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Master Thesis

Déclenchement artificiel du travail : création d’une classification permettant l’évaluation des pratiques

Abstract : Objectives - Artifical induction of labor, a very common process in obstetric, affects more than a fifth of pregnant women in France. This medical intervention is medically indicated and is subject to risks and additional costs. However, practices are disparate and need to be evaluated. Our objectives were to create a tool to evaluate induction of labor in order to use it to compare practices at the CHU Grenoble Alpes (CHUGA) between 2017 and 2019. Material and Methods - We have created a simple and robust classification, with 8 fully inclusive and mutually exclusive groups. This classification has been validated by thirteen national experts using a Delphi mehod. To compare practices at the CHUGA, we carried out a retrospective study by analyzing computerized files. Results - Our classification includes 8 clinically relevant groups based on five obstetric criteria. We included 760 patients in 2017 and 569 in 2019. Our induction rate significantly decreased by 5.6 % between these two years. Two groups represent an important part of the induction of labor : firstly, the post-term induction of labor with intact membranes group and secondly, the rupture of membranes before labor at term group. Discussion and conclusion - By modifying our practices and the collegial discussion of each case, we have significantly lowered our induction rate. Some predominant groups require additional work to continue this trend. With the aim of improving the quality of care, our classification will allow a homogenization of the evaluation of the practices of artificial induction of labor by different maternities in a same network and beyond.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02990606
Contributor : Jean-Hugues Morneau <>
Submitted on : Thursday, November 5, 2020 - 4:04:36 PM
Last modification on : Tuesday, November 24, 2020 - 4:00:15 PM

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Manon Vanneaux. Déclenchement artificiel du travail : création d’une classification permettant l’évaluation des pratiques. Médecine humaine et pathologie. 2020. ⟨dumas-02990606⟩

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