Pub Date : 2026-02-06DOI: 10.1016/j.gofs.2026.02.001
Guillaume Parpex, Antoine Gaudet Chardonnet, Anaïs Guillermin-Bernard, Louis Marcellin, Charles Chapron
{"title":"[How I do… Echo-Guided Ethanol Sclerotherapy of Ovarian Endometrioma Using Transvaginal Catheterization].","authors":"Guillaume Parpex, Antoine Gaudet Chardonnet, Anaïs Guillermin-Bernard, Louis Marcellin, Charles Chapron","doi":"10.1016/j.gofs.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.gofs.2026.02.001","url":null,"abstract":"","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144735","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 : 2026-02-05DOI: 10.1016/j.gofs.2026.01.017
Guillaume Braun, Julie Blanc, Barthélémy Tosello, Camille Rougerie- Baila, Magali Barbier, Pierre Castel
Objective: To estimate the prevalence of pregnant women using cannabis during pregnancy in Marseille, and to determine their socio-demographic characteristics and general knowledge on the subject.
Materials and methods: We conducted a cross-sectional descriptive epidemiological investigation in the maternity wards of Hôpital Nord and Hôpital de la Conception. We distributed a questionnaire to eligible patients hospitalized after delivery, designed to gather socio-demographic and gynecological information, as well as information on cannabis, tobacco, alcohol and other drug use habits, and knowledge of the consequences of such use.
Results: We distributed the questionnaires over a 6-month period between April and September 2023. 503 responses were analyzed. The proportion of patients who had used cannabis during pregnancy was 2.7% [1.3 - 4.1]. Cannabis was overwhelmingly consumed in the form of a smoked joint. There was no difference in socio-demographic characteristics between the groups of patients who used cannabis and those who did not. The majority of women surveyed (79%) felt that cannabis use was harmful to both mother and fetus.
Conclusion: Although cannabis use during pregnancy may seem marginal, it remains the most widely used illicit substance. Even if estimating this consumption is difficult, it remains a topical concern.
目的：估计马赛孕妇在怀孕期间使用大麻的患病率，并确定其社会人口统计学特征和关于该主题的一般知识。材料和方法：我们在Hôpital Nord和Hôpital de la Conception产科病房进行了横断面描述性流行病学调查。我们向分娩后住院的合格患者分发了一份调查问卷，旨在收集社会人口和妇科信息，以及关于大麻、烟草、酒精和其他药物使用习惯的信息，以及对此类使用后果的了解。结果：问卷发放时间为2023年4月至9月，为期6个月。分析了503份回复。怀孕期间使用过大麻的患者比例为2.7%[1.3 - 4.1]。绝大多数人吸食大麻。在使用大麻和不使用大麻的患者群体之间，社会人口统计学特征没有差异。大多数接受调查的妇女（79%）认为使用大麻对母亲和胎儿都有害。结论：虽然怀孕期间大麻的使用似乎很少，但它仍然是使用最广泛的非法物质。即使估算这种消耗是困难的，它仍然是一个值得关注的话题。
{"title":"[Cannabis use among pregnant women: an epidemiological investigation.]","authors":"Guillaume Braun, Julie Blanc, Barthélémy Tosello, Camille Rougerie- Baila, Magali Barbier, Pierre Castel","doi":"10.1016/j.gofs.2026.01.017","DOIUrl":"https://doi.org/10.1016/j.gofs.2026.01.017","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of pregnant women using cannabis during pregnancy in Marseille, and to determine their socio-demographic characteristics and general knowledge on the subject.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional descriptive epidemiological investigation in the maternity wards of Hôpital Nord and Hôpital de la Conception. We distributed a questionnaire to eligible patients hospitalized after delivery, designed to gather socio-demographic and gynecological information, as well as information on cannabis, tobacco, alcohol and other drug use habits, and knowledge of the consequences of such use.</p><p><strong>Results: </strong>We distributed the questionnaires over a 6-month period between April and September 2023. 503 responses were analyzed. The proportion of patients who had used cannabis during pregnancy was 2.7% [1.3 - 4.1]. Cannabis was overwhelmingly consumed in the form of a smoked joint. There was no difference in socio-demographic characteristics between the groups of patients who used cannabis and those who did not. The majority of women surveyed (79%) felt that cannabis use was harmful to both mother and fetus.</p><p><strong>Conclusion: </strong>Although cannabis use during pregnancy may seem marginal, it remains the most widely used illicit substance. Even if estimating this consumption is difficult, it remains a topical concern.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138161","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 : 2026-02-03DOI: 10.1016/j.gofs.2026.01.016
Salomé Dumeil, Anne Alice Chantry, Camille Le Ray, Jeanne Fresson, Damien Subtil, Jennifer Zeitlin
Introduction: The increase in infant mortality in France, driven by the rise in neonatal mortality, raises concerns about the quality of perinatal care. While better organization is identified as a key improvement strategy, data are sparse on the organizational characteristics of maternity units in France.
