Gynecologie Obstetrique Fertilite & Senologie最新文献

{"title":"[Colorectal endometriosis surgery: Technical and technological innovations in service of a complex surgery].","authors":"Adrien Crestani, Benjamin Merlot, Quentin Denost, Marc Olivier Francois, Vincent Assenat, Isabella Chanavaz Lacheray, Thomas Dennis, Horace Roman","doi":"10.1016/j.gofs.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.03.007","url":null,"abstract":"<p><strong>Introduction: </strong>Digestive endometriosis represents the most common form of deep endometriosis, significantly impacting patients' quality of life. The optimization of its surgical management has been marked by major technological advances. This review explores the evolution of colorectal endometriosis surgery, highlighting the progress in laparoscopy, the contribution of robotics, the shift towards organ preservation, and the optimization of postoperative care.</p><p><strong>Methods: </strong>A systematic literature search was conducted in the PubMed and Embase databases, focusing on clinical studies, meta-analyses, and international guidelines published between 1980 and 2025. Articles were selected based on their relevance to technical advancements and clinical outcomes.</p><p><strong>Results: </strong>Laparoscopy has replaced laparotomy, leading to a reduction in complications and an improvement in postoperative quality of life. Robotics, while not a groundbreaking revolution, provides advantages in precision and surgeon comfort. Conservative procedures have emerged as safe alternatives to systematic extensive segmental resection. Indication criteria have evolved to favor strategies tailored to the depth and extent of lesions while minimizing complication risks and preserving digestive function and quality of life. The standardization of procedures, the abandonment of systematic protective ileostomy, and enhanced recovery protocols have contributed to reducing surgical morbidity and improving patients' quality of life.</p><p><strong>Conclusion: </strong>Technical and technological advancements have transformed colorectal endometriosis surgery. Surgical strategies are shifting towards personalized approaches, integrating minimally invasive surgery and optimized multidisciplinary management. The future lies in the continuous improvement of techniques and the better standardization of surgical indications.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744529","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":"[Evaluation of scalp sampling practice and methods before and after training in intrapartum monitoring].","authors":"Lisa Krzepisz, Louise Ghesquière, Elodie Drumez, Hélène Behal, Damien Subtil, Charles Garabedian","doi":"10.1016/j.gofs.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.03.005","url":null,"abstract":"<p><strong>Objective: </strong>To compare the methods of performing scalp sampling before and after training teams in per partum monitoring.</p><p><strong>Materials and methods: </strong>This was a single center (Lille, France), retrospective, before and after study comparing the period 2017-2018 before training and the period 2019-2020 after training. It consisted of 1/ theoretical training with courses on fetal physiology, recognition of risk factors for fetal hypoxia and pathophysiology of fetal acidosis; 2/ practical training with analysis of local clinical cases; 3/ real-life scenarios within the simulation platform. At the same time, a service protocol for scalp stimulation was established. One hundred patients were randomly selected for each period from those who met the inclusion criteria: at least one scalp sampling, cephalic presentation of the fetus, and singleton.</p><p><strong>Results: </strong>In the 2016-2017 period, 8.7% of patients had a scalp sample and 1.5% in the 2020-2021 period (p<0.001). The percentage of patients who had more than one scalp sample (among those who had at least one) was significantly higher in the pre-training group than in the post-training group (36% vs 11%, p<0.001). There was no significant difference between the two groups in terms of cervical dilation for pH, time to decision/insertion/result/birth, number of operators and attempts, failure rate and finally in terms of the measured parameters.</p><p><strong>Conclusion: </strong>Training of professionals in intrapartum monitoring, combined with a protocol for scalp stimulation, resulted in less recourse to second-line investigations, but did not change the how scalp sampling were performed.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744532","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 I do… a partial mastectomy associated with analysis of the axillary sentinel lymph node under local anesthesia].","authors":"Pierre Bédat, Rose Ferrer, Yolande Maisonnette-Escot, Francis Berthier","doi":"10.1016/j.gofs.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.03.003","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744535","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":"[Preterm prolong rupture of membrane in twin : prognosis factors of neonatal survival].","authors":"Maud Allary, Emmanuelle Lesieur, Julie Blanc, Franck Mauviel, Lucile Petit Jean, Xavier Donato, Cindy Faust, Edwin Quarello, Florence Bretelle","doi":"10.1016/j.gofs.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.03.004","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and identify factors influencing neonatal survival of twins in twin pregnancies with prolonged preterm premature rupture of membranes (PPROM) affecting one twin before 37 weeks of gestation.