DOSSIER DE PRESSE - Collège National des Sages

!"
!
!
"
"
"
#$%%&'("#'")('%%'"
!
!
!
!
!
!
!
"#$!%&'($))*'#!+*,,-#.*&$!$#!%,$*#$!&-/',"0*'#*******************%1!2!
o +,-./01".2"%134/2"56/778692:");-</.2=02".6">177?@2"A80/1=87".2<"%8@2<BC2992<".2"
C;8=D2"
"
.3+*#*)0&.0*'#!3$!,4'560'7*#$!,'&)!3"!0&./.*,!)%'#0.#-!8!
.3'%0'#)!,$)!9'#)!&-(,$5$)!:EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE%1!;!
o +2<"31/=0<".,872;02"20"3;-D1=/<80/1=<".6">A%C"
o $FG01D/=2"16"1DG01D/=2"H"
o I="6<8@2"2FD2<</J"H"
"
,$)!&$7'++.#3.0*'#)!%'"&!,.!%&.0*<"$!7,*#*<"$******************E%1=!
o +2<"2=<2/@=292=0<"D7-<".2"D2<"()>"
o K2;<"6=2"92/7726;2"/=J1;980/1=".2<"J2992<"<6;"72".-;167292=0".2"726;"
8DD16D4292=0"
o &=02;L/2M".2">1;/==2"#631=0:"%8@2BC2992"D42;D426;"N)4#O:"D11;./=80;/D2"
.2<"()>"N(-<286"P6;1;2:"+G1=O"
o I="160/7"316;"<2";23-;2;"
"
.##$5$)**********************************************E%1>?!
o +8"9-041.171@/2".2"D2<"(2D1998=.80/1=<"316;"78");80/Q62">7/=/Q62"
o +2<"3;/=D/3872<";2D1998=.80/1=<"2=".-08/7"
o +2<"86026;<".2"D2<"3;29/?;2<"()>"
o R"3;131<".6">A%C"
" "

S"
"#$!%&'($))*'#!+*,,-#.*&$!$#!%,$*#$!&-/',"0*'#!
"
Le#Collège#National#des#Sages-Femmes#de#France#(CNSF)#fête#ses#15#ans.#Reconnaissance#du#niveau#
Master#1,#intégration#dans#la#filière#du#PACES,#élargissement#des#compétences,#investissement#dans#le#
domaine# de# la# recherche# sont# autant# de# transformations# qui# ont# scandé# ces# dernières# années.#
L’élaboration# de# recommandations# officielles# pour# la# pratique# clinique# (RPC)# marque# une# nouvelle#
étape.#Retour#sur#une#profession#en#pleine#mutationE""
"
T">278"J8/0"!U"8=<"Q62"72">177?@2"A80/1=87".2<"%8@2<BC2992<".2"C;8=D2"8"-0-"
D;--E"'="!U"8=<:"Q62".2"D429/="38;D16;6E"%/"78"98V260/Q62"2<0"D2=0;872".8=<"
=10;2" 3;80/Q62:" 72<" <8@2<BJ2992<" <1=0" 71/=" .WX0;2" <267292=0" .2<"
8DD16D426<2<E"%@ABCDDEAF!GHIEJKLC!ICMNED!>OPQ:"86F"DY0-<".2<"9-.2D/=<"20"
.2<" .2=0/<02<:" =16<" 8L1=<" 8DQ6/<" 86" J/7" .2<" 8=<:" .2<" ;2<31=<8Z/7/0-<"
D;1/<<8=02<" 2=" 980/?;2" .2! RDKFSH! THFHDEUNCR! [" <6/L/" @G=-D171@/Q62" .2"
3;-L2=0/1=:" .-3/<08@2" .2<" D8=D2;<" .6" <2/=" 20\16" .6" D17" .2" 7,60-;6<:"
D1=0;8D230/1=:" <8=0-" <2F62772:" J1=0" 38;0/2" .6" D4893" .W8D0/1=" .2<" <8@2<B
J2992<E"
(2<08/0" 6=" .198/=2" 1]" 72<" <8@2<BJ2992<" =W8L8/2=0" 38<" 2=D1;2" 36" <2" J8/;2" 2=02=.;2:" D276/" .2" 78"
;2D42;D42E" +2<" <8@2<BJ2992<"<1648/08=0"<WG"D1=<8D;2;"20" 2=0898=0" .2<".1D01;80<" .W-3/.-9/171@/2:"
.2"<1D/171@/2:".2"<8=0-"36Z7/Q62:"<1=0".2"376<"2="376<"=19Z;26<2<E"'772<"1=0"38;0/D/3-"8D0/L292=0"86F"
;2D1998=.80/1=<"36Z7/-2<"D2<".2;=/?;2<"8==-2<"38;"72">A5$C!E"
I="=16L286"38<"2<0"J;8=D4/"2="S^!_"8L2D!LK!MNVLEJKSEAF!MAN@!LK!M@CGEW@C!BAED!IC!@CJAGGKFIKSEAFD!
