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  • Title: [Audipog perinatal network 2004-2005. Part 2: assessment of medical practices].
    Author: Vendittelli F, Rivière O, Crenn-Hébert C, Claris O, Tessier V, Pinquier D, Teurnier F, Lansac J, Maria B, pour les membres du réseau Sentinelle Audipog.
    Journal: Gynecol Obstet Fertil; 2008 Dec; 36(12):1202-10. PubMed ID: 19008145.
    Abstract:
    OBJECTIVE: To describe specific clinical practices in France in 2004-2005 based on data from the Audipog sentinel network. PATIENTS AND METHODS: The database for 2004 and 2005 covers 71406 pregnancies from 86 maternity units throughout the year. We constructed a random subsample each year by including only the births occurring during a single month for each maternity ward. Our study therefore analyzes 6987 pregnancies in 2004 and 7648 pregnancies in 2005. RESULTS: Among the very preterm (<33 weeks of gestation) infants from multiple pregnancies, 77.4% were born in level 3 hospitals in 2000-2001, and only 44.9% in 2004-2005 (p<0.0001). Among the very preterm infants from singleton pregnancies, the percentage born in level 3 maternity hospitals rose between 1996-1997 and 2004-2005 (55% versus 73%; p=0.001). The rate of corticosteroid therapy before delivery among very preterm infants did not change significantly between 2000 and 2005 (p=0.58). The cesarean rate rose from 14% in 1994 to 20.0% in 2005. The percentage of actively managed third stages of labor increased from 1994-1995 to 2005 (6.2% versus 31.3%). Fewer episiotomies were performed: 56% in 1994-1995 and 41.3% in 2005. Exclusive breast-feeding rose from 51.2% in 2000-2001 to 58.5% in 2005 (p<0.0001). Early discharge increased between 1994-1995 and 2005 (p<0.0001). DISCUSSION AND CONCLUSION: Indicators monitoring implementation of some of the national clinical practice guidelines have improved slightly over time, although most often before the publication of these guidelines.
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