Gynecologie Obstetrique & Fertilite最新文献

{"title":"Prédictibilité préopératoire de la malignité des tumeurs ovariennes à partir du score ADNEX et utilisation en pratique clinique","authors":"E. Joyeux ,&nbsp;T. Miras ,&nbsp;I. Masquin ,&nbsp;P.-E. Duglet ,&nbsp;K. Astruc ,&nbsp;S. Douvier","doi":"10.1016/j.gyobfe.2016.07.007","DOIUrl":"10.1016/j.gyobfe.2016.07.007","url":null,"abstract":"<div><h3>Objective</h3><p>The principal aim of this study was the predictability of malignant ovarian tumors and to determine a cut-off value for this score to indicate the risk of malignancy that would be easy to use in clinical practice.</p></div><div><h3>Methods</h3><p>We retrospectively calculated the ADNEX score for all patients who underwent surgery for ovarian tumours in two Burgundy hospitals (Dijon University Hospital and Chalon-sur-Saône Hospital). We used the nine criteria of the ADNEX model. The inclusion criteria were the presence of all of the ADNEX criteria and a histology result. We analysed the sensitivity, specificity, PPV and PNV of four cut-offs (3%, 5%, 10% and 15%) for the entire pool then by age groups; from 14 to 42 (group 1) and 43 and more (group 2)</p></div><div><h3>Results</h3><p>Two hundred and eighty-four patients managed for an ovarian tumour were included between the 1st January 2013 and the 31st December 2015. Our AUC was of 0.94 (95% CI [0.903–0.977]) for discrimination between benign and malignant ovarian tumors. For a cut-off of 10%, sensitivity was 90%, specificity was 81.1%, PPV was 34.6% and PNV 98.5%. Results were lower for young women than for the second group. For a cut-off of 10%, group 1 had a sensitivity of 77.7% and specificity of 89.6%, PPV of 46.6% and PNV 97.5%. For the group 2, sensitivity was 95.2%, specificity was 76.6%, PPV was 33.8% and PNV was 99.2%. The most reasonable cut-off for the whole pool was 10%. For group 1 a cut-off of 5% was retained due to the less satisfying detection of “borderline” tumours more frequent in younger patients. For group 2 the cut-off of 10% gave the best results.</p></div><div><h3>Conclusion</h3><p>In our study, a lower cut-off for younger women seemed better suited to discriminate borderline tumours. In practice, the ADNEX score associated with the peroperative laparoscopic examination seems to be the best way to use the ADNEX model. Our study showed that the ADNEX model allows a good predictability of malignant ovarian tumours. The predictability becomes less satisfying for the youngest patients. A cut-off malignity value allowing surgical treatment of patients in a specialised facility was reached for two age groups: a cut-off of 5% for women under 42 years old and a cut-off of 10% for women over 43 years old.</p></div>","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 557-564"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.07.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34342650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hystérectomie et ganglion sentinelle en ambulatoire par voie robot-assistée : sommes-nous prêt en France ?","authors":"J. Belghiti ,&nbsp;E. Marchand ,&nbsp;M. Nikpayam ,&nbsp;G. Corsia ,&nbsp;G. Canlorbe ,&nbsp;C. Uzan","doi":"10.1016/j.gyobfe.2016.08.017","DOIUrl":"10.1016/j.gyobfe.2016.08.017","url":null,"abstract":"","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 605-606"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72885604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"G. Kayem","doi":"10.1016/j.gyobfe.2016.08.014","DOIUrl":"10.1016/j.gyobfe.2016.08.014","url":null,"abstract":"","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 609-610"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90958523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment je fais… la mise en place d’un drain cannelé siliconé par voie cœlioscopique ?","authors":"P. Kadhel ,&nbsp;D. Borja de Mozota","doi":"10.1016/j.gyobfe.2016.08.010","DOIUrl":"10.1016/j.gyobfe.2016.08.010","url":null,"abstract":"","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 598-600"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77915601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"G. Kayem","doi":"10.1016/j.gyobfe.2016.08.013","DOIUrl":"10.1016/j.gyobfe.2016.08.013","url":null,"abstract":"","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Page 