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Guittier Marie-Julia

Professeure HES associée

Main contract

Professeure HES associée

Haute école de santé - Genève
Avenue de Champel 47, 1206 Genève, CH

Faculty
Santé

Main Degree Programme
Sage-femme

MSc HES-SO/UNIL en Sciences de la santé - HES-SO Master

BSc HES-SO de Sage-femme - Haute école de santé - Genève

Completed

Posture maternelle et correction des variétés de présentations foetales occipito-postérieures: un essai clinique randomisé.

AGP

Role: Main Applicant

Financement: FNS

Description du projet : Les variétés de présentations foetales occipito-postérieures représentent 10 % à 34% des présentations céphaliques en début de travail. La majorité effectuera une rotation spontanée en mode occipito-antérieur au cours du travail mais 5 à 8% persisteront en mode postérieur pour la phase expulsive de l'accouchement. Des observations ont montré que pour celles-ci, le risque de travail anormalement long, d'épuisement materno-foetal, d'accouchement instrumenté, de lésions périnéales graves, et de césarienne, est augmenté. L'attitude habituelle lors du diagnostic de variété postérieure est l'expectative. Des techniques posturales ont été décrites dans plusieurs ouvrages d'obstétrique pour favoriser l'eutocie du travail. Une posture maternelle destinée à faciliter la rotation foetale en mode antérieur a été décrite précisément par le Dr de Gasquet. Une revue Cochrane sur le sujet a montré que des postures similaires sont bien acceptées par les femmes et réduisent les douleurs lombaires. Par contre, la taille d'échantillon des études inclues semblait insuffisantes pour permettre une évaluation d'un intérêt pour les issues de l'accouchement en général et pour les issues défavorables associées aux variétés de présentation postérieures en particulier. Tenter de traiter ces malpositions foetales par une technique posturale bien acceptée par les femmes nous semble une façon assez facile à mettre en oeuvre mais nécessitant au préalable une évaluation scientifique de l'efficacité. Le dernier essai clinique randomisé sur ce thème a été réalisé en 2005 et ne permet pas de statuer sur l'efficacité. Actuellement, aucun essai clinique randomisé sur ce sujet ne figure dans le répertoire du « Clinicaltrials.gov ».

Research team within HES-SO: Guittier Marie-Julia

Partenaires académiques: HUG; Santé; Guittier Marie-Julia, Santé

Durée du projet: 01.04.2011 - 30.09.2014

Montant global du projet: 250'000 CHF

Statut: Completed

Impact of mode of delivery on the physical and psychological health of first-time parents

AGP

Role: Main Applicant

Financement: HES-SO Rectorat

Description du projet : The steady increase in the number of Cesarean sections in industrialized countries raises concern. The World Health Organization recommends a maximum rate of Cesarean sections of 15%, whereas in Switzerland it has reached 31%. It is difficult to control this phenomenon even though the obstetric and physical consequences of the different modes of delivery are not well understood in the medium term (6 months to 2 years). Similarly, psychological aspects such as the experience of childbirth, depression, changes in the marital relationship, sex within the relationship, as well as the impact on health behaviors such as physical activity and addictions in both parents are poorly documented. Data on the father are especially rare. A possible relationship with the fact that 25% of married couples divorce within the first five years of marriage also awaits exploration. In light of the medical, psychological, social and economic issues, there is an urgent need to scientifically evaluate the multidimensional impact of the mode of delivery on the health of young parents.

Research team within HES-SO: Guittier Marie-Julia

Partenaires académiques: Santé

Durée du projet: 07.03.2013 - 30.05.2013

Montant global du projet: 11'000 CHF

Statut: Completed

Posture maternelle et correction des variétés de présentations foetales occipito-postérieures: un essai clinique randomisé.

