Gynecologie Obstetrique Fertilite & Senologie最新文献

{"title":"Devenir clinique après transfert de blastocystes vitrifiés selon l’indication de congélation","authors":"Emmanuelle Bodin ,&nbsp;Romane Sainte-Rose ,&nbsp;Claire Petit ,&nbsp;Marion Cornuau ,&nbsp;Fabrice Guérif","doi":"10.1016/j.gofs.2024.06.002","DOIUrl":"10.1016/j.gofs.2024.06.002","url":null,"abstract":"<div><h3>Objectives</h3><div>In France, embryo thawing concern 45.8% of attempts at assisted reproductive technologies excluding artificial inseminations. This proportion is constantly increasing for various reasons. The main objective of this study is to compare the live birth rate following frozen blastocyst transfer (FBT) according to the initial indication for freezing.</div></div><div><h3>Methods</h3><div>This is a retrospective study including patients who underwent FBT between 01/01/2020 and 06/30/2022 at the Regional University Hospital Center of Tours. The results were compared (univariate and multivariate analyses) between the three main indications for freezing: freezing of the complete cohort of blastocysts for risk of ovarian hyperstimulation (=OHS), freezing of supernumerary blastocysts after fresh blastocyst transfer (BT) with pregnancy (=second request) or without pregnancy (=BT failure). Results have also been described for other indications.</div></div><div><h3>Results</h3><div>Among the 963 FBT cycles selected, 28% of live births by thawing were obtained, all indications of freezing combined. A significantly lower rate was identified in the FBT failure group compared to the OHS group. However, after adjustment, the results remained significant for the age of the patient on the freezing cycle but not for the indication for freezing.</div></div><div><h3>Conclusions</h3><div>The outcome of a FBT does not seem significantly impacted by the indication of freezing considering the confounding factors. The prospective analysis of more data from a multicenter study would be necessary to confirm these results.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 12","pages":"Pages 690-696"},"PeriodicalIF":0.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473099","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":"La nouvelle version du site internet du Centre de référence sur les agents tératogènes et ses fonctionnalités optimisées","authors":"Bénédicte Coulm ,&nbsp;Delphine Beghin ,&nbsp;Mathilde Latour ,&nbsp;Bilal Majed ,&nbsp;Catherine Vauzelle ,&nbsp;Elisabeth Elefant ,&nbsp;Benoît Marin","doi":"10.1016/j.gofs.2024.05.005","DOIUrl":"10.1016/j.gofs.2024.05.005","url":null,"abstract":"<div><div>The Centre de Référence sur les Agents Tératogènes (CRAT) is a unique French national reference center involved in the risk assessment of exogenous agents (mainly drugs, but also medical imaging and addictions) on pregnancy, breastfeeding and fertility. To help improve patient care, CRAT makes its expertise available to healthcare professionals via its website (<span><span>www.lecrat.fr</span><svg><path></path></svg></span>), a free, independent and public online resource regularly updated by its multidisciplinary team. In December 2023, a new version was launched, based on the evolutions desired by the CRAT team and on a satisfaction survey of website's users. A predictive search bar integrated into the home page now enables users to find the specific information they are looking for more quickly. To optimize the access via smartphones, a mobile version is now available.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 12","pages":"Pages 725-729"},"PeriodicalIF":0.6,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285400","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":"Gestation pour autrui altruiste en France : contexte et perspectives","authors":"Mikaël Agopiantz ,&nbsp;Matthieu Dap ,&nbsp;Guillaume Mougniotte ,&nbsp;Charline Bertholdt ,&nbsp;Olivier Morel","doi":"10.1016/j.gofs.2024.02.001","DOIUrl":"10.1016/j.gofs.2024.02.001","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 436-439"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716631","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":"Les pièges de l’analyse dichotomique d’une variable biologique continue : l’exemple de la taille maternelle et du pronostic de l’accouchement d’un enfant de plus de 4,0 kg","authors":"Jeremy Boujenah ,&nbsp;Anne Wahnich ,&nbsp;Diane Korb","doi":"10.1016/j.gofs.2024.01.009","DOIUrl":"10.1016/j.gofs.2024.01.009","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 425-426"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547758","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":"Mise en place du dépistage de l’infection congénitale à cytomégalovirus dans une maternité française de type 3","authors":"Perrine Coste-Mazeau ,&nbsp;Magali Hamon ,&nbsp;Élodie Ribot ,&nbsp;Sébastien Hantz ,&nbsp;Sophie Alain","doi":"10.1016/j.gofs.2024.01.010","DOIUrl":"10.1016/j.gofs.2024.01.