Gynecologie Obstetrique Fertilite & Senologie最新文献

{"title":"[Recommendations for clinical practice: Prevention and management of varicella zoster virus (VZV) infection during pregnancy and the perinatal period (extended version)].","authors":"Caroline Charlier, Olivia Anselem, Marion Caseris, Marie Lachâtre, Asmaa Tazi, Marine Driessen, Didier Pinquier, Chemsa Le Cœur, Aurélie Saunier, Mathilde Bergamelli, Roxane Gibert Vanspranghels, Anaïs Chosidow, Charles Cazanave, Sophie Alain, Karine Faure, André Birgy, François Dubos, Philippe Lesprit, Julie Guinaud, Robert Cohen, Jean-Winoc Decousser, Emmanuel Grimprel, Cyril Huissoud, Julie Blanc, Gilles Kayem, Fanny Vuotto, Christelle Vauloup-Fellous","doi":"10.1016/j.gofs.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.01.001","url":null,"abstract":"<p><p>The Société de Pathologie Infectieuse de Langue Française released in 2024 a new national recommendation for clinical practice on the prevention and management of varicella zoster virus (VZV) infection during pregnancy and the perinatal period. The previous recommendation was issued in 1998, at a time of anti-VZV immunoglobulins shortage; it has hence become obsolete. This recommendation is a formalized expert consensus focusing on infectious diseases management; it is drawn up by a multidisciplinary working group (infectiologists, obstetricians, pediatricians, microbiologists, midwives, hygienists). It has been endorsed by the Collège National des Gynécologues Obstétriciens Français, the Société Française de Médecine Périnatale, the Société Française de Néonatologie, the Collège des Sage-femmes, and the Groupe Infections et Périnatalité of the Société Française de Microbiologie. The aim of this article is to explain and recontextualize the elements of this recommendation.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How do I do... clitoral reconstructive surgery after ritual excision in ten steps].","authors":"Erdogan Nohuz, Philippe Chabert, Gautier Chene","doi":"10.1016/j.gofs.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.01.002","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of a fetus suspected of differences of sex development (DSD).]","authors":"Ornella Maltese, Pierre Macé, Alice Faure, Rachel Reynaud, Jean Philippe Bault, Guillaume Gorincour, Edwin Quarello","doi":"10.1016/j.gofs.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.gofs.2024.12.006","url":null,"abstract":"<p><p>The management of a fetus suspected of having a variation in genital development is a complex situation. In cases of complete discordance or an unusual appearance of the external genitalia (EG), management always begins with a diagnostic morphological ultrasound. This ultrasound aims to provide detailed imaging of the EG and internal genitalia (IG), focusing on identifying the presence of Müllerian derivatives and detecting any associated malformations. During a multidisciplinary meeting, we should assess the appropriateness of determining the genetic sex through cell-free DNA analysis and to refer the patient to an expert center if necessary.These clinical situations include all atypical presentations of the genital organs with the inability to determine the phenotype, as well as any hypospadias associated with other genital organ involvement. Patients presenting with isolated posterior (or proximal) hypospadias also benefit from an assessment at an expert center. Isolated anterior and middle hypospadias (with negative genetic findings) are excluded from this protocol. Performing an invasive sampling is almost always indicated. The expert center provides the couple with information on the different variations of genital development and the perspectives of managing the child, explaining the recently proposed paradigm shift, according to the new decree of November 15, 2022, in application of Article L-2131-6 of the Public Health Code, which now entails, in some of these situations, delayed surgical management. The diagnostic and prognostic uncertainty of the developmental variation is communicated to the couples. Multidisciplinary care is therefore essential to establish an accurate diagnosis, define the anatomical and functional prognosis, and propose the most appropriate surgical strategy, taking into account the associated morbidities, defining whether or not to adopt a surgical strategy, and providing the most suitable surgical approach, as well as supporting the couple and the child in dealing with this situation.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Visions and repercussions of identity-release in oocyte and sperm donors: Descriptive survey among gamete donors].","authors":"Clémence Cirade, Inès Braham, Jérôme Delotte, Samir Boukaidi, Sarah Dupuis, Adeline Morisot, Valérie Benoit, Nicolas Chevalier","doi":"10.1016/j.gofs.2024.12.005","DOIUrl":"10.1016/j.gofs.2024.12.005","url":null,"abstract":"<p><strong>Objectives: </strong>The Bioethics Law of August 2nd, 2021 established access to origins for people conceived by gamete donation. Two years after the implementation of this disposition, what is the proportion of former gamete donors informed about access to origins, and what is their position on this matter? What could be the potential repercussions of this new law on them?</p><p><strong>Methods: </strong>Retrospective single-center cohort study using questionnaires.</p><p><strong>Results: </strong>When former gamete donors were asked about access to origins, only 53% of oocytes donors and 71% of sperm donors were aware of this measure. When participants were asked about the ideal method of donation, it emerged that 41% of female donors and 47% of male donors were in favour of access to their identifying data for the person resulting from the donation. More than half were in favour of access to non-identifying and medical data. If one day someone conceived from their donation requested access to their identifying data, 62% of oocytes donors and 56% of sperm donors would grant it.