Methods: This study describes the organization of perinatal care in mainland France in 2016 and 2021, at both national and regional levels, based on data from the National Perinatal Surveys and Annual Hospital Statistics. Six indicators were analysed: maternity unit volume (annual number of births), authorization type, triple on-call coverage (continuous presence of an obstetrician, anaesthesiologist, and paediatrician), understaffed obstetric teams (fewer than 7 full-time equivalents), midwives' workload (ratio of midwives-to-births), and use of temporary staff.
Results: Between 2016 and 2021, the number of maternity units decreased by 8%, and the number of births by 9%. In 2021, 42.5% of maternity units performed fewer than 1,000 deliveries per year, 55.4% did not provide triple on-call coverage, 65.9% of obstetric teams were understaffed, 21.1% of midwifery teams had a very high workload, and 68.0% of units used temporary staff at least once a month. These issues varied significantly depending on the region and the unit's level of care.
Conclusion: A large part of the maternity care system was affected by organizational challenges. Their impact on perinatal health needs to be assessed to propose effective solutions for the upcoming revision of the 1998 perinatal care regulations. Significant regional disparities also call for responses tailored to local specificities.
{"title":"[Organization of Perinatal Care in Mainland France 2016-2021: overview, trends, and regional comparisons].","authors":"Salomé Dumeil, Anne Alice Chantry, Camille Le Ray, Jeanne Fresson, Damien Subtil, Jennifer Zeitlin","doi":"10.1016/j.gofs.2026.01.016","DOIUrl":"https://doi.org/10.1016/j.gofs.2026.01.016","url":null,"abstract":"<p><strong>Introduction: </strong>The increase in infant mortality in France, driven by the rise in neonatal mortality, raises concerns about the quality of perinatal care. While better organization is identified as a key improvement strategy, data are sparse on the organizational characteristics of maternity units in France.</p><p><strong>Methods: </strong>This study describes the organization of perinatal care in mainland France in 2016 and 2021, at both national and regional levels, based on data from the National Perinatal Surveys and Annual Hospital Statistics. Six indicators were analysed: maternity unit volume (annual number of births), authorization type, triple on-call coverage (continuous presence of an obstetrician, anaesthesiologist, and paediatrician), understaffed obstetric teams (fewer than 7 full-time equivalents), midwives' workload (ratio of midwives-to-births), and use of temporary staff.</p><p><strong>Results: </strong>Between 2016 and 2021, the number of maternity units decreased by 8%, and the number of births by 9%. In 2021, 42.5% of maternity units performed fewer than 1,000 deliveries per year, 55.4% did not provide triple on-call coverage, 65.9% of obstetric teams were understaffed, 21.1% of midwifery teams had a very high workload, and 68.0% of units used temporary staff at least once a month. These issues varied significantly depending on the region and the unit's level of care.</p><p><strong>Conclusion: </strong>A large part of the maternity care system was affected by organizational challenges. Their impact on perinatal health needs to be assessed to propose effective solutions for the upcoming revision of the 1998 perinatal care regulations. Significant regional disparities also call for responses tailored to local specificities.</p>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127516","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}
The prevalence of abnormally invasive placenta (AIP) has increased over recent decades. AIP is associated with significant maternal morbidity, mainly due to the high risk of massive hemorrhage, the need for blood transfusions, urologic injuries, and the frequent use of hysterectomy. A multidisciplinary approach is essential, involving obstetricians, anesthesiologists, radiologists, surgeons, and intensive care specialists. The internationally recommended management strategy is cesarean hysterectomy. However, alternative approaches can be considered, taking into account the severity of placental invasion and the woman's desire to preserve fertility. Individualized, anticipatory, and standardized management in an expert center helps reduce the maternal and neonatal complications associated with this high-risk condition. This work describes the various stages of care, from prenatal diagnosis to surgical treatment.