EDDNCD! IN! 7)#("2="38;02=8;/80"8L2D"72">A5$C:"7W&=<2;9S":"72">&PA'`:"6="3-./80;2"20"6="8=2<04-</<02E"
>2<";2D1998=.80/1=<"<1=0"L-;/08Z7292=0"6=!KJSC!RBAFIKSCN@R!316;"72"D177?@2E"'772<"72"31</0/1==2=0"
D1992"6="38;02=8/;2"/=D1=016;=8Z72"2="980/?;2".2";2D42;D42"20".2"IEBBNDEAF!IC!@CJAGGKFIKSEAFD!
IC!M@KSEUNC!JLEFEUNCE"'772<"L/2==2=0"38;"8/7726;<"L871;/<2;"72<"D193-02=D2<"<D/2=0/J/Q62<"20"78"D838D/0-"
.2" D2;08/=2<" <8@2<BJ2992<" a" ./;/@2;".2<" ;2D42;D42<E" >1;/==2" #631=0" 2<0" 8/=</" 78" 3;29/?;2" <8@2B
J2992"0/0678/;2".W6=2"b#("N48Z/7/080/1="a"./;/@2;".2<";2D42;D42<O:"Q6/";23;-<2=02"72"376<"4860"=/L286"
6=/L2;</08/;2E"'772"8"31;0-"8L2D"c8;/1=">8;8G17"D2"3;1d20E">W2<0"6=2"J/2;0-"316;"72"D177?@2".2"9200;2"2="
769/?;2"726;" 0872=0"20" D276/".2<" 860;2<" <8@2<BJ2992<"0/0678/;2<".2" 04?<2"2=" <8=0-" 36Z7/Q62"Q6/"1=0"
D1778Z1;-"a"D2"0;8L8/7E"
"
)16;"D2<"3;29/?;2<"()>:"=16<"8L1=<"D41/</".2"=16<"/=0-;2<<2;"a"7W60/7/<80/1=".2"7W1FG01D/=2"32=.8=0"72"
0;8L8/7" <31=08=-E" I=2" -06.2" ;-D2=02" .2" 7W&=<2;9" ;-87/<-2" a" 38;0/;" .,6="-D48=0/771="31;08=0" <6;" !^_"
9802;=/0-<" 2=" C;8=D2" ;23;-<2=08=0" S^" e" .2<" 8DD16D4292=0<" <6;" 72" 02;;/01/;2:" 8" 91=0;-" Q62"
7W1FG01D/=2"9670/37/8/0"38;"!:f"72";/<Q62".,4-91;;8@/2"@;8L2"20"Q62"D2"<6;B;/<Q62"86@92=08/0"8L2D"78"
.1<2".,41;91=2"8.9/=/<0;-2"32=.8=0"72"0;8L8/7E"
&7" -08/0" 71@/Q62" Q62" 72<" <8@2<BJ2992<" <W/=02;;1@2=0" <6;" D2002" 41;91=2:" Q6W2772<" 60/7/<2=0"
Q610/./2==292=0"316;"J8D/7/02;"72"0;8L8/7E"
#W1;2<"20".-da"72"D177?@2"2=L/<8@2".2"<2"32=D42;"<6;".W860;2<"3;80/Q62<:"2="L62".W-9200;2".2"98=/?;2"
;-@67/?;2".2<";2D1998=.80/1=<"["78"Q62<0/1=".2"78";--.6D80/1="3-;/=-872:"7W8778/0292=0:"7W8DD62/7".6"
=16L286B=-*"A16<"8L1=<"2=D1;2"Z286D163".2"3/<02<"38<</1==8=02<"a"2F371;2;"g"hE"
"
)AMXEC!Y"*,,."+$Z!%@HDEICFSC!IN!7#)(!
