Gynecologie Obstetrique Fertilite & Senologie最新文献

{"title":"[Practices of general practitioners in the follow-up of precarious pregnant patients: A qualitative study].","authors":"Hugo Texier, Irène Lacamp, Pierre-François Ceccaldi, Priscille Sauvegrain","doi":"10.1016/j.gofs.2024.11.003","DOIUrl":"10.1016/j.gofs.2024.11.003","url":null,"abstract":"<p><strong>Objective: </strong>Socio-economic conditions are one of the critical factors of the health of pregnant women. However, precariousness remains poorly defined and detected by general practitioners because too few tools adapted to private practice are available. General practitioners, as the first point of contact for these patients and often the future doctors of the children to come, take charge of them or refer them to other practitioners. Their medical and social practices in this context are mostly undocumented. The purpose of this practice survey is to understand the underlying rationale and frame of reference according to which GPs identify precarious pregnant women and the way they take care of them.</p><p><strong>Method: </strong>This is a qualitative study based on semi-structured interviews. They were thematically analyzed using the inductive method of grounded theorizing. Private general practitioners carrying out pregnancy follow-ups were enrolled via GP networks and then sampled according to the \"respondent driven sampling\".</p><p><strong>Results: </strong>Twelve interviews were conducted between September 2020 and April 2021. The analysis led to explore 6 main themes, poverty identification, feelings about it, the care of precarious women and the attitude, resources and training of the GPs.</p><p><strong>Conclusion: </strong>The definition of precariousness by GPs is directly linked to their own representation of it. They work in formal or informal networks to avoid being isolated in the care that they describe as complex. They feel the need for suitable training and information related to the support of these patients.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693586","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":"Sommaire","authors":"","doi":"10.1016/S2468-7189(24)00337-4","DOIUrl":"10.1016/S2468-7189(24)00337-4","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 12","pages":"Pages v-vi"},"PeriodicalIF":0.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660865","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":"[Blood and tears. To stop the cycle of conflict-related sexual violence].","authors":"Denis Mukwege, Gautier Chene","doi":"10.1016/j.gofs.2024.11.002","DOIUrl":"10.1016/j.gofs.2024.11.002","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632985","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":"[Study of the profile and trajectory of women seeking a maternal medical termination of pregnancy for psychosocial reasons at the University Hospital of Tours from 2017 to 2021].","authors":"Caroline Sylvestre, Nathalie Trignol-Viguier","doi":"10.1016/j.gofs.2024.10.010","DOIUrl":"10.1016/j.gofs.2024.10.010","url":null,"abstract":"<p><strong>Objective: </strong>The law of 7 July 2011 adopts the concept of therapeutic abortion (Medical Termination of Pregnancy or MTP) for maternal reasons if the pregnancy poses a \"serious threat\" to the woman's health, allowing for the introduction of the concept of psycho-social distress.</p><p><strong>Materials and methods: </strong>This was a retrospective monocentric study involving 33 women seeking IMG for psychosocial reasons between January 2017 and December 2021 at the University Hospital of Tours. The study resulted in 29 approvals and 25 MTP procedures performed.</p><p><strong>Results: </strong>Eighty-seven per cent of the requests were accepted. Over half of the women were under 25 years old and were primiparous. The procedures were performed at a mean gestational age of 22 weeks. Sixty percent did not use contraception at the time of conception, and 36% did not use it after the MTP. About a third of the women experienced violence and had psychiatric histories. The majority of the women did not have stable economic resources. Fifty-six per cent of the MTP procedures involved feticide. There were 7 immediate complications with no subsequent consequences. The average time to completion was 16.5 days.</p><p><strong>Conclusion: </strong>This is a delicate and underexplored subject in literature. Although sporadic in France, these procedures have been practiced for many years. The diversity of opinions during multidisciplinary committees ensures the best objectivity. Requests for psychosocial IMG are rare, but responding to them is in accordance with the law. Analyzing the profile and journey of women has contributed to a better understanding of the complex situations that lead them to this decision.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633030","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":"[Impact of HypnoVR© with local anesthesia on pain and anxiety during oocyte pick-up].","authors":"Anne-Laure Vanderstraeten, Samir Boukaidi, Coralie Cruzel, Coralie Dumont, Jérôme Delotte","doi":"10.1016/j.gofs.2024.10.011","DOIUrl":"10.1016/j.gofs.2024.10.011","url":null,"abstract":"<p><strong>Objective: </strong>Virtual reality with Snow World shows a 45% decrease in painful peaks during the care of burn victims. Hypnosis has anxiolytic effect and modulate the response to pain. HypnoVR© is based on many concepts recognized in medicine accessible without specific training. In our practice, 95% of oocyte pick-up are made with local anesthesia and simple premedication, whereas conscious sedation is recommanded in Europe. HypnoVR© is systematically offered during oocyte pick-up. Our study had to compare the pain felt between the 2 group with or without HypnoVR©, also anxiety, tolerance and satisfaction of patients.</p><p><strong>Method: </strong>It was a prospective comparative, non-randomized, single-center, open-label study. We included all patients who were to benefit from an oocyte pick-up from 18 to 43 years-old. The usual protocol of pick-up was used and it was possible to add HypnoVR©. A questionnaire was distributed to each patient to collect their opinion.