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Master Thesis

Anomalies du rythme cardiaque fœtal et variabilité d'interprétation chez les sages-femmes en salle de naissance

Abstract : The main objective of this study is to identify factors and/or elements that may influence the variability of inter and intra individual interpretation of foetal heart rate's anomalies by midwives in the birth room. The secondary objectives are to identify and analyse the perceived consequences of these interpretative variabilities for midwives and tho identify possible suggestions for improvement. A qualitative study by a grounded theory has been led in order to collect and study the midwives point of view practicing in the birth sector facing this problematic. The interviewed midwives had to be practitioners in the public hospital's sector and/or private or in birthing centres in Marseille or nearby , and taking custodies in delivery room. They have been selected on the base of volunteering. The results shows multiples subjective hypothesis concerning the intra individual variability, often closely linked to the working 's modalities of the midwives concerned like the level of maternity in which they are engaged or the continuing training they have undergone. Consideration of the clinical context remains the most discussed element. The inter individual variability seems distinct between midwives only or between midwives and obstetrical gynaecologists. Between midwives, it could be due to a different professional experience, meanwhile for the obstetrical gynaecologists, the causes meet the course of action relatively to the foetal heart rate's anomalies. The consequences of this variability are numerous and seems to affect various fields like the midwife herself, the obstetric team or even the mother-infant couple. The diminution of this variability seems to be made possible by the different improvement's actions like a regular continuous training common to different health professionals. This study demonstrated how the causes of variability in the interpretation of foetal heart rate's anomalies the perspective of midwives are diverse and varied. For inter individual variability between midwives, it seems positively perceived. With obstetrician gynaecologists, however, the quality of the relationship and inter professional communication seems to allow for a better experience oh these situations of disagreement. Continuing training of professionals remains the main area of improvement in an attempt to reduce this variability in interpretation.
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Submitted on : Wednesday, November 4, 2020 - 3:48:00 PM
Last modification on : Saturday, November 7, 2020 - 3:25:48 AM
Long-term archiving on: : Friday, February 5, 2021 - 6:48:23 PM


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  • HAL Id : dumas-02988231, version 1


Coline Daddi. Anomalies du rythme cardiaque fœtal et variabilité d'interprétation chez les sages-femmes en salle de naissance. Gynécologie et obstétrique. 2020. ⟨dumas-02988231⟩



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