Pub Date : 2025-02-01DOI: 10.1016/j.jogoh.2024.102892
Pauline Cavagna , Tess Martin , Nicolas Martelli , Huyen-Thu Nguyen-Xuan , Henri Azais , Louise Benoit , Enrica Bentivegna , Anne-Sophie Bats , Meriem Koual
Background
Wire-guided localization (WGL) for non-palpable breast cancer lesions has drawbacks like wire migration, localization difficulties, and logistical challenges. Wireless methods, such as reflector-guided localization (RGL), address these issues and are compatible with breast MRI. This study evaluates the organizational and cost impacts of RGL compared to WGL.
Research Design and methods
Our retrospective study compared the organizational impacts and costs of RGL and WGL at a university hospital. Quantitative and qualitative assessments included operating time and a questionnaire for surgeons and radiologists. Cost analysis covered device costs.
Results
The study involved 60 patients (30 with RGL and 30 with WGL). The RGL group had a significantly longer duration between device insertion and surgery (3.73 ± 5.5 days) compared to the WGL group (same day or day before surgery). The WGL group required more devices whereas cost were higher for RGL. Health professionals reported a major positive impact of RGL on healthcare processes and safety, with minor negative impact on training.
Conclusions
RGL offers flexible scheduling by decoupling radiology and surgery but is limited by high costs. Further data is needed to identify ideal candidates, assess patient satisfaction, and evaluate its long-term benefits in breast cancer care.
{"title":"Reflector-guided localization compared with wire-guided localization for non-palpable breast cancer resection: organizational impacts and costs analysis","authors":"Pauline Cavagna , Tess Martin , Nicolas Martelli , Huyen-Thu Nguyen-Xuan , Henri Azais , Louise Benoit , Enrica Bentivegna , Anne-Sophie Bats , Meriem Koual","doi":"10.1016/j.jogoh.2024.102892","DOIUrl":"10.1016/j.jogoh.2024.102892","url":null,"abstract":"<div><h3>Background</h3><div>Wire-guided localization (WGL) for non-palpable breast cancer lesions has drawbacks like wire migration, localization difficulties, and logistical challenges. Wireless methods, such as reflector-guided localization (RGL), address these issues and are compatible with breast MRI. This study evaluates the organizational and cost impacts of RGL compared to WGL.</div></div><div><h3>Research Design and methods</h3><div>Our retrospective study compared the organizational impacts and costs of RGL and WGL at a university hospital. Quantitative and qualitative assessments included operating time and a questionnaire for surgeons and radiologists. Cost analysis covered device costs.</div></div><div><h3>Results</h3><div>The study involved 60 patients (30 with RGL and 30 with WGL). The RGL group had a significantly longer duration between device insertion and surgery (3.73 ± 5.5 days) compared to the WGL group (same day or day before surgery). The WGL group required more devices whereas cost were higher for RGL. Health professionals reported a major positive impact of RGL on healthcare processes and safety, with minor negative impact on training.</div></div><div><h3>Conclusions</h3><div>RGL offers flexible scheduling by decoupling radiology and surgery but is limited by high costs. Further data is needed to identify ideal candidates, assess patient satisfaction, and evaluate its long-term benefits in breast cancer care.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102892"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jogoh.2024.102884
S. Friszer , JP. Bernard , T. Bultez , U. Metzger , R. Bessis , C. Lamourdedieu , B. Deloison
Objectives
To provide new prospective 2D ultrasound reference charts of fetal corpus callosum (CC) length on a large sample size with emphasis on the third trimester of pregnancy and to establish other standards of CC growth evaluation (external cranial occipitofrontal dimension (ECOFD) / CC length ratio and head circumference (HC) / CC length ratio) in a large population of healthy fetuses.
Methods
A prospective observational study was conducted in a single expert center for fetal ultrasound between November 1st 2021 and June 30th 2022. CC measurement was performed in all fetuses examined between 17 weeks and 36+6 weeks. Image quality criteria for a strict mid-sagittal plane of the fetal brain and caliper position for CC measurement were defined prior to data collection and only high-quality measurements were included for analysis. Fetuses with inaccurate gestational ages and at high-risk of central nervous system anomalies were excluded.
