état des lieux, en France, de la prise en charge des utérus cicatriciels PDF Download

Author: Anne-claire Sans
Publisher:
ISBN:
Category :
Languages : fr
Pages : 90

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Book Description
Depuis 15 ans, le taux de césarienne a augmenté en France La prise en charge obstétricale des utérus cicatriciels est sujette à controverse. Nous avons voulu décrire les attitudes obstétricales françaises, afin d'identifier d'éventuelles disparités de prise en charge et de les confronter aux recommendations scientifiques. Nous avons contacté 595 maternités françaises par courrier postal, électronique et par téléphone, pour répondre à un questionnaire anonyme de 34 items concernant la prise en charge des utérus cicatriciels. Parmi les 194 maternités ayant répondu, on compte 37 CHU et 312 praticiens dont 75,6% exercent en secteur public et 19,2% en secteur privé. Seulement 29,6% des obstétriciens utilisent un protocole de prise en charge (14% en secteur privé, p=0,003). La pelvimétrie est proposée systématiquement par 44,4% des médecins (71,3% en secteur privé, p=0,0002). La tentative de voie basse est autorisée lors d'une présentation du siège par 20% des obstétriciens ayant répondu, lors d'une grossesse gémellaire par 23,7% lors d'un utérus bicicatriciel par 12%, majoritairement en maternités de niveau III, en CHU, et en maternités effectuant plus de 1500 accouchement par an. Le déclenchement sur un utérus cicatriciel est réalisé par 73,9% des obstétriciens, en général par ocytociques. Le déclenchement par prostine est proposé par 14,5% d'entre eux (24,6% en CHU, p=0,01), par propess par 19,2% d'entre eux (30% en CHU, p=0,008). Nous retrouvons des disparités significatives quant à la prise en charge des utérus cicatriciels. Parfois, les atitudes obstétricales ne suivent pas les recommendations. Ces résultats doivent conduire les professsionnels à mettre en place une évaluation d'un certain nombre de leurs pratiques non étayées par des études.

Author: Clémentine Valentin
Publisher:
ISBN:
Category :
Languages : fr
Pages : 118

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Book Description
L'utérus cicatriciel est défini comme un utérus portant une ou plusieurs cicatrices, survenue pendant ou en dehors de la grossesse. Dans 95% des cas, cette cicatrice est liée à un antécédent de césarienne. En France, le taux annuel de césarienne avoisine 20% des accouchements. L'utérus cicatriciel augmente le risque de complications obstétricales pour les grossesses et accouchements futurs. Parmi les principaux risques, nous pouvons citer la rupture utérine, les anomalies d'insertions placentaires, ou encore le développement d'adhérences chirurgicales. L'objectif de ce mémoire a été de réaliser un état des lieux des pratiques des sages-femmes, professionnels de premier recours en salle d'accouchement, lors du suivi de travail des patientes porteuses d'un utérus cicatriciel. Nous avons réalisé une étude quantitative observationnelle à visée descriptive, à l'aide de questionnaires distribués aux sages-femmes travaillant en salle de naissance en Champagne-Ardenne et dans l'Aisne. Nous avons obtenu 168 réponses, soit un taux de réponse de 49,2%. Les réponses nous montrent que la prise en charge des utérus cicatriciels est fréquente. Nous avons pu observer que les sages-femmes se sont bien appropriées les recommandations du CNGOF de 2012, et les appliquent dans leur globalité. Au niveau des connaissances, en dehors du risque de rupture utérine, les sages-femmes ont eu des difficultés à citer les autres risques liés à l'utérus cicatriciel comme les anomalies d'insertion placentaire ou les adhérences chirurgicales. La prise en charge des utérus bi-cicatriciels lors de TVBAC est rare. Les axes d'améliorations identifiés concernent l'établissement de recommandations sur la prise en charge de l'utérus bi-cicatriciel, ou d'un protocole hospitalier, ainsi qu'une actualisation des connaissances concernant les risques liés à l'utérus cicatriciel.

Author: Kieran O'Driscoll
Publisher: Mosby Incorporated
ISBN: 9780723432029
Category : Medical
Languages : en
Pages : 223

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Book Description
This manual encompasses a comprehensive approach to the management of labour. Based on the simple proposition that effective uterine action is the key to normal delivery, Active Management of Labour covers all aspects of delivery for nulliparous women with vertex presentation and single foetus. This is an accessible and practical guide for obstetricians and midwives as well as anaesthetists and the auxiliary staff of maternity units. Encourages an active interest in labour by all professional staff Emphasises the importance of constant personal attention and good communication in labour Discusses in detail the need to distinguish between: - first and subsequent births - single cephalic and all other pregnancies - induction and acceleration of labour Fosters the development of a team spirit between midwife and obstetrician Demonstrates how good labour ward organisation can improve care Proves the importance of audit in ensuring quality of care Updated chapters on dystocia and caesarean section New key points summary at the end of each chapter Updated review of clinical outcomes at the National Maternity Hospital

Author: Julio Elito Jr.
Publisher: BoD – Books on Demand
ISBN: 1838804544
Category : Medical
Languages : en
Pages : 122

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Book Description
"Non-Tubal Ectopic Pregnancy" is a comprehensive book, written in an organized and concise format. The book offers an immersion into non-tubal ectopic pregnancy and the reader is invited, chapter after chapter, to visit the most important aspects of non-tubal ectopic pregnancies. The book covers all aspects of non-tubal ectopic pregnancies including epidemiology, diagnosis, and management. Experts from all over the world have contributed to it, bringing the best from their research.The book presents the reader with the latest advances on non-tubal ectopic pregnancies.

Author: Mohamed M. Ghoneim (M.D.)
Publisher: Butterworth-Heinemann
ISBN:
Category : Medical
Languages : en
Pages : 216

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Book Description
* First comprehensive source on facts about consciousness while under anesthesia * Includes a detailed pharmacology of drugs * Details techniques for detection and prevention. * Author is leading expert in field

Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241594845
Category : Medical
Languages : en
Pages : 42

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Book Description
This publication contains answers to a range of frequently asked questions on medical abortion services, based on the discussions at an international conference held in Bellagio, Italy in November 2004. By focusing on practical issues, the answers should be particularly helpful to health-care personnel who are considering establishing, or already providing, a service for medical abortion in the early first trimester.

Author: Robert N. Taylor
Publisher: Elsevier
ISBN: 0124079458
Category : Medical
Languages : en
Pages : 500

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Book Description
Chesley's Hypertensive Disorders in Pregnancy continues its tradition as one of the beacons to guide the field of preeclampsia research, recognized for its uniqueness and utility. Hypertensive disorders remain one the major causes of maternal and fetal morbidity and death. It is also a leading cause of preterm birth now known to be a risk factor in remote cardiovascular disease. Despite this the hypertensive disorders remain marginally studied and management is often controversial. The fourth edition of Chesley's Hypertensive Disorders in Pregnancy focuses on prediction, prevention, and management for clinicians, and is an essential reference text for clinical and basic investigators alike. Differing from other texts devoted to preeclampsia, it covers the whole gamut of high blood pressure, and not just preeclampsia. - Features new chapters focusing on recent discoveries in areas such as fetal programming, genomics/proteomics, and angiogenesis - Includes extensive updates to chapters on epidemiology, etiological considerations, pathophysiology, prediction, prevention, and management - Discusses the emerging roles of metabolic syndrome and obesity and the increasing incidence of preeclampsia - Each section overseen by one of the editors; each chapter co-authored by one of the editors, ensuring coherence throughout book

Author: John M. Hutson
Publisher: Springer Science & Business Media
ISBN: 3642229646
Category : Medical
Languages : en
Pages : 311

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Book Description
The rapid advances in medicine over the last 50 years have totally changed the outlook for children with disorders of sex development (DSD), but there is still much to learn. This book crystallizes the combined experience of a leading dedicated unit over 25 years in delivering expert medical and surgical care to children with DSD in a holistic environment. It documents the most recent advances in the molecular biology and embryology of sex development, and describes each disorder in detail. The clinical presentation and approach to diagnosis are described both for babies and for children presenting later in childhood or at adolescence. The chapters on management highlight all the latest knowledge and include the shared wisdom of the authors on current controversies, such as the timing of surgical treatment. Finally, the authors describe their short-, medium-, and long-term outcomes, which demonstrate the strengths of holistic team management.

Author: Royal College of Paediatrics and Child Health
Publisher: BMJ Books
ISBN: 9780727911797
Category : Medical
Languages : en
Pages : 80

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Book Description
this concise book covers all aspects of neonatal resuscitation from the moment of birth to transfer to the neonatal unit. It discusses special considerations, and communication with parents and other professionals. The advice has been drawn up by a working party, giving it the authority of a distinguished body of specialists.

Author: Judith Lothian
Publisher: Da Capo Press
ISBN: 1451619227
Category : Family & Relationships
Languages : en
Pages : 284

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Book Description
For a Safe and Healthy Birth… Your Way! Giving Birth with Confidence will help take the mystery out of having a baby and help you better understand how your body works during pregnancy and childbirth, giving you the confidence to make decisions that best ensure the safety and health of you and your baby. Giving Birth with Confidence is the first and only pregnancy and childbirth guide written by Lamaze International, the leading childbirth education organization in North America. Written with a respectful, positive tone, this book presents: • Information to help you choose your maternity care provider and place of birth • Practical strategies to help you work effectively with your care provider • Information on how pregnancy and birth progress naturally • Steps you can take to alleviate fear and manage pain during labor • The best available medical evidence to help you make informed decisions Previously titled The Official Lamaze Guide, this 3rd edition has updated information on: • How vaginal birth, keeping mother and baby together, and breastfeeding help to build the baby’s microbiome. • How hormones naturally start and regulate labor and release endorphins to help alleviate pain. • Maternity-care practices that can disrupt the body’s normal functioning. • The latest recommendations on lifestyle issues like alcohol, vitamins, and caffeine. • Room sharing and cosleeping: the controversy, recommendations, and safety guidelines. • Out-of-hospital births are on the rise: New research and advice on planned home birth, including ACOG’s revised guidelines, which support women’s choices and promote seamless transfer to hospital, if needed. • The importance of avoiding unnecessary caesareans for mother and child. Includes the new ACOG guidelines on inductions and active labor. • The research in support of the Lamaze International’s “Six Healthy Birth Practices,” which are: • Let labor begin on its own. • Walk, move around, and change positions throughout labor. • Bring a loved one, friend, or doula for continuous support. • Avoid interventions that aren’t medically necessary. • Avoid giving birth on your back and follow your body’s urges to push. • Keep mother and baby together—it’s best for mother, baby, and breastfeeding.