Childbirth, Epidural; Anesthesia
Conditions
Keywords
Maternal satisfaction, ambulatory epidural, physiology, analgesia
Brief summary
Childbirth is a special event for women. Maternal satisfaction regarding childbirth is quite important, that is why this factor has to be taken into account. A bad experience related to childbirth could lead to serious psychological and organic consequences such as postpartum depression, mother-baby bond deterioration and chronic pelvic pain. Childbirth image changed over the years to the extent that an increasingly physiological process keeping analgesia and safety is more and more desired. In this perspective, this study aims to investigate an approach so-called ambulatory epidural. Indeed, only a few studies have been conducted and the ones published in 1990s did not involve the current recommended pharmacological protocols.
Detailed description
This is a multi-centre prospective observational analytical before/after-type study. Practice changes are planned in concerned departments, in particular regarding usual patient care. This observational study aims to quantify the impact of practice changes on patient experience using a Childbirth Assessment Questionnaire (QEVA). During the "before" period, patients will receive a conventional epidural while the others, during the "after" period, will receive an ambulatory epidural. The women involved into this study must fill the QEVA form 2 days after giving birth (at the maternity) then 4 weeks after giving birth in order to get a feedback related to postpartum feelings (phone call).
Interventions
BEHAVIORALQEVA questionnaire
QEVA questionnaire administered at 2 days pospartum (in hospital) and 4 weeks postpartum (phone call). (specific for the study)
Sponsors
Centre Hospitalier Régional Metz-Thionville
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Women older than 18 years old * with Physiological pregnancy (fetus cephalic position, normal fetal heart rate, spontaneous work between 37 and 41 SA) * Having benefited from epidural, usual or ambulatory depending on the study period * who speeks and understand French * who signed a free and informed consent form
Exclusion criteria
* Hearing or comprehension impairment * Twin pregnancies * Scarred uterus * Fetus in non cephalic position * Imminent delivery * Women under protective supervision (guardianship, curatorship) * Women bereaved of a spouse or child during pregnancy * Hospitalization of child in neonatology after delivery * Women hospitalized in critical care units after childbirth
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Obstetrical labor and delivery experience in birthgiving women | at 2 days postpartum | The "emotional state" dimension of the Childbirth Assessment Questionnaire (QEVA) will be evaluated. This questionnaire is written and validated in French. It contains 26 questions covering 4 dimensions: emotional state, relations with nursing staff, first moments with the baby, and the young mother's feelings one month before delivery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Relations with nursing staff and first moments with the child | at 2 days postpartum | Other dimensions and isolated items of the QEVA questionnaire |
| Obstetrical labor and delivery experience in birthgiving women | at 4 weeks postpartum | " emotional state " dimension of the Childbirth Assessment Questionnaire (QEVA) |
| Labor and delivery safety : time spent in the delivery room | at 2 days postpartum | Time spent in the delivery room (min) |
| Labor and delivery safety: need for instrumental extraction | at 2 days postpartum | Need for instrumental extraction (yes/no) |
| Labor and delivery safety : emergency caesarean sections | at 2 days postpartum | Emergency caesarean sections (yes/no), |
| Labor and delivery safety: ability to maintain spontaneous micturition | at 2 days postpartum | Ability to maintain spontaneous micturition (yes/no) |
| Safety of ambulation | at 2 days postpartum | absence of the following events : motor block, hypotension, malaise, falls, difficulty in achieving ambulation |
Countries
France
Contacts
CONTACTArpiné EL NAR, PhD
CONTACTMélanie JUNKE
PRINCIPAL_INVESTIGATORLisa LEON, MD
CHR Metz Thionville Hopital Femme Mère Enfant
Outcome results
None listed