Obstetric Labor Clinical Trial
Mobilization, ambulation, during obstetrical work attitudes are naturally adopted by women
since ancient times in many countries. The advent of the epidural in the 60s revolutionized
the management of pain during childbirth. The consideration of such advance is to keep the
laboring parturients lying down. Indeed at this time the use of high doses of local
anesthetics charge of an engine block against formally allocate all up.
In a matchless analgesic efficacy during childbirth, epidurals also offers the possibility
of a secure obstetrical gesture because without general anesthesia, inhalation great
purveyor in these women with full stomach. These advantages explain the considerable growth
in the number of epidurals performed in obstetric work in France over the last thirty years.
However, this analgesia technique will soon be implicated in the alterations of obstetric
mechanics, its effects depend primarily on the nature and concentration of the products
used.
Evolution is then marked by a considerable reduction of concentrations of local anesthetics
used with the addition of opioids, allowing to achieve an isolated analgesia without
impairing motor skills, it involves the lower limbs or muscles pelvis, allowing the woman to
mobilize.
Ambulatory epidural and made its appearance in the early 90. Responding to women in labor
demand wishing to receive effective labor analgesia without being confined to bed, she then
puts to the test the dogmas and practices on how to provide analgesia that is both effective
and safe. It is now well codified and used daily in some maternity hospitals.
The mobilization of women during labor is a subject that motivates obstetric teams Caen
University Hospital for many years. Motherhood has thus given the means for monitoring and
ambulatory epidural analgesia protocol suitable for this technique.
The introduction of this daily care protocol opens new possibilities of care delivery hoped
more physiological and less iatrogenic.
A critical evaluation of the changes possibly recorded on obstetric mechanics inherent
question, motivating, for which the answers are now few and discordant in the literature.
The investigators therefore propose a randomized study evaluating single-center relative to
obstetrical work typically occurring in a bed, the mobilizations of repercussions out of
bed, in terms of obstetrical mechanics and comfort of the parturient.
Those will be objectified by a significant change in the working hours. This study included
560 patients is scheduled to last 2 years. Positive effects could also have repercussions in
terms of public health and even of health economics.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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