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1. Évolution du taux de césariennes à partir de 37 semaines d’aménorrhée parmi les nullipares ou comment évaluer la validité externe d’un essai randomisé nord-américain sur le déclenchement artificiel du travail

Author: P. Raynal, Patrick Rozenberg, T. Quibel, C. Bouyer, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre Hospitalier de Versailles André Mignot (CHV), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Reproductive Medicine, [SDV]Life Sciences [q-bio], Obstetrics and Gynecology, Cesarean delivery, 030212 general & internal medicine, Nullipara Network, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Induction of labor, Expectative management
Abstract: Resume Objectif Determiner le risque de cesarienne d’une nullipare a partir de 37 semaines d’amenorrhee (SA) lorsqu’une attitude expectative est envisagee. Materiel et methodes Etude prospective incluant toutes les nullipares ayant accouche d’une grossesse unique en presentation cephalique a un terme ≥ 37 SA au sein d’un reseau de perinatalite (MYPA), entre le 1er janvier 2017 et le 31 decembre 2017. Pour chaque semaine d’amenorrhee de 37 SA a 41 SA, le taux de cesarienne etait calcule en fonction du mode d’entree en travail (spontane ou declenchement artificiel). Le taux de cesarienne lie a une attitude expectative a un âge gestationnel donne etait calcule en prenant la population totale arrivant a cet âge, diminue du nombre des patientes ayant eu un declenchement artificiel du travail ou une cesarienne programmee avant travail a ce meme âge gestationnel. Resultats Parmi les 16 085 patientes ayant accouche dans le reseau a ≥ 24 SA, 5498 (34,1 %) etaient des nullipares avec grossesse unique accouchant ≥ 37SA en presentation cephalique. Le risque de cesarienne augmentait a partir de 40 SA, quel que soit le mode d’entree en travail : en cas de travail spontane, le taux de cesarienne etait stable autour de 11 % jusqu’a 39 SA, puis augmentait a 14,1 % a 40 SA et 20 % a partir de 41 SA ; en cas de declenchement artificiel du travail, le taux de cesarienne passait de 28 % a 39 SA a 40 % a 40 SA et a 38 % a partir de 41 SA. Le risque global de cesarienne lorsqu’une attitude expectative etait envisagee des 37 SA restait stable autour de 21 %. Conclusion Le risque de cesarienne a partir de 37 SA d’une nullipare a bas risque geree par une attitude expectative au sein de ce reseau est proche de celui d’une patiente nullipare accouchant aux Etat-Unis.
Published: 2020

2. Recommandations pour la pratique clinique du CNGOF : il est temps d’évoluer !

Author: L, Sentilhes, M-V, Senat, T, Schmitz, A, Fauconnier, X, Fritel, HAL UVSQ, Équipe, Pôle d'Obstétrique Reproduction Gynécologie Centre Aliénor d'Aquitaine, Hôpital Pellegrin, Bordeaux, France., Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Research Center of Epidemiology, Biostatistics and Clinical Research, Université libre de Bruxelles (ULB), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, and Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Obstetrics, [SDV] Life Sciences [q-bio], [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Gynecology, [SDV]Life Sciences [q-bio], Practice Guidelines as Topic, Humans, CNGOF, Female, France, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2020

3. Recommandations pour la pratique clinique du CNGOF : révision méthodologique du processus d’élaboration

Author: Thomas Schmitz, Loïc Sentilhes, Elie Azria, M.-V. Senat, Arnaud Fauconnier, Xavier Fritel, Cyrille Huchon, Nicolas Bourdel, Catherine Deneux-Tharaux, Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and HAL UVSQ, Équipe
Subjects: GRADE system, 030219 obstetrics & reproductive medicine, [SDV]Life Sciences [q-bio], Grade system, Obstetrics and Gynecology, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 3. Good health, Clinical Practice, [SDV] Life Sciences [q-bio], 03 medical and health sciences, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 0302 clinical medicine, Reproductive Medicine, Political science, PICO question, AGREE II consortium, 030212 general & internal medicine, Clinical practice guidelines, Humanities
Abstract: Resume Objectifs Reviser l’organisation et la methodologie des recommandations pour la pratique clinique (RPC) du College national des gynecologues et obstetriciens francais (CNGOF). Methodes Les differentes methodes d’organisation et de cotation de la preuve scientifique ont ete consultees apres recherche dans la base de donnees Medline. Resultats Le groupe RPC du CNGOF a decide d’adopter une organisation des RPC basee sur les 23 criteres AGREE II (pour Appraisal of Guidelines for REsearch and Evaluation) et de coter la preuve scientifique selon la methode GRADE (pour Grading of Recommendation Assessment, Development, and Evaluation). Conclusion En adoptant les criteres du consortium AGREE II et la cotation de la preuve selon la methode GRADE, le CNGOF augmentera la qualite de l’ensemble du processus, delivrera des messages plus cibles et facilement assimilables, pour faciliter mieux encore les prises de decisions des professionnels, au benefice espere de la sante des femmes et de leurs enfants.
Published: 2020

4. CHIP et cancer de l’ovaire

Author: Fabrice Lecuru, Roman Rouzier, Olivier Glehen, Gilles Freyer, Christophe Pomel, Naoual Bakrin, Cyrille Huchon, Marc Pocard, Pierre-Emmanuel Colombo, Sebastien Gouy, Fabrice Narducci, G. Ferron, J-M Classe, Department of Gynecologic and Oncologic Surgery Hopital Européen Georges Pompidou, Department of Oncologic Surgery, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre René Gauducheau, CRLCC René Gauducheau, CRLCC Val d'Aurelle - Paul Lamarque, Department of Surgical Oncology Institut Claudius Regaud, Université de Lyon, Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Géosciences Environnement Toulouse (GET), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Observatoire Midi-Pyrénées (OMP), Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Surgical Oncology, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER-UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Curie [Paris], Université de Lille-UNICANCER, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])
Subjects: Oncology, Hyperthermia, medicine.medical_specialty, business.industry, MEDLINE, Obstetrics and Gynecology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Internal medicine, medicine, 030211 gastroenterology & hepatology, Ovarian cancer, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

5. Partie 2 rédigée à partir de la synthèse de la recommandation nationale de bonnes pratiques cliniques intitulée « Conduites à tenir initiales devant des patientes atteintes d’un cancer épithélial de l’ovaire » élaborée par FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY et labélisée par l’INCa. (Traitement systémique et intrapéritonéal, personnes âgées, préservation de la fertilité et suivi)

Author: Sofiane Bendifallah, Fabrice Narducci, P. Alfonsi, Isabelle Thomassin-Naggara, Laurence Gladieff, Mojgan Devouassoux-Shisheboran, Claire Falandry, Alexandra Leary, L. Ouldamer, F Guyon, C. Bourgin, François Planchamp, Laure Fournier, Vincent Lavoué, Francis Bonnet, Cherif Akladios, Naoual Bakrin, Chantal Touboul, C. Sénéchal-Davin, Marie-Aude Lefrère-Belda, Fabrice Lecuru, Nicolas Pouget, Blandine Courbiere, Catherine Uzan, François Golfier, Nathalie Chabbert-Buffet, T. de la Motte Rouge, I. Ray-Coquard, P. Collinet, Benoit You, Pierre-Adrien Bolze, Eric Lambaudie, Eric Leblanc, Christine Rousset-Jablonski, Emile Daraï, Cyrille Huchon, Patricia Pautier, A. Lemoine, Sebastien Gouy, G. Ferron, Marcos Ballester, Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), CRLCC Eugène Marquis (CRLCC), Institut Claudius Regaud, Institut Gustave Roussy (IGR), Département de chirurgie gynécologique [Gustave Roussy], Institut Bergonié [Bordeaux], UNICANCER, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Oncologie gynécologique, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Institut Curie [Paris], Centre Léon Bérard [Lyon], Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université Lille Nord de France (COMUE)-UNICANCER
Subjects: medicine.medical_specialty, Intra peritoneal, Bevacizumab, endocrine system diseases, Adjuvant chemotherapy, medicine.medical_treatment, Cancer de l’ovaire, [SDV.CAN]Life Sciences [q-bio]/Cancer, Cancer du péritoine primitif, Olaparib, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Medicine, Cancer de la trompe, Stage (cooking), Chirurgie, Gynecology, Chemotherapy, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, Carboplatin, female genital diseases and pregnancy complications, 3. Good health, Reproductive Medicine, chemistry, 030220 oncology & carcinogenesis, business, Stage iv, Chimiothérapie, medicine.drug
Abstract: National audience; Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A). For BRCA mutated patient, Olaparib is recommended (grade B).
Published: 2019

6. Prise en charge initiale du cancer épithélial de l’ovaire. Forces et faiblesses des Recommandations de bonnes pratiques cliniques françaises communes de FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY labélisées par l’INCa

Author: Vincent Lavoué, Fabrice Lecuru, Chantal Touboul, Cyrille Huchon, Denis Querleu, Emile Daraï, Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Bergonié [Bordeaux], UNICANCER, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Cancer de l’ovaire, Recommandations, Obstetrics and Gynecology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Chirurgie, Chimiothérapie
Abstract: Resume Un groupe de travail compose des representants des differentes societes savantes francaises s’est constitue sous l’egide de l’Institut national du cancer (INCa) pour rediger des recommandations pour la pratique clinique (RPC) pour la prise en charge du cancer de l’ovaire, de la trompe et du peritoine primitif. Ces RPC ont ete redigees selon une methodologie specifique avec des forces et des limites qu’il convient de souligner afin d’ameliorer la diffusion et surtout l’application des recommandations.
Published: 2019

7. Prise en charge initiale des tumeurs épithéliales de l'ovaire. Méthodes et organisation. Article rédigé sur la base des recommandations françaises communes du CNGOF, FRANCOGYN, SFOG, GINECO-ARCAGY et labellisées INCa

Author: Vincent Lavoué, Cyrille Huchon, Emile Daraï, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: 0301 basic medicine, Oncology, medicine.medical_specialty, Recommandations pour la pratique clinique, Méthodologie, endocrine system diseases, business.industry, Cancer de l’ovaire, Obstetrics and Gynecology, [SDV.CAN]Life Sciences [q-bio]/Cancer, 3. Good health, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Internal medicine, medicine, Epithelial ovarian cancer, business
Abstract: National audience; This text presents organizational and methodological aspects of the development of the French guidelines on the initial management of epithelial ovarian cancer.
Published: 2019