AGP

Role: Main Applicant

Financement: HES-SO Rectorat; Santé

Description du projet : Les variétés de présentations f'tales occipito-postérieures représentent 10 % à 34% des présentations céphaliques en début de travail. La majorité effectuera une rotation spontanée en mode occipito-antérieur au cours du travail mais 5 à 8% persisteront en mode postérieur pour la phase expulsive de l'accouchement. Des observations ont montré que pour celles-ci, le risque de travail anormalement long, d'épuisement materno-f'tal, d'accouchement instrumenté, de lésions périnéales graves, et de césarienne, est augmenté. L'attitude habituelle lors du diagnostic de variété postérieure est l'expectative. Des techniques posturales ont été décrites dans plusieurs ouvrages d'obstétrique pour favoriser l'eutocie du travail. Une posture maternelle destinée à faciliter la rotation f'tale en mode antérieur a été décrite précisément par le Dr de Gasquet. Une revue Cochrane sur le sujet a montré que des postures similaires sont bien acceptées par les femmes et réduisent les douleurs lombaires. Par contre, la taille d'échantillon des études inclues semblait insuffisantes pour permettre une évaluation d'un intérêt pour les issues de l'accouchement en général et pour les issues défavorables associées aux variétés de présentation postérieures en particulier. Tenter de traiter ces malpositions f'tales par une technique posturale bien acceptée par les femmes nous semble une façon assez facile à mettre en 'uvre mais nécessitant au préalable une évaluation scientifique de l'efficacité. Le dernier essai clinique randomisé sur ce thème a été réalisé en 2005 et ne permet pas de statuer sur l'efficacité. Actuellement, aucun essai clinique randomisé sur ce sujet ne figure dans le répertoire du « Clinicaltrials.gov ».

Research team within HES-SO: Guittier Marie-Julia

Durée du projet: 01.10.2010 - 15.10.2010

Montant global du projet: 22'000 CHF

Statut: Completed

Accompagnement des femmes enceintes par hypnose lors de la tentative de version céphalique externe du foetus en siège : une étude comparative.

AGP

Role: Main Applicant

Financement: HES-SO Rectorat; Santé

Description du projet : L'objectif de cette étude d'évaluer l'intérêt d'un accompagnement par hypnose pour les femmes enceintes d'un foetus en siège durant la tentative de version céphalique externe (VCE), avec comme effet attendu, une réduction de la perception de douleur et du sentiment d'anxiété durant cette intervention.

Research team within HES-SO: Guittier Marie-Julia

Durée du projet: 15.04.2010 - 08.06.2010

Montant global du projet: 22'000 CHF

Statut: Completed

2023

Near birth experience :

Scientific paper ArODES

an exploratory study on the communication experiences with a hypothetical prenatal consciousness

Marie-Julia Guittier, Helané Wahbeh, Magali Eykerman, Renaud Evrard

Explore, July-August 2023, vol. 19, no. 4, pp. 544-552

Link to the publication

Summary:

Context : Many cultures believe that the first traces of human consciousness during the incarnation may be present before birth. Practices based on this belief exist in many cultures. However, formal scientific inquiry into the possibility of communicating with prenatal consciousness has never been explored. Objective : To evaluate if it is possible to communicate with a hypothetical prenatal consciousness of the fetus during pregnancy. Design : This exploratory study used mixed methods and a triple-blind design. People (i.e., mediums) who could allegedly communicate with eleven pregnant women's prenatal consciousness (N=11) collected answers to ten questions that were then verified from parental reports. Ten mediums participated, with three to eight mediums providing answers per pregnant woman. Results : More than 1,500 statements were generated from attempts to communicate with the prenatal consciousness. Quantitative analysis showed higher agreement in spontaneously reported information versus responses to structured questions, 69.40%, and 17.63%, respectively. These results did not differ by the number of mediums per pregnant woman (three to five versus six to eight). Qualitative analysis suggested that some sessions resulted in verifiable communication with the prenatal consciousness, while others did not. Conclusion : The results, while preliminary and requiring follow-up studies, suggest the possibility to interact with a prenatal consciousness during pregnancy and the potential of novel scientific investigations into altered states of consciousness.

