| Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial. | |
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MedLine Citation:
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PMID: 20573150 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Decreasing the prevalence of severe postpartum haemorrhages (PPH) is a major obstetrical challenge. These are often considered to be associated with substandard initial care. Strategies to increase the appropriateness of early management of PPH must be assessed. We tested the hypothesis that a multifaceted intervention aimed at increasing the translation into practice of a protocol for early management of PPH, would reduce the incidence of severe PPH. DESIGN: Cluster-randomised trial. POPULATION: 106 maternity units in six French regions. METHODS: Maternity units were randomly assigned to receive the intervention, or to have the protocol passively disseminated. The intervention combined outreach visits to discuss the protocol in each local context, reminders, and peer reviews of severe incidents, and was implemented in each maternity hospital by a team pairing an obstetrician and a midwife. MAIN OUTCOME MEASURES: The primary outcome was the incidence of severe PPH, defined as a composite of one or more of: transfusion, embolisation, surgical procedure, transfer to intensive care, peripartum haemoglobin decrease of 4 g/dl or more, death. The main secondary outcomes were PPH management practices. RESULTS: The mean rate of severe PPH was 1.64% (SD 0.80) in the intervention units and 1.65% (SD 0.96) in control units; difference not significant. Some elements of PPH management were applied more frequently in intervention units-help from senior staff (P = 0.005), or tended to - second-line pharmacological treatment (P = 0.06), timely blood test (P = 0.09). CONCLUSION: This educational intervention did not affect the rate of severe PPH as compared with control units, although it improved some practices. |
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Authors:
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C Deneux-Tharaux; C Dupont; C Colin; M Rabilloud; S Touzet; J Lansac; T Harvey; V Tessier; C Chauleur; G Pennehouat; X Morin; M H Bouvier-Colle; R Rudigoz |
Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-06-24 |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 117 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-11-08 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 1278-87 Citation Subset: AIM; IM |
Affiliation:
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INSERM, UMR S953, UPMC, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, Paris, France. catherine.deneux-tharaux@inserm.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Clinical Protocols Cluster Analysis Education, Medical, Continuing Female France Hospitals, Maternity Humans Incidence Midwifery / education Obstetrics / education Patient Care Team Postpartum Hemorrhage / epidemiology, prevention & control* Pregnancy Professional Practice / standards* Sample Size Treatment Outcome |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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