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Master Thesis

Impact des recommandations de 2016 sur l'administration d'oxytocine au cours du travail spontané : étude mono-centrique au CHUGA de type avant-après, comparaisons entre les années 2015 et 2019

Abstract : Objectives – The main objective of this study was to make an appraisal of practices before and after the publication of national recommendations (2016) of oxytocin administration during spontaneous labor, in order to assess the impact of these on the labor, the delivery and the neonatal state. The secondary objective was to assess the application of these new recommendations. Methods – Comparative before-after, retrospective, monocentric study conducted in the Hôpital Couple Enfant in Grenoble. Two groups were formed: a group “before” (2015) the publication of national recommendations, and a group “after” (2019). Eligible patients were primiparous, giving birth at term with a spontaneous labor; fetus head presentations and patients with intact membrane when arrived at the maternity were included. Results – The oxytocin administration rate decreased significantly, from 72,2 % in the "before" group to 45,2 % in the "after" group. This decrease comes with a moderate increase of the active phase duration, without variation of the rate of cesarean section and with a constant rate of immediate postpartum hemorrhage between the two groups. No significant difference were found for the Apgar score at 5 min, the transfer rate and the pH < 7.10 rate in neonates. Regarding the oxytocin administration methods, the initial rate is significantly lower, without the total dose significantly decreasing, and with a total infusion duration constant between the two groups. Conclusion – In 23 % of cases, oxytocin is used in accordance with the recommendations. Improvement proposals arising from this study could be the drafting of service protocols on normal labor management, and the establishment of training within the service.
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https://dumas.ccsd.cnrs.fr/dumas-02951639
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Submitted on : Monday, September 28, 2020 - 6:15:50 PM
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Alice Bouvard. Impact des recommandations de 2016 sur l'administration d'oxytocine au cours du travail spontané : étude mono-centrique au CHUGA de type avant-après, comparaisons entre les années 2015 et 2019. Gynécologie et obstétrique. 2020. ⟨dumas-02951639⟩

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