Results
Among 3591 CC measurements available, 3191 were included in this study. An accurate high-quality measurement was obtained in 92.8 % of cases. We established the third-degree polynomial model expressing the length of the corpus callosum as a function of Corpus callosum length in mm=0.00213x(GA in weeks)3 − 0.2538x(GA in weeks)2 + 10.5897xGA in weeks −108.8556 +/- SD (SD=0.0567xGA In weeks + 0.1054), with an R² adj of 0.94. ECOFD/CC and HC/CC ratios were stable throughout pregnancy at 2.7 ± 0.2 and 7.7 ± 0.6 respectively.
Conclusion
These new reference charts were established using a uniform methodology of the highest quality in order to assess CC growth accurately and help clinicians correctly define a “short” CC. ECOFD/CC and HC/CC ratios may be used as additional markers of normal CC development in borderline cases.
{"title":"New reference charts for fetal ultrasound corpus callosum length with emphasis on the third trimester","authors":"S. Friszer , JP. Bernard , T. Bultez , U. Metzger , R. Bessis , C. Lamourdedieu , B. Deloison","doi":"10.1016/j.jogoh.2024.102884","DOIUrl":"10.1016/j.jogoh.2024.102884","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide new prospective 2D ultrasound reference charts of fetal corpus callosum (CC) length on a large sample size with emphasis on the third trimester of pregnancy and to establish other standards of CC growth evaluation (external cranial occipitofrontal dimension (ECOFD) / CC length ratio and head circumference (HC) / CC length ratio) in a large population of healthy fetuses.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted in a single expert center for fetal ultrasound between November 1st 2021 and June 30th 2022. CC measurement was performed in all fetuses examined between 17 weeks and 36<sup>+6</sup> weeks. Image quality criteria for a strict mid-sagittal plane of the fetal brain and caliper position for CC measurement were defined prior to data collection and only high-quality measurements were included for analysis. Fetuses with inaccurate gestational ages and at high-risk of central nervous system anomalies were excluded.</div></div><div><h3>Results</h3><div>Among 3591 CC measurements available, 3191 were included in this study. An accurate high-quality measurement was obtained in 92.8 % of cases. We established the third-degree polynomial model expressing the length of the corpus callosum as a function of Corpus callosum length in mm=0.00213x(GA in weeks)<sup>3</sup> − 0.2538x(GA in weeks)<sup>2</sup> + 10.5897xGA in weeks −108.8556 +/- SD (SD=0.0567xGA In weeks + 0.1054), with an R² adj of 0.94. ECOFD/CC and HC/CC ratios were stable throughout pregnancy at 2.7 ± 0.2 and 7.7 ± 0.6 respectively.</div></div><div><h3>Conclusion</h3><div>These new reference charts were established using a uniform methodology of the highest quality in order to assess CC growth accurately and help clinicians correctly define a “short” CC. ECOFD/CC and HC/CC ratios may be used as additional markers of normal CC development in borderline cases.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102884"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2021, France authorized access to assisted reproductive technology (ART) for single women (SWs) and lesbian couples (LCs). We aimed to describe these new populations and compare their characteristics with those of the historical population of heterosexual couples (HCs) using ART with sperm donation.
Material and methods
We conducted a monocentric observational retrospective study at the Nancy Regional University Hospital Fertility Center from October 1, 2021, to June 30, 2023. The demographic and clinical characteristics of all the women/couples willing to engage in parenthood with sperm donation, as well as their parenthood aspirations data, were collected.
Results
We included 638 women/couples; 49.7 % were SWs; 44.5 % were LCs; and only 5.8 % were HCs. The mean age of the whole population was 33.4 ± 5.5 years. The SW population was significantly older by 6 years and came from executive and intellectual professions. A total of 18.3 % of the LCs were interested in the reception of oocytes from the partner (ROPA). HCs (77.8 %) and LCs (73.2 %) were more interested in phenotypic matching than SWs (49.1 %) (p < 0.001). Monocentric support was more common in SW patients (88.9 %) than in LCs patients (79.5 %) and HCs (56.8 %) (p < 0.001).
Discussion
In a large cohort, we focused on and discussed the characteristics and the aspirations of these intended parents. We found that new populations favored ART with sperm donation. The overall characteristics of both heterosexual and lesbian couples were broadly comparable, as were the two LCs members. A French multicenter large-scale prospective study and anthropological studies are necessary to confirm and explain this data.