!
1#Collège#National#des#Gynécologues#et#Obstétriciens#Français#
2#Institut#National#de#la#Santé#et#de#la#Recherche#Médicale#
3#Collectif#interassociatif#autour#de#la#naissance.#Le#CIANE#représente#les#patients#et#usagers#concernés#par#la#grossesse,#
l'accouchement#et#la#périnatalité."
,C!DK[EC\][AND!^!
%8@2BJ2992".-</@=2"D276/"16"D2772"Q6/"iD1==8j0"72<"J2992<i"N.6"780/="i<83/2=<i:"D276/"Q6/"<8/0OE"+2"
16"78"<8@2BJ2992"2<0".1=D"7W/=02;71D6026;"3;/L/7-@/-".2"78"J2992"2="Z1==2"<8=0-"20"<1648/08=0"72"
;2<02;E"

`"
.3+*#*)0&.0*'#!3$!,4'560'7*#$!,'&)!3"!0&./.*,!)%'#0.#-!8!
.3'%0'#)!,$)!9'#)!&-,$5$)!:!
""
3.#)!,$!7.3&$!3$!)$)!%&$+*_&$)!&$7'++.#3.0*'#)!%'"&!,.!%&.0*<"$!7,*#*<"$!8!!
"
,$!7#)(!.,$&0$!8!
"
+,1FG01D/=2:"41;91=2"D16;8992=0"60/7/<-2"316;"J8L1;/<2;"78"./78080/1=".6"D17"20"8DD-7-;2;"
72" 0;8L8/7"2<0"6="160/7";298;Q68Z72".8=<"72"<6/L/".W6="8DD16D4292=0E"k1602J1/<:"2772"=,2<0"
38<"<8=<";/<Q62E"
"
,$!7#)(!%&-7'#*)$8!
"
!E
I=" 92/7726;" 8DD1938@=292=0" .2<" 3;80/D/2=<" N<8@2<BJ2992<" 20" @G=-D171@62<B
1Z<0-0;/D/2=<O"316;"6=2"8.9/=/<0;80/1=";8/<1==-2".2"7,1FG01D/=2E"
"
SE
I=2" 92/7726;2" /=J1;980/1=" .6" D1;3<" 9-./D87" <6;" 72<" ;/<Q62<" 20" Z-=-J/D2<" .2"
7,1FG01D/=2" 71;<" .6" 0;8L8/7" <31=08=-" 20" 72<" 91.87/0-<" 130/9872<" .2" <1="
8.9/=/<0;80/1=E"
"
`E
I=2" 92/7726;2" /=J1;980/1=" .2<" 6<8@2;<" 316;" 726;" 1JJ;/;" 78" 31<</Z/7/0-" .W6="
8DD16D4292=0"72"376<"34G</171@/Q62"31<</Z72E"

l"
'560'7*#$!'"!'760'7*#$!^!
