[Analysis of the evitability of intrapartum asphyxia with a peers review].

OBJECTIVE

To assess the quality of intrapartum care in birth asphyxia cases.

METHODS

Prospective analysis of all cases of birth asphyxia in nine maternity units during one year (2010). Birth asphyxia was defined as the combination of at least one clinical factor (Apgar≤7 at 5 minutes, signs of encephalopathy at birth) and at least one biological factor in cord (pH≤7, BD≥12 mmol/L, lactates>10 mmol/L). These cases were analyzed with a peer review from French guidelines 2007.

RESULTS

Fifty cases of birth asphyxia were identified. After peer-review, they were defined as 46% non preventable, 27% possibly preventable, 24% definitely preventable and 3% not established. The main causes have been described as (i) misinterpretation of CTG during the first and second stages of labour, (ii) delayed response time to CTG anomalies and (iii) prolonged second stage.

CONCLUSION

In half of the cases of birth asphyxia, this dreaded event was considered as preventable by a group of peers.