Pertinence de la gestion de la dystocie dynamique

Abstract : Introduction : Recommendations for the administration of oxytocin during spontaneous labour were published in 2016 by the CNSF, in collaboration with CNGOF, INSERM and CIANE. The purpose of this study was to evaluate the administration of oxytocin, on the one hand, and, on the other hand, the use of amniotomy during labour. Population and method : It was a cross-sectional study of clinical audit type, performed in a type III maternity, in the Auvergne Rhône-Alpes region. The medical records were analysed over a period of one month, from January 1, 2016, to January 31, 2016. Regarding the administration of oxytocin during spontaneous labour, a set of criteria was identified, based on recommendations issued by the CNSF, incollaboration with CNGOF, INSERM and CIANE. Results : In the course of this study, 177 medical records were audited. Almost half of the spontaneous labour parturients benefited from oxytocin (46,9%, n=83), excluding prophylactic administration of oxytocin. Only16.2% of parturients received appropriate administration of oxytocin in the event of dynamic dystocia during the first stage of labour, and 25% in the event of failure of the progression of the presentation during the second stage of labour. Of all women, 8,5% had postpartum haemorrhage. Discussion and conclusion : Some results of our study show discrepancies between the maternity clinical practice and the recommendations made. Improvements seem possible. A new evaluation should subsequently be carried within the maternity in order to assess the improvement actions that have been implemented as part of this analysis of professional practices.
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Marie Nayraguet. Pertinence de la gestion de la dystocie dynamique. Médecine humaine et pathologie. 2018. ⟨dumas-01986176⟩

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