2022

Fathers' anxiety levels during early postpartum :

Scientific paper ArODES

a comparison study between first-time and multi-child fathers

Charlotte Daire, Marie-Julia Guittier

Journal of affective disorders, September 2022, vol. 312, pp. 303-309

Link to the publication

Summary:

Background : The postnatal period is considered the most challenging period in the adjustment to fatherhood. This study aimed to assess anxiety levels among fathers during this period. Methods : A comparative study assessing the anxiety levels of first-time and multi-child fathers before the mother and child returned home (0–7 days after birth) was conducted. We used the French validation of the State–Trait Anxiety Inventory (STAI). Results : Among 235 fathers who were met at the maternity ward, 182 (77 %) responded to the questionnaire. For most fathers in both groups, anxiety levels were low or very low for trait anxiety (166/182, 91.21 %) and state anxiety (177/182, 97.25 %). Levels of state anxiety were statistically higher for first-time fathers compared to multi-child fathers but were mainly at a low or very low level (70/83 [84 %] versus 71/99 [71 %], respectively, p = 0.029). The multiple linear regression showed that “feeling prepared at birth time” was the only significantly (p < 0.001) associated factor with state anxiety among first-time fathers only. Limitations : The validity and reliability of the STAI have been widely proven for the general population but not specifically for men during the postpartum period. Conclusions : Most fathers had low to very low anxiety levels during the early postpartum period, suggesting that developing new specific support interventions is not needed during early postnatal care. Further research focusing on when the family is back home is warranted.

Application of honey to reduce perineal laceration pain during the postpartum period :

Scientific paper ArODES

a randomized controlled trial

Désirée Gerosa, Marika Santagata, Marie-Julia Guittier

Healthcare, 2022, vol. 10, no. 8, article 1515

Link to the publication

Summary:

Perineal lacerations affect between 35 and 85% of women during childbirth and may be responsible for postpartum pain. Honey has been demonstrated to have interesting properties that can promote wound healing. The aim was to evaluate the effectiveness of the application of honey to the perineum to reduce perineal pain during the early postpartum period. A randomized controlled trial including 68 women was conducted. In the intervention group, honey was applied to perineal lacerations for four days, in addition to standard care. The control group received only standard care. The primary outcome was pain intensity using the Visual Analog Scale and pain perception using the McGill Pain Questionnaire (QDSA). The secondary outcomes were a burning sensation, the use of a pain killer, and the women’s satisfaction with the honey application. The intensity of pain was not significantly different between the groups on Day 1 (VAS 3.38 in the control group versus 3.34 in the intervention group, p = 0.65) or on Day 4 (VAS 2.28 versus 1.41, respectively, p = 0.09). There was no significant difference regarding the perception of pain with the QDSA. Despite this, most of the women in the intervention group (93%) were satisfied or very satisfied with the use of honey on their perineum.

2021

First-time fathers’ experience of childbirth :

Scientific paper ArODES

a cross-sectional study

Jessica Franzen, Isabelle Cornet, Françoise Vendittelli, Marie-Julia Guittier

Midwifery, 2021, vol. 103, article 103153

Link to the publication

Summary:

Objectives: The purposes of this study are to report first-time fathers’ experiences of childbirth through three dimensions (professional support, worries and prenatal preparation) and to analyse the influence of sociodemographic, antenatal and obstetrical factors on the three dimensions. Setting: Participants were recruited in France and Switzerland from two university hospitals that routinely manage high-risk pregnancies (level 3 – perinatal care level), with 4,000 to 5,000 annual births each. Methods: This is a secondary analysis of a cross-sectional study. The data initially were collected for the cross-cultural validation of the First-Time Father Questionnaire (FTFQ) into French. Descriptive statistics were used to report the participants’ characteristics and their questionnaire responses. Multivariate linear regression analysis was carried out to stress the positive or negative factors linked with fathers’ experiences of childbirth. Findings: Among 350 first-time fathers, 160 completed the FTFQ (response rate of 45.7%). The average age of the participants was 33 years old. We observed 12 questionnaire items with more than 20% unfavourable responses, seven of which involved the measurement of the worry dimension. Antenatal education and the prenatal-preparation dimension were positive factors linked with fathers’ experiences. In addition, 57% of participants reported using one means of antenatal education, and 45% accessed information from family or friends. Conclusions and implications for practice: The results suggest that first-time fathers need more professional support to foster positive experiences of childbirth. Their experiences of childbirth are associated with considerable worry. Antenatal classes specifically for fathers could reduce this worry and support the fatherhood process. Research should be carried out on these topics.

