Gynecologie Obstetrique Fertilite & Senologie最新文献

Objectives: In France, each year, approximately 150 women request a medical termination of pregnancy due to psychosocial distress. There are no recommendations regarding their assessment process. Subjectivity can play an even greater role than in the case of a somatic pathology, and differing opinions can sometimes cause tension within teams. The primary objective was to describe these patients' access to care and the stages of their care pathway. The secondary objective was to identify decision-making factors.

Methods: Online questionnaire survey of the 48 CPDPNs in France.

Results: Of the 48 CPDPNs, 44 (91.7%) responded, 23 (52.3%) reported receiving fewer than 5 requests per year, and 10 (22.7%) reported receiving more than 10. Among the centers that responded to this question, 38/43 (88%) reported receiving patients systematically and 5 centers under certain conditions: gestational age, context of the request, or only upon referral from a psychiatrist. Fifteen centers (34%) have an evaluation protocol. After evaluation, 57% of centers report accepting the majority of requests. The most frequently cited factors in favor of acceptance were pregnancy resulting from rape, severe psychological distress, a history of violence, and the young age of the patient. The factors in favor of refusal were perceived ambivalence, lack of evident distress, and non-compliance with the assessment process.

Conclusion: It seems that not all CPDPNs in France systematically receive women who request a termination of pregnancy due to psychosocial distress. Regardless of the final decision concerning the continuation of the pregnancy, medical, social, and psychological support should be offered. A relevant multidisciplinary protocol could enable equitable treatment of patients.

Toxoplasmosis is a cosmopolitan protozoal disease caused by Toxoplasma gondii. Several studies have shown that at one instant approximately 1% of cats shed T. gondii oocysts in their faeces. In humans, the infection by this parasite is most often asymptomatic except for immunocompromised persons and seronegative pregnant women that were infected during the pregnancy. These women transmit the parasite to their foetuses who develop an infection with a variable gravity. In this context, there are two questions: what is the risk for a seronegative pregnant woman living with a cat and what attitude should she take toward this cat? Several preventive measures should be implemented to reduce the risk of T. gondii transmission from cats to pregnant women.

Objective - To assess the organizational impact of the UnyonSein Day Hospital at the Auxerre General Hospital on diagnostic and therapeutic timelines for patients with breast cancer. Methods - A retrospective observational before/after study was conducted comparing two periods: 2024 (standard pathway) and 2025 (structured HDJ pathway). Eleven key time intervals (D1 to D11) were analyzed. Results were expressed as medians (IQR) and compared using the Mann-Whitney test. Results - Two time intervals significantly improved after implementation of the HDJ: time from appointment request to surgical consultation (D1), and time from surgical consultation to operating room (D6). Diagnostic timelines (radiology, biopsy, pathology) remained stable. Timelines related to chemotherapy showed no improvement. Conclusion - The UnyonSein Day Hospital significantly enhances the fluidity of the initial surgical pathway. Extending this model to the oncological pathway appears essential to optimize chemotherapy initiation timelines.

Objectives: This study aimed to investigate epidemiological, diagnostic, and therapeutic aspects of benign breast diseases at the Centre Hospitalier Universitaire de la Mère et de l'Enfant Lagune (CHU-MEL) in Benin.

Methods: This descriptive cross-sectional study with retrospective data collection over the period of five years (2019 to 2023) included patients treated in the gynecology department of the CHU-MEL for benign breast disease and with a complete medical record. The data used are related to sociodemographic, clinical, paraclinical, and therapeutic characteristics. This work was approved by the local ethics committee for biomedical research at the University of Parakou (CLERB-UP).

Results: Benign breast disease represented 3.57% of gynecological consultation (n=447). The average age of the patients in our study was 30.82 ±1.23 years. The main reason for consultation was breast lumps (57.27%) and Breast self-examination was the main method of detection (48.32%). Ultrasound (70.25%) was the first-line examination, and ACR (American College of Radiology) classes 1, 2, and 3 were the most common (35.99%, 34.39%, and 28.09%, respectively). Adenofibromas was the most common among benign tumors (57.08%). Idiopathic mastodynia (39.82%) was the most common benign non-tumor pathology, followed by breast abscess (23.08%).

Conclusions: Benign breast diseases are common in young women and dominated by adenofibromas. Their management is limited by the low socioeconomic status of the population and lack of health insurance.