Search

Background: Regionalization of perinatal care is required throughout networks to reduce perinatal morbidity and mortality and to organize access to health services for high-risk new borns, such as in the eastern Paris in 2007. Our study sought to design a matrix to build a perinatal knowledge base for assessing health needs and facilitating public health planning process for the perinatal network in eastern Paris. Methods: Our matrix listed as its columns ‘perinatal stages’ from conception through the age of 6 years, whereas the rows covered components related to public health planning (i.e. target population, perinatal risk factors and health services). For each situation, the matrix lists require information and potential data sources to measure health status and health services. Results: Our matrix structures the cyclical process for building knowledge for action. The eastern Paris has a population of 670 000. Its nine maternity units are distributed into three levels of care, a level-3 unit opened up in June 2007. A total of 16 400 deliveries occur every year in the nine units; 2500 women living in the eastern area deliver outside the area. Conclusion: Our matrix is useful for building a comprehensive perinatal knowledge base depending upon perinatal stages and health-care dimensions. It should imply stakeholders in collecting, synthesizing and analysing massive amounts of data. It can be adapted to any health network or local health policy. [ABSTRACT FROM PUBLISHER]

The article discusses the NéMoSI project launched in France in 2010 to 2011 to improve stillbirth recording. Topics covered include the decline in stillbirth rates in France between 1901 and 2001, the increase in stillbirth rate in 2002, and the reason behind the inability to calculate stillbirth rates from civil registration data.

Objective: Hysterectomy is the most common procedure in women. We wanted to make an assessment of the hysterectomy in France in 2019. We also assessed the variations over time in the indications and the surgical approch for hysterectomy, this with regard to the various events that may have been at the origin of the modification practices., Methods: We used the Medical Information Systems Program in Medicine, Surgery, Obstetrics and Dentistry to extract all acts relating to a hysterectomy regardless of its route of approach from 2009 to 2019., Results: Hysterectomy is a frequent procedure which was performed in nearly 60,000 women in France in 2019. The most frequently used surgical approach is now laparoscopy, performed in 30% of hysterectomies, followed by laparotomic (29%), then vaginal approaches (26%) and coelio-vaginal (15%). Laparoscopic procedures are performed more often in public than private hospitals. Adnexectomy is associated with 41% of hysterectomies. A decrease in the number of hysterectomies was observed between 2008 and 2019, from approximately 72,000 in 2008 to approximately 60,000 in 2019. This decrease occurs during a period in which new therapies have emerged as well as new recommendations., Conclusion: The evolution of the number of hysterectomies is correlated with the development of therapeutic alternatives for pathologies for which a hysterectomy has traditionally been performed., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)