Study of the Prevalence of Complications Occurring in the Mother-newborn Couple During the First Month After Returning Home, Since the Introduction of Standard Outpatients (According to HAS 2014 Recommendations) at the Amiens-Picardie University Hospital
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 177
- 试验地点
- 2
- 主要终点
- The occurrence of complications in the first month of life in the "mother-newborn" couple.
研究概览
简要总结
Prior to the HAS recommendations of March 2014, the "mother - newborn" couple was discharged from the maternity home at 4 days after delivery by AVB and 5 days after caesarean section.
The stay in maternity allowed a follow-up of the newborn whose weight gain and the occurrence of a jaundice; And monitoring of the mother whose milky ascent and psychological feelings.
In March 2014, the HAS published new recommendations on maternity leave arrangements for the "mother - newborn" couple, the organization of postpartum follow - up for the mother and pediatric follow - up for the newborn. The HAS then defines so-called "optimal" conditions for so-called "standard" outputs, with 9 criteria to respect respectively for the mother and the newborn.
If the mother-to-newborn couple respects these so-called optimal conditions and is eligible according to the respective criteria, the latter leaves at home after 72 hours and before 96 hours for an AVB and after 96 completed hours and Before 120 hours for caesarean delivery.
As no pediatric discharge was done in the afternoons at the maternity hospital of Amiens, an arbitrary choice was made to allow a "standard" release to the "mother-newborn" couple only if the child was born between 00H00 and 11H59 so that his clinical examination of exit is carried out at 72 hours of the birth as recommended by the recommendations of the HAS.
These recommendations being recent (2014), no study has studied the impact and consequences on the triad "father / mother-newborn" of these exits including the occurrence of possible complications or events: re-hospitalizations again The early termination of breastfeeding, and whether the follow-up procedures advocated by the HAS are being followed.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Be taken care of in the Maternity Department of the Amiens-Picardie University Hospital.
- •Parents' agreement
- •Mother and Newborn who meet the eligibility criteria of the HAS for a "standard" exit.
- •1. Absence of a situation of psychological, social vulnerability, behaviors of addiction and severe dependencies
- •2. Adequate family and / or social support
- •3. Absence of chronic ill-balanced pathology
- •4. Absence of complications or pathologies requiring observation or continuous medical treatment
- •5. Absence of haemorrhage of the delivery, this one was checked and treated (if necessary)
- •6. Absence of active infection or signs of infection
- •7. Absence of thromboembolic signs
- •8. Controlled Pain
- •9. Satisfactory mother-child interactions
- •1. Newborn at term ≥ 37 weeks of amenorrhea, singleton and eutroph
- •2. Normal clinical examination performed imperatively 48 hours after birth and before discharge
- •3. Axillary temperature between 36 and 37 ° C or central between 36.5 and 37.5 ° C
- •4. Established feeding (if breastfeeding: observation of at least 2 feeds ensuring effective transfer of colostrum / milk recognized by the mother), urination and spontaneous stool emissions, established transit
- •5. Weight loss <8% of birth weight
- •6. Absence of jaundice requiring phototherapy according to the therapeutic indication curve and measurement of transcutaneous and / or blood bilirubin at the output referred to the nomogram (low risk and low intermediate risk only)
- •7. Lack of clinical or paraclinical evidence for infection; If risk factors of infection: recovered and negative biological and bacteriological samples
- •8. Planned neonatal screening and traceability
- •9. Post-partum follow-up after the organized event: an appointment with a referral professional within 48 hours following the exit or even in the week
排除标准
- •Patient not speaking French
- •Patient who does not meet the HAS criteria: newborn or ineligible mother (minor mother, non-singleton birth)
- •Assumption in another department than the Maternity department of the CHU Amiens-Picardie.
结局指标
主要结局
The occurrence of complications in the first month of life in the "mother-newborn" couple.
时间窗: 1 month
次要结局
未报告次要终点