Gynecologie Obstetrique Fertilite & Senologie最新文献

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IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-11-14 DOI: 10.1016/S2468-7189(24)00337-4

引用次数: 0

[Blood and tears. To stop the cycle of conflict-related sexual violence]. [血与泪。停止与冲突有关的性暴力循环]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-11-12 DOI: 10.1016/j.gofs.2024.11.002

Denis Mukwege, Gautier Chene

引用次数: 0

[Impact of HypnoVR© with local anesthesia on pain and anxiety during oocyte pick-up]. [HypnoVR©与局部麻醉对卵母细胞采集过程中疼痛和焦虑的影响]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-11-08 DOI: 10.1016/j.gofs.2024.10.011

Anne-Laure Vanderstraeten, Samir Boukaidi, Coralie Cruzel, Coralie Dumont, Jérôme Delotte

Objective : Virtual reality with Snow World shows a 45% decrease in painful peaks during the care of burn victims. Hypnosis has anxiolytic effect and modulate the response to pain. HypnoVR© is based on many concepts recognized in medicine accessible without specific training. In our practice, 95% of oocyte pick-up are made with local anesthesia and simple premedication, whereas conscious sedation is recommanded in Europe. HypnoVR© is systematically offered during oocyte pick-up. Our study had to compare the pain felt between the 2 group with or without HypnoVR©, also anxiety, tolerance and satisfaction of patients. Method : It was a prospective comparative, non-randomized, single-center, open-label study. We included all patients who were to benefit from an oocyte pick-up from 18 to 43 years-old. The usual protocol of pick-up was used and it was possible to add HypnoVR©. A questionnaire was distributed to each patient to collect their opinion. Results : A total of 112 patients were included, 60 without HypnoVR© and 52 with HypnoVR© ; 2 were excluded from the main analysis for missing data. There is no statistically significant difference in pain and anxiety between the groups. Patients are satisfied : 90.20% (n=46/52) would like to use it again and 98.04% (n=50/52) would recommend it. Conclusion : Despite the absence of a statistically significant difference, patients are satisfied with HypnoVR© and tolerance is good. It seems interesting to be able to offer it during oocyte pick-up.

目的："冰雪世界 "虚拟现实技术显示，在烧伤患者护理过程中，疼痛峰值减少了 45%。催眠具有抗焦虑和调节疼痛反应的作用。HypnoVR© 基于许多公认的医学概念，无需专门培训即可使用。在我们的临床实践中，95% 的卵母细胞采集都是在局部麻醉和简单预处理的情况下进行的，而在欧洲则建议使用意识镇静剂。在取卵过程中，我们会系统地提供催眠 VR©。我们的研究必须比较两组患者在使用或不使用 HypnoVR© 时的疼痛感受，以及患者的焦虑、耐受性和满意度。方法：这是一项前瞻性比较、非随机、单中心、开放标签研究。我们纳入了所有 18 至 43 岁的卵母细胞采集患者。我们采用了常规的取卵方案，并有可能添加 HypnoVR©。向每位患者发放调查问卷，收集他们的意见。结果：共纳入 112 名患者，其中 60 人未使用 HypnoVR©，52 人使用了 HypnoVR©；2 人因数据缺失被排除在主要分析之外。两组患者在疼痛和焦虑方面的差异无统计学意义。患者满意度：90.20%（n=46/52）的患者愿意再次使用，98.04%（n=50/52）的患者愿意推荐使用。结论：尽管在统计学上没有显著差异，但患者对 HypnoVR© 感到满意，并且耐受性良好。在卵母细胞采集过程中使用该方法似乎很有意义。

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引用次数: 0

[Study of the profile and trajectory of women seeking a maternal medical termination of pregnancy for psychosocial reasons at the University Hospital of Tours from 2017 to 2021.] [2017年至2021年图尔大学医院因社会心理原因寻求医学终止妊娠的产妇概况和轨迹研究]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-11-07 DOI: 10.1016/j.gofs.2024.10.010

Caroline Sylvestre, Nathalie Trignol-Viguier

Objective: The law of 7 July 2011 adopts the concept of therapeutic abortion (Medical Termination of Pregnancy or MTP) for maternal reasons if the pregnancy poses a "serious threat" to the woman's health, allowing for the introduction of the concept of psycho-social distress.

