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

Bagou, Gilles; Sentilhes, Loïc; Mercier, Frédéric J; Berveiller, Paul; Blanc, Julie; Cesareo, Eric; Dewandre, Pierre-Yves; Douai, Bénédicte; Gloaguen, Aurélie; Gonzalez, Max; Le Conte, Philippe; Le Gouez, Agnès; Madar, Hugo; Maisonneuve, Emeline; Morau, Estelle; Rackelboom, Thibaut; Rossignol, Mathias; Sibiude, Jeanne; Vaux, Julien; Vivanti, Alexandre; ... (2022). Guidelines for the management of urgent obstetric situations in emergency medicine, 2022. Anaesthesia, critical care & pain medicine, 41(5), p. 101127. Elsevier 10.1016/j.accpm.2022.101127

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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.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Maisonneuve, Emeline Louise Jacqueline

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2352-5568

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

10 Aug 2022 11:29

Last Modified:

05 Dec 2022 16:22

Publisher DOI:

10.1016/j.accpm.2022.101127

PubMed ID:

35940033

Uncontrolled Keywords:

Emergency Obstetrics Postpartum

BORIS DOI:

10.48350/171806

URI:

https://boris.unibe.ch/id/eprint/171806

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