La manœuvre de Jacquemier : évaluation des connaissances et des pratiques des sages-femmes d’une maternité de niveau 3

Conclusion La manœuvre de Jacquemier est peu pratiquée (situation rare, manque de formation). Des formations par simulation sont à mettre en place, car si la dystocie ne peut être anticipée, les séquelles néonatales peuvent être évitées. Objectives Shoulder dystocia is an uncommon but serious complication occurring in 0.2 to 3% of deliveries. We carried out a study in order to assess the midwives experience, knowledge and practices on shoulder dystocia, at the maternity hospital of Saint-Denis, Reunion Island. Methods The first part is a confidential questionnaire addressed to midwives working in the delivery unit. The second part is a retrospective desk review of shoulders dystocia which occurred from 2004 to 2014. Results (1) The population was made up of 28 midwives, having between 1 to 27 years of experience. Seventy-five percent of them had been faced with shoulder dystocia, and 62% had realized Jacquemier's maneuver. However, only 25% received this maneuver training. Less than a third of them answered correctly to at least 7 from the 8 theoretical questions about the Jacquemier's maneuver. (2) We studied 34 shoulders dystocia, occurring between 36+5 to 41+2 gestational weeks, mostly with no risk factors found. Mac Roberts’ maneuver is used as first-line in 88% of situations. Jacquemier's maneuver is used in 52.9% of cases (5.9% as first-line, 47% as second-line). In 26.4% of situations, the midwife is not able to reduce the dystocia. She usua...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research