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Childbirth is a special event for women. Maternal satisfaction regarding childbirth is quite important, that is why this factor has to be taken into account. A bad experience related to childbirth could lead to serious psychological and organic consequences such as postpartum depression, mother-baby bond deterioration and chronic pelvic pain. Childbirth image changed over the years to the extent that an increasingly physiological process keeping analgesia and safety is more and more desired. In this perspective, this study aims to investigate an approach so-called ambulatory epidural. Indeed, only a few studies have been conducted and the ones published in 1990s did not involve the current recommended pharmacological protocols.
This is a multi-centre prospective observational analytical before/after-type study.
Practice changes are planned in concerned departments, in particular regarding usual patient care. This observational study aims to quantify the impact of practice changes on patient experience using a Childbirth Assessment Questionnaire (QEVA). During the "before" period, patients will receive a conventional epidural while the others, during the "after" period, will receive an ambulatory epidural. The women involved into this study must fill the QEVA form 2 days after giving birth (at the maternity) then 4 weeks after giving birth in order to get a feedback related to postpartum feelings (phone call).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conventional epidural anesthesia (=before revision of the usual practice of the maternity ward) | A local anesthetic and an opioid are administered into the epidural space, as per department protocol (usual practice). |
| |
| Ambulatory epidural anesthesia (=after revision of the usual practice of the maternity ward) | Low doses of local anesthetic and an opioid are administered into the epidural space to allow the patient to walk around while being monitored, as per department revised protocol (usual practice) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| QEVA questionnaire | Behavioral | QEVA questionnaire administered at 2 days pospartum (in hospital) and 4 weeks postpartum (phone call). (specific for the study) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Obstetrical labor and delivery experience in birthgiving women | The "emotional state" dimension of the Childbirth Assessment Questionnaire (QEVA) will be evaluated. This questionnaire is written and validated in French. It contains 26 questions covering 4 dimensions: emotional state, relations with nursing staff, first moments with the baby, and the young mother's feelings one month before delivery. | at 2 days postpartum |
| Measure | Description | Time Frame |
|---|---|---|
| Relations with nursing staff and first moments with the child | Other dimensions and isolated items of the QEVA questionnaire | at 2 days postpartum |
| Obstetrical labor and delivery experience in birthgiving women |
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Inclusion Criteria:
Exclusion Criteria:
Birthgiving women
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Pregnant women willing to give birth at CHR Metz/Thionville (maternity)
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Arpiné EL NAR, PhD | Contact | 0033387557766 | projet-recherche-clinique@chr-metz-thionville.fr | |
| Mélanie JUNKE | Contact | projet-recherche-clinique@chr-metz-thionville.fr |
| Name | Affiliation | Role |
|---|---|---|
| Lisa LEON, MD | CHR Metz Thionville Hopital Femme Mère Enfant | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHR Metz Thionville Hopital Femme Mère Enfant | Recruiting | Metz | 57085 | France |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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" emotional state " dimension of the Childbirth Assessment Questionnaire (QEVA)
| at 4 weeks postpartum |
| Labor and delivery safety : time spent in the delivery room | Time spent in the delivery room (min) | at 2 days postpartum |
| Labor and delivery safety: need for instrumental extraction | Need for instrumental extraction (yes/no) | at 2 days postpartum |
| Labor and delivery safety : emergency caesarean sections | Emergency caesarean sections (yes/no), | at 2 days postpartum |
| Labor and delivery safety: ability to maintain spontaneous micturition | Ability to maintain spontaneous micturition (yes/no) | at 2 days postpartum |
| Safety of ambulation | absence of the following events : motor block, hypotension, malaise, falls, difficulty in achieving ambulation | at 2 days postpartum |
| CHR Metz-Thionville Hopital Mère Enfant | Recruiting | Thionville | 57100 | France |
|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |