Journal de gynécologie, obstétrique et biologie de la reproduction
-
J Gynecol Obstet Biol Reprod (Paris) · Jan 2015
[Prevalence of burnout among obstetrics and gynecology residents].
Prevalence assessment of burnout among obstetrics and gynecology residents and predisposing factors. ⋯ There is a strong personal accomplishment among obstetrics and gynecology residents; however, burnout and emotional exhaustion remains a reality during obstetrics and gynecology residency.
-
J Gynecol Obstet Biol Reprod (Paris) · Jan 2015
[Epidemiology of maternal mortality by infectious cause in France, 2007-2009, using data from confidential maternal mortality report].
Although deaths caused by infection during pregnancy and the postpartum period are rare in France, mortality rates have increased in several countries of the European community. In France, the rate of maternal mortality by infectious cause has decreased over the last 12 years. Infectious causes are currently in fifth place of maternal deaths. ⋯ These cases of puerperal septicemia show that when sepsis is clinically manifest, infection is already well established and widespread deterioration is therefore often irreversible. Maternal mortality is preventable in most cases if several points are observed: early diagnosis, probabilistic antibiotics targeting most frequently involved bacteria including Escherichia coli and Streptococcus A, early transfer to ICU, control septic portal entry, simple preventive measures, influenza vaccination. A "microbiological clinical diagnosis" approach must be initiated at the first clinical signs.
-
J Gynecol Obstet Biol Reprod (Paris) · Dec 2014
Review[Anesthetic management of severe or worsening postpartum hemorrhage.]
Risk factors of maternal morbidity and mortality during postpartum hemorrhage (PPH) include non-optimal anesthetic management. As the anesthetic management of the initial phase is addressed elsewhere, the current chapter is dedicated to the management of severe PPH. ⋯ The anesthetic management aims to restore and maintain optimal respiratory state and circulation, to treat coagulation disorders, and to allow invasive obstetrical and radiologic procedures. Clinical and instrumental monitoring are needed to evaluate the severity of PPH, to guide the choice of therapeutic options, and to assess treatments efficacy.
-
Produce recommendations for the management of placenta previa and placenta accrete. ⋯ Placental insertion abnormalities require anesthetic and obstetric coordination. Delivery must be planned in a suitable structure.