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Congenital cytomegalovirus (CMV) infection is the most common congenital infection and the leading cause of infectious neurosensorial disability in newborns. We wanted to organize the management of women from the beginning of pregnancy allowing access to antenatal treatment with valaciclovir, recognized since 2020 as limiting materno-fetal transmission. To this end, we set up and evaluated the interest of systematic screening for CMV infection in our maternity. We wanted to organize care for women from the very start of pregnancy.</p></div><div><h3>Methods</h3><p>Retrospective and comparative descriptive study carried out at the <em>CHRU de Limoges</em> from July 2017 to December 2019 (targeted screening), then from January 2020 to June 2022, during which period we implemented systematized screening by iterative serologies at the 3rd, 6th, 8th months and before delivery. Our main evaluation criteria were the seroprevalence of CMV infection and the rate of congenital infection. We then described our cases of infection (primary or secondary) during pregnancy.</p></div><div><h3>Results</h3><p>CMV seroprevalence in our pregnant women increased significantly from 52.7% (779/1478 women screened) to 58.4% (3852/6599 women screened) between the 2 study periods (<em>P</em> <!-->=<!--> <!-->0.04). We diagnosed 11 infections during the first part of the study vs. 27 during the second, with a significant increase in primary infections from 0.14% (9/6524 births) to 0.37% (24/6426 births) (<em>P</em> <!-->=<!--> <!-->0.008). Only 3 secondary infections were diagnosed during the second study period. The rate of congenital infections remained stable between the 2 study periods (6 children/6524<!--> <!-->=<!--> <!-->0.09% vs. 8 children/6426<!--> <!-->=<!--> <!-->0.12%; <em>P</em> <!-->=<!--> <!-->0.57).</p></div><div><h3>Conclusion</h3><p>Our results confirmed the interest of screening for CMV infection, while modifying the screening strategy we had initiated.</p></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 403-409"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565258","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":"Vaccination contre la varicelle, grossesse et allaitement : un état des lieux","authors":"Catherine Vauzelle ,&nbsp;Elisabeth Elefant ,&nbsp;Bénédicte Coulm ,&nbsp;Mathilde Latour ,&nbsp;Delphine Beghin ,&nbsp;Benoît Marin","doi":"10.1016/j.gofs.2024.01.012","DOIUrl":"10.1016/j.gofs.2024.01.012","url":null,"abstract":"<div><p>The varicella vaccine is recommended for women with no history of varicella who are planning to become pregnant, as well as for post-pregnancy women, to prevent the occurrence of this illness and its severe complications, especially an embryopathy, when it occurs in a pregnant woman (congenital varicella syndrome). This live attenuated vaccine should not be administered during pregnancy, nor in the month preceding it. However, when this occurs inadvertently, the data collected on the outcomes of exposed pregnancies, although few in women seronegative at the time of vaccination, allow to reassure the patients to date, as no congenital varicella syndrome has been reported to date following accidental vaccination in early pregnancy. On the other hand, during breastfeeding, a woman may be vaccinated if there is an expected short- or medium-term benefit (varicella exposure, planned pregnancy…).</p></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 432-435"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681951","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":"Développement d’un outil d’évaluation de l’anxiété de performance en obstétrique","authors":"Dio Andriamanjay ,&nbsp;Pierre Castel ,&nbsp;Claude D’Ercole ,&nbsp;Florence Bretelle ,&nbsp;Aubert Agostini ,&nbsp;Julie Berbis ,&nbsp;Julie Blanc","doi":"10.1016/j.gofs.2024.01.007","DOIUrl":"10.1016/j.gofs.2024.01.007","url":null,"abstract":"<div><h3>Objective</h3><p>Developing a measuring tool for physician's performance anxiety during obstetrical procedures, as a self-administered questionnaire.