Author: Mathilde ThalPublisher:
ISBN:
Category :
Languages : fr
Pages :
Book Description
Le déclenchement artificiel du travail pour rupture prématurée des membranes à terme par misoprostol versus dinoprostone
Author: Mathilde ThalUtilisation du misoprostol par voie vaginale dans le déclenchement artificiel du travail en cas de rupture prématurée des membranes à terme
Author: Hélène BernatRupture prématurée des membranes à terme et déclenchement artificiel du travail
Author: Olivia Armède (Sage-femme).)Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
Book Description
À terme, la rupture prématurée des membranes (RPM) concerne 5 à 10 % des grossesses (1). Les sages-femmes sont donc régulièrement confrontées à la gestion de cette situation. Elle nécessite une prise en charge spécifique, à adapter en fonction de l'âge gestationnel afin de réduire les complications maternelles, fœtales et néonatales. La rupture des membranes doit interpeller chaque femme enceinte concernée et l'encourager à se rendre aux urgences obstétricales. Le plus souvent, la rupture est facile à diagnostiquer ; néanmoins dans certaines circonstances la perte de liquide amniotique (LA) est plus difficile à affirmer et le terme de « fissuration » est souvent employé. Jusqu'à présent, il existe différentes possibilités admises concernant la prise en soin des femmes présentant une RPM à terme. En effet, d'après les recommandations du collège national des gynécologues et obstétriciens français (CNGOF), une attitude expectative ou une attitude interventionniste visant à induire le travail peuvent être envisagées. Concernant l'induction du travail, l'issue favorable d'un déclenchement dépend des caractéristiques du col de l'utérus, définies par le score de Bishop et d'autres facteurs cliniques comme la parité. Ainsi, en comparaison à un col utérin « favorable », le col dit « défavorable » constitue une élévation du risque d'échec du déclenchement (2). Les attitudes diffèrent d'un pays à l'autre. En France notamment, la haute autorité de santé (HAS) préconise de ne pas dépasser un délai d'expectative de plus de 48 heures (3). Au Royaume-Uni, le national institute for clinical excellence (NICE) recommande plutôt un délai de 96 heures (4). Le CNGOF recommande aussi de déclencher le travail si la rupture des membranes dépasse 96 heures ou en cas de LA méconial (5). Par conséquent, nous nous sommes rendu compte sur nos différents lieux de stages, que les modalités d'approche étaient hétérogènes concernant l'attitude à adopter mais également dans le délai d'expectative. Au vu de ces divergences, c'est un sujet qui nous interpelle. L'objectif de cette étude est de comparer les issues du déclenchement artificiel du travail en fonction du temps de latence entre RPM à terme et déclenchement artificiel du travail ainsi que les morbidités maternelles et néonatales associées.
Déclenchement artificiel du travail
Author: Caroline BoichutPublisher:
ISBN:
Category :
Languages : fr
Pages : 0
Book Description
Objective: The objective of this work is to compare the efficacy, tolerance, and cost of the use in real practice of Misoprostol oral tablet 25 mcgr in reference to Dinoprostone intra vaginal device 10 mg, in the artificial induction of labour. Material and methods: This is a a comparative and monocentric prospective cohort study, carried out in a level 2B maternity hospital in Colmar, Haut-Rhin, France, between January 1, 2019 and August 31, 2019. All patients who received an artificial induction of labour and mutually exclusive artificial labor induction with Misoprostol oral tablet 25 mcgr or Dinoprostone intra vaginal device 10 mg, in a single or multiple pregnancy with multiple pregnancies with live fetus(es) in first cephalic presentation after 30 weeks of amenorrhea was included. Exclusion criteria included patients and those with a scarred uterus. All obstetrical and maternal obstetrical and maternal-fetal data were collected from the standardized AUDIPOG medical record. Patient satisfaction was assessed one year after delivery by telephone questionnaire. A retrospective cost study was undertaken with the hospital pharmacy. The primary outcome was the caesarean section rate. Secondary endpoints included analysis of other obstetrical parameters, comparison of maternal-fetal outcomes, and evaluation of the tolerance and cost of each technique. Results: Over the entire study period, 198 patients were included. 87 patients in the oral Misoprostol group and 111 patients in the Dinoprostone intra vaginal group. The cesarean section rate did not differ between the two groups: 17.2% for oral Misoprostol and 20.7% for intra vaginal Dinoprostone (p= 0.5) but there were fewer instrumental deliveries with oral Misoprostol (DDRA 0.32 p=0.02). The proportion of patients delivering within the first 24 hours was higher with intra vaginal Dinoprostone than with oral Misoprostol (DDRA 2.30 p=0.01), but the mean duration of induction did not differ between the two groups (p=0.06). Maternal and neonatal outcomes were good and comparable between the two groups. The average cost of induction with oral Misoprostol was 113.30 euros per patient versus 104.07 euros per patient for intra vaginal Dinoprostone. Oral Misoprostol was however better tolerated than intra vaginal Dinoprostone, the latter having a high rate of vaginal burns during use (p
Le déclenchement artificiel du travail par prostaglandines après rupture prématurée des membranes
Author: Guillaume ChamardFrequently Asked Clinical Questions about Medical Abortion
Author: World Health OrganizationPublisher: World Health Organization
ISBN: 9241594845
Category : Medical
Languages : en
Pages : 42
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.
Second Trimester Pregnancy Termination
Author: M.J.N.C. KeirsePublisher: Springer
ISBN:
Category : Medical
Languages : en
Pages : 228
Book Description
Views and attitudes. towards termination of pregnancy have shown con siderable evolution over the past few decades. Along with these changes has come a growing concern to adopt means and methods which could make termination easier, safer and more effective. In this evolution, termination in the second trimester in par~icular is notable as being responsible for a dis proportionate share ofthe complications and adverse experiences associated with pregnancy termination. Although the almost universal shift towards earlier abortion has reduced the number of second trimester procedures as a percentage of the whole, the problems of interrupting pregnancy in the second trimester remain conspicuous. Delay in either seeking or obtaining abortion is still, in many parts of the world, all too frequent. AdditiDnally, recent developments in the prenatal diagnosis of fetal malformations, alphafeto protein screening programmes and changes in the pattern of and approaches to intrauterine fetal death now also place greater emphasis on the need for adequate methods of interrupting pregnancy in the second trimester. Unlike the first trimester in which vacuum aspiration is universally con sidered to be the method of choice, in the second trimester of pregnancy the clinician is faced with alternatives; one method may be more appropriate than another in a particular circumstance and no single method is unequivocall~ accepted as best. Neither do second trimester terminations form a neatly defined single category.
Statistics with Stata 3
Author: Lawrence C. HamiltonPublisher: Brooks/Cole
ISBN:
Category : Computers
Languages : en
Pages : 220
Book Description
This text contains a description of Stata 3.0 that should be useful to users of both the student and professional versions. The book includes a disk containing the student version of Stata 3.0.