La pratique de la délivrance artificielle par la sage-femme

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(1)La pratique de la délivrance artificielle par la sage-femme Bélinda Marchal. To cite this version: Bélinda Marchal. La pratique de la délivrance artificielle par la sage-femme. Human health and pathology. 2009. �hal-01888021�. HAL Id: hal-01888021 https://hal.univ-lorraine.fr/hal-01888021 Submitted on 4 Oct 2018. HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers.. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés..

(2) AVERTISSEMENT. Ce document est le fruit d'un long travail approuvé par le jury de soutenance et mis à disposition de l'ensemble de la communauté universitaire élargie. Il est soumis à la propriété intellectuelle de l'auteur. Ceci implique une obligation de citation et de référencement lors de l’utilisation de ce document. D'autre part, toute contrefaçon, plagiat, reproduction encourt une poursuite pénale.. illicite. Contact : ddoc-theses-contact@univ-lorraine.fr. LIENS Code de la Propriété Intellectuelle. articles L 122. 4 Code de la Propriété Intellectuelle. articles L 335.2- L 335.10 http://www.cfcopies.com/V2/leg/leg_droi.php http://www.culture.gouv.fr/culture/infos-pratiques/droits/protection.htm.

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(7) 6200$,5( ,QWURGXFWLRQ 35(0,(5(3$57,((7$7'(6&211$,66$1&(6 3K\VLRORJLHGHODGpOLYUDQFH . , A.. Les différents mécanismes impliqués ...................................................................5 Phase de décollement ........................................................................................5 La phase d’expulsion.........................................................................................6 L’Hémostase .....................................................................................................6 Phénomènes hormonaux de la délivrance .........................................................7 B. Clinique de la délivrance.......................................................................................7 1. Critères de décollement placentaire ..................................................................8 2. Attitudes préventives.........................................................................................9 ,, /HVGLIIpUHQWVW\SHVGHGpOLYUDQFH 1. 2. 3. 4.. A. B. C. D. E.. La délivrance normale spontanée........................................................................11 La délivrance spontanée......................................................................................11 La délivrance naturelle........................................................................................12 La délivrance dirigée...........................................................................................12 La délivrance artificielle .....................................................................................13 1. Technique........................................................................................................13 2. Indications .......................................................................................................14 3. Quels sont les risques de la DA ?....................................................................17 ,,, 5DSSHOVKLVWRULTXH HIPPOCRATE.........................................................................................................19 Biographie ......................................................................................................19 Chorion retenu.................................................................................................19 B. SORANOS D’EPHESE ............................................................................................20 1. Biographie ......................................................................................................20 2. La rétention de l’arrière-faix ...........................................................................20 C. La pile de LEGENDRE et la délivrance .................................................................21 D. Controverse sur la délivrance..............................................................................22 1. Les partisans d’une délivrance immédiate ......................................................22 2. Les partisans d’une délivrance confiée à la nature..........................................22 3. CAPURON : « Seconder la nature » ..................................................................23 E. L’avènement de l’hygiène et des antibiotiques ..................................................23 ,9 &DGUHOHJLVODWLI A.. 1. 2.. A.. Le code de déontologie des sages-femmes .........................................................25 1. Avant octobre 2006 .........................................................................................25 2. Après octobre 2006 .........................................................................................26 B. La formation initiale............................................................................................27 '(8;,(0(3$57,(0(7+2'2/2*,((735(6(17$7,21'(6(78'(6 ,. 0pWKRGRORJLH A. B.. La problématique ................................................................................................29 Objectif................................................................................................................29.

(8) C. Les hypothèses ....................................................................................................29 D. Etudes..................................................................................................................29 ,, (WXGHVHW5pVXOWDWV A.. Concernant les étudiants sages-femmes..............................................................31 Cadre de l’étude ..............................................................................................31 Les biais ..........................................................................................................31 Résultats ..........................................................................................................31 B. Concernant les Sages-femmes.............................................................................38 1. Cadre de l’étude ..............................................................................................38 2. Les biais ..........................................................................................................38 3. Résultats ..........................................................................................................39 752,6,(0(3$57,($1$/<6('(65(68/7$76(7',6&866,21 1. 2. 3.. /DIRUPDWLRQGHVpWXGLDQWVVDJHVIHPPHV . , A.. La formation théorique........................................................................................50 1. Enseignement sur la délivrance artificielle .....................................................50 2. La législation sur la délivrance artificielle ......................................................50 B. La formation pratique..........................................................................................51 C. Apres le diplôme : les acquis ..............................................................................52 ,, /DIRUPDWLRQGHVVDJHVIHPPHV A. B. C.. La formation initiale théorique et pratique..........................................................53 Après le diplôme : les acquis ..............................................................................53 L’exercice professionnel .....................................................................................53 1. La première délivrance artificielle ..................................................................53 2. Circonstances de réalisation............................................................................54 3. La pratique des sages-femmes au quotidien....................................................55 4. Habitudes de services......................................................................................57 5. Professionnel qui doit réaliser la délivrance artificielle..................................58 6. Connaissance de la législation ........................................................................59 ,,, &RQIURQWDWLRQ pWXGLDQWV VDJHVIHPPHV HW VDJHVIHPPHV GLIIpUHQFHV HW FRQFRUGDQFHV A.. La formation........................................................................................................60 La formation théorique....................................................................................60 La formation pratique......................................................................................60 Les acquis de la formation ..............................................................................60 B. La pratique au quotidien......................................................................................61 C. Connaissance de la legislation ............................................................................61 ,9 /HVSHUVSHFWLYHVG·pYROXWLRQVTXHOTXHVSURSRVLWLRQV 1. 2. 3.. A. La formation des étudiants ..................................................................................62 B. La formation des sages-femmes..........................................................................63 &RQFOXVLRQ %LEOLRJUDSKLH $QQH[H , Délivrance artificielle : Technique.................................................................................I $QQH[H,,.

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