Guidelines for the management of urgent obstetric situations in emergency medicine, 2022.

Emergency; Obstetrics; Postpartum; Critical Care; Emergencies; Female; Humans; Pregnancy; Anesthesiology; Emergency Medicine; Heart Arrest/therapy; Heart Arrest; Critical Care and Intensive Care Medicine; Anesthesiology and Pain Medicine

Abstract :

[en] [en] OBJECTIVE: To provide recommendations on the management of urgent obstetrical emergencies outside the maternity ward. DESIGN: A group of 24 experts from the French Society of Emergency Medicine (SFMU), the French Society of Anaesthesia and Intensive Care Medicine (SFAR) and the French College of Gynaecologists and Obstetricians (CNGOF) was convened. Potential conflicts of interest were formally declared at the outset of the guideline development process, which was conducted independently of industry funding. The authors followed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method to assess the level of evidence in the literature. The potential drawbacks of strong recommendations in the presence of low-level evidence were highlighted. Some recommendations with an insufficient level of evidence were not graded. METHODS: Eight areas were defined: imminent delivery, postpartum haemorrhage (prevention and management), threat of premature delivery, hypertensive disorders in pregnancy, trauma, imaging, cardiopulmonary arrest, and emergency obstetric training. For each field, the expert panel formulated questions according to the PICO model (population, intervention, comparison, outcomes) and an extensive literature search was conducted. Analysis of the literature and formulation of recommendations were conducted according to the GRADE method. RESULTS: Fifteen recommendations on the management of obstetrical emergencies were issued by the SFMU/SFAR/CNGOF panel of experts, and 4 recommendations from formalised expert recommendations (RFE) established by the same societies were taken up to answer 4 PICO questions dealing with the pre-hospital context. After two rounds of voting and several amendments, strong agreement was reached for all the recommendations. For two questions (cardiopulmonary arrest and inter-hospital transfer), no recommendation could be made. CONCLUSIONS: There was significant agreement among the experts on strong recommendations to improve practice in the management of urgent obstetric complications in emergency medicine.

Disciplines :

Human health sciences: Multidisciplinary, general & others

Author, co-author :

Bagou, Gilles; SAMU-SMUR of Lyon, University Hospital Edouard Herriot, Lyon, France. Electronic address: gilles.bagou@chu-lyon.fr

Sentilhes, Loïc; Gynaecology and Obstetrics Department, University Hospital Pellegrin, Bordeaux, France

Mercier, Frédéric ; Université de Liège - ULiège > Unités de recherche interfacultaires > GIGA-CRC In vivo Imaging (Centre de Recherche du Cyclotron) ; Department of Anaesthesiology and Critical Care Medicine, University Hospital Antoine Béclère, Clamart, France

Berveiller, Paul; Gynaecology and Obstetrics Department, CHI Poissy Saint-Germain, Poissy, France

Blanc, Julie; Gynaecology and Obstetrics Department, University Hospital Hôpital Nord, Marseille, France

Cesareo, Eric; SAMU-SMUR 69, University Hospital Hospices Civils de Lyon, Lyon, France

Dewandre, Pierre-Yves ; Université de Liège - ULiège > Département des sciences cliniques

Douai, Bénédicte; SAMU-SMUR 92, University Hospital Beaujon, Clichy, France

Gloaguen, Aurélie; Emergency Department, Hospital William Morey, Chalon-sur-Saone, France

Gonzalez, Max; Department of Anaesthesiology and Critical Care Medicine in Gynaecology and Obstetrics, University Hospital Jeanne de Flandre, Lille, France

More authors (14 more)

Language :

English

Title :

Guidelines for the management of urgent obstetric situations in emergency medicine, 2022.

Publication date :

October 2022

Journal title :

Anaesthesia, Critical Care and Pain Medicine

eISSN :

2352-5568

Publisher :

Elsevier Masson s.r.l., France

Volume :

Issue :

Pages :

101127

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S2352556822001084?httpAccept=text/xml

Available on ORBi :

since 29 November 2024

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SRLF, SFAR, SFMU, SOFRASIMS, Simulation teaching in acute care. 2019.