{"title":"Prise en charge d’un placenta accreta du diagnostic à la prise en charge","authors":"Mathilde Barrois , Maelys Nkobetchou , Aude Girault , Catherine Fischer , Vassilis Tsatsaris , Francois Goffinet","doi":"10.1016/j.gofs.2025.07.003","DOIUrl":"10.1016/j.gofs.2025.07.003","url":null,"abstract":"<div><div>The prevalence of abnormally invasive placenta (AIP) has increased over recent decades. AIP is associated with significant maternal morbidity, mainly due to the high risk of massive hemorrhage, the need for blood transfusions, urologic injuries, and the frequent use of hysterectomy. A multidisciplinary approach is essential, involving obstetricians, anesthesiologists, radiologists, surgeons, and intensive care specialists. The internationally recommended management strategy is cesarean hysterectomy. However, alternative approaches can be considered, taking into account the severity of placental invasion and the woman's desire to preserve fertility. Individualized, anticipatory, and standardized management in an expert center helps reduce the maternal and neonatal complications associated with this high-risk condition. This work describes the various stages of care, from prenatal diagnosis to surgical treatment.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"54 2","pages":"Pages 84-89"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627852","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 : 2026-02-01DOI: 10.1016/j.gofs.2025.09.090
Claire Vincens , Gaëlle De Decker , Amélie Denouel , Christine Triboulet , Anne Gabrielle Dumont , Maryline Ferron , Sandra Roy , Tal Anahory , Noémie Ranisavljevic
Objectives
Endometriosis is a chronic disease affecting approximately one in ten women of reproductive age. In cases of chronic pain associated with impaired quality of life, a multidisciplinary and integrative approach is recommended. In this context, a therapeutic patient education (TPE) program specifically dedicated to endometriosis was implemented in 2016. This article aims to describe the development and evolution of this program, as well as its evaluation by patients and participating healthcare professionals.
Method
A retrospective descriptive study was conducted to present the program's progression over eight years of practice. Patient evaluations were collected at the end of each workshop and during final assessment session.
Results
Therapeutic education appears to be a relevant tool for healthcare professionals, promoting better understanding and acceptance of the disease by patients, and improving treatment adherence. Patients gave the program an overall rating of 8 out of 10.
Conclusion
This TPE program represents a beneficial approach for both patients and caregivers, with a potential positive impact on the quality of life of individuals affected by endometriosis.
{"title":"Expérience d’un programme d’éducation thérapeutique Endométriose : bilan à 8 ans de sa création","authors":"Claire Vincens , Gaëlle De Decker , Amélie Denouel , Christine Triboulet , Anne Gabrielle Dumont , Maryline Ferron , Sandra Roy , Tal Anahory , Noémie Ranisavljevic","doi":"10.1016/j.gofs.2025.09.090","DOIUrl":"10.1016/j.gofs.2025.09.090","url":null,"abstract":"<div><h3>Objectives</h3><div>Endometriosis is a chronic disease affecting approximately one in ten women of reproductive age. In cases of chronic pain associated with impaired quality of life, a multidisciplinary and integrative approach is recommended. In this context, a therapeutic patient education (TPE) program specifically dedicated to endometriosis was implemented in 2016. This article aims to describe the development and evolution of this program, as well as its evaluation by patients and participating healthcare professionals.</div></div><div><h3>Method</h3><div>A retrospective descriptive study was conducted to present the program's progression over eight years of practice. Patient evaluations were collected at the end of each workshop and during final assessment session.</div></div><div><h3>Results</h3><div>Therapeutic education appears to be a relevant tool for healthcare professionals, promoting better understanding and acceptance of the disease by patients, and improving treatment adherence. Patients gave the program an overall rating of 8 out of 10.</div></div><div><h3>Conclusion</h3><div>This TPE program represents a beneficial approach for both patients and caregivers, with a potential positive impact on the quality of life of individuals affected by endometriosis.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"54 2","pages":"Pages 74-83"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281722","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 : 2026-02-01DOI: 10.1016/j.gofs.2025.10.013
Emmanuelle Jornet , François Goffinet , Jacques Lepercq
<div><h3>Objectifs</h3><div>Décrire les motifs de réclamations en maternité, puis identifier les patientes à risque accru de formuler une réclamation.</div></div><div><h3>Méthodes</h3><div>Étude rétrospective observationnelle des réclamations portant sur la prise en charge médicale ou soignante, puis étude cas-témoins (un cas, deux témoins consécutifs non appariés n’ayant pas formulé de réclamation). Les caractéristiques démographiques, maternelles, obstétricales et du post-partum ont été comparées en analyse univariée puis multivariée.</div></div><div><h3>Résultats</h3><div>Entre 2018 et 2022, 26 049 patientes ont accouché à la maternité Port-Royal. Parmi elles, cinquante (2‰) réclamantes ont été comparées à 100 témoins. Les trois principaux motifs de réclamations étaient un défaut d’information (58 %), une attitude incorrecte des professionnels (44 %), et une prise en charge médicale considérée comme inadaptée (30 %). En analyse univariée, les facteurs de risque de réclamation étaient les antécédents psychologiques ou psychiatriques (20 vs 7 %, <em>p</em> <!-->=<!--> <!-->0,02), la gémellité (16 vs 3 %, <em>p</em> <!-->=<!--> <!-->0,01), la survenue d’une pathologie fœtale (20 vs 6 %, <em>p</em> <!-->=<!--> <!-->0,01), la durée du travail<!--> <!-->≥<!--> <!-->12<!--> <!-->heures (30 vs 16 %, <em>p</em> <!-->=<!--> <!-->0,04), et l’hospitalisation de l’enfant en néonatologie (18 vs 5 %, <em>p</em> <!-->=<!--> <!-->0,01). En analyse multivariée, la gémellité (ORa IC 95 % 4,74 [0,97–23,23]) et la durée du travail<!--> <!-->≥<!--> <!-->12<!--> <!-->heures (ORa IC 95 % 2,45 [0,96–6,27]) étaient associées à une augmentation non significative des réclamations.</div></div><div><h3>Conclusion</h3><div>Ces résultats suggèrent des axes d’amélioration de la prise en charge des patientes en maternité en général, et chez certaines patientes à risque accru plus particulièrement.</div></div><div><h3>Objectives</h3><div>Quantify and describe the reasons for complaints in maternity, then identify patients at risk of complaining.</div></div><div><h3>Methods</h3><div>Retrospective observational study of complaints relating to medical or nursing care, then case-control study (one case, two consecutive unmatched controls). Demographic, maternal, obstetric and postpartum characteristics were compared using univariate and then multivariate analysis.</div></div><div><h3>Results</h3><div>Between 2018 and 2022, 26,049 patients gave birth at the Port-Royal maternity ward. Among them, 50 (2‰) complained to the patients’ rights department and were compared to 100 controls. The three main reasons for complaints were a lack of information (58%), an incorrect attitude of professionals (44%) and medical care considered unsuitable (30%). In univariate analysis, the risk factors for complaints were psychological or psychiatric background (20 vs. 7%, <em>P</em> <!-->=<!--> <!-->0.02), twinning (16 vs. 3%, <em>P</em> <!-->=<!--> <!-->0.01), the occurrence of a fetal pathology (20%
目的：量化和描述产妇投诉的原因，然后识别有投诉风险的患者。方法：对与医疗或护理有关的投诉进行回顾性观察研究，然后进行病例对照研究（1例，2个连续的不匹配对照）。采用单因素和多因素分析比较人口统计学、产妇、产科和产后特征。结果：2018年至2022年期间，有26,049名患者在皇家港产科病房分娩。其中向病权科投诉50例（2‰），对照100例。投诉的三个主要原因是缺乏信息（58%）、专业人员的不正确态度（44%）和认为不合适的医疗服务（30%）。在单因素分析中，主诉的危险因素为心理或精神病学背景（20%对7%，p=0.02）、双胞胎（16%对3%，p=0.01）、胎儿病理（20%对6%，p=0.01）、产程≥12小时（30%对16%，p=0.04）和新生儿住院（18%对5%，p=0.01）。在多变量分析中，双胞胎（OR 95% CI 4.74[0.97-23.23]）和工作时间≥12小时（OR 95% CI 2.45[0.96-6.27]）与投诉无显著性增加相关。结论：这些结果揭示了产妇护理的改进领域，特别是在某些高危患者中。
{"title":"Description et prévention des réclamations des patientes en maternité","authors":"Emmanuelle Jornet , François Goffinet , Jacques Lepercq","doi":"10.1016/j.gofs.2025.10.013","DOIUrl":"10.1016/j.gofs.2025.10.013","url":null,"abstract":"<div><h3>Objectifs</h3><div>Décrire les motifs de réclamations en maternité, puis identifier les patientes à risque accru de formuler une réclamation.</div></div><div><h3>Méthodes</h3><div>Étude rétrospective observationnelle des réclamations portant sur la prise en charge médicale ou soignante, puis étude cas-témoins (un cas, deux témoins consécutifs non appariés n’ayant pas formulé de réclamation). Les caractéristiques démographiques, maternelles, obstétricales et du post-partum ont été comparées en analyse univariée puis multivariée.</div></div><div><h3>Résultats</h3><div>Entre 2018 et 2022, 26 049 patientes ont accouché à la maternité Port-Royal. Parmi elles, cinquante (2‰) réclamantes ont été comparées à 100 témoins. Les trois principaux motifs de réclamations étaient un défaut d’information (58 %), une attitude incorrecte des professionnels (44 %), et une prise en charge médicale considérée comme inadaptée (30 %). En analyse univariée, les facteurs de risque de réclamation étaient les antécédents psychologiques ou psychiatriques (20 vs 7 %, <em>p</em> <!-->=<!--> <!-->0,02), la gémellité (16 vs 3 %, <em>p</em> <!-->=<!--> <!-->0,01), la survenue d’une pathologie fœtale (20 vs 6 %, <em>p</em> <!-->=<!--> <!-->0,01), la durée du travail<!--> <!-->≥<!--> <!-->12<!--> <!-->heures (30 vs 16 %, <em>p</em> <!-->=<!--> <!-->0,04), et l’hospitalisation de l’enfant en néonatologie (18 vs 5 %, <em>p</em> <!-->=<!--> <!-->0,01). En analyse multivariée, la gémellité (ORa IC 95 % 4,74 [0,97–23,23]) et la durée du travail<!--> <!-->≥<!--> <!-->12<!--> <!-->heures (ORa IC 95 % 2,45 [0,96–6,27]) étaient associées à une augmentation non significative des réclamations.</div></div><div><h3>Conclusion</h3><div>Ces résultats suggèrent des axes d’amélioration de la prise en charge des patientes en maternité en général, et chez certaines patientes à risque accru plus particulièrement.</div></div><div><h3>Objectives</h3><div>Quantify and describe the reasons for complaints in maternity, then identify patients at risk of complaining.</div></div><div><h3>Methods</h3><div>Retrospective observational study of complaints relating to medical or nursing care, then case-control study (one case, two consecutive unmatched controls). Demographic, maternal, obstetric and postpartum characteristics were compared using univariate and then multivariate analysis.</div></div><div><h3>Results</h3><div>Between 2018 and 2022, 26,049 patients gave birth at the Port-Royal maternity ward. Among them, 50 (2‰) complained to the patients’ rights department and were compared to 100 controls. The three main reasons for complaints were a lack of information (58%), an incorrect attitude of professionals (44%) and medical care considered unsuitable (30%). In univariate analysis, the risk factors for complaints were psychological or psychiatric background (20 vs. 7%, <em>P</em> <!-->=<!--> <!-->0.02), twinning (16 vs. 3%, <em>P</em> <!-->=<!--> <!-->0.01), the occurrence of a fetal pathology (20%","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"54 2","pages":"Pages 57-62"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281753","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 : 2026-02-01DOI: 10.1016/j.gofs.2025.11.001
Charlotte Fortun , Esther Samba , Claire Guinot , Isabelle Derrendinger , Isabelle Bouhier , Norbert Winer , Vincent Dochez
Objective
In obstetrics, walking or ambulatory epidural analgesia (APDD) represents an evolution of non-ambulatory epidural analgesia (APD), allowing women to maintain mobility during labor. In a context of increasing demand for more physiological childbirth, it is important to assess its impact on maternal satisfaction and obstetric safety. This article aims to compare maternal satisfaction and obstetric outcomes between women who received APDD and those who received non-ambulatory APD.
Methods
We conducted an ambispective cross-sectional cohort study in a tertiary maternity unit between June and November 2024. Women who delivered vaginally with either APDD or non-ambulatory APD were invited to complete the French Questionnaire d’Évaluation du Vécu de l’Accouchement (QEVA), supplemented by six items specifically addressing pain management. Obstetric and neonatal outcomes were collected from medical records.
