Accouchement inopiné extrahospitalier : prise en charge et facteur de risque

Objectives: To estimate the frequency of accidental out-of-hospital deliveries (OHDs), to describe the home care and the complications occurred, and to identify risk factors.Materials and methods: A retrospective case-control study from 1st January 2012 to 31 December 2012 in Lyon urban area. Cases were identified from the Emergency Medical Aid Service 69 (SAMU 69) registry and control from the birth registry of the maternity corresponding to the case, recruiting two controls per case.Results: The frequency of the OHDs was 0.3% [0.2-0.4]. At home, the prophylactic administration of oxytocin was performed in 18.3% [9.31-27.3] of cases and prevention of neonatal hypothermia was performed in 45.7% [34.1%-57.3%] of cases. Multiparity [OR: 3.43 (1.65-7.23)], a precarious situation [OR: 37.63 (5.02-7.81)], and lack of antenatal care [OR: 3.36 (2.72-4.15)] were OHDs' risk factors.Conclusion: The practical prevention of postpartum hemorrhage, and that of the home neonatal hypothermia could be improved. Points of vigilance for the medical teams to look for during the pregnancy monitoring are precariousness and less than 3 consultations scheduled

Évaluation de l’impact des revues de morbi-mortalité en obstétrique : revue de la littérature

International audienceObjectives: To assess this effectiveness of morbi-mortality conference (MMC) in improving quality of care.Materials and methods: A review was carried out by searching Medline, Pascal and Cochrane databases, Google scholar and websites of French obstetrics professional societies, until July 2011. Search terms included morbidity, mortality, conference, and obstetrics. The eligible reports of assessment of MMC in obstetrics have been analysed by four reviewers with a standardized form.Results: Among 319 records identified, four observational studies published between 2009 and 2011 were included. The objective of these MMC was students' training (n=2), quality of care improvement (n=1), or both (n=1). The MMC organization was heterogeneous. The impact of MMC was assessed using qualitative (n=2), semi-quantitative (n=1) or quantitative (n=1) method. None of these studies showed a significant impact of MMC on students' training or quality of care.Conclusion: Available evidence is insufficient to evaluate the effectiveness of MMC in improving quality of obstetrics care

Impact du retard de croissance intra-utérin sur la concentration sérique maternelle du PlGF (Placental Growth Factor) : une étude cas-témoin

International audienc

Severity of post-partum hemorrhage after vaginal delivery is not predictable from clinical variables available at the time post-partum hemorrhage is diagnosed

International audienc

Lien Ville-Hôpital : impact sur les pratiques

International audienc