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Published on: August 30, 2020
[Post-partum haemorrhage in delivery room: anaesthetists' practioner in Auvergne]
M Bazin1, M Bonnin, F Bolandard
1Anesthésie-réanimation, pôle gynécologie obstétrique et reproduction humaine, hôpital Estaing, 1 place Lucie-Aubrac, CHU de Clermont-Ferrand, Clermont-Ferrand cedex 1, France.
Objective:
To assess the management of post-partum haemorrhage (PPH) in delivery rooms by the anaesthetists of the Auvergne region.
Study Design:
Cross sectional study.
Methods:
An anonymous postal survey was sent to all the anaesthetists working in a public or private hospital with a maternity unit.
Results:
The response rate was about 70 %. Eight percent of the respondents never practiced in obstetrics; others all declared to have managed PPH at least once. Only 66 % declared to know the right definition of PPH, 98 % declared to have guidelines in the delivery room, 87 % to use graduate blood receipt pockets, 85 % to work under midwives-directed delivery at expulsion, 88 % to have a HemoCue™ system. More than 80 % declared to use first oxytocin and to switch for prostaglandins in case of failure, to put two venous catheters and a urinary catheter, to administer broad-spectrum prophylactic antibiotic and to draw a blood sample for early biology. Packed red cells, platelets and fresh frozen plasma were accessible in less than 30 minutes for 98 %. Transfusion guidelines were applied. Only 27 % could have arterial radiologic embolisation on site. The knowledge about PPH and its consensual care tended to be poorer in practitioners from the university hospital, and younger under 40 also.
Conclusion:
This survey, with a good response rate, showed a practice generally fitting to the guidelines, although with some failures depending on the practioner's age and type of hospital.
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