[CME MMC: Evaluation of a continuous medical education tool by e-learning from the morbi-mortality conferences of the Burgundy]. / DPC RMM : évaluation d'un outil de développement professionnel continue par e-learning à partir des revues de morbi-mortalité de Bourgogne.

OBJECTIVES: The objective of this study was to validate a continuing medical education e-learning tool. METHODS: The CME MMC was for all health professionals maternity Burgundy and concerned regional morbidity and mortality conferences. It was divided into steps: a pre-test for an assessment of initial knowledge, an access to the recommendations of each RMM and a post-test to assess the progress of participants. A satisfaction questionnaire was proposed after the test. The primary endpoint was the comparison of the post-test scores than the pre-test. RESULTS: CME MMC was opened 3 months and recorded 156 participants among 598 health professionals in Burgundy, a rate 2.4 times higher than the average participation rate at MMC the past two years. A statistically significant increase was demonstrated individually by comparing the post-test scores than the pre-test (P<0.00001). The increase was significantly higher for midwives and professionals absents at the RMM. Finally, 96.2% of participants have been satisfied by this formation. CONCLUSION: This prospective multicenter study validates our tool. CME MMC is accessible, without geographic or time restrictions, not expensive, and efficient because it proves that it can update our knowledge in obstetrics and perinatology.

[Assessment of restrictive episiotomy use and impact on perineal tears in the Burgundy's Perinatal Network]. / Évaluation de la pratique restrictive de l'épisiotomie et de l'impact sur les déchirures périnéales au sein du Réseau périnatal de Bourgogne.

OBJECTIVES: To analyse episiotomy and perineal tears rates in Burgundy after French National College of Obstetricians and Gynecologists (CNGOF) guidelines in 2005. MATERIALS AND METHOD: Multicenter retrospective study, between 2003-2005 (period 1) et 2012-2014 (period 2), conducted on singletons vaginal deliveries, in cephalic presentation from 37 weeks. We compared the episiotomy rate (ER), and perineal lesions in normal deliveries (ND) and instrumental deliveries (ID) between the two periods. RESULTS: A total of 74,268 women were included. The overall ER significantly decreased from 35.8 to 16.7% (P<0.01), without increasing third degree perineal tears (0.73% vs. 0.66%) or fourth degree (0.14% vs 0.14%). First degree perineal tears rose (42.1% vs 17.6%, P<0.001), second degree decreased (13.5% vs 20.5%, P<0.001). ER decreased whatever the level of motherhood, healthcare ward, vaginal delivery type, or the instrument used. CONCLUSION: Our study found a strong impact in Burgundy of the French guidelines for the practice of restrictive episiotomy for both ND and for ID without increasing sphincter tears and in decreasing spontaneous morbidity.