8. Management of endometriosis CNGOF/HAS clinical practice guidelines

Author: Collinet, Pierre, Fritel, Xavier, Revel-Delhom, Christine, Ballester, Marcos, Bolze, Pierre-Adrien, Borghese, Bruno, Bornsztein, Nicole, Boujenah, Jérémy, Brillac, Thierry, Chabbert-Buffet, Nathalie, Chauffour, Candice, Clary, Nathalie, Cohen, Jonathan, Decanter, Christine, Denouël, Amélie, Dubernard, Gil, Fauconnier, Arnaud, Fernandez, Hervé, Gauthier, Tristan, Golfier, Francois, Huchon, Cyrille, Legendre, Guillaume, Loriau, Jérôme, Mathieu-D’argent, Emmanuelle, Merlot, Benjamin, Niro, Julien, Panel, Pierre, Paparel, Philippe, Philip, Charles-André, Ploteau, Stéphane, Poncelet, Christophe, Rabischong, Benoît, Roman, Horace, Rubod, Chrystèle, Santulli, Piétro, Sauvan, Marine, Thomassin-Naggara, Isabelle, Torre, Antoine, Wattier, Jean-Michel, Yazbeck, Chadi, Bourdel, N., Canis, Michel, Clinique de Gynécologie [Lille] (Hôpital Jeanne de Flandre), Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Lille Nord de France (COMUE), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Haute Autorité de Santé [Saint-Denis La Plaine] (HAS), CHU Tenon [APHP], Service de Chirurgie Gynécologique Oncologique et Obstétrique [CHU Lyon Sud], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Service de Chirurgie Gynécologie Obstétrique 2 et Médecine de la Reproduction [AP-HP Hôpital Cochin], CHU Cochin [AP-HP], Génomique, Epigénétique et Physiopathologie de la Reproduction, [Institut Cochin] Département Développement, Reproduction et Cancer (DRC), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Sorbonne Paris Cité (USPC), Cabinet de Médecine Générale [Evry], Service de Gynécologie-Obstétrique [CHU Bondy], CHU Bondy, Centre médical du Château [Vincennes], Cabinet de Médecine Générale [Toulouse], Service de Gynécologie-Obstétrique et Médecine de la reproduction [AP-HP Hôpital Tenon], Hôpital Tenon, Assistance Publique - Hôpitaux de Paris (AP-HP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Gynécologie-Obstétrique et Reproduction Humaine [CHU Estaing], CHU Estaing [Clermont-Ferrand], ENDOmind France [Antony], Service d’Assistance médicale à la procréation et de préservation de la fertilité [CHRU Lille] (Hôpital Jeanne de Flandre), Gamétogenèse et Qualité du Gamète (GQG), Université de Lille-Université de Lille, Droit et Santé-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), EndoFrance [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Clinique gynécologique et obstétricale [CHU de Lyon HCL - GH Nord-Hôpital de la Croix Rousse], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre Hospitalier Universitaire de Lyon (CHU Lyon), Service de Gynécologie-Obstétrique [CHI Poissy-St-Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Gynécologie Obstétrique [AP-HP Hôpital Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Equipe Epidémiologie et évaluation des stratégies de prise en charge : VIH, reproduction, pédiatrie (CESP - INSERM U1018), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Ciblage individuel et prévention des risques de traitements immunosupresseurs et de la transplantation (IPPRITT), CHU Limoges-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique [CHU Limoges], CHU Limoges, Service de Chirurgie Gynécologique et Oncologique – Obstétrique [CHU Lyon Sud], Service de Gynécologie-Obstétrique [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Sexualité et soins (Genre, Sexualité, Santé) (Equipe 7 - CESP - INSERM U1018), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie digestive [GH Paris Saint-Joseph], Groupe hospitalier Paris Saint-Joseph - Hôpital, Université Pierre et Marie Curie - Paris 6 (UPMC), Chirurgie gynécologique [Bordeaux] (Clinique Tivoli Ducos), Clinique Tivoli Ducos [Bordeaux], Service de Gynécologie-Obstétrique [CH Versailles, Le Chesnay], Centre Hospitalier de Versailles (CHV), Service d’Urologie [CHU Lyon Sud], Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Nantes] (Hôpital Mère- Enfant), Hôpital Mère Enfant CHU Nantes-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Gynécologie-Obstétrique [CH Renée Dubos, Pontoise], Centre Hospitalier Renée Dubos [Pontoise], UFR Santé, Médecine et Biologie Humaine (UFR SMBH), Université Paris 13 (UP13), CHU Rouen, Normandie Université (NU), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Sorbonne Université (SU), Institut Universitaire de Cancérologie [UPMC Paris VI], Service de gynécologie-obstétrique et médecine de la reproduction, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Centre d’étude et traitement de la douleur [CHRU Lille] (Hôpital Claude Huriez), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Hôpital Claude Huriez [Lille], Service de Gynécologie-Obstétrique [AP-HP Hôpital Foch], AP-HP Hôpital Foch - Suresnes, Centre d’Assistance Médicale à la Procréation [Neuilly-Sur-Seine] (Clinique Pierre Cherest), Clinique Pierre Cherest [Neuilly-Sur-Seine], Fritel, Xavier, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie-obstétrique [Hôpital Jean Verdier, Bondy], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Gynécologie [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Sexualité et soins (Genre, Sexualité, Santé) (CESP - INSERM U1018 - Equipe 7), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier Saint-Joseph [Paris], Service de Gynécologie-Obstétrique [CH Versailles], Centre Hospitalier de Versailles André Mignot (CHV), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut Universitaire de Cancérologie [Paris] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Foch [Suresnes], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Institut Universitaire de Cancérologie [Sorbonne Université] (IUC)
Subjects: [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018

9. Prise en charge de l’endométriose : recommandations pour la pratique clinique CNGOF-HAS (texte court)

Author: Pierre-Adrien Bolze, Horace Roman, Benoit Rabischong, J. Loriau, Charles-André Philip, J. Cohen, Guillaume Legendre, Gil Dubernard, Christine Decanter, Hervé Fernandez, C Chauffour, M. Canis, C. Rubod, Julien Niro, A. Denouel, Arnaud Fauconnier, Pierre Panel, Pierre Collinet, C. Revel-Delhom, François Golfier, Nathalie Chabbert-Buffet, B. Merlot, J. Boujenah, M. Sauvan, Christophe Poncelet, C. Yazbeck, N. Clary, Stéphane Ploteau, Bruno Borghese, Antoine Torre, N. Bornsztein, Pietro Santulli, E. Mathieu-d’Argent, Nicolas Bourdel, J.-M. Wattier, Cyrille Huchon, Xavier Fritel, T. Brillac, Isabelle Thomassin-Naggara, Tristan Gauthier, Philippe Paparel, Marcos Ballester, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC), Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de Gynécologie-Obstétrique [CHU Limoges], CHU Limoges, GeoRessources, Institut national des sciences de l'Univers (INSU - CNRS)-Centre de recherches sur la géologie des matières premières minérales et énergétiques (CREGU)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence Universitaire de la Francophonie (AUF), Service de gynécologie et obstétrique [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHRU de Lille, Hôpital Jeanne de Flandre, Service de gynécologie, 59000 Lille, France, Aerospatiale Societe Nationale Industrielle, Aerospatiale, Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité INSERM U 472. Faculté de Médecine Paris Sud. 63 rue Gabriel Péri. 94276 Le Kremlin Bicêtre Cedex, CHU Tenon [APHP], Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Gamétogenèse et Qualité du Gamète (GQG), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Droit et Santé-Université de Lille, Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France., Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Centre de recherches sur la géologie des matières premières minérales et énergétiques (CREGU)-Institut national des sciences de l'Univers (INSU - CNRS), Service de gynécologie et obstétrique [Rouen], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Service de Gynécologie - Obstétrique [Lille]
Subjects: Infertility, medicine.medical_specialty, French National Authority for Health, medicine.medical_treatment, Endometriosis, Physical examination, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, 0302 clinical medicine, medicine, Levonorgestrel, Fertility preservation, French National College of Obstetricians and Gynecologists (CNGOF), Pelvic examination, ComputingMilieux_MISCELLANEOUS, Gynecology, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, medicine.disease, 3. Good health, Reproductive Medicine, 030220 oncology & carcinogenesis, Hormonal therapy, Hormone therapy, business, medicine.drug
Abstract: First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.
Published: 2018

10. [Epidemiology and diagnosis strategy: CNGOF-HAS Endometriosis Guidelines]

Author: Fauconnier, Arnaud, Borghese, B., Huchon, C., Thomassin-Naggara, I., Philip, C.-A., Gauthier, T., Bourdel, N., Denouel, A., Torre, A., Collinet, P., Canis, M., Fritel, X., Service de gynécologie et obstétrique [Poissy - Saint-Germain-en-Laye]], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Service de Gynécologie et Obstétrique [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de Gynécologie-Obstétrique [CHU Limoges], CHU Limoges, Ciblage individuel et prévention des risques de traitements immunosupresseurs et de la transplantation (IPPRITT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CHU Clermont-Ferrand, Image Science for Interventional Techniques (ISIT), Clermont Université-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS)-Clermont Université
Subjects: Diagnostic Imaging, Health-related quality of life, Recommandations, Endometriosis, Diagnostic laparoscopy, Guidelines, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Decision Support Techniques, Pelvic pain, Dysmenorrhea, Pelvic examination, Information, Humans, Diagnostic d’endométriose, Endometriosis diagnosis, Questionnaire, Transvaginal ultrasound, Douleur pelvienne, Cœlioscopie diagnostique, Dyspareunia, Dysménorrhée, Examen pelvien, Dyspareunie, Female, Laparoscopy, Counselling, Gynecological Examination, Échographie vaginale, Qualité de vie liée à la santé, IRM, MRI
Abstract: International audience; Based on the best evidence available, we have provided guidelines for clinical practice to target the nature of endometriosis as a disease, the consequences of its natural history on management, and the clinical and imaging evaluation of the disease according to the level of care (primary care, specialized or referral). The frequency of endometriosis is unknown in the general population; endometriosis requires management when it causes symptoms (pain, infertility) or when it affect the function of an organ. In the absence of symptom, there is no need for follow-up or screening of the disease. Endometriosis may be responsible for various pain symptoms such as severe dysmenorrhea, deep dyspareunia, painful bowel movements or low urinary tract signs increasing with menstruation, or infertility. A careful evaluation of the symptoms and their impact on the quality of life should be made. The first-line examinations for the diagnosis of endometriosis are: digital examination and pelvic ultrasound. The second-line examinations are: the pelvic exam by an expert clinician, the pelvic MRI and/or the transvaginal ultrasound by an expert. MRI and ultrasound carrying different and complementary information. Other examinations may be considered as part of the pre-therapeutic assessment of the disease in case of specialized care. Diagnostic laparoscopy may be suggested in case of clinical suspicion of endometriosis whereas preoperative examinations have not proved the disease, it must be part of a management plan of endometriosis-related pain or infertility. During management, it is recommended to give comprehensive information on the different therapeutic alternatives, the benefits and risks expected from each treatment, the risk of recurrence, fertility, especially before surgery. The information must be personalized and take into account the expectations and preferences of the patient, and accompanied by an information notice given to the patient.
Published: 2018

11. [Expectations of women with endometriosis: What information to deliver? CNGOF-HAS Endometriosis Guidelines]

Author: Denouel, A., Fauconnier, Arnaud, Torre, A., Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie-obstétrique et médecine de la reproduction, and Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve
Subjects: Physician-Patient Relations, Endométriose, [SDV]Life Sciences [q-bio], Decision Making, Endometriosis, Décision médicale partagée, Études qualitatives, Relation médecin patient, Patient Education as Topic, Humans, Shared medical decision making, Female, Health Information, Qualitative Research, Information dans la santé
Abstract: International audience; Women with endometriosis often say that the information doctors give them should be improved. Patient support groups can provide missing information but may lack objectivity, or reliability, and may even generate anxiety or even harm their health. Clear unbiased medical information is the ideal. New patients with endometriosis wish to be taken seriously by primary care physicians, and be referred quickly to a specialist without further unnecessary investigation or delay. The diagnosis of endometriosis should ideally be made quickly, and should clearly specify the nature of the disease, its evolution, and its consequences on quality of life, relationships, and fertility. When choosing a treatment, information should state the risks of each treatment, the risks of recurrence long term, and the therapeutic alternatives. These should include conventional medical treatment, lifestyle adaptation, or alternative therapies. In case of surgery, prior written information should be provided, the likely scar appearance, the short and long term consequences in terms of pain, postoperative recovery time and complication rates. Once the surgery is performed, the degree of endometriotic involvement and the treatment undertaken should be explained. At discharge, patients should be told the expected recovery time, and the consequences of the operation on daily life.
Published: 2018

12. Effets de la grossesse et des variations pondérales sur la survenue d’une incontinence urinaire chez la femme : une enquête étiologique sur la part réversible de l’incontinence urinaire

Author: Pizzoferrato, Anne-Cécile, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris Saclay (COmUE), Arnaud Fauconnier, Xavier Fritel, and STAR, ABES
Subjects: Epidemiology, Incontinence urinaire, Urinary incontinence, Epidémiologie, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Facteurs de risque, Grossesse, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pregnancy, Césarienne, Caesarean section, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Delivery, Accouchement
Abstract: Objective: the most often cited hypothese to explain urinary incontinence (UI) is the theory of birth trauma: vaginal delivery would be likely to cause perineal tears leading to UI and caesarean section appears as a protective factor. The objective of our work was to clarify the importance of non-obstetric factors involved in the genesis of UI in women.Material and Methods: we first studied the impact of UI risk factors in two distinct populations: one away from the first delivery (between 4 and 12 years), the other at 1 year of the first delivery.Results: Twelve years after 1st delivery, we found that the presence of a UI during pregnancy increase the risk of UI. It also reduced the chance of UI remission between 4 and 12 years after the first delivery. Mode of delivery and additional pregnancies were associated with the risk of UI at 12 years. A higher BMI was associated with a higher risk of developing UI 12 years after the first delivery, while the weight loss increased the chances of remission. At 1 year after the 1st delivery, the existence of UI during pregnancy was a factor strongly associated with the risk of UI in the postpartum period, regardless of mode of delivery. Prenatal cervical-urethral mobility (evaluated clinically or by ultrasound) was significantly associated with the risk of UI 1 year after first delivery.Conclusion: These results show the importance of the "non-traumatic" risk factors on the postnatal UI risk, especially individual susceptibility factors. Yet reading the abundant literature does not conclude as to the real impact of mode of delivery on postnatal IU and the only way to respond would be to set up a randomized trial comparing cesarean and vaginal delivery. In the third part of this work, we present the methodology of the research protocol we wish to set up to answer the question. The problem lies for us in the acceptability of this type of trial. A preliminary investigation will assess the feasibility of such a trial in France., Objectif : la principale théorie développée pour expliquer l’incontinence urinaire (IU) et le défaut de support urétral est la théorie du traumatisme obstétrical : l’accouchement par voie vaginale serait susceptible d’entraîner des lésions périnéales à l’origine de l’IU et la pratique de la césarienne constituerait un facteur protecteur. Notre objectif était de préciser la part des facteurs étiologiques non liés à l’accouchement qui participent à la genèse de l’IU reliée à la grossesse chez la femme.Matériel et Méthodes : nous avons d’abord étudié l’impact des facteurs de risque d’IU dans 2 populations distinctes : l’une à distance du premier accouchement (entre 4 et 12 ans), l’autre dans une cohorte de primipares suivies à 1 an du premier accouchement.Résultats : A long terme après le premier accouchement, nous avons retrouvé que la présence d’une IU au cours de la première grossesse augmentait le risque d’IU. Elle diminuait également les chances de rémission de l’IU entre 4 et 12 ans après le premier accouchement. Le mode d’accouchement et les grossesses supplémentaires n’étaient pas associés au risque d’IU à 12 ans. Par contre, un IMC élevé était associé à un risque plus élevé de développer une IU 12 ans après le premier accouchement, tandis que la perte de poids augmentait les chances de rémission. A 1 an après le premier accouchement, l’existence d’une IU lors de la grossesse était un facteur très fortement associé au risque d’IU dans le postpartum, indépendamment du mode d’accouchement. La mobilité cervico-urétrale prénatale, évaluée cliniquement ou à l’aide de l’échographie était associée significativement au risque d’IU 1 an après le premier accouchement. Nous n’avons pas retrouvé d’association significative avec le mode d’accouchement à 1 an du postpartum.Conclusion : Ces résultats montrent donc l’importance de la part des facteurs de risque « non traumatiques » sur le risque d’IU postnatale, en particulier les facteurs de susceptibilité individuelle et métaboliques. La lecture de la littérature pourtant abondante ne permet pas de conclure quant au réél impact du mode d’accouchement sur l’IU postnatale et la possibilité de prévention par la césarienne au sein de groupes à risque particulier. La seule façon d’y répondre serait de mettre en place un essai randomisé comparant la césarienne et l’accouchement vaginal. Dans la troisième partie de ce travail, nous présentons la méthodologie du protocole de recherche que nous souhaitons mettre en place pour répondre à la question. A une époque où la relation médecin-malade évolue, la difficulté réside essentiellement en l’acceptabilité de ce type d’essai, que ce soit auprès des patientes ou des obstétriciens. Une enquête préliminaire permettra d’évaluer la faisabilité d’un tel essai en France.
Published: 2017

13. [Cultural adaptation of the female pelvic floor questionnaire (FPFQ) into French]

Author: J, Deparis, V, Bonniaud, D, Desseauve, J, Guilhot, M, Masanovic, R, De Tayrac, A, Fauconnier, X, Fritel, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Réseau de Pelvi-Périnéologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHR La réunion, PHRC, and Fritel, Xavier
Subjects: Adult, Cultural Characteristics, Psychometrics, French, Symptômes, Périnée, Questionnaire, Reproducibility of Results, Pelvic floor, Pelvic floor – Symptoms – Questionnaire – Validation studies – French, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Pelvic Floor Disorders, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Français, Diagnostic Self Evaluation, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Validation studies, Surveys and Questionnaires, Adaptation culturelle, Symptoms, Humans, Female, Translations
Abstract: International audience; AIMS:The Female Pelvic Floor Questionnaire (FPFQ) is a self-administered tool on pelvic floor function. Our aim was to carry out a cultural adaptation of the FPFQ into French and to assess its psychometric properties.METHODS:After cross-cultural adaptation into French, acceptability and reliability of the questionnaire were assessed through a sample of 56 women in a test-retest. Discriminative construct validity was evaluated by comparing the results obtained by the FPFQ to those of other validated questionnaires. Longitudinal follow-up of the 282 pregnant women included in the PreNatal Pelvic floor Prevention trial (3PN) was used to analyze responsiveness.RESULTS:The proportion of missing data did not exceed 4 % for questions about bladder function, bowel function and pelvic organ prolapse; 10 % for issues related to sexual function. Question 9 was considered difficult to understand by 14 % of women. After rewriting, this issue was retested in a new sample of 52 women and presented no further problems. The intra-class correlation coefficient was greater than or equal to 0.7 for all domains during the test-retest. The FPFQ was strongly and significantly correlated (Spearman r>0.5) with the other validated questionnaires. The French version of FPFQ recorded changes in urinary and sexual symptoms for the women involved in 3PN trial with a standardized response mean equal to 0.83 and 0.44, respectively.CONCLUSION:The French version of the FPFQ is self-administered, reliable, valid, and can detect a change in symptoms during follow-up.LEVEL OF EVIDENCE:Level 4.
Published: 2017

14. Recommandations pour l’administration d’oxytocine au cours du travail spontané. Chapitre 5 : risques et effets indésirables materno-fœtaux liés à l’administration d’oxytocine au cours du travail spontané

Author: A Burguet, A. Rousseau, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
Subjects: 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Adverse effects, [SDV]Life Sciences [q-bio], Maternity and Midwifery, Spontaneous labor, 030212 general & internal medicine, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Oxytocin, Practice guidelines
Abstract: Resume Objectif Decrire les risques et effets indesirables materno-fœtaux lies a l’administration d’oxytocine au cours du travail spontane. Methodes Revue de la litterature entre janvier 1995 et avril 2016 a partir des bases de donnees Medline et Cochrane Library, ainsi que des recommandations internationales des societes savantes. Resultats Au total, 35 articles originaux et 8 meta-analyses ont ete retenues. L’administration d’oxytocine au cours du travail spontane augmente le risque d’hyperactivite uterine selon un effet dose-dependant. Celle-ci peut entrainer des anomalies du rythme cardiaque fœtal (RCF) et etre associee a une acidose neonatale. En cas d’administration d’oxytocine, il est recommande d’enregistrer l’activite uterine et de surveiller le RCF (Grade C), et en cas d’anomalie du RCF a risque d’acidose associee a une hyperactivite uterine, il est recommande d’arreter la perfusion d’oxytocine (Accord professionnel). D’autre part, l’administration d’oxytocine pendant le travail spontane est associee a un risque augmente d’hemorragie du post-partum, d’autant plus lorsque la dose utilisee pendant le travail est elevee, si les intervalles d’augmentations sont courts, si la patiente ne beneficie pas d’administration prophylactique d’oxytocine au moment de la naissance. Les donnees de la litterature ne permettent pas d’etablir de relation de causalite entre l’administration d’oxytocine pendant le travail, la douleur et l’insatisfaction des femmes. Conclusion Au vu des risques lies a l’utilisation de l’oxytocine au cours du travail spontane, il est recommande d’administrer l’oxytocine selon des indications strictes, a dose minimale efficace, en tenant compte de la reponse uterine et du rythme cardiaque fœtal (Grade C).
Published: 2017

15. Recommandations pour l'administration d'oxytocine au cours du travail spontané. Texte court des recommandations [Oxytocin administration during spontaneous labour: Guidelines for clinical practice. Guidelines short text]

Author: Dupont, Corinne, Carayol, M., Le Ray, C., Barasinski, C., Beranger, R., Burguet, A., Chantry, A., Chiesa, C., Coulm, B., Evrard, A., Fischer, C., Gaucher, L., Guillou, C., Leroy, F., Phan, E., Rousseau, Anne, Tessier, V., Vendittelli, F., Deneux-Tharaux, C., Riethmuller, D., Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement (PEPRADE), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Chimie des Substances Naturelles (ICSN), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), CH Montélimar, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université Claude Bernard Lyon 1 ( UCBL ), Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement ( PEPRADE ), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I ( UdA ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques ( CIC-EC ), Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Chimie des Substances Naturelles ( ICSN ), Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Physique des Plasmas ( LPP ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Observatoire de Paris-École polytechnique ( X ) -Sorbonne Universités-PSL Research University ( PSL ) -Université Paris-Saclay-Centre National de la Recherche Scientifique ( CNRS ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: [SDV.EE]Life Sciences [q-bio]/Ecology, environment, [ SDV.EE ] Life Sciences [q-bio]/Ecology, environment
Abstract: National audience; Objectives To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. Method A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. Results The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5 cm of cervical dilatation. Rate of cervical dilatation is considered as abnormal below 1 cm per 4 hour during the first part of the active phase, and blow 1 cm per 2 hours above 7 cm of dilatation. During the latent phase of the first stage of labor, i.e. before 5 cm of cervical dilatation, it is recommended that an amniotomy not be performed routinely and not to use oxytocin systematically. It is not recommended to expect the active phase of labor to start the epidural analgesia if patient requires it. If early epidural analgesia was performed, the administration of oxytocin must not be systematic. If dystocia during the active phase, an amniotomy is recommended in first-line treatment. In the absence of an improvement within an hour, oxytocin should be administrating. However, in the case of an extension of the second stage beyond 2 hours, it is recommended to administer oxytocin to correct a lack of progress of the presentation. If dynamic dystocia, it is recommended to start initial doses of oxytocin at 2 mUI/min, to respect at least 30 min intervals between increases in oxytocin doses delivered, and to increase oxytocin doses by 2 mUI/min intervals without surpassing a maximum IV flow rate of 20 mUI/min. The reported maternal adverse effects concern uterine hyper-stimulation, uterine rupture and postpartum haemorrhage, and those of neonatal adverse effects concern foetal heart rate anomalies associated with uterine hyper-stimulation, neonatal morbidity and mortality, neonatal jaundice, weak suck/poor breastfeeding latch and autism. Conclusion The widespread use of oxytocin during spontaneous labour must not be considered as simply another inoffensive prescription without any possible deleterious consequences for mother or foetus. Conditions for administering the oxytocin must therefore respect medical protocols. Indications and patient consent have to be report in the medical file. © 2016 Elsevier Masson SAS
Published: 2017

16. Recommandations pour l’administration d’oxytocine au cours du travail spontané. Chapitre 6 : risques et effets indésirables fœtaux, et pédiatriques de l’administration de l’oxytocine au cours du travail spontané

Author: A. Rousseau, A. Burguet, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Neonate, Adverse effects, [SDV]Life Sciences [q-bio], Maternity and Midwifery, Labour augmentation, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Oxytocin, Child, 030217 neurology & neurosurgery
Abstract: International audience; Les risques et effets indésirables fœtaux, et pédiatriques de l’utilisation de l’oxytocine au cours du travail spontané, s’ils existent, sont globalement de cinq types : (1) difficultés d’adaptation à la vie extra-utérine, (2) ictère néonatal, (3) hyponatrémie néonatale, (4) perturbations de la succion en période néonatale et (5) troubles envahissant du développement (autisme) chez l’enfant. De nombreuses difficultés méthodologiques interdisent l’établissement d’un lien causal entre l’exposition à l’oxytocine et ces cinq effets indésirables : manque de puissance des essais randomisés, sélection dans les essais randomisés de parturientes qui ne correspondent pas à celles observées dans les enquêtes en population, et inversement mise en évidence dans les enquêtes en population d’effets indésirables dans des conditions d’administration de l’oxytocine (indication, posologie, préparation) qui ne sont pas forcément celles établies dans les recommandations. Néanmoins, compte tenu de la forte fréquence actuelle de l’administration de l’oxytocine au cours du travail spontané en France, notre groupe d’experts attire l’attention des prescripteurs sur la nécessité d’une grande vigilance : cette vigilance doit s’articuler notamment autour de la rédaction de protocole d’administration de l’oxytocine au cours du travail spontané dans chaque maternité, autour de l’analyse de l’administration de l’oxytocine lors des reprises de cas ou revue de morbi-mortalité des nouveau-nés ayant présenté une mauvaise adaptation à la vie extra-utérine, et du taux d’administration de l’oxytocine au cours du travail spontané dans chaque maternité.
Published: 2017

17. Effectiveness of 'threshold' in the management of ovarian cancer: A review of the literature

Author: Julien, Seror, Eugénie, Guillot, Anne-Sophie, Genin, Delphine, Hequet, Nicolas, Pouget, Coraline, Dubot, Roman, Rouzier, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Curie [Paris], Hôpital René HUGUENIN (Saint-Cloud), and Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ)
Subjects: Ovarian Neoplasms, Surgeons, Hospitals, Low-Volume, Survival, Genital Neoplasms, Female, Volume, Threshold, [SDV]Life Sciences [q-bio], Cancer Care Facilities, Survival Analysis, Ovarian cancer, Humans, Female, Surgery, Prospective Studies, Hospitals, High-Volume, Retrospective Studies
Abstract: International audience; Objective The "Institut national du cancer" has established since 2007 a minimum threshold of 20 patients per year per center to treat patients with gynecologic cancer. This review aims to assess whether the literature data validate this approach, and specifically for ovarian cancer. Methods A search of the MEDLINE database was conducted, to reference all relevant articles evaluating one hand the links between the survival of patients with ovarian cancer and the average volume of patients per center and by operator; and secondly the relationship between quality of oncological surgery and these volumes. Results Nineteen studies met our inclusion criteria; seventeen were retrospective and two were prospective; population samples ranged from 476 to 96,802 patients. The most important data, quantitatively and qualitatively, concern the evaluation of survival based on the average volume per center, with 8 out of 13 studies finding a statistically significant correlation between average volume per center and survival. Data on the quality of surgery are less abundant and more heterogeneous, depending on the definition of the "optimal" surgery by the authors. Conclusion The establishment of threshold centers appears to be an effective way to improve survival in ovarian cancer. However, these thresholds would have to be specific to ovarian cancer and not extended to "gynecological cancers."
Published: 2016

18. Caractérisation moléculaire des cancers du sein en pratique clinique

Author: D. De Croze, Claire Bonneau, A. Vincent Salomon, Roman Rouzier, Y. Zemmouri, Département de chirurgie, Institut Curie [Paris], Hôpital René HUGUENIN (Saint-Cloud), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: 0301 basic medicine, Oncology, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Molecular classification, Molecular level, Breast cancer, Internal medicine, medicine, Genomic signature, Gynecology, business.industry, Precision medicine, Obstetrics and Gynecology, General Medicine, medicine.disease, Predictive value, 3. Good health, Clinical Practice, 030104 developmental biology, Reproductive Medicine, 030220 oncology & carcinogenesis, business
Abstract: International audience; Breast cancer involves various types of tumors. The objective of this review was to provide a summary of the main methods currently available in clinical practice to characterize breast cancers at a molecular level and to discuss their prognostic and predictive values. Hormonal receptors expression and the HER2 status are prognostic markers and can also predict the response to targeted therapies. Their analysis through immunohistochemistry is systematical. Ki67 is an effective prognostic marker, but its reliability is debated because of its low reproducibility between laboratories and between pathologists. Commercial genomic signatures are all considered valid prognostic tools and may guide physicians to make therapeutic choices. These signatures are costly and should therefore be restricted to situations in which the use of chemotherapy remains equivocal.
Published: 2016

19. Chimiothérapie intrapéritonéale pressurisée en aérosol (CIPPA): Une nouvelle voie d'administration dans les carcinoses péritonéales d'origine ovarienne

Author: Sabaila, Anne, Fauconnier, Arnaud, Huchon, Cyrille, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and HAL UVSQ, Équipe
Subjects: [SDV] Life Sciences [q-bio], PIPPAC, Ovarian cancer, [SDV]Life Sciences [q-bio], Chemotherapy, ComputingMilieux_MISCELLANEOUS, Peritoneal carcinomatosis
Abstract: International audience
Published: 2015

20. Early-onset neonatal infection: Assessment of professional practices in 14 maternity wards in the Île-de-France region in 2013