"
#-D16L2;02"2="!m^m:"7W1DG01D/=2"2<0"6=2"41;91=2"3;1.6/02"38;"7W4G310487896<:"<2D;-0-2"=108992=0"
86" 9192=0" .2" 7W8DD16D4292=0" 20" 32=.8=0" 7W8778/0292=0E" '772" 8@/0" <6;" 72" 96<D72" 7/<<2" 60-;/=" 316;"
<0/9672;"72<"D1=0;8D0/1=<"86"D16;<".6"0;8L8/7"N./78080/1=".6"D17:"2F367</1=".6"Jn06<O"20"/99-./80292=0"
83;?<"7W8DD16D4292=0:"316;";-.6/;2"72";/<Q62".W4-91;;8@/2".6"31<0B38;069"Nb))OE"
+W1FG01D/=2"2<0"6="8=871@62".2"<G=04?<2".2"7W1DG01D/=2"=806;2772E"c/<"86"31/=0".8=<"72<"8==-2<"U^:"D2"
9-./D892=0"8"1Z02=6"<1="Pcc"N8601;/<80/1=".2"9/<2"<6;"72"98;D4-O"2="81o0"!mp^E"+2<"/=./D80/1=<"
.2"7WPcc"<1=0"72<"<6/L8=02<"[""
o /=<6JJ/<8=D2".2<"D1=0;8D0/1=<"60-;/=2<"N>IO"2=".-Z60"16"2="D16;<".2"0;8L8/7"q"
o D4/;6;@/2" 1Z<0-0;/D872" ND-<8;/2==2:" /=02;;630/1=" .2" @;1<<2<<2*O" 2=" L62".W6=2" Z1==2"
;-0;8D0/1="60-;/=2"q"
o 801=/2"60-;/=2"D1=<-D60/L2"a"6=2"4-91;;8@/2".6"31<0B38;069"/99-./80"Nb))OE"
)16;" D2<" 0;1/<" /=./D80/1=<"LC! DC@[EJC! GHIEJKL! @CFIN! `)+&a! CDS! H[KLNH! JAGGC!EGMA@SKFS! MK@! LK!
JAGGEDDEAF!IC!S@KFDMK@CFJC!IC!LK!b.)"Nb8602"P601;/0-".2"%8=0-OE"
'="C;8=D2:"7W1FG01D/=2"<2"3;-<2=02"<16<"6="<267"D1=./0/1==292=0"2="8931672".2"<1760/1="/=d2D08Z72"
.2"UI&\97"N%G=01D/=1=rOE""
"
+W1FG01D/=2" 2<0" .W6<8@2" D16;8=0" 2=" 9802;=/0-" G" D193;/<" 316;" 72<" 380/2=02<" .1=0" 72"0;8L8/7" 2<0"
<31=08=-E"+W1Zd2D0/J"2<0".2"@KJJAN@JE@! LK!IN@HC! IN! S@K[KEL! IKFD!LcAMSEUNC! IC!IEGEFNC@! LK!GA@VEIESH!
GKSC@FCLLC!CS!BdSKLC!8<<1D/-2"a"6="0;8L8/7"3;171=@-E"'="S^!_"<8"3;/=D/3872"/=./D80/1="2<0"78"dystocie#
dynamique4E"
"
"#!").Y$!$57$))*(!^!
!