Une préparation prénatale pour les pères :

Professional paper ArODES

l'expérience de la maternité des HUG

Marie-Julia Guittier

Obstetrica, 2021, no. 9, pp. 60-63

Link to the publication

Summary:

La maternité des Hôpitaux universitaires de Genève (HUG) propose depuis 2019 des «Rencontres entre (futurs)papas», espace spécifiquement dédié aux futurs pères, dont l’objectif est de les impliquer au plus tôt dans le processus de paternité et de promouvoir un soutien social entre pères. Marie-Julia Guittier relaie dans cet article la première évaluation de ce dispositif.

2016

Financer des projets de recherche tout en favorisant les interactions entre professionnels

Professional paper ArODES

Marie-Julia Guittier, Sabine Cerutti-Chabert

Sage-femme.ch = Hebamme.ch = Levatrice.ch = Spendera.ch, 2016, vol. 9, pp. 32

Link to the publication

Summary:

Bien qu'indispensable, la recherche en périnatalité souffre d'un manque de financement. La concurrence avec les autres domaines de recherche est forte et les subsides publics pour la recherche scientifique sont insuffisants à eux seuls. C'est pourquoi une Fondation pour la recherche en périnatalité (FReP) a été créée au début de l'année 2016 avec un Fonds de financement privé, spécifiquement dédié à la naissance et à la parentalité. Une autre piste pour renforcer l'interprofessionnalité.

Maternal positioning to correct occiput posterior fetal position during the first stage of labour :

Scientific paper ArODES

a randomised controlled trial

Marie-Julia Guittier, V. Othenin-Girard, B. De Gasquet, Olivier Irion, M. Boulvain

BJOG: an international journal of obstetrics and gynaecology, December 2016, vol. 123, no. 13, pp. 2199-2207

Link to the publication

Summary:

Objective : To evaluate the efficacy of the hands and knees position during the first stage of labour to facilitate the rotation of the fetal head to the occiput anterior position. Design Randomised controlled trial. Setting : Geneva University Hospitals, Switzerland. Population : A total of 439 women with a fetus in the occiput posterior position during the first stage of labour. Methods : The women in the intervention group were invited to take a hands and knees position for at least for 10 minutes. Women allocated to the control group received the usual care. For both groups, 15 minutes after randomisation, women completed a short questionnaire to report their perceived pain and the comfort of their position. Main outcome measures : The rotation of the fetal head in occiput anterior position confirmed by ultrasonography 1 hour after randomisation. Results : One hour after the randomisation, 35 of 203 (17%) fetuses were diagnosed as being in the occiput anterior position in the intervention group compared with 24 of 209 (12%) in the control group. This difference was not statistically significant (relative risk 1.50; 95% CI 0.93–2.43; P = 0.13). The change in the evaluation of comfort between the randomisation and 15 minutes after showed an improvement in 70 and 39 women, no change in 82 and 78 women and a decrease in 56 and 86 women in the intervention and control groups, respectively (P = 0.02). Conclusions : This study could not demonstrate a benefit of the hands and knees position to correct the occiput posterior position of the fetus during the first stage of labour, but the women reported an increase in their comfort level.

2015

Vécu des femmes lors des interventions professionnelles en fin de grossesse et pour l'accouchement

Professional paper ArODES

Marie-Julia Guittier

Sage-femme.ch = Hebamme.ch = Levatrice.ch = Spendera.ch, 2015, vol. 5, pp. 35-37

Link to the publication

Summary:

Dans le cadre d'une thèse de doctorat, plusieurs recherches ont été menées avec l'objectif d'évaluer les effets des interventions professionnelles sur le vécu des femmes, dans le cas précis de la présentation foetale en siège. Les résultats ont mis en évidence une succession d'étapes pour la femme au cours desquelles nos interventions professionnelles, tant techniques que relationnelles, doivent être finement ajustées.

Version du siège et médecines alternatives

Professional paper ArODES

Marie-Julia Guittier

Sage-femme.ch = Hebamme.ch = Levatrice.ch = Spendera.ch, 2015, vol. 5, pp. 32-34

Link to the publication

Summary:

Pour tenter de corriger la malposition du foetus avant l'accouchement, il existe diverses techniques issues des médecines complémentaires et alternatives. L'auteure fait le point sur leur utilisation et leur efficacité en se basant sur les résultats des études les plus récentes.

