{"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}
Andréa Musard, Marie-Martine Padéano, Nathalie Méjean, Françoise Beltjens, Charles Coutant, Sarah Jacinto
{"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}
Célie Cervantes, Mathilde Bourdon, Chloé Maignien, Giulia Galducci, Catherine Patrat, Valérie Blanchet, Julia Gonnot, Audrey Houliat, Emmanuelle Laviron, Charles Chapron, Pietro Santulli
{"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}
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 , Christelle Vauloup-Fellous
{"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 , 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 , 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 , Hélène Piclet , Florence Bretelle , Julien Mancini , Aubert Agostini , 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 , 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}
Elie Mouanes-Abelin , Sophie Brouillet , Fatima Barry , Margaux Anav , Alice Fournier , Anéta Andreeva , Marine Miaille , Tal Anahory , Samir Hamamah
{"title":"Augmenter le taux cumulé de naissance vivante : les blastocystes de bas grade, un potentiel négligé","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":"<div><div>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.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"53 3","pages":"Pages 155-161"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","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":"Étude du profil et du parcours des femmes en demande d’une interruption médicale de grossesse maternelle au motif psychosocial au CHRU de Tours de 2017 à 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":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"53 3","pages":"Pages 142-147"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}