| Practices for prevention, diagnosis and management of postpartum haemorrhage: impact of a regional multifaceted intervention. | |
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MedLine Citation:
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PMID: 19538416 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the effectiveness of a multifaceted intervention on practices for prevention, diagnosis and management of postpartum haemorrhage (PPH) and on the prevalence of major PPH in a French perinatal network. DESIGN: Quasi-experimental before-and-after survey. SETTING: All maternity units (n = 19) of a French administrative region, operating as a perinatal network. SAMPLE: One representative sample of all women delivering in the network, one representative sample of women with PPH deliveries and an exhaustive sample of women with major PPH. METHODS: The multifaceted intervention took place between February 2003 and March 2004. Information was retrospectively collected for two periods, 2002 (before the intervention) and 2005 (after). MAIN OUTCOME MEASURES: Practices for prevention, diagnosis and management of PPH and prevalence of major PPH. RESULTS: After the intervention, the pharmacological prevention of PPH increased from 58.8% to 75.9% of vaginal deliveries (P < 10(-4)), and the use of blood collecting bags from 3.9% to 76.3% (P < 10(-4)), but initial PPH management did not change significantly. However, the median delay for second-line pharmacological treatment was significantly shortened [from 80 min (35-130) in 2002 to 32.5 min (20-75) in 2005]. An increase was observed in the use of surgery for PPH (0.06% versus 0.12% of deliveries; P = 0.03) and in blood transfusions (0.18% versus 0.33%; P = 0.01). The prevalence of major PPH did not change (0.80% versus 0.86% of deliveries; P = 0.62). CONCLUSIONS: The intervention was effective at improving PPH-related preventive and diagnostic practices in a perinatal network. Improving management practices and reducing the prevalence of major PPH might require a different intervention design. |
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Authors:
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E Audureau; C Deneux-Tharaux; P Lefèvre; S Brucato; R Morello; M Dreyfus; M-H Bouvier-Colle |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2009-06-17 |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 116 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-20 Completed Date: 2009-09-30 Revised Date: 2010-01-19 |
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: 1325-33 Citation Subset: AIM; IM |
Affiliation:
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INSERM, UMR S953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, UPMC Univ Paris 06, Paris, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortifacient Agents, Nonsteroidal
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administration & dosage Adult Clinical Protocols / standards* Dinoprostone / administration & dosage, analogs & derivatives Female Hospitals, Maternity / standards* Humans Infusions, Intravenous Oxytocics / administration & dosage Oxytocin / administration & dosage Postpartum Hemorrhage* / diagnosis, prevention & control, surgery Practice Guidelines as Topic Pregnancy Professional Practice / standards* Prospective Studies Specimen Handling Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Abortifacient Agents, Nonsteroidal; 0/Oxytocics; 363-24-6/Dinoprostone; 50-56-6/Oxytocin; 60325-46-4/sulprostone |
| Comments/Corrections | |
Comment In:
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BJOG. 2010 Feb;117(3):370; author reply 370-1
[PMID:
20078590
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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