+W60/7/<80/1=".2" 7W1FG01D/=2"32=.8=0" 72" 0;8L8/7" <29Z72" .2" 376<"2=" 376<" Z8=87/<-2" .8=<"72"D8.;2" .2" 78"
idirection# active# du# travail"5E" %271=" 72<" ;-<67080<" .2" 7W'=Q6X02" 3-;/=80872" 2=" S^!^:" 7W1FG01D/=2" -08/0"
8.9/=/<0;-2"D42s"_l"e".2<"J2992<"2="0;8L8/7_E""
"
$;" D1992" 01602<" 72<" <6Z<08=D2<" 8D0/L2<:" D2" 9-./D892=0" =W2<0" 38<" .-316;L6" .W2JJ20<" <2D1=.8/;2<E"
P6F"'080<BI=/<:"7W1FG01D/=2" /=0;8L2/=26<2"N$FG01D/=2" &KO"8"-0-"8d160-2"<6;" 78" 7/<02".2<" 9-./D892=0<"
3102=0/277292=0" a" ;/<Q62" 38;" 7WInstitute# for# safe# médication# practices,# ISMP7E" %1=" 60/7/<80/1=" 2<0"
=108992=0"8<<1D/-2"a".2<"-L-=292=0<"/=.-</;8Z72<"@;8L2<"D1992"72<"8=1987/2<".2"78"D1=0;8D0/7/0-"
60-;/=2"2=0;8j=8=0".2<"8=1987/2<".6";G0492"D8;./8Q62"Jn087"N(>COE"
"
4#Dystocie#:# la# dystocie# désigne# les# difficultés# survenant# lors# d'un# accouchement.# La# dystocie# dynamique#est# due# à# des#
anomalies#de#contraction#de#l'utérus.##
5#Direction#active#du#travail#:#ensemble#des#interventions#ayant#pour#but#de#limiter#la#durée#du#travail,#afin#notamment#de#
réduire#le#nombre#des#césariennes.#L'amniotomie#(rupture#des#membranes)#et#la#mise#en#place#d'une#perfusion#d'oxytocine#
en#sont#les#deux#piliers.##
6#Oxytocin#administration#during#labor.#Results#from#the#2010#French#National#Perinatal#Survey#Belghiti#J1,#Coulm#B,#Kayem#
G,#Blondel# B,#Deneux-Tharaux# C.# J# Gynecol# Obstet# Biol# Reprod# (Paris).#2013# Nov;42(7):662-70.# doi:#
10.1016/j.jgyn.2013.02.011.#Epub#2013#Apr#6.#
7#https://1q3nfm4evj5z1sgm624e93ka-wpengine.netdna-ssl.com/wp-
content/uploads/2014/11/original_Oxytocin_the_new_high_alert_medication.pdf

U"
I=2"-06.2".2"7W&=<2;9"36Z7/-2"2="S^!!"92008/0"2="@8;.2"D1=0;2"72";/<Q62".W4-91;;8@/2"@;8L2".6"31<0B
38;069" D1=<-D60/L2" a" 7W8.9/=/<0;80/1=" .W1FG01D/=2" 32=.8=0" 72" 0;8L8/7fE" T"+2" <6;B;/<Q62" 1Z<2;L-"
86@92=02" 8L2D" 78" .1<2" .W41;91=2" 3;2<D;/02"h" D1=<0802" 72" #;" >8042;/=2" #2=26FBk48;86F" N6=/0-"
&=<2;9"!!U`OE"+Wb))"D1=<0/062"78"3;/=D/3872"D86<2".2".-D?<"9802;=27"2="C;8=D2mE"
"
#
#«#On#médicalise#beaucoup#l'accouchement#en#France.#Le#déclenchement,#la#péridurale,#l'épisiotomie,#
l'administration#d'oxytocine#sont#globalement#plus#pratiqués#que#dans#les#autres#pays#d'Europe.#Ces#
recommandations# sont# importantes# car# elles# visent# à# trouver# un# juste# milieu.# Il# ne# s'agit# pas# de#
"démédicaliser"#mais#de#mieux#prescrire,#la#juste#dose,#au#bon#moment#»,#précise#le#Dr#Camille#Le#Ray,#
gynécologue-obstétricienne,#CNGOF,#AP-HP#(Paris).#
#
#
# #
8#www.inserm.fr/actualites/rubriques/actualites-recherche/hemorragies-apres-l-accouchement-quel-role-pour-l-ocytocine#
9#www.cngof.asso.fr/D_PAGES/PURPC_12.HTM"