Journal de gynécologie, obstétrique et biologie de la reproduction
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J Gynecol Obstet Biol Reprod (Paris) · Apr 2011
[The confidential enquiries into maternal deaths, 1996-2006 in France: what consequences for the obstetrical care?].
The national confidential enquiry into maternal deaths (ENCMM) and its committee (CNEMM) have the target to study all maternal deaths occurring in France, in order to expertise the care provided. The current report covers the 1996--year of the ENCMM establishment--to 2006 years. After being informed of the potential maternal deaths by the Epidemiological center on medical causes of deaths (CépiDC), and agreement from the medical doctors concerned, two assessors (one anesthetist and one obstetrician) gather the medical or obstetrical information near the team involved in the care of the women, by the mean of a detailed and specific questionnaire. ⋯ Half of maternal deaths were considered preventable by the CNEMM, particularly haemorrhage and sepsis. The factors of avoidability are delay to treat (31%) inadapted therapeutics (28%), even professional default (20%) no diagnosis (15%) or reluctant patient (7%). Seven deaths are discussed in a specific section including a detailed description of, and recommendations on how the quality of care may be improved.
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2010
Practice Guideline[Risks associated with laparoscopic entry].
To provide guidelines for clinical practice from the French college of obstetrics and gynecology (CNGOF), based on the best evidence available, on laparoscopic entry techniques and technologies and their associated complications. ⋯ Implementation of this guideline should optimize the decision-making process in choosing a particular technique to enter the abdomen during laparoscopy.
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J Gynecol Obstet Biol Reprod (Paris) · Nov 2010
[Sequential use of cervical length measurement before fetal fibronectin detection to predict spontaneous preterm delivery in women with preterm labor].
To test a sequential test with fetal fibronectin detection after ultrasound measurement of cervical length to predict preterm delivery in women with preterm labor. ⋯ A sequential test with selective use of fetal fibronectin detection in population selected by ultrasound measurement of cervical length appears to be as effective than fetal fibronectin detection or cervical length alone for predicting preterm birth, if preterm labor, avoiding more than one third of fibronectin tests.
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J Gynecol Obstet Biol Reprod (Paris) · Oct 2010
[Management of umbilical cord prolapse and neonatal outcomes].
To evaluate the obstetrical management of umbilical cord prolapse and the neonatal outcomes. ⋯ The umbilical cord prolapse remains a serious event for the newborns. The reduction of the DDT in cephalic presentation seems to be correlated to a better neonatal state. The caesarean section is the preferential way of childbirth.
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Various studies have shown that the use of a checklist in the operating room lowers mortality and morbidity related to the act of anaesthesia and surgery. The WHO launched a program in June 2008 to improve the safety of surgical care; the main point is the rational use of a simple tool: the Surgical Safety Checklist. ⋯ This checklist can of course be supplemented by other checklists specific from specialty teams or places but it can never be abridged or altered. The HAS provides for the promotion of the implementation of this checklist, the certification of health facilities with its introduction into the V2010 and accreditation of doctors.