts. Method: a before-after the implementation of e-learning formation (1)(2), observational, retrospective and multicenter study, in five maternity hospitals in Ile-de-France. We have included all of the birth after 37 weeks of gestation that occurred between the first period so-called « before » (between July 1rst and December 31rst 2014) and the second period so-called « after » (between January 1rst and June 30rst 2017). We excluded all multiple pregnancies, premature births, antenatal detection of chromosomal abnormalities, breech births and all scheduled caesarean sections. Intra-partum asphyxia cases were anonymized and analyzed by pair of experts composed of midwifes and obstetrician-gynaecologists. The primary criteria of our study was the prevalence of intra-partum avoidable asphyxia. Results: the rate of intra-partum asphyxia who were considered avoidable by a group of expert was 0,30 per 100 live births for the first period, before e-learning formation and 0,28 per 100 live births for the second one, after e-learning formation (p=0,769). The main causes of the asphyxia was the same between the two periods: delay in patient management, errors in the analysis and interpretation of the fœtal heart rate and in the monitoring of labor (p=0,731). Conclusion: néoventa© e-learning formation to analyze fetal heart rate, for obstetricians and midwives who work in delivery room, has no impact, in this study, on the risk of avoidable intra-partum asphyxia.
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Emilie Lefèvre. Évitabilité de l’asphyxie per-partum : impact d’une formation e-learning à l’analyse du RCF. Étude multicentrique, avant-après . Gynécologie et obstétrique. 2018. ⟨dumas-01859715⟩



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