2014

Impact of mode of delivery on the birth experience in first-time mothers :

Scientific paper ArODES

a qualitative study

Marie-Julia Guittier, Christine Cedraschi, Nasir Jamei, Michel Boulvain, Francis Guillemin

BMC pregnancy and childbirth, 2014, vol. 14, article 254

Link to the publication

Summary:

Background : The birth of a first child is an important event in a woman’s life. Delivery psychological impacts vary depending on whether delivery has been positively or negatively experienced. Delivery experience determinants have been identified but the understanding of their expression according to the mode of delivery is poorly documented. The purpose of the study was to determine important elements associated with women’s first delivery experience according to the mode of delivery: vaginal or caesarean section. Methods : Qualitative approach using thematic content analysis of in-depth interviews conducted between 4 and 6 weeks’ postpartum, in 24 primiparous women who delivered at Geneva University Hospital in 2012. Results : Perceived control, emotions, and the first moments with the newborn are important elements for the experience of childbirth. Depending on the mode of delivery these are perceived differently, with a negative connotation in the case of caesarean section. Other elements influencing the delivery experience were identified among all participants, irrespective of the mode of delivery. They included representations, as well as the relationship with caregivers and the father in the delivery room, privacy, unexpected sensory experiences, and ownership of the maternal role. Women’s and health professionals’ representations sometimes led to a hierarchy based on the mode of delivery and use of analgesia. Conclusions : The mode of delivery directly impacts on certain key delivery experience determinants as perceived control, emotions, and the first moments with the newborn. The ability/inability of the woman to imagine a second pregnancy is a good indicator of the birth experience. Certain health professional gestures or attitudes can promote a positive delivery experience. We recommend to better prepare women during prenatal classes for the eventuality of a caesarean section delivery and to offer all women and, possibly, their partners, the opportunity to talk about the experience of childbirth during the postpartum period. The results of this study suggest that further research is required on the social representations of women and health professionals regarding the existence of a hierarchy associated with the mode of delivery.

Maternal positioning to correct occipito-posterior fetal position in labour :

Scientific paper ArODES

a randomised controlled trial

Marie-Julia Guittier, Véronique Othenin-Girard, Olivier Irion, Michel Boulvain

BMC pregnancy and childbirth, 2014, vol. 14, article 83

Link to the publication

Summary:

Background : The occipito-posterior (OP) fetal head position during the first stage of labour occurs in 10-34% of cephalic presentations. Most will spontaneous rotate in anterior position before delivery, but 5-8% of all births will persist in OP position for the third stage of labour. Previous observations have shown that this can lead to an increase of complications, such as an abnormally long labour, maternal and fetal exhaustion, instrumental delivery, severe perineal tears, and emergency caesarean section. Usual care in the case of diagnosis of OP position is an expectant management. However, maternal postural techniques have been reported to promote the anterior position of the fetal head for delivery. A Cochrane review reported that these maternal positions are well accepted by women and reduce back pain. However, the low sample size of included studies did not allow concluding on their efficacy on delivery outcomes, particularly those related to persistent OP position. Our objective is to evaluate the efficacy of maternal position in the management of OP position during the first stage of labour. Methods/design : A randomised clinical trial is ongoing in the maternity unit of the Geneva University Hospitals, Geneva, Switzerland. The unit is the largest in Switzerland with 4,000 births/year. The trial will involve 438 women with a fetus in OP position, confirmed by sonography, during the first stage of the labour. The main outcome measure is the position of the fetal head, diagnosed by ultrasound one hour after randomisation. Discussion : It is important to evaluate the efficacy of maternal position to correct fetal OP position during the first stage of the labour. Although these positions seem to be well accepted by women and appear easy to implement in the delivery room, the sample size of the last randomised clinical trial published in 2005 to evaluate this intervention had insufficient power to demonstrate clear evidence of effectiveness. If the technique demonstrates efficacy, it would reduce the physical and psychological consequences of complications at birth related to persistent OP position.

Achievements

PEOPLE@HES-SO Directory and Skills inventory

Guittier Marie-Julia

Professeure HES associée

Professeure HES associée

PEOPLE@HES-SO
Directory and Skills inventory