</p><p><strong>Results: </strong>A total of 112 patients were included, 60 without HypnoVR© and 52 with HypnoVR©; 2 were excluded from the main analysis for missing data. There is no statistically significant difference in pain and anxiety between the groups. Patients are satisfied: 90.20% (n=46/52) would like to use it again and 98.04% (n=50/52) would recommend it.</p><p><strong>Conclusion: </strong>Despite the absence of a statistically significant difference, patients are satisfied with HypnoVR© and tolerance is good. It seems interesting to be able to offer it during oocyte pick-up.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632992","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":"[Pregnancy in a patient with Turner syndrome after cardiac surgery and double gamete donation].","authors":"Leila Ghassemi, Sébastien Grandfils, Patrick Emonts","doi":"10.1016/j.gofs.2024.10.009","DOIUrl":"10.1016/j.gofs.2024.10.009","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632995","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":"[What do French professionals think of the current limits of assisted reproduction technologies in France, should the bioethics law evolve?]","authors":"Joelle Belaisch Allart","doi":"10.1016/j.gofs.2024.11.001","DOIUrl":"10.1016/j.gofs.2024.11.001","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607605","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":"Sommaire","authors":"","doi":"10.1016/S2468-7189(24)00312-X","DOIUrl":"10.1016/S2468-7189(24)00312-X","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 11","pages":"Pages v-vi"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554268","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":"Utilité de la mesure échographique du segment utérin inférieur avant accouchement parmi les femmes ayant un antécédent de césarienne : revue de la littérature","authors":"","doi":"10.1016/j.gofs.2024.03.007","DOIUrl":"10.1016/j.gofs.2024.03.007","url":null,"abstract":"<div><div>Identifying women with a history of cesarean delivery and at real risk for uterine rupture is an important aim in obstetric care. It is with this objective that different authors have evaluated the interest of ultrasound for predicting the risk of a cesarean scar defect by measuring the thickness of the lower uterine segment. The literature is sparse and subject to numerous biases because they are mainly prospective cohort studies with small numbers. However, the results are concordant: Ultrasound measurements of lower uterine segment thickness are strongly correlated with the operative findings observed during cesarean delivery. Moreover, the thinner the lower uterine segment on ultrasound, the higher the likelihood of a uterine defect. Two randomized trials have recently been published. The PRISMA cluster randomized controlled trial evaluated a multifaceted intervention including an ultrasound estimation of the risk of uterine rupture by ultrasound measurement of the lower uterine segment thickness and aimed at helping women in their choice of mode of delivery after a previous cesarean delivery. This multifaceted intervention resulted in a significant reduction in the rates of major perinatal and maternal morbidity, without any increase in the rate of cesarean delivery or uterine rupture. However, due to its design, it is impossible to specifically specify the benefit of lower uterine segment measurement in reducing major maternal and perinatal morbidity since the trial combined several interventions. The LUSTrial randomized controlled trial evaluated the impact on maternal-fetal morbidity and mortality of proposing a mode of delivery based on ultrasound measurement of the lower uterine segment thickness compared to usual care among women with a history of cesarean delivery. Ultrasound measurement of lower uterine segment thickness was not associated with a statistically significant reduction in maternal-fetal morbidity and mortality compared to usual care. In this literature review, we will mainly detail and analyze the results of this trial.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 11","pages":"Pages 639-645"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195204","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":"Enquête nationale sur la stratégie de prise en charge du placenta accreta en France","authors":"","doi":"10.1016/j.gofs.2024.03.008","DOIUrl":"10.1016/j.gofs.2024.03.008","url":null,"abstract":"<div><h3>Objective</h3><div>Placenta accreta belongs to placenta accreta spectrum and is defined by an adhesion or even invasion of the placental villi in the myometrium. The main risk factor is a history of cesarean section. Its incidence is increasing following an increase in the cesarean section rate in recent years and the cause of severe maternal morbidity (hemorrhage, transfusions, hysterectomy). Treatment can be radical by cesarean section-hysterectomy or conservative with an attempt at uterine preservation. American, English, Canadian and international recommendations have been established but there are no French recommendations to date. The objective of this study was to investigate management strategy for placenta accreta in type III maternity hospitals in France.</div></div><div><h3>Materials and methods</h3><div>An anonymous questionnaire was sent by email to the obstetrics referents of the university hospital centers in France with type III maternity.</div></div><div><h3>Results</h3><div>Forty-eight centers were approached, with a participation rate of 77%.</div></div><div><h3>Conclusion</h3><div>The management of placenta accreta spectrum in France is relatively heterogeneous on several points such as multidisciplinary management, evaluation by placental MRI, preoperative urological evaluation, treatment adopted as first-line, cesarean section-hysterectomy or conservative treatment, therapeutic strategy according to the placental invasion. However, the literature is currently poor, which may explain divergent treatment.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 11","pages":"Pages 620-626"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332321","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}