</p></div><div><h3>Methods</h3><p>We used the Delphi method. First, we did a literature review to identify the items to submit for the first round. A panel of experts was asked to rate the relevance of items from one to six. For the first round of Delphi, items were retained if more than 70% of respondents assigned a five or six rating. Items were excluded if more than 70% of respondents assigned a one or two rating. All the other items, plus those suggested by the panel, were submitted to a second round of Delphi. The same item selection conditions were applied to the second round.</p></div><div><h3>Results</h3><p>The overall response rate to the Delphi was 79% (19 respondents). At the end of the first round, 14 items were consensually relevant, no item was consensually irrelevant. For the second round, the 18 items that did not find consensus and seven new items suggested by the experts in the first round were submitted. At the end of the second round, nine items were retained by consensus as relevant.</p></div><div><h3>Conclusion</h3><p>This study defined by consensus 23 items for a self-questionnaire to measure specific performance anxiety in obstetrics divided into five dimensions: perceived stress, assessment of the risk of complications, medico-legal risk, impact of the healthcare team and peers, self-confidence and decision-making confidence. We intend to validate this tool in real population.</p></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 384-390"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468718924000114/pdfft?md5=898766396e723d182e3fff741c0c498a&pid=1-s2.0-S2468718924000114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514166","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":"Oxytocine et neuroprotection en période néonatale : évidences conceptuelles et précliniques","authors":"Olivier Baud ,&nbsp;Marit Knoop","doi":"10.1016/j.gofs.2023.12.005","DOIUrl":"10.1016/j.gofs.2023.12.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;p&gt;La prématurité et le retard de croissance utérin sont responsables de lésions cérébrales associées à l’apparition de troubles neurocognitifs et comportementaux chez plus de 9 millions d’enfants chaque année. Le bénéfice clinique de la plupart des stratégies pharmacologiques visant à prévenir les lésions cérébrales périnatales reste à confirmer. En revanche, l’enrichissement de l’environnement du nouveau-né induit des effets positifs sur la structure et la fonction du cerveau, influence les réponses hormonales du nouveau-né et semble avoir des conséquences neurocomportementales durables pendant la petite enfance et à l’âge adulte. L’ocytocine (OT), un neuropeptide libéré par l’hypothalamus, pourrait représenter la base hormonale de ces effets à long terme.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthode&lt;/h3&gt;&lt;p&gt;Cette revue de la littérature fait le point sur les connaissances concernant l’effet de l’OT chez le nouveau-né et les données précliniques suggérant son effet neuroprotecteur.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;p&gt;L’OT joue un rôle pendant la période périnatale, dans l’attachement parents-enfant et dans le comportement social. En outre, des études précliniques suggèrent fortement que l’OT endogène et synthétique est capable de réguler la réponse inflammatoire du système nerveux central en réponse aux situations de prématurité ou plus généralement d’agressions du cerveau en développement. L’effet à long terme de l’adminsitration d’OT synthétique au cours du travail est également abordé.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;L’ensemble des données conceptuelles et expérimentales converge pour indiquer que l’OT serait un acteur clé dans la neuroprotection néonatale, notamment par la régulation de la neuroinflammation.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;Prematurity and intra-uterine growth retardation are responsible for brain damage associated with various neurocognitive and behavioral disorders in more than 9 million children each year. Most pharmacological strategies aimed at preventing perinatal brain injury have not demonstrated substantial clinical benefits so far. In contrast, enrichment of the newborn's environment appears to have positive effects on brain structure and function, influences newborn hormonal responses, and has lasting neurobehavioral consequences during infancy and adulthood. Oxytocin (OT), a neuropeptide released by the hypothalamus, may represent the hormonal basis for these long-term effects.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;p&gt;This review of the literature summarizes the knowledge concerning the effect of OT in the newborn and the preclinical data supporting its neuroprotective effect.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;OT plays a role during the perinatal period, in parent-child attachment and in social behavior. Furthermore, preclinical studies strongly suggest that endogenous and synthetic OT is capable of regulating the inflammatory response of the central nervous system in response to situations of prematurity or more g","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 418-424"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246871892300257X/pdfft?md5=30ced80001e5d926c8aa3d21fea46062&pid=1-s2.0-S246871892300257X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038182","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’accouchement des femmes enceintes de jumeaux : les enseignements de l’étude nationale observationnelle prospective comparative JUMODA","authors":"Thomas Schmitz ,&nbsp;François Goffinet","doi":"10.1016/j.gofs.2023.11.005","DOIUrl":"10.1016/j.gofs.2023.11.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To summerize the results of the JUMODA study (JUmeaux MODe d’Accouchement) on the planned mode of delivery of twin pregnancy and the management of second twin delivery.</p></div><div><h3>Methods</h3><p>JUMODA was a national observational prospective comparative study that took place between february 2014 and march 2015 in 176 french maternity units performing more than 1500 deliveries per year. Its main objectives were the comparison of neonatal and maternal morbidity according to the planned mode of delivery and the determination of the managements of second twin delivery associated with the best neonatal outcomes. To control for potential confounding factors and indication biases, statistical analyses comprized multivariate logistic regressions and matching on propensity scores.</p></div><div><h3>Results</h3><p>The JUMODA study recruited 8823 women with twin delivery at or beyond 22 weeks of gestation. For twin pregnancies with a cephalic first twin at 32 weeks of gestation and beyond, severe neonatal morbidity was higher in the planned cesarean (150/2908 (5.2 %) than in the planned vaginal delivery group (199/8922 (2.2 %), aOR 1.56, 95 % CI 1.19-2.04). Increased neonatal morbidity in the planned cesarean delivery group was explained by higher severe morbidity in neonates born preterm (aOR 1.64, 95 % CI 1.13-2.39, for deliveries between 32⁺⁰ and 34⁺⁶ weeks of gestation, aOR 2.04, 95 % CI 1.22-3.41, for deliveries between 35⁺⁰ SA and 36⁺⁶ weeks of gestation) but not in neonates born at term (aOR 1.19, 95 % CI 0.58-2.44). In comparison with planned cesarean delivery, planned vaginal delivery was not associated with increased severe neonatal morbidity in case of breech presenting first twin after 32 weeks of gestation or with decreased survival witout severe neonatal morbidity in case of delivery before 32 weeks of gestation whatever the first twin presentation. In comparison with planned vaginal delivery, planned cesarean delivery was associated with increased severe maternal morbidity only in women aged 35 and higher. Delivery of non cephalic second twin was associated with similar severe neonatal morbidity rate than delivery of cephalic second twin. Finally, in case of cephalic second twin, internal version followed by total breech extraction was associated with less cesarean for the second twin but with higher severe neonatal morbidity in case of preterm birth in comparison with pushing efforts, ocytocin perfusion and artificial rupture of membranes.</p></div><div><h3>Conclusions</h3><p>Planned vaginal delivery is the planned mode of delivery to encourage for the majority of pregnant women with twins, whatever first twin presentation and gestational age at delivery. No management of cephalic second twin appears better than an other, its choice will rest on obstetrician preferences.</p></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 410-417"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300720","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":"Conséquences de la réforme du 3e cycle des études médicales sur l’accès à la formation en médecine de la reproduction","authors":"Geoffroy Robin (Coordonnateur national de la FST Médecine et Biologie de la Reproduction – Andrologie)","doi":"10.1016/j.gofs.2024.05.003","DOIUrl":"https://doi.org/10.1016/j.gofs.2024.05.003","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"52 6","pages":"Pages 381-383"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294570","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}