Results
A total of 217 women were included (48 in the APDD group and 169 in the APD group). APDD was associated with lower maternal dissatisfaction: no women reported feeling “not at all active” or “not at all autonomous” during childbirth, nor that they would not recommend the technique, whereas dissatisfaction rates reached up to 5.9% in the APD group. The overall QEVA score did not significantly differ between groups (60.9 ± 5.3 vs. 60.2 ± 6.1; P = 0.44). Among extreme responses (value = 1), only the frequency of “unusual sensations” differed significantly (4.2 vs. 18.9%; P = 0.012). Obstetric and neonatal outcomes (cesarean rate, instrumental delivery, postpartum hemorrhage, neonatal complications) were comparable between groups.
Conclusion
APDD appears to be a safe technique that improves maternal satisfaction without compromising obstetric or neonatal outcomes. Its broader implementation, supported by national guidelines, could better meet women's growing expectations for a more physiological childbirth.
目的：在产科中，行走或动态硬膜外镇痛（APDD）代表了非动态硬膜外镇痛（APD）的演变，使妇女在分娩过程中保持活动能力。在越来越多的生理分娩需求的背景下，重要的是评估其对产妇满意度和产科安全的影响。本文旨在比较接受APDD和非门诊APD的产妇满意度和产科结果。方法：我们于2024年6月至11月在一家三级产科病房进行了一项双向横断面队列研究。阴道分娩时患有APDD或非门诊APD的妇女被邀请完成QEVA问卷（法语问卷d‘Évaluation du vvac del ’ accouchement），并补充了六个专门针对疼痛管理的项目。从医疗记录中收集产科和新生儿结局。结果：共纳入217例女性（APDD组48例，APD组169例）。APDD与较低的产妇不满有关：没有妇女报告在分娩过程中感到“一点也不活跃”或“一点也不自主”，也没有她们不推荐这项技术，而APD组的不满意率高达5.9%。总体QEVA评分组间差异无统计学意义（60.9±5.3比60.2±6.1;p = 0.44）。在极端反应（值= 1）中，只有“不寻常感觉”的频率差异显著（4.2% vs. 18.9%; p = 0.012）。产科和新生儿结局（剖宫产率、器械分娩、产后出血、新生儿并发症）组间具有可比性。结论：APDD似乎是一种安全的技术，可以提高产妇满意度，而不会影响产科或新生儿结局。在国家指导方针的支持下，它的广泛实施可以更好地满足女性对生理性分娩日益增长的期望。
{"title":"Analgésie péridurale obstétricale déambulatoire : satisfaction maternelle et sécurité obstétricale – étude de cohorte","authors":"Charlotte Fortun , Esther Samba , Claire Guinot , Isabelle Derrendinger , Isabelle Bouhier , Norbert Winer , Vincent Dochez","doi":"10.1016/j.gofs.2025.11.001","DOIUrl":"10.1016/j.gofs.2025.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>In obstetrics, walking or ambulatory epidural analgesia (APDD) represents an evolution of non-ambulatory epidural analgesia (APD), allowing women to maintain mobility during labor. In a context of increasing demand for more physiological childbirth, it is important to assess its impact on maternal satisfaction and obstetric safety. This article aims to compare maternal satisfaction and obstetric outcomes between women who received APDD and those who received non-ambulatory APD.</div></div><div><h3>Methods</h3><div>We conducted an ambispective cross-sectional cohort study in a tertiary maternity unit between June and November 2024. Women who delivered vaginally with either APDD or non-ambulatory APD were invited to complete the French Questionnaire d’Évaluation du Vécu de l’Accouchement (QEVA), supplemented by six items specifically addressing pain management. Obstetric and neonatal outcomes were collected from medical records.</div></div><div><h3>Results</h3><div>A total of 217 women were included (48 in the APDD group and 169 in the APD group). APDD was associated with lower maternal dissatisfaction: no women reported feeling “not at all active” or “not at all autonomous” during childbirth, nor that they would not recommend the technique, whereas dissatisfaction rates reached up to 5.9% in the APD group. The overall QEVA score did not significantly differ between groups (60.9<!--> <!-->±<!--> <!-->5.3 vs. 60.2<!--> <!-->±<!--> <!-->6.1; <em>P</em> <!-->=<!--> <!-->0.44). Among extreme responses (value<!--> <!-->=<!--> <!-->1), only the frequency of “unusual sensations” differed significantly (4.2 vs. 18.9%; <em>P</em> <!-->=<!--> <!-->0.012). Obstetric and neonatal outcomes (cesarean rate, instrumental delivery, postpartum hemorrhage, neonatal complications) were comparable between groups.</div></div><div><h3>Conclusion</h3><div>APDD appears to be a safe technique that improves maternal satisfaction without compromising obstetric or neonatal outcomes. Its broader implementation, supported by national guidelines, could better meet women's growing expectations for a more physiological childbirth.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"54 2","pages":"Pages 63-68"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582754","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 : 2026-02-01DOI: 10.1016/j.gofs.2025.11.004
Charline Bertholdt , Salomé Bleurvacq , Lisa Lang , Matthieu Dap , Olivier Morel
Objectives
Exceeding the legal working hours of residents, particularly in on-call specialties such as obstetrics and gynecology, raises significant issues regarding patient safety, work-life balance, and training. Despite European regulations limiting weekly working hours to 48, available data indicate a systematic overrun, particularly on weekends, without adequate compensatory time off. This study aimed to compare the weekly working hours of residents between a period before the implementation of compensatory days off and a subsequent period. Secondary objectives included assessing the feasibility, impact on annual leave, theoretical training days, and clinical activity related to the compensatory rest.