Author: Sikias, Patrick, Parmentier, Cyrielle, Imbert, Patrick, Rajguru, Mandovi, Chavet, M. S., Coquery, Sarah, Foix-L'Hélias, Laurence, Boileau, Pascal, Hôpital privé d’Antony, Service d'hématologie-immunologie-oncologie pédiatrique [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital d'Instruction des Armées Begin, Service de Santé des Armées, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut hospitalier Franco-Britannique [Levallois-Perret], Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and CHI Poissy-Saint-Germain
Subjects: Adult, Gastric Juice, Bacteria, [SDV]Life Sciences [q-bio], Infant, Newborn, Bacterial Infections, Infectious Disease Transmission, Vertical, Anti-Bacterial Agents, C-Reactive Protein, Pregnancy, Practice Guidelines as Topic, Humans, Female, France, Guideline Adherence, Prospective Studies, Practice Patterns, Physicians', Pregnancy Complications, Infectious, Hospital Units
Abstract: International audience; Introduction: Early-onset neonatal infection remains a major cause of morbidity and mortality in neonates. Both universal vaginal screening for group-B streptococcus (GBS) and intrapartum antibiotic prophylaxis have decreased the incidence of early-onset GBS disease. Almost 12 years after the implementation of the French recommendations, we assessed the practices around screening, diagnosis, and treatment of early-onset neonatal infection in the Île-de-France region. Patients and methods: We conducted a prospective, multicenter, observational study in 14 volunteer maternity wards from 18 to 31 March 2013. All live newborn infants delivered at 35 gestational weeks or more were eligible. Maternal, obstetrical, and neonatal characteristics were collected, as well as the management of suspected early-onset neonatal infections. Results: A total of 1194 mothers and 1217 neonates were included. Among the latter, 54% had bacteriological samplings at birth, with at least a gastric aspirate. Bacteriological samples were collected at birth in 85% of cases based on major or minor anamnestic infection criteria defined by the French National Authority for Health in 2002. In addition, 26% of neonates had at least one blood sample taken. Antibiotic treatment was administered in 4% of the infants with cefotaxime administered in two thirds of cases. Conclusion: An update of the French guidelines for the management of early-onset neonatal infections is required in order to improve targeting of newborn infants suspected of having an infection and to optimize the antibiotics administered. Moreover, the role of bacteriological sampling at birth needs to be clarified.
Published: 2015

21. Evaluation of the metrological quality of the medico-administrative data for perinatal indicators: A pilot study in 3 university hospitals

Author: Pierron, A., Revert, Mathilde, Goueslard, Karine, Vuagnat, Albert, Cottenet, Jonathan, Benzenine, Éric, Fresson, Jeanne, Quantin, Catherine, Service Biostatistiques et Informatique Médicale (CHU de Dijon) (DIM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Sorbonne Université - Faculté de Médecine - École de sages-femmes Saint-Antoine (SU ESF), Sorbonne Université (SU), Direction de la recherche, des études, de l'évaluation et des statistiques (Ministère des Affaires sociales, de la Santé et des Droits des femmes) (DREES), Maternité Régionale Adolphe Pinard [Nancy], Lipides - Nutrition - Cancer (U866) (LNC), and Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)
Subjects: Perinatal indicators, Maternal Health, [SDV]Life Sciences [q-bio], Pilot Projects, PMSI, Delivery, Obstetric, Medical Records, Perinatal health, Data Accuracy, Hospitals, University, Sensitivity, Pregnancy, Humans, Female, France, Positive predicitve value
Abstract: International audience; Background: In order to assess public health policies for the perinatal period, routinely produced indicators are needed for the whole population. In France, these indicators are used to compare the national public health policy with those of other European countries. French administrative and medical data (PMSI) are straightforward and reliable and may be a valuable source of information for research. This study aimed to measure the quality of PMSI data from three university health centers for core indicators in perinatal health. Method: PMSI data were compared with medical files in 2012 from 300 live births after 22 weeks of amenorrhea, drawn at random from University Hospitals in Dijon, Paris and Nancy. The variables were chosen based on the Europeristat Project's core and recommended indicators, as well as those of the French National Perinatal survey conducted in 2010. The information gathered blindly from the medical files was compared with the PMSI data positive predictive value (PPV) and the sensitivity was used to assess data quality. Results: Data on maternal age, parity and mode of delivery as well as the rates of premature births were superimposable for the two sources. The PPV for epidural injection was 96.2% and 94.3% for perineal tears. Overall, maternal morbidity was underdocumented in the PMSI, so the PPV was 100.0% for pre-existing diabetes, 88.9% for gestational diabetes and 100.0% for high blood pressure with a rate of 9.0% in PMSI and 6.3% in the medical files. The PPV for bleeding during labor was 89.5%. Conclusion: To conclude, PMSI data are apparently becoming more and more reliable for two reasons: on one hand, the importance of these data for budgetary promotion in hospitals; on the other, the increasing use of this information for statistical and epidemiological purposes.
Published: 2015

22. Evidence-based evaluation and expertise of methotrexate off label use in gynaecology and obstetrics: Work of the CNGOF

Author: Marret, Henri, Fauconnier, Arnaud, Dubernard, Gil, Misme, Hélène, Lagarce, Laurence, Lesavre, Magali, Fernandez, H., Mimoun, Camille, Tourette, Claire, Curinier, Sandra, Rabishong, Benoit, Agostini, Aubert F., Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France., Service de Médecine Nucléaire, CHRU de Tours, boulevard Tonnellé, 37000 Tours, France, INSERM U930, Université François Rabelais, boulevard Tonnellé, 37000 Tours, France, INSERM CIC 1415, boulevard Tonnellé, 37000 Tours, France., Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de Gynécologie et Obstétrique [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Collège National des Gynécologues et Obstétriciens Français (CNGOF), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de Gynécologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)
Subjects: Abortifacient Agents, Nonsteroidal, Evidence-Based Medicine, Ectopic pregnancy, [SDV]Life Sciences [q-bio], HCG, Off-Label Use, Guideline, Cervical pregnancy, Pregnancy, Ectopic, Obstetrics, Methotrexate, Gynecology, Pregnancy, Humans, Female, Interstitial pregnancy
Abstract: International audience; In the absence of contraindication, methotrexate by intramuscular unique injection of 1mg/kg or 50mg/m2 is the medical treatment recommended for tubal ectopic pregnancy (EP; LE1). It can be renewed once, at the same dose, according to hCG rates decrease. The pretherapeutic biological assessment contains blood cells numeration, renal and hepatic function. Methotrexate therapy constitutes an alternative conservative treatment to laparoscopic salpingotomy for non-complicated tubal EP (LE1) with hCG level 2000 UI/L, the systematic treatment by methotrexate is an option. The methotrexate is not indicated for first trimester termination of pregnancy or miscarriage neither in placentas accreta nor in association with other treatments such myfegine or potassium.
Published: 2015

23. [Threatened late miscarriage. French guidelines]

Author: Carcopino, Xavier, Barde, K., Petrovic, Melinda, Beucher, Gaël, Capmas, Perrine, Huchon, Cyrille, Deffieux, Xavier, D’ercole, C., Bretelle, Florence, Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'Obstétrique et Gynécologique [Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de Gynécologie-Obstétrique et Médecine de la Reproduction [AP-HP Hôpital Antoine Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), AP-HP - Hôpital Antoine Béclère [Clamart], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Late miscarriage, Progesteronetherapy, [SDV]Life Sciences [q-bio], Bacterial vaginosis, Membrane prolapse, Cerclage, Abortion, Spontaneous, Antibiotics, Pregnancy, Pregnancy Trimester, Second, Practice Guidelines as Topic, Humans, Female, France, Cervical length
Abstract: International audience; Objectives-To define guidelines for the management of women diagnosed with threatenedlate miscarriage (TLM).Materials and Methods-A systematic review of the literature was performed using Pubmedand the Cochrane library databases and the guidelines from main international societies.Results-Management of women diagnosed with threatened LM requires a complete history-taking searching for a previous history of LM and/or of premature delivery (Grade B). Speculumexamination is required to diagnose membrane prolapse (Grade B) and vaginal ultrasound scanis recommended to measure the cervical length (Grade B). Finally, initial management shouldallow to rule out chorioamniotitis (Grade B). Vaginal progesterone therapy (90-200 mg daily) isrecommended for women diagnosed with a sole shortened cervix (< 25 mm) in mid-pregnancy(Grade A). Cerclage is only recommended in women with both history of previous prematuredelivery and/or previous LM and shortened cervical length diagnosed before 24 weeks of ges-tation (Grade A). Finally, cervical cerclage (Mc Donald technique) associated with systematictocolytic therapy (indometacine) and antibiotics are to be recommended in women diagnosedwith TLM with dilated cervical os eventually associated with membrane prolapse (Grade C).
Published: 2014

24. [Chronic maternal diseases and pregnancy losses. French guidelines]

Author: Nizard, Jacky, Guettrot-Imbert, Gaëlle, Plu-Bureau, Geneviève, Ciangura, Cécile A., Jacqueminet, Sophie, Leenhardt, Laurence, Nedellec, Sophie, Gallot, Vanessa, Vialard, François, Quibel, Thibault, Huchon, Cyrille, Costedoat-Chalumeau, Nathalie, Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut des Systèmes Intelligents et de Robotique (ISIR), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Interne [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de nutrition [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de diabétologie [CHU Pitié-Salpétrière], Institut E3M [CHU Pitié-Salpêtrière], Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Gamètes, implantation, gestation (GIG), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHI Poissy-Saint-Germain, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Nutrition [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Service de Diabétologie [CHU Pitié-Salpétrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP]
Subjects: [SDV]Life Sciences [q-bio], Diabetes, Stillbirth, Miscarriage, Abortion, Spontaneous, Pregnancy Complications, Pregnancy loss, Pregnancy, Chronic Disease, Practice Guidelines as Topic, Humans, Female, Obesity, France, Antiphospholipidsyndrome, Fetal Death, Thrombophilias, Chronic maternaldisease
Abstract: International audience; Aim.-To review the available data on maternal chronic diseases and pregnancy losses.Material and Methods-We searched PubMed and the Cochrane library with pregnancy loss,stillbirth, intrauterine fetal demise, intrauterine fetal death, miscarriage and each maternaldiseases of this paper.Results-Antiphospholipid antibodies (anticardiolipin, anti-beta-2-glycoprotein, lupus anti-coagulant) should be measured in case of miscarriage after 10 WG confirmed by ultrasound(grade B) and an antiphospholipid syndrome should be treated by a combination of aspi-rin and low-molecular-weight heparin during a subsequent pregnancy (grade A). We donot recommend testing for genetic thrombophilia in case of first trimester miscarriage(grade B) or stillbirth (grade C). Glycemic control should be a goal before pregnancyfor women with pregestational diabetes to limit the risks of pregnancy loss (grade A)with a goal of prepregnancy HbA1c < 7%. Overt and subclinical hypothyroidisms should betreated by L-thyroxin during pregnancy to reduce the risks of pregnancy loss (grade A).Women who are positive for TPOAb should have TSH concentrations follow-up during pre-gnancy and subsequently treated by L-thyroxin if they develop subclinical hypothyroidism(grade B).Conclusions.-Prepregnancy management of most chronic maternal diseases, ideally throughprepregnancy multidisciplinary counseling, reduces the risks of pregnancy loss.
Published: 2014