{"title":"The characteristics and parenthood aspirations of single women and lesbian couples seeking motherhood through sperm donation","authors":"Claire Gouya , Romane Mougel , George Riley , Catherine Diligent , Delphine Morettini , Olivier Morel , Mikaël Agopiantz","doi":"10.1016/j.jogoh.2024.102889","DOIUrl":"10.1016/j.jogoh.2024.102889","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2021, France authorized access to assisted reproductive technology (ART) for single women (SWs) and lesbian couples (LCs). We aimed to describe these new populations and compare their characteristics with those of the historical population of heterosexual couples (HCs) using ART with sperm donation.</div></div><div><h3>Material and methods</h3><div>We conducted a monocentric observational retrospective study at the Nancy Regional University Hospital Fertility Center from October 1, 2021, to June 30, 2023. The demographic and clinical characteristics of all the women/couples willing to engage in parenthood with sperm donation, as well as their parenthood aspirations data, were collected.</div></div><div><h3>Results</h3><div>We included 638 women/couples; 49.7 % were SWs; 44.5 % were LCs; and only 5.8 % were HCs. The mean age of the whole population was 33.4 ± 5.5 years. The SW population was significantly older by 6 years and came from executive and intellectual professions. A total of 18.3 % of the LCs were interested in the reception of oocytes from the partner (ROPA). HCs (77.8 %) and LCs (73.2 %) were more interested in phenotypic matching than SWs (49.1 %) (<em>p</em> < 0.001). Monocentric support was more common in SW patients (88.9 %) than in LCs patients (79.5 %) and HCs (56.8 %) (<em>p</em> < 0.001).</div></div><div><h3>Discussion</h3><div>In a large cohort, we focused on and discussed the characteristics and the aspirations of these intended parents. We found that new populations favored ART with sperm donation. The overall characteristics of both heterosexual and lesbian couples were broadly comparable, as were the two LCs members. A French multicenter large-scale prospective study and anthropological studies are necessary to confirm and explain this data.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102889"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jogoh.2024.102885
Anne Pinton , Sonia Doucet , Alice Hoquette , Pierre Delorme
Objective
To describe the experiences of partners accompanying pregnant women during a caesarean section and to identify factors which influence the experiences.
Methods
It is a prospective, single-center, observational study which included all partners of women who underwent a planned or an unplanned caesarean section in a maternity hospital during a two months period (1st November 2020 – 1st January 2021). The outcome was evaluated by a standardized questionnaire: the first-time father questionnaire (FTFQ) (1). Univariate and multivariate analyses were carried out to evaluate the factors associated with the results of the FTFQ.
Results
A total of 100 partners were included in the study. Partners were generally satisfied with their attendance at the caesarean section, with 91 % claiming a good experience of it and expressed a willingness to repeat the experience. The partners were satisfied with the support provided by the medical team and with their accompaniment (79 %). Most partners were reassured and guided by health professionals when necessary (61 %). Nevertheless, partner anxiety was common (50 %) throughout the procedure. Only one factor was significantly associated with a decreased partner satisfaction: transfer of the newborn to the intensive care or neonatology unit (p = 0.04).
Conclusion
Almost all partners were satisfied to be in the operating room for a cesarean section regardless of the type of caesarean (planned and unplanned). Partner satisfaction should be considered by maternity staff as a relevant factor in their decision to accept or refuse the partner's presence in the operating room during the cesarean section.
{"title":"Partners experiences of caesarean deliveries in the operating room","authors":"Anne Pinton , Sonia Doucet , Alice Hoquette , Pierre Delorme","doi":"10.1016/j.jogoh.2024.102885","DOIUrl":"10.1016/j.jogoh.2024.102885","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the experiences of partners accompanying pregnant women during a caesarean section and to identify factors which influence the experiences.</div></div><div><h3>Methods</h3><div>It is a prospective, single-center, observational study which included all partners of women who underwent a planned or an unplanned caesarean section in a maternity hospital during a two months period (1st November 2020 – 1st January 2021). The outcome was evaluated by a standardized questionnaire: the first-time father questionnaire (FTFQ) (1). Univariate and multivariate analyses were carried out to evaluate the factors associated with the results of the FTFQ.</div></div><div><h3>Results</h3><div>A total of 100 partners were included in the study. Partners were generally satisfied with their attendance at the caesarean section, with 91 % claiming a good experience of it and expressed a willingness to repeat the experience. The partners were satisfied with the support provided by the medical team and with their accompaniment (79 %). Most partners were reassured and guided by health professionals when necessary (61 %). Nevertheless, partner anxiety was common (50 %) throughout the procedure. Only one factor was significantly associated with a decreased partner satisfaction: transfer of the newborn to the intensive care or neonatology unit (<em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>Almost all partners were satisfied to be in the operating room for a cesarean section regardless of the type of caesarean (planned and unplanned). Partner satisfaction should be considered by maternity staff as a relevant factor in their decision to accept or refuse the partner's presence in the operating room during the cesarean section.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102885"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovarian cancer remains a leading cause of cancer-related deaths in women. Early detection improves prognosis, but current diagnostic tools still need improvement. We aimed to identify high-risk patient profiles for ovarian cancer using cluster analysis of age and tumor marker data.
