46 research outputs found
Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial.: Intervention to decrease severe postpartum haemorrhage
International audienceOBJECTIVE: Decreasing the prevalence of severe postpartum haemorrhages (PPH) is a major obstetrical challenge. These are often considered to be associated with substandard initial care. Strategies to increase the appropriateness of early management of PPH must be assessed. We tested the hypothesis that a multifaceted intervention aimed at increasing the translation into practice of a protocol for early management of PPH, would reduce the incidence of severe PPH. DESIGN: Cluster-randomised trial. POPULATION: 106 maternity units in six French regions. METHODS: Maternity units were randomly assigned to receive the intervention, or to have the protocol passively disseminated. The intervention combined outreach visits to discuss the protocol in each local context, reminders, and peer reviews of severe incidents, and was implemented in each maternity hospital by a team pairing an obstetrician and a midwife. MAIN OUTCOME MEASURES: The primary outcome was the incidence of severe PPH, defined as a composite of one or more of: transfusion, embolisation, surgical procedure, transfer to intensive care, peripartum haemoglobin decrease of 4 g/dl or more, death. The main secondary outcomes were PPH management practices. RESULTS: The mean rate of severe PPH was 1.64% (SD 0.80) in the intervention units and 1.65% (SD 0.96) in control units; difference not significant. Some elements of PPH management were applied more frequently in intervention units-help from senior staff (P = 0.005), or tended to - second-line pharmacological treatment (P = 0.06), timely blood test (P = 0.09). CONCLUSION: This educational intervention did not affect the rate of severe PPH as compared with control units, although it improved some practices
Complications materno-foetales de l'épreuve utérine
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Performance et place de l'échographie endovaginale avec augmentation de contraste dans l'évaluation des anomalies bénignes de la cavité utérine
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
L' hystérosonographie pour l'étude de la cavité utérine (à propos d'une série récente de 283 cas et bilan de 10 ans de pratique)
BREST-BU MĂ©decine-Odontologie (290192102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
La Mortalité périnatale au sein du réseau Aurore sur l'année 2006 (analyse de la qualité des prises en charge de 2005 à 2007)
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Diagnostic et suivi des anémies foetales par la mesure doppler des vélocimétries à l'artère cérébrale moyenne
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Devenir périnatal des chylothorax diagnostiqués en anténatal
LYON1-BU Santé (693882101) / SudocSudocFranceF
Evaluation du protocole code couleur de réalisation des césariennes en urgence à la maternité de la Croix-Rousse de juillet 2008 à décembre 2010
LYON1-BU Santé (693882101) / SudocSudocFranceF
L'échographie tridimensionnelle dans l'étude des fentes labio-maxillo-palatines (sémiologie, techniques, apport à la prise en charge anténatale)
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Etude d'impact des revues de morbi-mortalité sur la fréquence des hémorragies graves de la délivrance au sein d'une maternité
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF