1. Normal delivery: physiologic support and medical interventions. Guidelines of the French National Authority for Health (HAS) with the collaboration of the French College of Gynecologists and Obstetricians (CNGOF) and the French College of Midwives (CNSF)
- Author
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Karine Petitprez, Aurélien Mattuizzi, Sophie Guillaume, Maud Arnal, France Artzner, Catherine Bernard, François-Marie Caron, Isabelle Chevalier, Claude Daussy-Urvoy, Anne-Sophie Ducloy-Bouthorsc, Jean-Michel Garnier, Hawa Keita-Meyer, Jacqueline Lavillonnière, Valérie Lejeune-Sadaa, Camille Le Ray, Anne Morandeau, Marjan Nadjafizade, Franck Pizzagalli, Clemence Schantz, Thomas Schmitz, Raha Shojai, Bernard Hédon, and Loïc Sentilhes
- Subjects
medicine.medical_specialty ,Psychological intervention ,Oxytocin ,National authority ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Active phase ,medicine ,Humans ,Cardiotocography ,Stage (cooking) ,Intermittent Auscultation ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Obstetrics ,business.industry ,Normal delivery ,Infant, Newborn ,Obstetrics and Gynecology ,Delivery, Obstetric ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Female ,business ,Umbilical cord clamping - Abstract
Objective To define for women at low obstetric risk methods of management that respect the rhythm and the spontaneous course of giving birth as well as each woman's preferences. Methods These clinical practice guidelines were developed through professional consensus based on an analysis of the literature and of the French and international guidelines available on this topic. Results Labor should be monitored with a partograph (professional consensus). Digital cervical examination should be offered every 4 h during the first stage of labor, hourly during the second. The choice between continuous (cardiotocography) or discontinuous (by cardiotocography or intermittent auscultation) monitoring should be left to the woman (professional consensus). In the active phase of the first stage of labor, dilation speed is considered abnormal if it is less than 1 cm/4 h between 5 and 7 cm or less than 1 cm/2 h after 7 cm. In those cases, an amniotomy is recommended if the membranes are intact, and the administration of oxytocin if the membranes are already broken and uterine contractions are judged insufficient (professional consensus). It is recommended that pushing not begin when full dilation has been reached; rather, the fetus should be allowed to descend (grade A). Umbilical cord clamping should be delayed beyond the first 30 s in newborns who do not require resuscitation (grade C). Conclusion The establishment of these clinical practice guidelines should enable women at low obstetric risk to receive better care in conditions of optimal safety while supporting physiologic birth.
- Published
- 2021