Material and methods
A secondary dataset analysis was conducted using unsupervised learning techniques. Data were from a University Hospital, originally collected between July 2011 and July 2018 in Taiwan. In total, 349 women diagnosed with ovarian masses, including both benign and malignant tumors, were included in this analysis. The median age was 45 years, and 49 % were diagnosed with ovarian cancer in pathology. We used a hierarchical clustering algorithm to find groups of patients with similar features.
Results
Two clusters were identified (N = 204 and 145), with a high-risk cluster (66.2 % malignancy) characterized by significantly older age, higher CA125, HE4, CEA, and AFP levels, and a lower CA19–9 level than the low-risk cluster (24.8 % malignancy). The assessment of clustering stability and internal validity yielded a figure of merit score of 0.970 and a silhouette coefficient of 0.524. A classification model using age, CA125, HE4, and CA19–9 demonstrated high accuracy (89.4 %), sensitivity (94.5 %), specificity (83.7 %), and a large area under the curve (89.1 %) for the risk stratification.
Conclusion
Integrating tumor markers with patient demographics improved the differentiation between benign and malignant ovarian masses. This approach can help clinicians prioritize high-risk patients for further diagnostic evaluation and reduce unnecessary invasive procedures for low-risk patients.
{"title":"High-risk patient profiles for ovarian cancer: A new approach using cluster analysis of tumor markers","authors":"Zahra Jamalpour , Somayeh Ghaderi , Mostafa Fathian-Kolahkaj","doi":"10.1016/j.jogoh.2024.102888","DOIUrl":"10.1016/j.jogoh.2024.102888","url":null,"abstract":"<div><h3>Objective</h3><div>Ovarian cancer remains a leading cause of cancer-related deaths in women. Early detection improves prognosis, but current diagnostic tools still need improvement. We aimed to identify high-risk patient profiles for ovarian cancer using cluster analysis of age and tumor marker data.</div></div><div><h3>Material and methods</h3><div>A secondary dataset analysis was conducted using unsupervised learning techniques. Data were from a University Hospital, originally collected between July 2011 and July 2018 in Taiwan. In total, 349 women diagnosed with ovarian masses, including both benign and malignant tumors, were included in this analysis. The median age was 45 years, and 49 % were diagnosed with ovarian cancer in pathology. We used a hierarchical clustering algorithm to find groups of patients with similar features.</div></div><div><h3>Results</h3><div>Two clusters were identified (<em>N</em> = 204 and 145), with a high-risk cluster (66.2 % malignancy) characterized by significantly older age, higher CA125, HE4, CEA, and AFP levels, and a lower CA19–9 level than the low-risk cluster (24.8 % malignancy). The assessment of clustering stability and internal validity yielded a figure of merit score of 0.970 and a silhouette coefficient of 0.524. A classification model using age, CA125, HE4, and CA19–9 demonstrated high accuracy (89.4 %), sensitivity (94.5 %), specificity (83.7 %), and a large area under the curve (89.1 %) for the risk stratification.</div></div><div><h3>Conclusion</h3><div>Integrating tumor markers with patient demographics improved the differentiation between benign and malignant ovarian masses. This approach can help clinicians prioritize high-risk patients for further diagnostic evaluation and reduce unnecessary invasive procedures for low-risk patients.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102888"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jogoh.2024.102893
Charlotte Dupont , Sophie Grateau , Emilie Moreau , Nicolaï Johnson , Diane Rivet-Danon , Sarra Cristofari , Marie Prades , Rachel Lévy , Kamila Kolanska , Nathalie Chabbert-Buffet , Nathalie Sermondade
Background
Transgender men face reproductive challenges due to the potential impact on fertility of gender-affirming hormone therapy (GAHT) and surgical interventions. Testosterone therapy during “female to male” transition leads to anovulation and amenorrhea. Although these effects are typically reversible upon stopping treatment, the long-term effects of androgens on future fertility and health of potential children remain poorly known. Despite being long overlooked, the desire for parenthood is a significant reality among transgender men. Advances in medical techniques and legislative changes now make fertility preservation (FP), primarily through oocyte cryopreservation, possible for transgender men. Yet, published data on FP outcomes for this population are still limited.
Design
We conducted a retrospective study to compare ovarian stimulation outcomes between transgender men and presumed fertile women from an oocyte donation program.
Results
Between June 2018 and February 2022, 118 transgender men were referred to the FP consultation, of whom 13 ultimately underwent FP through oocyte vitrification following ovarian stimulation. These 13 individuals were compared to a control group of 13 matched female oocyte donors. We did not observe any significant difference in the clinical and biological outcomes of ovarian stimulation, including duration of stimulation, total FSH dose administered, number of oocytes retrieved, and number of mature oocytes obtained.
Conclusion
Our experience suggests that FP through oocyte vitrification after ovarian stimulation is feasible and effective for transgender men, with outcomes comparable to those of cisgender women of the same age. Larger studies are necessary to validate these findings and assess the long-term success rates.
{"title":"Reproductive functions and fertility preservation in transgender men: A French case series","authors":"Charlotte Dupont , Sophie Grateau , Emilie Moreau , Nicolaï Johnson , Diane Rivet-Danon , Sarra Cristofari , Marie Prades , Rachel Lévy , Kamila Kolanska , Nathalie Chabbert-Buffet , Nathalie Sermondade","doi":"10.1016/j.jogoh.2024.102893","DOIUrl":"10.1016/j.jogoh.2024.102893","url":null,"abstract":"<div><h3>Background</h3><div>Transgender men face reproductive challenges due to the potential impact on fertility of gender-affirming hormone therapy (GAHT) and surgical interventions. Testosterone therapy during “female to male” transition leads to anovulation and amenorrhea. Although these effects are typically reversible upon stopping treatment, the long-term effects of androgens on future fertility and health of potential children remain poorly known. Despite being long overlooked, the desire for parenthood is a significant reality among transgender men. Advances in medical techniques and legislative changes now make fertility preservation (FP), primarily through oocyte cryopreservation, possible for transgender men. Yet, published data on FP outcomes for this population are still limited.</div></div><div><h3>Design</h3><div>We conducted a retrospective study to compare ovarian stimulation outcomes between transgender men and presumed fertile women from an oocyte donation program.</div></div><div><h3>Results</h3><div>Between June 2018 and February 2022, 118 transgender men were referred to the FP consultation, of whom 13 ultimately underwent FP through oocyte vitrification following ovarian stimulation. These 13 individuals were compared to a control group of 13 matched female oocyte donors. We did not observe any significant difference in the clinical and biological outcomes of ovarian stimulation, including duration of stimulation, total FSH dose administered, number of oocytes retrieved, and number of mature oocytes obtained.</div></div><div><h3>Conclusion</h3><div>Our experience suggests that FP through oocyte vitrification after ovarian stimulation is feasible and effective for transgender men, with outcomes comparable to those of cisgender women of the same age. Larger studies are necessary to validate these findings and assess the long-term success rates.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102893"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><div>Achondroplasia, due to a specific pathogenic variant in FGFR3, is the most common viable skeletal dysplasia and the diagnosis is mostly done in the prenatal period. Since 2021, the use of Vosoritide, a specific treatment for achondroplasia, validated in phase 3 placebo-controlled trials, has been recommended to significantly increase the height of children and infants. In the light of these new therapeutic prospects, a complete understanding of the pathophysiology of skeletal damages occurring from foetal life is required.</div></div><div><h3>Objectives</h3><div>To describe foetal imaging and the antenatal and postnatal management of pregnancies complicated by a diagnosis of foetal achondroplasia.</div></div><div><h3>Methods</h3><div>A retrospective and descriptive study, including all pregnant women with a prenatal diagnosis of achondroplasia, was conducted in the prenatal unit of Necker Hospital (Paris, France) between 2009 and 2022. Maternal and obstetric characteristics and foetal imaging (ultrasound and bone CT) were collected. Pregnancy outcomes, paediatric follow-up in the case of live births, and post-mortem examination (PME) data in the case of termination of pregnancy were reported. In addition, we have prospectively developed a specific research protocol using foetal brain MRI to assess the anatomy of the foramen magnum, following the same approach currently recommended in the postnatal period.