</p><p><strong>Methods: </strong>A retrospective multicenter cohort study (2015-2021) including: 1/ twin pregnancies with PPROM between 13 and 37 weeks of gestation, 2/ two live fetuses at the time of rupture, and 3/ delayed delivery (>48 hours after rupture). The primary outcome was the survival of the affected twin. The secondary outcome was the survival of the co-twin. Univariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Among 402 cases of preterm prelabor rupture of membranes (PPROM), 132 patients were included. Survival at hospital discharge was 79.5% for twins with membrane rupture and 84.1% for their co-twins. Survival was correlated with a higher gestational age at the time of rupture (p=0.03) and at delivery (p<0.01). Improved survival was associated with dichorionic pregnancies (aOR 2.98; 95% CI: 1.06-8.34), a normal amniotic fluid volume, and a shorter latency period. The same was observed with the administration of corticosteroids and antibiotic prophylaxis. The prognosis of the unborn child is primarily associated with gestational age at delivery.</p><p><strong>Conclusion: </strong>The survival of twins with prolonged PPROM is high. Dichorionic chorionicity and factors such as gestational age at delivery, normal amniotic fluid levels, and shorter duration of rupture improve survival.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744541","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":"[Is previable rupture of membranes an independent neonatal prognostic factor from the gestational age at birth?]","authors":"Mélodie Luk, Lola Loussert, Karim Daou, Juliana Patkai, Aude Girault, Emmanuelle Cohen","doi":"10.1016/j.gofs.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.gofs.2025.03.001","url":null,"abstract":"<p><strong>Objective: </strong>Compare, at the same gestational age at birth, survival without severe neonatal morbidity among live-born infants after previable premature rupture of membranes (PROM) occurring before 22 weeks of gestation (WG) versus at or after 22 weeks.</p><p><strong>Methods: </strong>Retrospective study conducted in a tertiary care referral center between 2016 and 2021, including live births between 23 and 36 weeks + 6 days after PROM. Only live-born infants with neonatal resuscitation care were included. Each infant from the group PROM < 22 weeks was matched for gestational age at birth with the next two infants born after PROM ≥ 22 weeks. Maternal characteristics, obstetric outcomes, and neonatal outcomes were compared between the two groups. The primary outcome was survival without severe neonatal morbidity at discharge Results: In total, 35 infants were included in the PROM < 22weeks group and 70 in the PROM ≥22 weeks group. The median gestational age at birth was 28.4 weeks (IQR [25,3-31,2]). The rate of survival without severe neonatal morbidity was significantly lower in the PROM <22 weeks group compared to the PROM ≥22 weeks group (15/35 (42.9 %) vs 58/70 (82.9 %), p<0,01)). The number of deaths in the neonatal intensive care unit before 36 weeks corrected age was higher in the PROM <22 weeks group (6 (17.1%) versus 3 (4.3%), p=0.03)).</p><p><strong>Conclusion: </strong>Previable PROM is associated with a survival rate without severe neonatal morbidity that is twice lower than infants born at the same gestational age after PROM ≥ 22 weeks.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617922","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":"[Underestimation of pure radial scars: A retrospective evaluation in a cancer center].","authors":"Andréa Musard, Marie-Martine Padéano, Nathalie Méjean, Françoise Beltjens, Charles Coutant, Sarah Jacinto","doi":"10.1016/j.gofs.2025.02.007","DOIUrl":"10.1016/j.gofs.2025.02.007","url":null,"abstract":"<p><strong>Objectives: </strong>Radial scars (RS) are benign lesions, but their imaging appearance can mimic that of carcinoma. Traditionally, most RS were surgically excised due to the risk of underestimation. However, guidelines now exist allowing for their surveillance. The objective of this study was to evaluate the risk of underestimation and, secondarily, to identify associated risk factors, as well as to describe the proportion of women who developed breast cancer during follow-up.</p><p><strong>Methods: </strong>This was a single-center, retrospective, observational study conducted using data from patients who underwent biopsies identifying RS in a cancer center between January 2000 and December 2015.</p><p><strong>Results: </strong>A total of 116 biopsies revealing radial scars without atypia were analyzed. Seventy patients underwent excision (66 [56.9%] via segmentectomy and 4 [3.4%] via vacuum-assisted biopsy), among which 55 were classified as \"pure\" radial scars (78.6%), 13 as radial scars with atypia (18.6%), and 2 as ductal carcinoma in situ (2.9%). The overall underestimation rate was 21.4%. The underestimation rate for carcinoma (in situ or invasive) was 2.9%. No predictive factors for underestimation were identified in our study. Follow-up data were available for 72 patients, among whom 12 (16.7%) developed breast cancer.</p><p><strong>Conclusions: </strong>Our study shows an underestimation rate of 21.4% for radial scars, with no predictive risk factors identified, emphasizing the importance of multidisciplinary team discussions.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574571","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":"[Patient satisfaction regarding hypnosis-assisted oocyte retrieval under local anesthesia].","authors":"Célie Cervantes, Mathilde Bourdon, Chloé Maignien, Giulia Galducci, Catherine Patrat, Valérie Blanchet, Julia Gonnot, Audrey Houliat, Emmanuelle Laviron, Charles Chapron, Pietro Santulli","doi":"10.1016/j.gofs.2025.02.006","DOIUrl":"10.1016/j.gofs.2025.02.006","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the satisfaction of patients accompanied by hypnosis during oocyte retrieval under local anesthesia.