Materials and methods: This was a retrospective monocentric study involving 33 women seeking IMG for psychosocial reasons between January 2017 and December 2021 at the University Hospital of Tours. The study resulted in 29 approvals and 25 MTP procedures performed.

Results: Eighty-seven per cent of the requests were accepted. Over half of the women were under 25 years old and were primiparous. The procedures were performed at a mean gestational age of 22 weeks. 60% did not use contraception at the time of conception, and 36% did not use it after the MTP. About a third of the women experienced violence and had psychiatric histories. The majority of the women did not have stable economic resources. Fifty-six per cent of the MTP procedures involved feticide. There were 7 immediate complications with no subsequent consequences. The average time to completion was 16.5 days.

Conclusion: This is a delicate and underexplored subject in literature. Although sporadic in France, these procedures have been practiced for many years. The diversity of opinions during multidisciplinary committees ensures the best objectivity.Requests for psychosocial IMG are rare, but responding to them is in accordance with the law. Analyzing the profile and journey of women has contributed to a better understanding of the complex situations that lead them to this decision.

目标：2011 年 7 月 7 日的法律采纳了治疗性流产（医学终止妊娠或 MTP）的概念，如果妊娠对妇女的健康构成 "严重威胁"，则可出于孕产原因进行治疗性流产，并允许引入心理社会痛苦的概念：这是一项回顾性单中心研究，涉及图尔大学医院 2017 年 1 月至 2021 年 12 月间因社会心理原因申请 IMG 的 33 名妇女。研究结果显示，有29人获得批准，并实施了25项MTP手术：结果：87%的申请被接受。结果：87%的申请被接受，超过一半的妇女年龄在25岁以下，且为初产妇。手术的平均孕周为 22 周。60% 的妇女在受孕时没有采取避孕措施，36% 的妇女在人流术后没有采取避孕措施。约有三分之一的妇女曾遭受过暴力，并有精神病史。大多数妇女没有稳定的经济来源。56%的人流手术涉及堕胎。有 7 例立即出现的并发症，没有造成后续后果。手术完成的平均时间为 16.5 天：结论：在文献中，这是一个微妙且未被充分探讨的主题。虽然这种手术在法国并不常见，但已经存在多年。多学科委员会意见的多样性确保了最佳的客观性。要求进行社会心理干预的情况很少见，但对这些要求做出回应是符合法律规定的。对妇女的情况和历程进行分析，有助于更好地了解导致她们做出这一决定的复杂情况。

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引用次数: 0

[Pregnancy in a patient with Turner syndrome after cardiac surgery and double gamete donation]. [特纳综合征患者在心脏手术和双配子捐献后怀孕]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-11-06 DOI: 10.1016/j.gofs.2024.10.009

Leila Ghassemi, Sébastien Grandfils, Patrick Emonts

引用次数: 0

Désir de grossesse après cancer du sein : accompagner la « transgression » [乳腺癌后怀孕：支持 "越轨行为"]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-10-19 DOI: 10.1016/j.gofs.2024.10.007

Catherine Uzan , Carole Mathelin , Charlotte Vaysse , Nathalie Chabbert-Buffet , Lise Selleret

引用次数: 0

Population transmasculine : hormonothérapie, prévention et soins en santé sexuelle et reproductive, revue de la littérature et propositions de suivi [跨性别者：性别肯定荷尔蒙疗法、性健康和生殖健康预防与护理、医学审查和后续建议]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-08-02 DOI: 10.1016/j.gofs.2024.06.004

Juliette Cuq , Marion Lapoirie , Ingrid Plotton , Eloise Fraison , Paul Neuville , Séverine Oriol

Transmasculine individuals have a poor access to health care, mostly regarding the sexual and reproductive health. Despite a lack of official guidelines, they need a gynecological follow-up, the aim of this review was to describe it. The present study involved an exhaustive search of MEDLINE, 68 articles were included to analyze the impact of hormonal therapy, prevention, and care regarding sexual and reproductive health of transmasculine individuals. Despite a lack of solid data, the global literature agrees that transmasculine individuals require sexual and reproductive health care. Care must be adapted to each pathway and may be impacted by gender-affirming care. The cancer risk does not seem to be increased in this population, particularly in relation to hormonal therapy. Prevention programs do not differ from those offered to cis women in the absence of gender-affirming surgeries. Transmasculine individuals require follow-up and care adapted to their needs and their pathways. Healthcare professionals must be trained to provide such care.