25. Standardisation de la terminologie des pertes de grossesse : consensus d’experts du Collège national des gynécologues et obstétriciens français (CNGOF)

Author: François Vialard, Guillaume Legendre, Jacky Nizard, Xavier Carcopino, Nathalie Costedoat-Chalumeau, V. Gallot, Gael Beucher, Amélie Delabaere, Vincent Lavoué, E. Iraola, Cyrille Huchon, S. Nedellec, F. Venditelli, V. Lejeune, Damien Subtil, Didier Lémery, Xavier Deffieux, Patrick Rozenberg, Perrine Capmas, Thibaud Quibel, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de Gynécologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Pontchaillou [Rennes], Centre hospitalier de Saint-Quentin, Structure fédérative de recherche François Bonamy (SFR François Bonamy), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Santé de l'Université de Nantes (IRS-UN), Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Gynécologie Obstétrique, Hôpital Nord [CHU - APHM], Gamètes, implantation, gestation (GIG), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Unité de pathologie cellulaire et génétique (UPCG), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Reproductive Medicine, Obstetrics and Gynecology, General Medicine, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, ComputingMilieux_MISCELLANEOUS
Abstract: Resume Objectif L’objectif de cette etude etait de produire une terminologie francaise des pertes de grossesse et sa traduction anglaise. Materiel et methode Revue de la litterature, construction d’une terminologie et cotation des propositions par un groupe d’experts en utilisant une methode de consensus formalise. Cette terminologie a ete relue et critique par un panel multidisciplinaire de professionnels. Resultats Une fausse couche est l’expulsion spontanee du contenu uterin, avant 22 SA. Une grossesse arretee precoce est un arret de developpement (stagnation de la taille du sac gestationnel et/ou de la longueur cranio-caudale et/ou disparition d’une activite cardiaque) Conclusion Cette terminologie devrait etre utilisee par tous les professionnels de sante.
Published: 2014

26. Pertes de grossesse : recommandations pour la pratique clinique – Texte court

Author: Xavier Carcopino, Guillaume Legendre, François Vialard, E. Iraola, Thibaud Quibel, S. Nedellec, Perrine Capmas, Amélie Delabaere, Didier Lémery, Jacky Nizard, V. Gallot, V. Lejeune-Saada, Xavier Deffieux, Gael Beucher, Nathalie Costedoat-Chalumeau, Damien Subtil, Vincent Lavoué, Cyrille Huchon, Jean Levêque, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gynécologie Obstétrique, Hôpital Nord [CHU - APHM], Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Université Paris Descartes - Paris 5 (UPD5), Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes], Laboratoire d'Annecy de Physique des Particules (LAPP), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Structure fédérative de recherche François Bonamy (SFR François Bonamy), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Santé de l'Université de Nantes (IRS-UN), Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Gamètes, implantation, gestation (GIG), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Gynecology, medicine.medical_specialty, Reproductive Medicine, business.industry, medicine, Obstetrics and Gynecology, General Medicine, Abortion, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, business, ComputingMilieux_MISCELLANEOUS
Abstract: Journal de Gynecologie Obstetrique et Biologie de la Reproduction - Vol. 43 - N° 10 - p. 918-928
Published: 2014

27. Épidémiologie des pertes de grossesse

Author: Cyrille Huchon, S. Nedellec, V. Gallot, Damien Subtil, Thibaud Quibel, Didier Lémery, H. Laurichesse-Delmas, Xavier Carcopino, Xavier Deffieux, Chloé Barasinski, Gael Beucher, Françoise Vendittelli, François Vialard, Denis Gallot, Amélie Delabaere, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Structure fédérative de recherche François Bonamy (SFR François Bonamy), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Santé de l'Université de Nantes (IRS-UN), Gamètes, implantation, gestation (GIG), Service de Gynécologie Obstétrique, Hôpital Nord [CHU - APHM], Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), AP-HP - Hôpital Antoine Béclère [Clamart], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Gynecology, medicine.medical_specialty, Reproductive Medicine, Fetal death, business.industry, Fausse couche, Obstetrics and Gynecology, Medicine, General Medicine, Fetal loss, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, business, ComputingMilieux_MISCELLANEOUS
Abstract: Resume But Etude epidemiologique des pertes de grossesse. Materiels et methodes Recherche bibliographique en langue francaise et anglaise a partir des banques de donnees de PubMed, Cochrane Library et des recommandations des societes savantes internationales. Resultats La survenue d’une fausse couche (FC) precoce concerne 12 % des grossesses. Les facteurs de risque retrouves sont les âges maternel et paternel, un indice de masse corporel superieur ou egal a 25 kg/m2, la consommation de cafe, de tabac et d’alcool, l’exposition aux champs magnetiques et aux radiations ionisantes, un antecedent de FC precoce, d’interruption volontaire de grossesse (IVG) et certains troubles de la fertilite. Une FC tardive (FCT) complique moins de 1 % des grossesses. Les principaux facteurs de risque sont l’âge maternel, le fait de vivre seule ou non mariee, un faible niveau d’education, des antecedents de FC precoce, de FCT, d’accouchement premature, d’IVG, de malformation uterine, de trachelectomie, une vaginose bacterienne, la realisation d’une amniocentese, un col court au second trimestre, ou ouvert avec poche des eaux dans le vagin. La mort fœtale in utero a une prevalence de 2 % dans le monde et de 5/1000 en France. Les facteurs de risque sont detailles dans le chapitre dedie.
Published: 2014

28. [Epidemiology and risk factors for cancer of the uterus]

Author: Bonneau, Claire, Perrin, Morgane, Koskas, Martin, Genin, Anne Sophie, Rouzier, Roman, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and HAL UVSQ, Équipe
Subjects: [SDV] Life Sciences [q-bio], Risk Factors, [SDV]Life Sciences [q-bio], Uterine Neoplasms, Humans, Female, Genetic Predisposition to Disease, France
Abstract: International audience; Cancers of the uterus correspond to cervical cancers and uterine corpus cancers. Cervical cancer is common among young women, especially in immunocompromised populations. Its carcinogenesis is induced by the human papilloma vims (HPV). All factors promoting the HPV contamination and/or limiting the clearance of HPV or promoting its progression are risk factors for cervical cancer: sex at an early age, multiple sexual partners, multiparty, smoking, hormonal contraceptives, immunosuppression or certain infections. Cancers of the uterine corpus, substantially represented by endometrial cancers, represent the fourth leading cause of cancer in women in France. Risk factors are related to hyperestrogenism with early age of menarche and late menopause, obesity, diabetes, inadequate hormone-replacement therapy for menopause. Endometrial cancers fall in the scope of familial cancers making evoke a Lynch syndrome/HNPC
Published: 2014

29. Reluctances in organized breast cancer screenig in Yvelines

Author: Tomietto, M., Soyer, P., Heitz, Denis, Fauconnier, Arnaud, Huchon, Cyrille, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: [SDV]Life Sciences [q-bio], Breast Neoplasms, Organized screening, Middle Aged, Patient Acceptance of Health Care, Breast cancer, Surveys and Questionnaires, Individual screening, Humans, Mass Screening, Female, France, Aged, Mammography
Abstract: International audience; Objectives.-Women's participation in organized screening of breast cancer was 52% in France and 40% in the Île de France in 2010. We wanted to investigate the reasons for non-participation in the screening program and the reluctance of women to it at the level of a department in Île de France.Materials and Methods.-An anonymous questionnaire was sent to non-respondents in organized screening for breast cancer in the Yvelines department in September 2011 on the occasion of the event "Octobre Rose", month of national mobilization for mass screening for breast cancer. The analysis of these questionnaires was used to determine the causes of non-adherence to organized screening and reluctance to it. We compared the questionnaire responses in the characteristics of patients attending an individual screening with those of patients without any screening.Results.-Two thousand nine hundred and ninety-two questionnaires were sent and 3026 responses received (10%). Two thousand six hundred and fifteen women (86%) reported regular screening and make mammograms every two years while 411 (14%) reported occasional or no screening. About the reluctance to conduct the review, the lack of time, the bad memories of a previous mammogram and the fear of pain were the predominant brakes. Nearly 50% of women do not participate in screening because they did not consider themselves at risk for various reasons (lack of symptoms, healthy lifestyle and no family history) and 22% of women surveyed had an attitude of denial cope with the disease. The typical profile of women performing individual or organized screening of breast cancer was that young, single, working, of low socio-professional category and rarely attending their general practitioner or gynaecologist. Health-care professionals seem most likely to cause adherence to screening for breast cancer.Discussion and conclusion.-Focusing on the poor communication and promote organized screening instead of individual screening by health-care professionals themselves could increase adherence to organized screening in the Yvelines.
Published: 2014

30. What's new... in organized screening for breast cancer? - With profits subject to controversy and still insufficient coverage rate

Author: Rollin, I., Soyer, P., Huchon, Cyrille, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: Breast cancer, [SDV]Life Sciences [q-bio], Humans, Mass Screening, Breast Neoplasms, Female, Organized screening, France, Mammography
Abstract: International audience; This article presents a general discussion of several aspects of our present understanding of quantum mechanics. The emphasis is put on the very special correlations that this theory makes possible: they are forbidden by very general arguments based on realism and local causality. In fact, these correlations are completely impossible in any circumstance, except the very special situations designed by physicists especially to observe these purely quantum effects. Another general point that is emphasized is the necessity for the theory to predict the emergence of a single result in a single realization of an experiment. For this purpose, orthodox quantum mechanics introduces a special postulate: the reduction of the state vector, which comes in addition to the Schrödinger evolution postulate. Nevertheless, the presence in parallel of two evolution processes of the same object (the state vector) maybe a potential source for conflicts; various attitudes that are possible to avoid this problem are discussed in this text. After a brief historical introduction, recalling how the very special status of the state vector has emerged in quantum mechanics, various conceptual difficulties are introduced and discussed. The Einstein Podolsky Rosen (EPR) theorem is presented with the help of a botanical parable, in a way that emphasizes how deeply the EPR reasoning is rooted into what is often called "scientific method''. In another section the GHZ argument, the Hardy impossibilities, as well as the BKS theorem are introduced in simple terms.
Published: 2014