</p><p><strong>Conclusions: </strong>A significant proportion of our participants expressed the desire to benefit from information on possible descendants resulting from their donation. Among the donors interviewed, only half are informed of the legislation introducing access to origins, now two years after its implementation. These results encourage us to strengthen communication efforts around access to origins.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Increasing the cumulative live birth rate: Low-grade blastocysts, potential overlook].","authors":"Elie Mouanes-Abelin, Sophie Brouillet, Fatima Barry, Margaux Anav, Alice Fournier, Anéta Andreeva, Marine Miaille, Tal Anahory, Samir Hamamah","doi":"10.1016/j.gofs.2024.12.003","DOIUrl":"10.1016/j.gofs.2024.12.003","url":null,"abstract":"<p><p>It is now widely recognized that, following prolonged culture, the transfer of a high-quality morphologically graded blastocyst is the preferred strategy in embryo transfer. Low-grade blastocysts are often considered to have a low implantation potential, and their use remains highly limited. We conducted a general review of the literature, including publications from August 2017 to October 2023, to assess the current state of knowledge regarding these embryos, which are generally excluded in routine practice. Our primary outcome measure was the \"live birth rate\" following the frozen transfer of a low-grade morphologically classified blastocyst according to the Gardner classification. The \"miscarriage rates\" were also evaluated. The bibliographic research led to the selection of 9 articles. Low-grade blastocysts can result in live births, with rates ranging from 5.97 to 40%, and in the birth of healthy children, which remains the primary goal of assisted reproductive technology. It would therefore be relevant to reconsider the routine use of these embryos.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Assesment of anxiety and depression in pregnant women in home care management].","authors":"Anais Malandain, Mathilde Barrois","doi":"10.1016/j.gofs.2024.12.002","DOIUrl":"10.1016/j.gofs.2024.12.002","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to identify factors associated with depressive and anxious symptomatology in pregnant women hospitalized during the antepartum period in home care management (Hospitalisation à domicile).</p><p><strong>Method: </strong>This is a quantitative, single-center, observational, and descriptive study that included all French-speaking women hospitalized in the HAD of AP-HP between September 2022 and February 2023. Anxious and depressive symptoms were assessed using the self-administered HADS (Hospital Anxiety and Depression Scale) questionnaire. Analyses were conducted according to two distinct groups, comparing patients with an anxiety or depression scores below 8 on the HADS to those with a score of 8 or above (the threshold set on the questionnaire corresponding to intermediate symptomatology). A second questionnaire created for the study detailed maternal history, pregnancy experience, and lifestyle.</p><p><strong>Results: </strong>A total of sixty-four women were included from September 20, 2022, to February 15, 2023. Eighteen women (28%) evaluated had anxious symptomatology and thirteen women (20%) had depressive symptomatology. Factors significantly associated with anxiety were poor pregnancy experience (P=0.04), the need for psychological follow-up during pregnancy (P<0.01), country of birth (P=0.022), as well as psychiatric history such as previous consultations with a mental health specialist (P=0.015) and previous psychotropic treatment (P=0.028). Additionally, a history of violence (respectively, P=0.034 and P<0.01) and the women's belief that a consultation with a psychologist would benefit them were also associated with anxious and depressive symptomatology (respectively, P<0.01 and P<0.01) CONCLUSION: Our results highlight the importance and necessity of enhancing the screening and prevention of various mental disorders during pregnancy. It would be interesting to implement organized screening for anxiety, similar to depression, in pregnant women hospitalized at home and for the entire obstetric population.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Support for the mother-child relationship during total denial of pregnancy: Midwives' point of view].","authors":"Justine Paoli, Rahmeth Radjack","doi":"10.1016/j.gofs.2024.11.007","DOIUrl":"10.1016/j.gofs.2024.11.007","url":null,"abstract":"<p><strong>Objectives: </strong>Total pregnancy denial is a phenomenon where the woman does not recognize her pregnancy until a late stage, sometimes just before childbirth. These complex situations raise many questions about the support of the mother-child dyad. This qualitative study aims to describe the experiences and strategies of midwives when dealing with cases of total pregnancy denial, as well as the relational dynamics within these particular dyads, in order to identify avenues for appropriate care.</p><p><strong>Methodology: </strong>Eight semi-structured interviews were conducted with midwives practicing in Île-de-France (hospital, private practice, home hospitalization, and maternal and child protection services). The data were analyzed using grounded theory with the help of the Quirkos software.</p><p><strong>Results: </strong>The midwives' experiences show that the mother-child relationship evolves favorably in most cases, even in anonymous childbirth situations. The results are organized into several themes: the description of the mother-child relationship, the proposed care approaches, and the midwives' experiences. For the first theme, five sub-themes emerged: maternal investment, psychological ambivalence, childbirth circumstances, the influence of the social environment, and maternal guilt. The second theme highlights the importance of multidisciplinary and personalized support, respecting the pace of the dyad.