变性人很难获得医疗保健服务，主要是在性健康和生殖健康方面。尽管缺乏官方指南，但他们仍需要妇科随访，本综述旨在对此进行描述。本研究对 MEDLINE 进行了详尽的检索，共收录了 68 篇文章，以分析激素治疗、预防和护理对跨性别者性健康和生殖健康的影响。尽管缺乏可靠的数据，但全球文献一致认为，跨性别者需要性健康和生殖健康护理。护理必须适应每种途径，并可能受到性别肯定护理的影响。这类人群患癌症的风险似乎并没有增加，尤其是与荷尔蒙疗法有关的癌症。在没有进行性别确认手术的情况下，预防计划与为顺性女性提供的预防计划并无不同。跨性别者需要根据他们的需求和途径进行跟踪和护理。医疗保健专业人员必须接受培训，以提供此类护理。

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引用次数: 0

Étude RIESC : risques d’infections uro-génitales et d’expulsion dans l’association stérilet et coupe menstruelle [宫内节育器与月经杯结合使用时的泌尿系统感染和排出风险]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-07-14 DOI: 10.1016/j.gofs.2024.07.003

Johanna Madar , Méghane Gaucher , Adriaan Barbaroux , Jérôme Delotte , Carol-Anne Boudy

Objectives

The increase in intrauterine devices (IUDs) contraception, and the growing use of reusables menstrual hygiene products such as the menstrual cup, necessitates an assessment of the implications of their co-use. The objectives are to assess whether women with IUDs who use menstrual cups have an increased risk of IUD expulsion and/or a change in the risk of upper and lower urogenital tract infections compared to women who use other menstrual hygiene products.

Method

An observational, prospective, multicenter study was conducted in France between 2020 and 2023. Participants were recruited by health professionals and data were collected by telephone questionnaire at the time of IUD insertion and at one year. The primary endpoints were the occurrence of IUD expulsion and the occurrence of urogenital tract infections in menstrual cup users compared to non-users.

Results

One hundred and three women out of 119 included were analyzed, 25 of them were regular menstrual cup users and five experienced IUD expulsion. Among regular users, 12% experienced IUD expulsion compared to 2.6% among non-users, with no statistically significant difference (Chi² = 3.65; P = 0.056). Regarding urogenital tract infections, nine women (36%) of the regular menstrual cup users had urogenital infections, compared with 27 (34.6%) of the non-users or not regular users, with no statistically significant difference.

Conclusion

The tendency of menstrual cup users to expel their IUDs is a reason for caution, although it is not sufficient to contraindicate co-use. Physicians should therefore systematically screen such co-use and inform patients of the risks and monitoring instructions.

目的：随着宫内节育器（IUDs）避孕的增加，以及月经杯等可重复使用的月经卫生用品的使用日益增多，有必要对其共同使用的影响进行评估。目的是评估与使用其他月经卫生用品的妇女相比，使用月经杯的宫内节育器妇女是否会增加宫内节育器脱出的风险和/或改变上下泌尿生殖道感染的风险：一项观察性、前瞻性、多中心研究于 2020 年至 2023 年在法国进行。参与者由专业医护人员招募，在放置宫内节育器时和一年后通过电话问卷收集数据。主要终点是与未使用月经杯者相比，使用月经杯者的宫内节育器脱出发生率和泌尿生殖道感染发生率：对 119 名妇女进行了分析，其中 25 人经常使用月经杯，5 人发生过宫内节育器脱出。在经常使用月经杯的妇女中，12%的人出现过宫内节育器脱出的情况，而在未使用月经杯的妇女中，这一比例仅为 2.6%，两者在统计学上无显著差异（Chi2 = 3.65；P = .056）。在泌尿生殖道感染方面，月经杯的定期使用者中有 9 名妇女（36%）发生过泌尿生殖道感染，而非使用者或非定期使用者中有 27 名妇女（34.6%）发生过泌尿生殖道感染，两者在统计学上无显著差异：结论：月经杯使用者容易将宫内节育器排出体外，这一点值得警惕，但这并不足以成为共同使用的禁忌。因此，医生应系统地筛查此类共同使用情况，并告知患者其风险和监测说明。

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引用次数: 0

Devenir clinique après transfert de blastocystes vitrifiés selon l’indication de congélation [玻璃化囊胚移植后的临床结果与冷冻适应症的关系]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-06-26 DOI: 10.1016/j.gofs.2024.06.002

Emmanuelle Bodin , Romane Sainte-Rose , Claire Petit , Marion Cornuau , Fabrice Guérif

Objectives

In France, embryo thawing concern 45.8% of attempts at assisted reproductive technologies excluding artificial inseminations. This proportion is constantly increasing for various reasons. The main objective of this study is to compare the live birth rate following frozen blastocyst transfer (FBT) according to the initial indication for freezing.