31. La vie après un cancer de l'utérus

Author: Koskas, Martin, Rodier, Jean Michel P., Bretel, Jean Jacques, Bonneau, Claire, Luton, Dominique, Touboul, Cyril, Rouzier, Roman, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and HAL UVSQ, Équipe
Subjects: [SDV] Life Sciences [q-bio], Postoperative Complications, Radiotherapy, [SDV]Life Sciences [q-bio], Uterine Neoplasms, Fertility Preservation, Humans, Antineoplastic Agents, Female, Continuity of Patient Care, Neoplasm Metastasis, Neoplasm Recurrence, Local, Sexuality
Abstract: International audience; This overview focuses on the follow up after uterine cervix and corpus cancers. At early stage, troth are associated with good prognosis. Screening for recurrence is mainly based on clinical examination. Screening for a second cancer after endometrial cancer is already planned according to the French recommendations for systematic breast and colon cancer screening. Screening for a second cancer after cervical cancer requires a close examination of organs close to the cervix receiving high doses of radiations and HPV exposed (anus, vulva, vagina and perineum). Late chemotherapy related toxicity after both cancers is rarely encountered and mainly comprise neurological peripheral effects. Late surgical and/or radiation related side effects are more frequent. However, no more than 10% of patients are affected and in such cases, digestive, urinary and lymphatic systems are impaired. Prevalence of sexual dysfunction in patients with uterine cancers is particularly high but the radiotherapy related anatomical modifications (vaginal stenosis for example) might not be the sole reason. Fertility preservation is possible tor uterine cancers but requires a rigorous selection of candidates and should be coordinated by specialized tea
Published: 2014

32. Outpatient vaginal hysterectomy, feasibility and morbidity: An observational study on thirty patients

Author: Pizzoferrato, Anne Cécile, Bader, Georges, Nyangoh Timoh, Krystel, Andriamafidy-Berti, C., Villefranque, Vincent, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, and Centre Hospitalier René Dubos [Pontoise]
Subjects: Adult, Pain, Postoperative, [SDV]Life Sciences [q-bio], Operative Time, Satisfaction, Middle Aged, Outpatient surgery, Vaginal hysterectomy, Postoperative pain, Ambulatory Surgical Procedures, Patient Satisfaction, Electrofusion, Hysterectomy, Vaginal, Feasibility Studies, Humans, Female, France, Analgesia, Pain Measurement
Abstract: International audience; Objective Outpatient surgery is nowadays a major evolution axis of the surgery in France. Outpatient vaginal hysterectomy is possible with the use of electrosurgical bipolar vessel sealing allowing the reduction of operative time and postoperative pain. Our aim was to study the feasibility and morbidity of outpatient vaginal hysterectomy by assessment of postoperative pain and satisfaction. Patients and methods Thirty patients were enrolled in this observational study. All patients underwent an outpatient vaginal hysterectomy with a standardized operative technic. Pain was evaluated by administering a 10 cm visual analogic scale (VAS) at the first and second postoperative days. The total duration of analgesic treatment was noticed. Patient's satisfaction was recorded at the postoperative visit one month after the intervention and by a telephonic interview. Results The mean operative time was 59.3 (25-110) minutes and the mean uterine weight was 170.2 (60-710) grams. No intraoperative complications were reported. Among the thirty patients, 3 (10%) were not discharged the same day. At the first and second postoperative days, the VAS was 4.40 and 4.35 respectively. The mean total duration of analgesic's use was 5 days (3-8 days). Patients were very satisfied of medical care in 36.7% of cases (11/30), satisfied in 53.3% (16/30) and not much satisfied in 10% (3/30). In total, 83.3% (25/30) have agreed to repeat the procedure in the ambulatory sector. Discussion and conclusion Outpatient vaginal hysterectomy seems to be a possible and a safe technique with a high patient's satisfaction in France at the present time.
Published: 2014

33. Élastographie du col utérin: prédiction du délai dgaccouchement lors dgun déclenchement par prostaglandines

Author: Sonnier, Louise, Bouhanna, Philippe, Arnou, C., Rozenberg, Patrick, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: [SDV]Life Sciences [q-bio], Consistency, Induction of labor, Elastography, Cervix
Abstract: International audience; Objective. Induction of labor for medical indications has become a routine practice. To date, the Bishop score remains as the standard method to predict the duration of induced labor. Elastography is an objective method of assessing the relative consistency of tissues. Therefore, we sought to assess strain elastography of cervix to predict delay from induction to delivery in pregnant women with a low Bishop score.Patients and methods. Ultrasound elastography was immediately performed before induction of labor for medical indications among patients with a singleton pregnancy at > 36 weeks of gestation and a Bishop score < 6. Patients received 50 mg of misoprostol intravaginally, repeated 6 hours later if regular painful uterine contractions had not started. A second ultrasound elastography was also performed 6 hours after starting the induction before the second dose of misoprostol if regular painful uterine contractions had not started. At each examination, a color map from blue (hardest tissue) to red (softest tissue) was produced. The cervical elastography was considered as positive if at least one part of its anterior wall was red. We assessed the predictive value of elastography on vaginal delivery within 24 hours. Patients delivering by cesarean section were excluded from this study.Results. Elastography was initially performed in 48 patients. Twelve patients delivering by cesarean section after induction of labor were excluded, leading to 36 patients evaluated in this study. Among these 36 patients with elastography performed before induction of labor, 20 had a second elastography before the second dose of misoprostol. Sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of elastography performed before induction of labor on vaginal delivery within 24 hours were 40%, 27.3%, 55.6%, and 16.7%, respectively. Sensibility, specificity, PPV and NPV of elastography performed before the second dose of misoprostol were 64.3%, 16.7%, 64.3% and 16.7%, respectively. Among the 8 patients with red color occurring on the second cervical color map, sensibility, specificity, PPV and NPV were 83.3%, 0%, 62.5%, and 0%.Discussion and conclusion. Qualitative cervical elastography is a poor predictor for delay from induction to delivery in pregnant women with a low Bishop score.
Published: 2014

34. Évaluation d'un réseau périnatal à partir des premiers certificats de santé

Author: Lebreton, Élodie, Rozenberg, Patrick, Chalavoux, K., Huart, F., COTTE, Benjamin, Pineau, C., Marier, A. E., Topalian, S., Goffinet, F., Agence Régionale de la Santé (ARS), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Conseil Général des Yvelines, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], and Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, [SDV]Life Sciences [q-bio], Infant, Newborn, Parturition, Gestational Age, First certificate of health, Hospitals, Maternity, Delivery, Obstetric, Community Networks, Perinatal network, Perinatal Care, Neonatal Screening, Health Records, Personal, Pregnancy, Episiotomy, Humans, Female, France, Cesarean section, Evaluation, Maternal Age
Abstract: International audience; Objective To describe the methodology for continuous reporting of perinatal indicators in Maternité en Yvelines et Pays Associés (MYPA) network, and the main results for its evaluation. To discuss the implications for practice in a perinatal network. Material and methods CoNaissance 78 program is a collaboration between MYPA network, Conseil général des Yvelines, ARS Île-de-France and U953 Inserm unit. Continuous recording of data is produced using the first certificate of health (PCS) of infants born in the network maternities, an additional health certificate including data about severe maternal morbidity, perineal tears and episiotomies, and a stillbirth certificate including all cases of fetal deaths and medical termination of pregnancy from 22 weeks of gestation. Description of the population and obstetric practices with comparison between the network maternities covers the period from 2008 to 2011. Results The analysis includes 79,232 births. The used variables had a missing data rate below 5%. The mean maternal age at delivery was 30.9, women aged 35 years or above accounting for 23.2% of deliveries (from 17.1 to 32.8% according to the maternity, P < 0.001). Nullipara rate was 42.5% (from 36.6 to 50% according to the maternity, P < 0.001) and multiple pregnancies rate was 1.8% (from 0.3 to 3.4% according to the maternity, P < 0.001). Mode of onset of labor was spontaneous in 66.1% cases (from 55.5 to 72.9% according to the maternity, P < 0.001), induced in 21.5% cases (from 16.9 to 30.8% according to the maternity, P < 0.001) and a planned cesarean section was performed in 12.4% cases (from 8.4 to 19.6% according to the maternity, P < 0.001). The global mean rate of cesarean sections was 24.3% (from 18.4 to 29.6% according to the maternity, P < 0.001). The cesarean section rate was in a selected low risk group was 14.7% (from 11.4 to 20.2% [P < 0.001] according to the maternity). The episiotomy rate was 26.1% (from 16.3 to 43.6% [P < 0.001] according to the maternity). The rate of very preterm neonates born alive inside a tertiary center was 70.8%. Conclusion This program allowed to observe a large disparity in practices, and highlighted significant shortcomings in the organization of in utero transfers to the tertiary center for very preterm births.
Published: 2014

35. Prise en charge d'un antécédent de fausse couche tardive (14 à 22 SA)

Author: Capmas, Perrine, Thellier, Élise, Carcopino, Xavier, Huchon, Cyrille, Deffieux, Xavier, Fernandez, H., Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie Obstétrique [AP-HP Hôpital Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Service de Gynécologie-Obstétrique, CHU Marseille, Hôpital Nord, AP-HM, 13015 Marseille, France., CHU Marseille, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), AP-HP - Hôpital Antoine Béclère [Clamart], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Uterinemalformation, Cervico-isthmiccerclage, [SDV]Life Sciences [q-bio], Late pregnancy loss, Cervix Uteri, Guidelines, Cerclage, Abortion, Spontaneous, Pregnancy, Pregnancy Trimester, Second, Practice Guidelines as Topic, Humans, Female, Fetal Death, Cervical length, Pessaire, Progesterone, Cerclage, Cervical
Abstract: International audience; Objective-To provide guidelines concerning management after a late fetal pregnancy loss:etiological assessment, follow-up and therapeutic management for subsequent pregnancy.Methods-French and English publications led to guidelines.Results-In case of a previous late fetal loss, exploration of cavity has to be done (gradeC), except hysterosalpingography, which is not recommended (grade A). If uterine anomaliesare found, it is recommended to correct them (grade C). In case of stillbirth or unknown foetalvitality before expulsion, antiphospholipid syndrome has to be looked for (grade A). In pregnantwomen, measurement of cervical length has to be done between 15 and 24 weeks of gestation(grade B); in case of singleton pregnancy and short cervix (less than 25 mm), a Mc Donaldcerclage has to be done (grade A). A cerclage is also recommended in case of three previousfetal loss (grade B). In case of failure of a previous Mc Donald cerclage, a cervico-isthmiccerclage is recommended (grade C).Conclusion -In case of a previous fetal loss, uterine cavity has to be explored. In subsequentpregnancy, cervical length has to be evaluated between 15 and 24 SA to indicate a cervicalcerclage.
Published: 2014