610"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90877705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro fertilization outcomes after ablation of endometriomas using plasma energy: A retrospective case-control study","authors":"I. Motte ,&nbsp;H. Roman ,&nbsp;B. Clavier ,&nbsp;F. Jumeau ,&nbsp;I. Chanavaz-Lacheray ,&nbsp;M. Letailleur ,&nbsp;B. Darwish ,&nbsp;N. Rives","doi":"10.1016/j.gyobfe.2016.08.008","DOIUrl":"10.1016/j.gyobfe.2016.08.008","url":null,"abstract":"<div><h3>Objective</h3><p>Ovarian endometrioma ablation using plasma energy appears to be a valuable alternative to cystectomy, because it could spare underlying ovarian parenchyma resulting in high spontaneous and overall pregnancy rates. After initial postoperative decrease, anti-mullerian hormone (AMH) level progressively increases several months after ablation. The aim of our study was to assess the outcomes of in vitro fertilization (IVF) in women managed for ovarian endometriomas by ablation using plasma energy, when compared to those in women free of endometriosis.</p></div><div><h3>Methods</h3><p>Retrospective preliminary case-control study, enrolling women undergoing IVF or IntraCytoplasmic Sperm Injection (ICSI), from July 2009 to December 2014. Cases were infertile women with previous ovarian endometrioma ablation using plasma energy and were matched by age, AMH level and assisted reproductive technique with controls presumed free of endometriosis. IVF/ICSI response (type of protocol, dose of gonadotrophin, number of oocytes, fertilization rate) and outcomes were compared between the two groups.</p></div><div><h3>Results</h3><p>In all, 37 cases were compared to 74 controls. Age (30.9<!--> <!-->±<!--> <!-->4.4 years vs. 31.7<!--> <!-->±<!--> <!-->4.2 years), AMH level (2.8<!--> <!-->±<!--> <!-->2<!--> <!-->ng/mL vs. 2.8<!--> <!-->±<!--> <!-->1.7<!--> <!-->ng/mL) and ART procedures (ICSI in 24.3% vs. 27%) were comparable between the two groups. Of the 37 cases, previous surgical procedures on right and left ovaries were performed in 27% and 21.6% of patients respectively, 81% of patients were nullipara. AFSr score was 73<!--> <!-->±<!--> <!-->41, while deep endometriosis infiltrated the rectum and the sigmoid colon in respectively 40.5% and 27% of patients. Despite a lower number of oocytes retrieved, cases presented better implantation rate, pregnancy and delivery rates per cycle, oocyte retrieval, transfer, and embryo, as well as superior cumulative birth rate per transfer.</p></div><div><h3>Conclusion</h3><p>Ovarian endometrioma ablation using plasma energy is followed by good IVF/ICSI outcomes, suggesting that surgical procedure spares underlying ovarian parenchyma. These results consolidate those of previous studies reporting high spontaneous conception rate. Hence, ovarian endometrioma ablation using plasma energy appears to be a valuable alternative to cystectomy in patients presenting with endometriosis and pregnancy intention.</p></div>","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 541-547"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72537752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dans quelle position les femmes accouchent-elles en 2015 ? Résultats d’une étude prospective régionale multicentrique","authors":"D. Desseauve ,&nbsp;B. Gachon ,&nbsp;P. Bertherat ,&nbsp;L. Fradet ,&nbsp;P. Lacouture ,&nbsp;F. Pierre","doi":"10.1016/j.gyobfe.2016.06.010","DOIUrl":"10.1016/j.gyobfe.2016.06.010","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the frequency of labor and birth positions in 2015, and identify factors associated with choosing and changing position during labor.</p></div><div><h3>Methods</h3><p>Multicenter prospective study during five weeks in 2015. We collected the distribution of the observed positions during the first and second stage of labor. Then we considered the main birth position as the one used for the longest duration. Factors associated to the main birth position as well as to the changes of position during labor were studied using univariate analysis and the role of each factor was analyzed using multilevel logistic regression.