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Master Thesis

Facteurs humains et aggravation des hémorragies du post-partum

Abstract : Objectives: The objective of this study was to investigate the correlation between human factors and the worsening of PPH. For this, we compared simple PPH and severe PPH in order to look for associated human factors. Our hypotheses included : fatigue, overwork, stress and professional experience. Material and methods: We carried out a case study (severe PPH) - controls (simple PPH), retrospective by collecting data over two years : from 2017 to 2019, in a level III maternity unit. Results: We found a significant difference depending on the mode of expulsion (p=0.04) with more instrumental extractions for severe PPH : 26% of vacuum extraction and 10% of forceps (against 20% of vacuum extraction and 1% of forceps for simple PPH). We also find a significant difference for perineal lesions (p=0.04) with, in the severe PPH group, more episiotomies with 26% (versus 13%), less intact perineum with 25% (versus 26%) and less simple tears with 49% (versus 61%). We find more pathological APGAR score at 5 minutes of life in the severe PPH group with 7% against 0% in the simple PPH group (p = 0.003). Conclusion: We can highlight the worsening of PPH in the context of complex materno-neonatal care causing stress or overwork. The on call intern’s role in relation to human factors could constitute a complementary study to this one. Our work highlighted the difficulty of collecting human factors. Hence our results can be influenced by a significant number of biases. The choice of variables is an important element to take into account for this type of study.
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https://dumas.ccsd.cnrs.fr/dumas-03219227
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Submitted on : Thursday, May 6, 2021 - 3:05:50 PM
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Lison Cordier. Facteurs humains et aggravation des hémorragies du post-partum. Gynécologie et obstétrique. 2020. ⟨dumas-03219227⟩

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