</div></div><div><h3>Results</h3><div>29 cases of achondroplasia were included. Median gestational age at referral was 31<sup>+2</sup> weeks’, about 1 week after the suspected diagnosis on routine ultrasound. Shortening of the femoral length and of all the other long bones, macrocephaly, facial abnormalities, increased metaphyseal-diaphyseal angle and tapering of the proximal femoral bone were the five most prevalent ultrasound signs. Foetal diagnosis was done by the identification of the foetal FGFR3 mutation and/or by CT scans (<em>n</em> = 15) where specific abnormalities of the long bones, platyspondyly and abnormal profile have been described in 100 % of cases. PME revealed: i) on external examinations (<em>n</em> = 7) that all fetuses had very short long bones, moderate platyspondyly, small iliac wings with internal spines, macrocrania, and narrow thorax, ii) on internal examination (<em>n</em> = 5) all had severe abnormalities in the growth plate and particularities in the temporal cortex and hippocampal region. One foetal MRI was performed at 33 weeks’ and revealed tight stenosis of the foramen magnum and compression of the spinal cord. Of the live-born infants for whom follow-up was known (<em>n</em> = 6), 2/6 (including the case who had a foetal MRI) required neurosurgical intervention in the first few months of life for spinal cord compression due to severe stenosis of the foramen magnum.</div></div><div><h3>Conclusion</h3><div>A complete mapping of the skeletal features present in foetuses with achondropla
{"title":"Foetal achondroplasia: Prenatal diagnosis, outcome and perspectives","authors":"Anne-Lyse Vallin , David Grévent , Bettina Bessières , Laurent J Salomon , Laurence Legeai-Mallet , Valérie Cormier-Daire , Geneviève Baujat , Yves Ville , Valentine Faure-Bardon","doi":"10.1016/j.jogoh.2024.102891","DOIUrl":"10.1016/j.jogoh.2024.102891","url":null,"abstract":"<div><h3>Background</h3><div>Achondroplasia, due to a specific pathogenic variant in FGFR3, is the most common viable skeletal dysplasia and the diagnosis is mostly done in the prenatal period. Since 2021, the use of Vosoritide, a specific treatment for achondroplasia, validated in phase 3 placebo-controlled trials, has been recommended to significantly increase the height of children and infants. In the light of these new therapeutic prospects, a complete understanding of the pathophysiology of skeletal damages occurring from foetal life is required.</div></div><div><h3>Objectives</h3><div>To describe foetal imaging and the antenatal and postnatal management of pregnancies complicated by a diagnosis of foetal achondroplasia.</div></div><div><h3>Methods</h3><div>A retrospective and descriptive study, including all pregnant women with a prenatal diagnosis of achondroplasia, was conducted in the prenatal unit of Necker Hospital (Paris, France) between 2009 and 2022. Maternal and obstetric characteristics and foetal imaging (ultrasound and bone CT) were collected. Pregnancy outcomes, paediatric follow-up in the case of live births, and post-mortem examination (PME) data in the case of termination of pregnancy were reported. In addition, we have prospectively developed a specific research protocol using foetal brain MRI to assess the anatomy of the foramen magnum, following the same approach currently recommended in the postnatal period.</div></div><div><h3>Results</h3><div>29 cases of achondroplasia were included. Median gestational age at referral was 31<sup>+2</sup> weeks’, about 1 week after the suspected diagnosis on routine ultrasound. Shortening of the femoral length and of all the other long bones, macrocephaly, facial abnormalities, increased metaphyseal-diaphyseal angle and tapering of the proximal femoral bone were the five most prevalent ultrasound signs. Foetal diagnosis was done by the identification of the foetal FGFR3 mutation and/or by CT scans (<em>n</em> = 15) where specific abnormalities of the long bones, platyspondyly and abnormal profile have been described in 100 % of cases. PME revealed: i) on external examinations (<em>n</em> = 7) that all fetuses had very short long bones, moderate platyspondyly, small iliac wings with internal spines, macrocrania, and narrow thorax, ii) on internal examination (<em>n</em> = 5) all had severe abnormalities in the growth plate and particularities in the temporal cortex and hippocampal region. One foetal MRI was performed at 33 weeks’ and revealed tight stenosis of the foramen magnum and compression of the spinal cord. Of the live-born infants for whom follow-up was known (<em>n</em> = 6), 2/6 (including the case who had a foetal MRI) required neurosurgical intervention in the first few months of life for spinal cord compression due to severe stenosis of the foramen magnum.</div></div><div><h3>Conclusion</h3><div>A complete mapping of the skeletal features present in foetuses with achondropla","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102891"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jogoh.2024.102890
Bruna Elias Parreira Lopes Ferraz , Roney César Signorini Filho , Lucas Ribeiro Borges Carvalho , Michelle Samora Almeida , Tatiana Carvalho de Souza Bonetti , Edward Araujo Júnior , Antonio Braga , Sue Yazaki Sun
Objective
Cervical cancer is the third most common cancer in Brazil. Although rare, its diagnosis during pregnancy represents a great challenge for the medical team and the patient. The objective of this study was to evaluate the maternal and perinatal outcomes of pregnant women who underwent neoadjuvant chemotherapy with carboplatin and paclitaxel for advanced stage cervical cancer.
