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Master Thesis

Audit des pratiques concernant le suivi de grossesse des femmes rhésus D négatif à l’Hôpital Couple Enfant de Grenoble

Abstract : Objectives: Our main objective was to asses conformity, regarding the pregnancy follow-up of rhesus negative patients, one year after the addition of fetal rhesus genotyping to NABM. Material and Methods: This study was a descriptive, retrospective, monocentric transversal clinical audit via the review of the computer records of the Maternity of Grenoble University Hospital from the first of July, 2018 to the first of July, 2019. Using as a reference the recommendations of good practice of the HAS. Results: During our study 86 files has been audited. Considering the set of good practice recommendations, only 1% of the files audited were compliant, if we ignore the collection and traceability of consents for genotyping and immunoglobulin injection, the compliance rate was 28%. We obtained satisfactory compliance rates for the prescription or verification of the group card (90%) as well as the prescription of detection of red cell antibodies (85%), the genotyping proposal (88%). the follow-up of detection of red cell antibodies was consistent in 37% cases. The injection of anti D Ig at 28 SA was carried out correctly when needed (97%), the management of potentially immunizing events was compliant (100% for prescription of detection of red cell antibodies and for the injection of Ig anti D). As well as post-natal care, 99% of the new-borns had a rhesus determination and 98% of women received an Ig anti D injection after a Kleihauer test. The consent necessary for the prescription of genotyping was attached in 58% of the files and the one for the injection of anti D Ig at 28 SA in 3% of the files, in post-partum no consent was found (0%). Conclusion: We identified shortcomings in the management of RH : -1 women during pregnancy compared with the HAS’s recommendations. Especially regarding the detection of red cell antibodies prescriptions, and the management and the traceability of consents. We would like to disseminate these results, in order to discuss different ways of improving the management of RH : - 1 patients. For this purpose, a form to facilitate the collection of patient consent to blood-derived drugs injection and a new protocol have been developed.
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https://dumas.ccsd.cnrs.fr/dumas-03040356
Contributor : Jean-Hugues Morneau <>
Submitted on : Friday, December 4, 2020 - 12:07:02 PM
Last modification on : Sunday, December 6, 2020 - 3:15:49 AM
Long-term archiving on: : Friday, March 5, 2021 - 6:50:30 PM

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  • HAL Id : dumas-03040356, version 1

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Wafae El Khloufi. Audit des pratiques concernant le suivi de grossesse des femmes rhésus D négatif à l’Hôpital Couple Enfant de Grenoble. Gynécologie et obstétrique. 2020. ⟨dumas-03040356⟩

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