Hémorragie sévère du post partum immédiat : évaluation des pratiques et profil épidémiologique dans le réseau MYPA
Year: 2015
Type: dissertation
Abstract: Objective Describe management of severe postpartum hemorrhages (PPH) in MYPA network (Yvelines’s perinatality network, identify HPP risks factors about maternal characteristics and maternity units organizational characteristics. Materials and methods The data sources were: information database and questionnaire from EPIMOMS trial conducted by INSERM. It was firstly a descriptive analysis of the severe PPH’s epidemiology and management in MYPA network. Severe PPH was defined by: blood loss equal or greater than 1500 ml, a transfusion of 4 red blood cells or more, arterial embolization, vascular ligatures and/or compressive sutures, or hemostasis hysterectomy. Then it was a case/control study including 477 cases: 403 controls and 74 cases severe PPH occurred in 10 maternities belonging to the MYPA network from 2 April 2012 to 1 April 2013. The intrinsic maternal characteristics and obstetrics characteristics were compared between the 2 groups by univariate analysis. Finally a transversal study was conducted analyzing by an univariate analysis the of 74 severe PPH incidence in different organizational characteristics of maternity units. Results The rate of severe PPH in MYPA was 0.41 % during this study year and no death due to PPH has occurred. The management of severe PPH generally correctly followed the 2004 recommendations. Individual risks factors which have been found in this study are: previous caesarean delivery, premature delivery, multiple pregnancy, induced labor, caesarean. About the characteristic’s maternities we did not get rid of level 3 selection biases so the results could not be used. Conclusions The low incidence of severe PPH in the MYPA network could be explained by the following of the 2004 recommendations and by the frequent use of intrauterine tamponade balloon.
Source: HAL
Author: Cécile Truchot
Institution: Université de Versailles Saint-Quentin-en-Yvelines
Language: French
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2274461936