Materials and methods
A retrospective observational before-and-after study was conducted at a French university center over two one-year periods (November 2022 to October 2024). A regulatory measure was established starting in November 2023, involving the allocation of compensatory days off after weekend on-call shifts (1 day for Friday and Sunday, 2 days for Saturday). The theoretical weekly working hours were calculated according to a standardized formula that incorporated on-call duties and compensatory rest. Data on the number of on-call responsibilities, internship posts, leaves, and training were collected for each intern from weekly schedules.
Results
The study included 46 residents over two years (20 in the pre-implementation period, 26 in the post-implementation period). The weekly working hours significantly decreased after the introduction of compensatory days off (52.1 h vs. 47.7 h, p < 0.001). The number of individual training days decreased during the post-implementation period, but there was no significant impact on the number of clinical internship days in key sectors.
Conclusion
The implementation of compensatory days off after weekend on-call duties is a feasible and effective measure to reduce the weekly working hours of residents. It allows for compliance with regulatory requirements while maintaining clinical activity or continuity of care.
{"title":"Temps de travail des internes en gynécologie-obstétrique : concilier formation et réglementation","authors":"Charline Bertholdt , Salomé Bleurvacq , Lisa Lang , Matthieu Dap , Olivier Morel","doi":"10.1016/j.gofs.2025.11.004","DOIUrl":"10.1016/j.gofs.2025.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Exceeding the legal working hours of residents, particularly in on-call specialties such as obstetrics and gynecology, raises significant issues regarding patient safety, work-life balance, and training. Despite European regulations limiting weekly working hours to 48, available data indicate a systematic overrun, particularly on weekends, without adequate compensatory time off. This study aimed to compare the weekly working hours of residents between a period before the implementation of compensatory days off and a subsequent period. Secondary objectives included assessing the feasibility, impact on annual leave, theoretical training days, and clinical activity related to the compensatory rest.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational before-and-after study was conducted at a French university center over two one-year periods (November 2022 to October 2024). A regulatory measure was established starting in November 2023, involving the allocation of compensatory days off after weekend on-call shifts (1 day for Friday and Sunday, 2 days for Saturday). The theoretical weekly working hours were calculated according to a standardized formula that incorporated on-call duties and compensatory rest. Data on the number of on-call responsibilities, internship posts, leaves, and training were collected for each intern from weekly schedules.</div></div><div><h3>Results</h3><div>The study included 46 residents over two years (20 in the pre-implementation period, 26 in the post-implementation period). The weekly working hours significantly decreased after the introduction of compensatory days off (52.1<!--> <!-->h vs. 47.7<!--> <!-->h, <em>p</em> <!--><<!--> <!-->0.001). The number of individual training days decreased during the post-implementation period, but there was no significant impact on the number of clinical internship days in key sectors.</div></div><div><h3>Conclusion</h3><div>The implementation of compensatory days off after weekend on-call duties is a feasible and effective measure to reduce the weekly working hours of residents. It allows for compliance with regulatory requirements while maintaining clinical activity or continuity of care.</div></div>","PeriodicalId":56056,"journal":{"name":"Gynecologie Obstetrique Fertilite & Senologie","volume":"54 2","pages":"Pages 69-73"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643198","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