36. Staphylococcal toxic shock syndrome after breast surgery

Author: A, Pelissier, J, Dumesnil, R, Levy, C, Charron, R, Rouzier, Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital René HUGUENIN (Saint-Cloud), Hôpital Henri Mondor, Hôpital Ambroise Paré [AP-HP], Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: Adult, Staphylococcus aureus, Superantigens, [SDV]Life Sciences [q-bio], Staphylococcal Infections, Mastectomy, Segmental, Breast surgery, Shock, Septic, Postoperative Complications, Toxic shock syndrome, Humans, Surgical Wound Infection, Female, Surgical site infection
Abstract: International audience; The surgical site infection occurs within 30 days after surgery. It is the most common complication of surgery, with a rate of 1 to 5% without antibiotic prophylaxis and less than 1% with antibiotic prophylaxis. The toxic shock syndrome (TSS) is a dramatic complication. We report the case 39-year-old woman who presented a life-threatening TSS acquired after breast surgery. We describe the signs and symptoms of this condition as well as treatment principles.
Published: 2014

37. Prise en charge d'une infection génitale haute non compliquée

Author: Bourret, Antoine, Fauconnier, Arnaud, Brun, Jean Luc, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), and Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS)
Subjects: Treatment, Uncomplicated pelvic inflammatory diseases, Antibiotics, [SDV]Life Sciences [q-bio], Laparoscopy
Abstract: International audience; Since the 1993 French consensus conference on uncomplicated pelvic inflammatory diseases (uPID), new antibiotics appeared and bacterial resistances did evoluate. This methodic analysis of the literature updates different aspects of its treatment. Antibiotherapy must be established early (EL3). Inpatient and intravenous treatment is not superior to outpatient and oral treatment (EL1). Ofloxacine + metronidazole association can be proposed in first intention (EL1). If case of Neisseria gonorrhoeae infection, one ceftriaxone injection must be associated (EL4). All the other antibiotics associations have shown to be efficient except the metronidazole + doxycycline association, which is not indicated (EL2). Two weeks treatment seems to be a sufficient duration. Laparoscopic treatment in first intention is not justified except for diagnostic doubts or unfavorable evolution of the medical treatment (EL4). Neither non-steroidic antiinflamatorries, nor corticosteroids, have been proved to be efficient to decrease the adherence risk in uPID (EL3). Early extraction of an intra uterine device (IUD) allows symptomatologic improvement (EL2). Partners treatment with azithromycin improves the 4 months bacteriologic results (EL2). HIV positive patients do not need specific treatment (EL3).
Published: 2012

38. Diagnostic d'une infection génitale haute. Quels critères cliniques, paracliniques? Place de l'imagerie et de la cœlioscopie?

Author: Bouquier, Julie, Fauconnier, Arnaud, Fraser, William Donald, Dumont, Alexandre, Huchon, Cyrille, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, CHU Sainte Justine [Montréal], Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique (MERIT - UMR_D 261), Institut de Recherche pour le Développement (IRD)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique (MERIT - UMR_D 216), and Institut de Recherche pour le Développement (IRD)-Université de Paris (UP)
Subjects: Adult, Diagnostic Imaging, Metrorrhagia, Palpation, Adolescent, MEDLINE, [SDV]Life Sciences [q-bio], Chlamydia trachomatis, Cervix Uteri, Chlamydia Infections, Pelvic Pain, Likelihood ratio, Young Adult, Sensitivity, Specificity, Humans, Female, Laparoscopy, France, Diagnostic, Pelvic inflammatory disease, Leukorrhea
Abstract: International audience; Diagnosis of pelvic inflammatory disease is difficult. We focus on a systematic literature review to study diagnostic values of history-taking, clinical examination, laboratory tests and imagery. After this literature review, we build a diagnostic model for pelvic inflammatory disease. This diagnostic model is built on two major criteria: presence of adnexal tenderness or cervical motion tenderness. Additional minor criteria, increasing the likelihood of the diagnosis of pelvic inflammatory disease were added based on their specificity and their positive likelihood ratio. These minor criteria are supported by history-taking, clinical examination, laboratory tests and also on relevant ultrasonographic criteria.
Published: 2012

39. [Vaginal laxity: Semiology, diagnosis and treatments].

Author: Taibi KO, Armengaud C, and Fauconnier A
Subjects: Pregnancy, Humans, Female, Quality of Life, Vagina pathology, Delivery, Obstetric adverse effects, Pelvic Organ Prolapse surgery, Dyspareunia diagnosis, Dyspareunia etiology, Dyspareunia therapy
Abstract: Objectives: Vaginal laxity concerns 24 to 38% of women but it's still poorly understood and studied. The objective of this study is to do an inventory of current scientific knowledge about its definition, its diagnostic criteria, and treatments., Methods: We conducted a non systematic review of literature including original articles in French and English about the definition, diagnostic criteria and treatments of vaginal laxity using data bases such as Cochrane, Embase, Medline, PubMed et Science Direct., Results: It is a feeling of excessive looseness that can alter the quality of sexual intercourses. The main risk factor is vaginal delivery. The feeling of vaginal laxity appears to be linked to an excessive distensibility of the levator ani muscle that can be evaluated during physical examination by the measure of the genital hiatus and the perineal body (GH and PB measures from the POP-Q classification) during vasalva or by the measure of genital hiatus area by translabial sonography during valsalva. Although pelvic muscle training is currently prescribed as a first line treatment, data are limited to confirm its effectiveness in this affection. Colpoperineorraphy with levator ani myorraphy which was mostly evaluated in case of genital prolapse is associated with a high success rate but is at risk of dyspareunia. New nonsurgical treatments such as radiofrequency and vaginal laser seems to lead to lower success rate than surgical treatments but they are less invasive. Their effectiveness and long-term effects are still unknown which restrict their application in this condition., Conclusion: Vaginal laxity is a frequent condition that impacts on the quality of life and sexual function. Further studies should be conducted to better understand its physiopathology and the optimal treatment., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Published: 2024
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40. [Assessment of neuropathic pain among women with suspected endometriosis based on two specific surveys].

Author: Margueritte F, Afraoucene A, Furdui R, Armengaud C, and Fauconnier A
Subjects: Humans, Female, Retrospective Studies, Pain Measurement, Surveys and Questionnaires, Endometriosis complications, Endometriosis diagnosis, Endometriosis epidemiology, Neuralgia diagnosis, Neuralgia epidemiology
Abstract: Objectives: A significant proportion of women with suspected endometriosis present neuropathic pain. The aim of this study is to assess this prevalence and the relevance of specific tests used., Methods: This is a single-center retrospective study in the CHI of Poissy Saint Germain en Laye with patients who were referred for suspected endometriosis and who benefited from evaluation of neuropathic pain by two distinct questionnaires. The PAINdetect was evaluated by a series of 7 questions scored from 0 to 5 with a positive test if score>18. For the DN4, 7 binary questions were asked and 3 other questions were related to the clinical examination with a positivity threshold reached if score≥4 and in the absence of clinical examination if score≥3., Results: From November 2020 to June 2022, 57 patients were examined with a prevalence of neuropathic pain (one of the two test positive) evaluated at 36.8%. PAINdetect and DN4 positivity rates were at 26.8% and 30.9%. A discordance was found in 14.8% of cases with a kappa coefficient calculated at 0.63. There was a significant association between radiological examination and neuropathic pain with more neuropathic pain when the radiological examination was negative (P=0.03). The myofascial syndrome was present in only 59.5% of the patients and wasn't associated with neuropathic pain (P=1.00)., Conclusion: Prevalence of neuropathic pain in case of suspected endometriosis appears to be high. This need to be confirmed in a multicenter study with also assessment of the validity of the two diagnostic tests., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Published: 2023
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41. [Impact of the quality of ultrasound scan performed in gynecological emergencies in the diagnosis of ectopic pregnancy].

Author: Athiel Y, Nguyen-Xuan HT, Huchon C, and Fauconnier A
Subjects: Adult, Female, Humans, Pregnancy, Pregnancy, Ectopic therapy, Retrospective Studies, Endosonography, Pregnancy, Ectopic diagnostic imaging, Ultrasonography, Prenatal
Abstract: Objectives: There are no recommendations on the way emergency ultrasound should be performed but there are Standardized Acute Female Echography (SAFE) planes with quality criteria for ultrasound scoring. The objective of this study was to evaluate the impact of the quality of ultrasound on the diagnosis of ectopic pregnancy., Methods: A retrospective study was conducted in 2016-2017 and included all Ectopic Pregnancies (EP). Clinical, biological and ultrasonographic characteristics were collected, in particular the analysis of ultrasound scans according to the scoring score of standardized planes (total score out of 15). EP diagnosed at first ultrasound and those from Pregnancy of unknown location (PUL) were compared., Results: Hundred and seventeen patients were included: 45 (38.5%) in the group "EP from PLU" and 72 (61.5%) in the group "EP diagnosed directly". The ultrasound images were significantly better in the "directly diagnosed EP" group than in the "EP from PUL" group: 11.9/15 vs. 10.07/15 respectively (P=0.005). Moreover, in the group "EP from PUL", the images were significantly better on the final ultrasound diagnosing the EP compared to the first ultrasound performed: 11.4/15 vs. 10.07/17 (P=0.04)., Conclusion: The evaluation of quality of ultrasound scan using a standardized scoring system shows an impact in the diagnosis of ectopic pregnancies., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Published: 2019
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