Methods

This is a retrospective study including patients who underwent FBT between 01/01/2020 and 06/30/2022 at the Regional University Hospital Center of Tours. The results were compared (univariate and multivariate analyses) between the three main indications for freezing: freezing of the complete cohort of blastocysts for risk of ovarian hyperstimulation (=OHS), freezing of supernumerary blastocysts after fresh blastocyst transfer (BT) with pregnancy (=second request) or without pregnancy (=BT failure). Results have also been described for other indications.

Results

Among the 963 FBT cycles selected, 28% of live births by thawing were obtained, all indications of freezing combined. A significantly lower rate was identified in the FBT failure group compared to the OHS group. However, after adjustment, the results remained significant for the age of the patient on the freezing cycle but not for the indication for freezing.

Conclusions

The outcome of a FBT does not seem significantly impacted by the indication of freezing considering the confounding factors. The prospective analysis of more data from a multicenter study would be necessary to confirm these results.

目的：在法国，除人工授精外，胚胎解冻占辅助生殖技术尝试的 45.8%。由于各种原因，这一比例在不断上升。本研究的主要目的是根据冷冻囊胚移植（FBT）的最初适应症，比较冷冻囊胚移植后的活产率：这是一项回顾性研究，包括 2020 年 1 月 1 日至 2022 年 6 月 30 日期间在图尔地区大学医院中心接受冷冻囊胚移植手术的患者。对三种主要冷冻适应症的结果进行了比较（单变量和多变量分析）：因卵巢过度刺激（=OHS）风险而冷冻完整的囊胚群、冷冻新鲜囊胚移植（BT）后妊娠（=第二次要求）或未妊娠（=BT失败）的超数囊胚。结果：结果：在选定的 963 个 FBT 周期中，通过解冻获得活产的比例为 28%，所有冷冻适应症合并计算。与OHS组相比，FBT失败组的比例明显较低。然而，经过调整后，与冷冻周期中患者的年龄有关的结果仍然显著，但与冷冻适应症无关：考虑到各种混杂因素，冷冻适应症似乎对冷冻治疗的结果影响不大。有必要对一项多中心研究的更多数据进行前瞻性分析，以证实这些结果。

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引用次数: 0

La nouvelle version du site internet du Centre de référence sur les agents tératogènes et ses fonctionnalités optimisées [新版法国畸形信息服务网站 "CRAT"]。

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2024-06-04 DOI: 10.1016/j.gofs.2024.05.005

Bénédicte Coulm , Delphine Beghin , Mathilde Latour , Bilal Majed , Catherine Vauzelle , Elisabeth Elefant , Benoît Marin

The Centre de Référence sur les Agents Tératogènes (CRAT) is a unique French national reference center involved in the risk assessment of exogenous agents (mainly drugs, but also medical imaging and addictions) on pregnancy, breastfeeding and fertility. To help improve patient care, CRAT makes its expertise available to healthcare professionals via its website (www.lecrat.fr), a free, independent and public online resource regularly updated by its multidisciplinary team. In December 2023, a new version was launched, based on the evolutions desired by the CRAT team and on a satisfaction survey of website's users. A predictive search bar integrated into the home page now enables users to find the specific information they are looking for more quickly. To optimize the access via smartphones, a mobile version is now available.

外源性药物风险评估中心（Centre de Référence sur les Agents Tératogènes (CRAT)）是法国唯一一家从事外源性药物（主要是药物，也包括医学影像和成瘾药物）对妊娠、哺乳和生育风险评估的国家级参考中心。为了帮助改善患者护理，CRAT 通过其网站 (www.lecrat.fr) 向医疗保健专业人员提供其专业知识，该网站是一个免费、独立和公开的在线资源，由其多学科团队定期更新。2023 年 12 月，根据 CRAT 团队所希望的发展以及对网站用户的满意度调查，推出了新版本。现在，集成在主页上的预测搜索栏使用户能够更快地找到他们正在寻找的特定信息。为了优化智能手机的访问，现在还推出了手机版。

引用次数: 0

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