Journal de gynécologie, obstétrique et biologie de la reproduction
-
J Gynecol Obstet Biol Reprod (Paris) · Dec 2014
Review[Obstetric and anesthetic specificities in the management of a postpartum hemorrhage (PPH) associated with cesarean section.]
To describe the characteristics of post-partum hemorrhage (PPH) associated with cesarean section (CS), the modalities diagnosis and specific obstetric and anesthetic management. ⋯ The occurrence of PPH associated with cesarean delivery requires close collaboration between obstetrician and anesthesiologist to ensure a rapid and coordinated management (professional consensus).
-
J Gynecol Obstet Biol Reprod (Paris) · Dec 2014
Review[Clinical and pharmacological procedures for the prevention of postpartum haemorrhage in the third stage of labor.]
To describe the clinical and pharmacological procedures for the prevention of Postpartum Haemorrhage (PPH). ⋯ Vaginal birth: only the use of uterotonics reduces the incidence of PPH. Oxytocin is the treatment of choice if it is readily available (grade A). Oxytocin can be used either after the shoulders expulsion or rapidly after the placental delivery (grade B). A dose of 5 or 10IU must be administrated IV over at least 1minute or directly by an intramuscular injection (professional agreement) except in women with documented cardiovascular disease in which the duration of the IV perfusion should be over at least 5minutes (professional agreement). Mechanical procedures have no significant impact on PPH. The decision to use a collector bag is left to the medical team (professional agreement). A systematic complementary oxytocin perfusion is not recommended (professional agreement). Caesarean delivery: There is no evidence to recommend a particular type of caesarean technique to prevent PPH (professional agreement) but a lower uterine section is recommended (grade B). All types of incision expansion may be used (professional agreement). A controlled cord traction is associated with lower blood losses than manual removal of the placenta (grade B). A dose of 5 or 10IU can be injected (IV) over 1minute, and over 5minutes in women with cardiovascular disease (professional agreement). Carbetocin reduces the incidence of PPH but there is presently no inferiority study comparing oxytocin and carbetocin so that oxytocin remains the gold standard therapy to prevent PPH in C-section (professional agreement).
-
J Gynecol Obstet Biol Reprod (Paris) · Nov 2014
[Management of blood products in obstetric services.]
Define the access conditions and mode of use of blood products in the context of the management of immediate postpartum hemorrhage. ⋯ Transfusion management in postpartum hemorrhage should be a multidisciplinary approach and requires mastery of emergency circuits to obtain promptly blood products.
-
J Gynecol Obstet Biol Reprod (Paris) · May 2014
Comparative Study[Evolution of waiting time and length of stay between 2005 and 2012 in an obstetric and gynaecologic emergency unit in a French teaching hospital].
To compare and analyze waiting time and length of stay between 2005 and 2012 in the obstetric and gynaecologic emergency unit of Nantes teaching hospital, new unit opened in 2004. ⋯ Our organization enabled to improve some lengths of time despite an increased activity. Those lengths of time should be monitored as they reflect our organizations and are indicators of efficiency.
-
J Gynecol Obstet Biol Reprod (Paris) · May 2014
[Current and future use of surgical skills simulation in gynecologic resident education: a French national survey].
Simulation is a promising method to enhance surgical education in gynecology. The purpose of this study was to provide baseline information on the current use of simulators across French academic schools. ⋯ Surgical skills simulators are already experienced by a majority of French gynecologic residents. However, the use of these educational tools varies among surgical schools and remains occasional for the majority of residents. There was a strong agreement that simulation technology should be a component of training.