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Master Thesis

Évaluation de la mise en place d'un protocole de réhabilitation améliorée après césariennes urgentes et programmées à la maternité de Bordeaux

Abstract : Background: the clinical benefits in terms of post-operative complications and length of hospital stay of improved rehabilitation protocols are demonstrated in many types of surgery. Recommendations for caesarean section surgery are recent, with few studies published to date mainly about scheduled caesarean sections, even though it’s most often an unscheduled procedure. In addition to the usual markers of this concept, compliance with the protocol over time is rarely reported. We have thus evaluated the implementation of an improved rehabilitation protocol after scheduled or unscheduled caesarean sections in the maternity unit of the Bordeaux University Hospital, in order to assess its feasibility and effectiveness while providing a two-year follow-up. Methods: 195 patients who had a scheduled or unscheduled caesarean sections were included; 103 patients at the implementation of the protocol in March 2018 and 92 at its re-evaluation in February 2020. Data analysis focused on the markers defined by the ERAS recommendations and caregiver compliance with drug and non-drug measures were studied. Results: compliance with the protocol was significantly improved after two years with 70 % of patients having benefited from the improved rehabilitation compared to 37 % initially. Analgesic management on the third day was also improved and the management of food intake, early mobilization and catheters was respected consistently over time, except for the management of urinary retention which needed to be improved. There were no differences in the length of hospitalization, complications or the readmission rate at 30 days. Conclusion: the implementation of an improved rehabilitation protocol is possible and effective in clinical practice for scheduled or unscheduled caesarean sections and requires regular follow-up to ensure sustainability.
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https://dumas.ccsd.cnrs.fr/dumas-03085891
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Submitted on : Tuesday, December 22, 2020 - 9:43:57 AM
Last modification on : Saturday, February 13, 2021 - 3:10:00 AM

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Bastien Poutier. Évaluation de la mise en place d'un protocole de réhabilitation améliorée après césariennes urgentes et programmées à la maternité de Bordeaux. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03085891⟩

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