</p><p><strong>Methods: </strong>This cohort study included patients undergoing oocyte retrieval under local anesthesia with hypnotic support provided either by a hypnotherapist or via a virtual reality headset between November 2022 and November 2023. A questionnaire was distributed after the procedure, assessing satisfaction with hypnosis for pain and anxiety management, as well as the experience of pain (visual analog scale) and anxiety (State-Trait Anxiety Inventory) during the procedure. Incomplete questionnaires and non-French-speaking patients were excluded from the analysis. The two methods of hypnosis were compared.</p><p><strong>Results: </strong>Out of 600 eligible women, 209 (34.8%) were included (mean age : 34.4±4.1 years). Hypnosis was conducted by a hypnotherapist for 167 patients (79.9%) and via a virtual reality headset for 42 patients (20.1%). Satisfaction with pain management was reported by 73.7% of the participants, and with anxiety management by 86.1%. Significantly more women found hypnosis beneficial for anxiety in the hypnotherapist group compared to the virtual reality group (148/167 [88.6%] versus 32/42 [76.2%], P=0.04). The mean visual analog scale score was 5.3±2.6, and the State-Trait Anxiety Inventory score during the oocyte retrieval was 36.7±17.8. No significant differences were found between the two groups for these scores.</p><p><strong>Conclusions: </strong>Women who received hypnosis during oocyte retrieval under local anesthesia were generally satisfied with this support, finding it beneficial for pain and anxiety management. Further research is needed to optimize the patient experience during this stressful procedure.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568844","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":"Recommandations pour la pratique clinique : prévention et prise en charge de l’infection par le virus varicelle zona (VZV) pendant la grossesse et la période périnatale (version longue)","authors":"Caroline Charlier ,&nbsp;Olivia Anselem ,&nbsp;Marion Caseris ,&nbsp;Marie Lachâtre ,&nbsp;Asmaa Tazi ,&nbsp;Marine Driessen ,&nbsp;Didier Pinquier ,&nbsp;Chemsa Le Cœur ,&nbsp;Aurélie Saunier ,&nbsp;Mathilde Bergamelli ,&nbsp;Roxane Gibert Vanspranghels ,&nbsp;Anaïs Chosidow ,&nbsp;Charles Cazanave ,&nbsp;Sophie Alain ,&nbsp;Karine Faure ,&nbsp;André Birgy ,&nbsp;François Dubos ,&nbsp;Philippe Lesprit ,&nbsp;Julie Guinaud ,&nbsp;Robert Cohen ,&nbsp;Christelle Vauloup-Fellous","doi":"10.1016/j.gofs.2025.01.001","DOIUrl":"10.1016/j.gofs.2025.01.001","url":null,"abstract":"<div><div>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.</div><div>The previous recommendation was issued in 1998, at a time of anti-VZV immunoglobulins shortage; it has hence become obsolete.</div><div>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).</div><div>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.</div><div>The aim of this article is to explain and recontextualize the elements of this recommendation.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"53 3","pages":"Pages 118-129"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facteurs influençant la douleur lors de la pose d’un dispositif intra-utérin","authors":"Chloé Guerry ,&nbsp;Hélène Piclet ,&nbsp;Florence Bretelle ,&nbsp;Julien Mancini ,&nbsp;Aubert Agostini ,&nbsp;Mallaury Vitabile","doi":"10.1016/j.gofs.2024.12.007","DOIUrl":"10.1016/j.gofs.2024.12.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Fear of pain during intrauterine device (IUD) insertion remains a barrier to its adoption. In the absence of consensus on an optimal pharmacological strategy, it is crucial to determine the factors influencing this pain to reassure and improve the patient experience.</div></div><div><h3>Methods</h3><div>It was a prospective study conducted in Provence-Alpes-Côte d’Azur between August 2023 and 2024, interviewing adult patients and healthcare professionals during consultations for IUD insertion. The primary outcome studied was the pain experienced during IUD insertion, measured using a numerical rating scale from 0 to 10. After an univariate analysis, a multiple linear regression was performed to identify the factors associated with this pain.</div></div><div><h3>Results</h3><div>Of the 110 questionnaires analyzed, the average pain score at IUD insertion was 4.1<!--> <!-->±<!--> <!-->2.7. Factors associated with pain included European origin, no history of vaginal delivery, apprehension and use of a tenaculum. In contrast, prior IUD insertion, the presence of dysmenorrhea, menstruation at the time of insertion, or premedication had no significant effect on pain. Prior bladder emptying and the use of equimolar mixture of oxygene and nitrous oxide (EMONO) could also be considered as strategies but require further studies.</div></div><div><h3>Conclusion</h3><div>IUD insertion should be played down, given the moderate and temporary pain it causes. Physicians have a key role in identifying patients at risk of increased pain in order to provide them a personalized approach.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"53 3","pages":"Pages 148-154"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’accompagnement de la relation mère-enfant lors d’un déni de grossesse total : point de vue des sages-femmes","authors":"Justine Paoli ,&nbsp;Rahmeth Radjack","doi":"10.1016/j.gofs.2024.11.007","DOIUrl":"10.1016/j.gofs.2024.11.007","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methodology</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"53 3","pages":"Pages 130-135"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","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}