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Master Thesis

Pratique de l'épisiotomie chez la primipare et estimation du risque de lésion anale : étude quantitative réalisée au sein d'un CHU de type III

Abstract : Introduction : Anal trauma is a severe obstetrical complication with lots of consequences in a woman’s life. The episiotomy, long considered as protective, has become the most practiced surgical procedure. However its profits are being called into question and a restrictive practice is advocated. Objectives : The main objective was to observe the link between the current practice of episiotomy and the estimated level of anal sphincter injuries. The secondary objective was to search for threshold values of the score allowing a decrease of the rate episiotomy without increasing the prevalence of OASI. Material and method : case/control epidemiological study, carried out with a computerized obstetric records of 505 primiparous within a Type III Hospital Centre. Results : Episiotomies are mostly performed on patients with a high risk score, in which the prevalence of OASI is increased. In addition, an abstention of the episiotomy for a score below 8 points, allows to pass an episiotomy rate of 36% to 16.6% without increasing the risk of OASI. Discussion : The risk score created could be tested on a larger scale in order to establish a national tool, accessible to all midwives during the obstetrical work of the parturients. Conclusion : It seems necessary to raise awareness among health care professionals about the importance of preventing and screening anal injuries, for which a score risk assessment could be a valuable help.
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Master Thesis
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Submitted on : Tuesday, July 7, 2020 - 2:57:07 PM
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Margaux Lemaire. Pratique de l'épisiotomie chez la primipare et estimation du risque de lésion anale : étude quantitative réalisée au sein d'un CHU de type III. Médecine humaine et pathologie. 2019. ⟨dumas-02892369⟩

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