Methods
This was a descriptive, retrospective study that included pregnant women with advanced stage cervical cancer (IB3 a IIIC1) who were treated at our center over 12 years. These patients received neoadjuvant chemotherapy with carboplatin plus paclitaxel during pregnancy to prevent disease progression.
Results
Tumor shrinkage of at least 50 % was observed in four patients, while the disease remained stable in three others. There was one case of fetal death without apparent cause at 29 weeks, but all other mothers were discharged from the hospital at the same time as their healthy newborns.
Conclusion
Chemotherapy with carboplatin and paclitaxel administered to pregnant women with advanced stage cervical cancer (IB3 - IIIC1) may have prevented disease progression without worsening neonatal outcomes.
目的：宫颈癌是巴西第三大常见癌症。虽然罕见，但在怀孕期间的诊断对医疗团队和患者来说都是一个巨大的挑战。本研究的目的是评估接受卡铂和紫杉醇新辅助化疗治疗晚期宫颈癌的孕妇的孕产妇和围产期结局。方法：这是一项描述性、回顾性研究，纳入了在我们中心治疗超过12年的晚期宫颈癌（IB3 a IIIC1）孕妇。这些患者在怀孕期间接受卡铂加紫杉醇的新辅助化疗以预防疾病进展。结果：4例患者肿瘤缩小至少50%，3例患者病情保持稳定。有一例在29周时无明显原因的胎儿死亡，但所有其他母亲都与健康的新生儿同时出院。结论：卡铂和紫杉醇联合化疗对妊娠晚期宫颈癌（IB3 - IIIC1）患者可预防疾病进展，且不影响新生儿预后。
{"title":"Neoadjuvant chemotherapy with carboplatin and paclitaxel in pregnant women with advanced stage cervical cancer: Maternal and perinatal outcomes","authors":"Bruna Elias Parreira Lopes Ferraz , Roney César Signorini Filho , Lucas Ribeiro Borges Carvalho , Michelle Samora Almeida , Tatiana Carvalho de Souza Bonetti , Edward Araujo Júnior , Antonio Braga , Sue Yazaki Sun","doi":"10.1016/j.jogoh.2024.102890","DOIUrl":"10.1016/j.jogoh.2024.102890","url":null,"abstract":"<div><h3>Objective</h3><div>Cervical cancer is the third most common cancer in Brazil. Although rare, its diagnosis during pregnancy represents a great challenge for the medical team and the patient. The objective of this study was to evaluate the maternal and perinatal outcomes of pregnant women who underwent neoadjuvant chemotherapy with carboplatin and paclitaxel for advanced stage cervical cancer.</div></div><div><h3>Methods</h3><div>This was a descriptive, retrospective study that included pregnant women with advanced stage cervical cancer (IB3 a IIIC1) who were treated at our center over 12 years. These patients received neoadjuvant chemotherapy with carboplatin plus paclitaxel during pregnancy to prevent disease progression.</div></div><div><h3>Results</h3><div>Tumor shrinkage of at least 50 % was observed in four patients, while the disease remained stable in three others. There was one case of fetal death without apparent cause at 29 weeks, but all other mothers were discharged from the hospital at the same time as their healthy newborns.</div></div><div><h3>Conclusion</h3><div>Chemotherapy with carboplatin and paclitaxel administered to pregnant women with advanced stage cervical cancer (IB3 - IIIC1) may have prevented disease progression without worsening neonatal outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102890"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1016/j.jogoh.2025.102917
Emma Bajeux , Stéphanie Hamonic , Solène Brunet-Houdard , Krystel Nyangoh Timoh , Ludivine Dion , Alexia Guecheff , Vincent Lavoue
Introduction
The role of Robotic Assisted Laparoscopy (RAL) versus conventional laparoscopy (CL) in the surgical treatment of endometrial cancer remains a matter of debate. We aimed to compare RAL and CL in terms of clinical outcomes (hospital stay characteristics and 3-month complications) in patients undergoing hysterectomy for endometrial cancer.
