ArticlePloS one2016
Variations in Postpartum Hemorrhage Management among Midwives: A National Vignette-Based Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 22 citations in OpenAlex.
- Comparative satisfaction and effectiveness of virtual simulation and usual supervised work for postpartum hemorrhage management: a crossover randomized controlled trial.BMC medical education · 2022Trial
- Assessing use of eau recommendations in diagnostic and therapeutic strategies for chronic pelvic pain syndrome: a case vignette study on dutch pelvic floor physiotherapists practices.BMC women's health · 2025Article
- Promptness of oxytocin administration for first-line treatment of postpartum hemorrhage: a national vignette-based study among midwives.BMC pregnancy and childbirth · 2022Article
- The role of midwife in postpartum hemorrhage.European journal of midwifery · 2020Article
- Variation in severe postpartum hemorrhage management: A national vignette-based study.PloS one · 2018Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess variations in adherence to guidelines for management of postpartum hemorrhage (PPH) among midwives.
methodsA multicentre vignette-based study was e-mailed to a random sample of midwives from 145 maternity units in France. They were asked to describe how they would manage the PPH described in 2 case-vignettes. These previously validated case-vignettes described 2 different scenarios for severe PPH. Vignette 1 described a typical immediate, severe PPH and vignette 2 a less typical case of severe but gradual PPH. They were constructed in 3 successive steps and included multiple-choice questions proposing several types of clinical practice options at each step. An expert consensus defined 14 criteria for assessing adherence to guidelines issued by the French College of Obstetricians and Gynecologists in 2004 in the midwives' responses. We analyzed the number of errors among the 14 criteria to quantify the level of adherence.
resultsWe obtained 450 complete responses from midwives from 87 maternity units. The rate of complete adherence (no error for any of the 14 criteria) was low: 25.1% in vignette 1 and 4.2% in vignette 2. The error rate was higher for pharmacological management, especially oxytocin use, than for non-pharmacological management and communication-monitoring-investigation. Adherence to guidelines varied substantially between and within maternity units, as well as between the vignettes for the same midwives.
conclusionReponses to case-vignettes demonstrated substantial variations in PPH management and especially individual variations in adherence to guidelines. Midwives should participate in continuous and individualized training.
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