</p><p><strong>Conclusion: </strong>This study emphasizes the importance of not stigmatizing women in total pregnancy denial when establishing the mother-child bond. A personalized and gradual care approach, based on empathetic, non-judgmental, and multidisciplinary support, fosters the mother-child bond.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[High-risk obstetric surgery: Can we do without Cell-saver in France in 2024?]","authors":"Maud Vachette, Aude Girault, François Goffinet, Catherine Fischer, Yoann Athiel","doi":"10.1016/j.gofs.2024.12.001","DOIUrl":"10.1016/j.gofs.2024.12.001","url":null,"abstract":"<p><p>Certain obstetric situations, such as abnormalities in placental invasion, present a major hemorrhagic risk often requiring massive transfusion. To reduce complications associated with massive transfusions and minimize the use of the labile blood product stock, perioperative blood salvage techniques, such as the Cell-saver, have been developed, including in obstetrics. The aim of this article is to provide an update on the use of the Cell-saver in obstetrics, particularly during high hemorrhagic risk obstetric surgeries (such as surgeries for placenta accreta). Firstly, we will review the indications for using the Cell-saver in obstetrics and the technical modalities described in the literature and at our expert center. Secondly, in light of the literature data, we will list the benefits associated with the use of the Cell-saver in obstetrics as well as its risks, complications, and contraindications.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Profiles and motivations of women seeking oocyte preservation in France: A two-years' survey].","authors":"Estelle Anstett, Philippe Gosset, Loïc Maurer, Jeanine Ohl","doi":"10.1016/j.gofs.2024.11.005","DOIUrl":"10.1016/j.gofs.2024.11.005","url":null,"abstract":"<p><strong>Objectives: </strong>The new bioethics law of August 2, 2021 allows French women to self-preserve.</p><p><strong>Methods: </strong>National observational survey over 2 years based on an online questionnaire conducted under the aegis of GEDO (Groupe d'études pour le don d'ovocytes).</p><p><strong>Results: </strong>The average age of the 282 women who answered the questionnaire, 34.5 years, is consistent with the benefit/risk balance described in the literature. The most educated women, also very vulnerable, remain the most affected. They are single and childless, but most of them see themselves as a couple and want to become mothers in the future. Their main motivation is to have the choice to postpone a pregnancy without fear of infertility until they have found a suitable partner. Careerist or selfish motivations are anecdotal. The projected fate of unused vitrified oocytes is above all donation to others.</p><p><strong>Conclusion: </strong>This study shows that oocyte self-preservation is undeniably experienced as a societal victory and is perceived as a step towards gender equality. While oocyte self-preservation is not an absolute guarantee of having a future child, it is part of a primary preventive strategy for age-related fertility decline. Public authorities and health professionals will have to widely disseminate accurate and complete information to allow everyone to have access to an informed reproductive choice.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[First French data on sperm donation requests from female couples].","authors":"Lina Abdiche, Diane Rivet-Danon, Clémence Farabet-Demarquette, Clarisse Vallée, Anna Ly, Ludmilla Ogouma-Aworet, Marie Prades, Isabelle Berthaut, Kamila Kolanska, Nathalie Sermondade, Charlotte Dupont","doi":"10.1016/j.gofs.2024.11.004","DOIUrl":"10.1016/j.gofs.2024.11.004","url":null,"abstract":"<p><strong>Objective: </strong>The new bioethics law, enacted on August 2, 2021, has expanded access to medically assisted reproduction (MAR) with sperm donation to unmarried women and female couples. The implementation of this law led to a significant influx of sperm donation requests at French sperm banks. This major development in the field of ART in France, and in French society as a whole, prompted us to focus specifically on the requests from female couples.</p><p><strong>Method: </strong>A retrospective, single-center study was conducted at a gamete donation center in Paris. The data of women in same-sex couples who attended a first consultation with a biologist between October 1, 2021, and October 31, 2022, were analyzed and compared to those of women in heterosexual couples who also requested MAR with sperm donation during the same period. The ART attempts and their outcomes were analyzed up until May 31, 2024.</p><p><strong>Results: </strong>A total of 117 women in same-sex couples and 75 women in heterosexual couples were included in the study. The profiles in terms of age, ovarian reserve, and history of gynecological conditions did not differ between the two groups. The only observed differences were related to lifestyle, particularly alcohol consumption, which was slightly higher among women in same-sex couples. Additionally, women in same-sex couples appeared to belong more frequently to the category of intermediate professions, but no differences were observed concerning other occupational categories. Regarding the outcomes of ART attempts, cumulative rates of early and ongoing pregnancies were not different between the two groups.</p><p><strong>Conclusion: </strong>This study thus provides an initial insight into the profile and outcomes for women in same-sex couples who received ART with sperm donation shortly after the enactment of the bioethics law in France. The similarity in profiles and ART outcomes between women in same-sex couples and those in heterosexual couples supports the approach of offering similar medical care, regardless of the couple's configuration.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}