</p></div><div><h3>Results</h3><p>Among women who delivered, 86.1% did so in gynecological position. There was a center effect for the position during the expulsive phase, which was not related to legal status or level of perinatal care. After adjustment, a labor duration shorter than 2<!--> <!-->hours was associated to dorsal decubitus during labor (OR<!--> <!-->=<!--> <!-->2.1 95%CI [1.01–4.3]). Prematurity and labor duration less than 2<!--> <!-->hours decreased the occurrence of changes in position during labor: OR<!--> <!-->=<!--> <!-->0.05 95%CI [0.01–0.2] and OR<!--> <!-->=<!--> <!-->0.2 95%CI [0.1–0.3]. Epidural analgesia was associated to change in birth position during labor: (OR<!--> <!-->=<!--> <!-->2.1 95%CI [1.2–3.8]). During the expulsive phase, primiparity and labor duration less than 2<!--> <!-->hours were associated to dorsal decubitus position (OR<!--> <!-->=<!--> <!-->3.6 95%CI [1.2–10.8]).</p></div><div><h3>Conclusion</h3><p>Women still mostly deliver in gynecological position in 2015. A systematic collection of birth positions on the partograph, with an acute definition of these positions, could allow an evaluation of the benefits/disadvantages of the different positions currently available.</p></div>","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 548-556"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.06.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34696647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polémique sur la stérilisation tubaire","authors":"G. Chene ,&nbsp;G. Lamblin","doi":"10.1016/j.gyobfe.2016.08.004","DOIUrl":"10.1016/j.gyobfe.2016.08.004","url":null,"abstract":"","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 539-540"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74872007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quels signes échographiques doit-on rechercher (2D/3D) pour affirmer la bonne localisation des implants tubaires ? À propos d’une étude rétrospective de 92 cas","authors":"M. Simorre,&nbsp;P. Lopes,&nbsp;C. Le Vaillant","doi":"10.1016/j.gyobfe.2016.05.001","DOIUrl":"10.1016/j.gyobfe.2016.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study is to propose an analysis of the route and the curvature of the Essure^® system in 3D ultrasound to determine their correct location so as not to miss a tubal perforation.</p></div><div><h3>Methods</h3><p>This is a retrospective single center study during 2 years analyzing 92 3D ultrasound performed by a single sonographer. Implant placement was performed by different operators. One prescribed 3D ultrasound control in case of difficulties with the installation; other indications where systematics.</p></div><div><h3>Results</h3><p>The Essure^®’s position is right in 79% of cases. Twenty-eight implants appear incorrectly positioned on ultrasound 3D positioning. Abnormalities found are those described by the classification proposed in the literature. In one case, the curvature of the implant, not taking into account this classification, allowed to evoke a tubal perforation. Among the 28 cases of non-visualized implants in place, 3 cases of wrong position of the implant were confirmed by additional examinations (laparoscopy or HSG). For 14 cases, the ASP or HSG disproved the wrong position of the implants. In other cases, we did not have other complementary examinations.</p></div><div><h3>Conclusion</h3><p>Ultrasonography 3D seems to be the method of choice to control implants for simple implementation and good reproducibility. However, the interpretation of 3D ultrasound images is sometimes difficult. The study of the curvature of the implant should be systematically analyzed not to miss a tubal perforation.</p></div>","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 572-577"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34655592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment je fais… une résection segmentaire urétérale par cœlioscopie","authors":"C. Poupon,&nbsp;J. Niro,&nbsp;A. Le Tohic,&nbsp;P. Panel","doi":"10.1016/j.gyobfe.2016.08.007","DOIUrl":"10.1016/j.gyobfe.2016.08.007","url":null,"abstract":"","PeriodicalId":55077,"journal":{"name":"Gynecologie Obstetrique & Fertilite","volume":"44 10","pages":"Pages 601-604"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78398435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}