Materials and Methods
We conducted a single-center, retrospective study in a tertiary teaching hospital comparing two groups of women who underwent hysterectomy for endometrial carcinoma by RAL performed by a surgeon during the beginning of learning curve, or CL.
Results
Of the 110 patients included, 56 were in the RAL group and 54 in the CL group. The patients in the RAL group were significantly older (71.6±8.7 vs 67.8±9.7, p=0.031) and had a higher BMI (33.1±7.0 vs 29.8±6.1, p=0.030) than those in the CL group. Operating room occupancy time was higher with RAL (4.6 hours±1.3 vs 3.5±1.3, p<0.001). Although less spinal analgesia was used in the RAL group (35% vs 74%, p<0.001), the patients in this group consumed less postoperative paracetamol (9.4g±5.3 vs 13.0±9.9, p=0.032) meaning faster recovery. Conversely, there was a higher rate of unplanned consultations during the 3-month follow-up in the RAL vs CL group (18.5% vs 3.6%, p=0.012).
Discussion
RAL was associated with less postoperative pain even at the beginning of learning curve. Surgeons were more likely to perform RAL than CL for older and/or obese patients, suggesting they intuitively consider RAL of added benefit for these patients.
{"title":"Robot-assisted versus conventional laparoscopic hysterectomy in endometrial cancer: An observational study in a French tertiary teaching hospital at the beginning of the learning curve","authors":"Emma Bajeux , Stéphanie Hamonic , Solène Brunet-Houdard , Krystel Nyangoh Timoh , Ludivine Dion , Alexia Guecheff , Vincent Lavoue","doi":"10.1016/j.jogoh.2025.102917","DOIUrl":"10.1016/j.jogoh.2025.102917","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of Robotic Assisted Laparoscopy (RAL) versus conventional laparoscopy (CL) in the surgical treatment of endometrial cancer remains a matter of debate. We aimed to compare RAL and CL in terms of clinical outcomes (hospital stay characteristics and 3-month complications) in patients undergoing hysterectomy for endometrial cancer.</div></div><div><h3>Materials and Methods</h3><div>We conducted a single-center, retrospective study in a tertiary teaching hospital comparing two groups of women who underwent hysterectomy for endometrial carcinoma by RAL performed by a surgeon during the beginning of learning curve, or CL.</div></div><div><h3>Results</h3><div>Of the 110 patients included, 56 were in the RAL group and 54 in the CL group. The patients in the RAL group were significantly older (71.6±8.7 vs 67.8±9.7, p=0.031) and had a higher BMI (33.1±7.0 vs 29.8±6.1, p=0.030) than those in the CL group. Operating room occupancy time was higher with RAL (4.6 hours±1.3 vs 3.5±1.3, p<0.001). Although less spinal analgesia was used in the RAL group (35% vs 74%, p<0.001), the patients in this group consumed less postoperative paracetamol (9.4g±5.3 vs 13.0±9.9, p=0.032) meaning faster recovery. Conversely, there was a higher rate of unplanned consultations during the 3-month follow-up in the RAL vs CL group (18.5% vs 3.6%, p=0.012).</div></div><div><h3>Discussion</h3><div>RAL was associated with less postoperative pain even at the beginning of learning curve. Surgeons were more likely to perform RAL than CL for older and/or obese patients, suggesting they intuitively consider RAL of added benefit for these patients.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 4","pages":"Article 102917"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1016/j.jogoh.2025.102919
Pinar Karacin
{"title":"Letter to the Editor.","authors":"Pinar Karacin","doi":"10.1016/j.jogoh.2025.102919","DOIUrl":"https://doi.org/10.1016/j.jogoh.2025.102919","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":" ","pages":"102919"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号