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Objective: To assess the maternal and fetal benefits of delaying oxytocin perfusion by 24 h following labor induction by amniotomy after 41 weeks of gestation (WG)., Methods: We performed a retrospective review including all women with a vertex presentation fetus who had an indication for labor induction by amniotomy with or without oxytocin after 41 WG between 2015 and 2022. Patients who underwent an IOL by amniotomy followed by oxytocin perfusion within 0 to 4 hours (early oxytocin group: EO group) were compared with patients who underwent an IOL by amniotomy alone or followed by an oxytocin perfusion after an expectant period for up to 24 hours in the absence of a spontaneous onset of labor (delayed oxytocin group: DO group). The primary outcome was the rate of vaginal delivery (natural or operative). The secondary outcomes were maternal and neonatal complications., Results: We included 363 patients: 103 patients in the EO group and 260 in the DO group. Only 47 of the women in the DO group (18 %) required oxytocin. The proportion of vaginal deliveries was significantly higher in the DO group (248 patients, 95.4 %) than in the EO group (85 patients, 82.55 %) (p<0.01). Maternal morbidity did not differ significantly between groups. Fewer babies displayed severe newborn acidemia or required transfer to the neonatal intensive care unit in the DO group (p<0.05)., Conclusion: Delaying oxytocin administration by 24 hours after amniotomy was associated with a significantly higher rate of vaginal delivery. These results required confirmation in prospective randomized studies., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Masson SAS.)

In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network. Here, we analyze in detail the assumptions of the normalized fetal brain reference frame and quantify its accuracy with respect to the acquisition of transventricular (TV) standard plane (SP) for fetal biometry. We investigate the impact of registration quality in the training and testing data and its subsequent effect on trained models. Finally, we introduce data augmentations and larger training sets that improve the results of our previous work, achieving median errors of 2.97 mm and 6.63° for translation and rotation, respectively.

Objective: To describe symptoms and fertility and quality of life outcomes after isthmocele surgery., Study Design: We conducted a retrospective study on from January 2012 to December 2017 in two tertiary referral centers in Rennes (France). All the patients diagnosed with isthmocele and operated were included. They all underwent isthmocele surgery by hysteroscopy, vaginal way or laparotomy., Results: The following data were collected: surgical procedure, symptoms and fertility before and after surgery, patient satisfaction about the surgery, and quality of life after surgery. Eighteen patients were included. The mean duration of follow-up was 15 months. Surgical procedures consisted of hysteroscopy (n = 5/18, 27.8%), vaginal surgery (n = 8/18, 44.4%) and laparotomy (n = 5/18, 27.8%). Surgical indications were: secondary infertility (n = 10/18, 55 %), pelvic pain (n = 5/18, 28%) and abnormal uterine bleeding (n = 3/18, 17%). Among patients with abnormal uterine bleeding, improvement was obtained after hysteroscopy, laparotomy and vaginal surgery for 83.3%, 75% and 50%, respectively. Among those with pelvic pain, improvement was obtained after hysteroscopy, laparotomy and vaginal surgery for 80%, 81% and 66%, respectively. One patient (1/18, 5.5%) had post-operative complication. Of the 12 patients who wished to conceive eleven pregnancies were obtained (91.7%). Of the 10 patients with secondary infertility, six became pregnant (60%). Five pregnancies (5/11, 45.4%) were carried to full term, including four in patients whose surgical indication was infertility. Among these, one patient had a vaginal delivery (after vaginal surgery) without obstetric complication. All patients operated on by hysteroscopy would recommend this surgery versus 75% of patients with vaginal surgery and 60% of patients with laparotomy (p = 0.24). Pain and quality-of-life scores were comparable between the three groups., Conclusion: Isthmocele surgery is effective for abnormal uterine bleeding, pain and infertility regardless of the surgical route., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: The direct method is a procedure designed to cause less pain during insertion of an intrauterine contraceptive device (IUCD). It was first reported in 2005 and differs from the standard method of insertion recommended by IUCD manufacturers. In France, the direct method is well known and used by experienced practitioners, but it has never been evaluated against the standard method of insertion. The aim of the study was therefore to compare the direct method with the standard method in terms of pain experienced during insertion and the side effects and satisfaction rates over 6 months. Methods: A prospective observational study was conducted in France between June and December 2016 to compare the direct and standard methods of IUCD insertion. Results: The study included 535 women: 281 in the direct method group (DM group) and 254 in the standard method group (SM group). Women in the DM group reported less pain. This difference was assessed by multilevel multivariate analysis (-8.3 mm, 95% confidence interval (CI) -14.3, -2.3). There was no difference in the occurrence of infection (1.4% vs. 2.8%; p  = .366) and 6-month continuation rates (89.4% vs. 89.2%; p  = .936). Satisfaction rates at 6 months were higher in the DM group (93.6% vs. 87.4%; p  = .019). Conclusions: The results of the study suggest that the direct method of IUCD insertion is associated with less pain and does not increase the risk of adverse effects. Widespread adoption of the direct method could improve women's comfort and lead to a higher uptake of the IUCD as a form of contraception.

On a chronic preparation of an adult Rabbit, the cortical visual evoked response, produced by a weak luminous stimulation activating only the scotopic system is characterized by the suppression of the early surface-positive phase and by a lengthening of the latencies of the following deflection. The profile of the fields of potential corresponding to the various defletions in relation to the depth, has been investigated.

Pharmacological investigations have been carried out on a new p-chlorobenzoyl substituted phenoxy-isobutyric acid derivate with potent antilipidemic activity, isopropyl-[4'-(p-chlorobenzoyl)-2-phenoxy-2-methyl]propionate (LF 178; procetofene; Lipanthyl¿). The compound depressed total lipids and total cholesterol significantly in the normal rat from 15-20 mg/kg upwards. At 100 mg/kg, the drug-induced depression of total lipids was twice the effect observed with 300 mg/kg of clofibrate. Significant depression of lipid parameters was induced in the senescent rat, in the dietary hyperlipidemic and in the triton hyperlipidemic rat. In the two last models clofibrate failed to affect lipid parameters at 300 mg/kg. The absence of pharmacological side effects indicates a high pharmacological specificity with respect to lipid metabolism. It might be concluded that LF 178 presents an antilipidemic profile different from the well known hypolipidemic drug clofibrate.