Gynecologie Obstetrique Fertilite & Senologie最新文献

英文中文

Comment je fais… la pose d’un dispositif intra-utérin en post-partum immédiat ? 如何在产后插入宫内节育器？］

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 10.1016/j.gofs.2025.10.022

Adèle Bichon, Solène Vigoureux

引用次数: 0

Analgésie péridurale obstétricale déambulatoire : satisfaction maternelle et sécurité obstétricale – étude de cohorte [门诊产科硬膜外镇痛：产妇满意度和产科安全-队列研究]。

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 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。

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引用次数: 0

Temps de travail des internes en gynécologie-obstétrique : concilier formation et réglementation 妇产科住院医师工作时间：平衡培训与规范。

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 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.

目标：超过住院医生的法定工作时间，特别是在产科和妇科等随叫随到的专业，会引发有关患者安全、工作与生活平衡和培训的重大问题。尽管欧洲规定将每周工作时间限制在48小时以内，但现有数据表明，由于没有足够的补休时间，这种情况系统性地超出了工作时间，尤其是在周末。本研究旨在比较补偿休假实施前与实施后住院医师的周工作时数。次要目标包括评估可行性、对年假的影响、理论培训天数和与补偿性休息相关的临床活动。材料和方法：在法国一所大学中心进行了为期两年（2022年11月至2024年10月）的回顾性观察前后研究。从2023年11月开始，制定了一项监管措施，包括在周末随叫随到的轮班后分配补休日（周五和周日1天，周六2天）。理论每周工作时间是根据一个标准公式计算的，其中包括随叫随到的工作和补偿性休息。从每周的时间表中收集每个实习生随叫随到的职责、实习岗位、休假和培训的数据。结果：研究对象为两年以上的46名居民（实施前20名，实施后26名）。引入补休后，居民每周工作时间明显减少（52.1小时vs 47.7小时）。结论：在周末随叫随到后实行补休是减少居民每周工作时间的可行有效措施。它允许遵守法规要求，同时保持临床活动或护理的连续性。

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引用次数: 0

Sommaire 摘要

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 10.1016/S2468-7189(26)00016-4

引用次数: 0

Dépistage des violences conjugales chez les patientes hospitalisées lors de deux périodes de deux jours : étude pilote [法国大学医院住院女性患者亲密伴侣暴力的系统筛查]。

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 10.1016/j.gofs.2025.10.024

Iris Bouchayer , Jean-Yves Lefrant , Sylvie Ripart

引用次数: 0

Facteurs prédictifs d’une résection hystéroscopique des fibromes sous-muqueux en deux temps. Étude rétrospective unicentrique 两步宫腔镜切除粘膜下肌瘤的预测因素。一项单中心回顾性研究]。

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 10.1016/j.gofs.2025.10.017

Marion Beck , Fabien Subtil , Nathalie Hoen , Lucie Bonin-Crepet , Pierre Descargues , Delphine Raffin , Pierre-Adrien Bolze , François Golfier

Objectives

Hysteroscopic resection of submucosal fibroids is an effective technique to reduce menometrorrhagia and improve fertility. Identifying predictors of two-step resections is essential to optimize preoperative counseling and surgical planning. The objective of this retrospective study was to assess predictive factors previously reported in the literature.

Methods

We analyzed 106 patients who underwent hysteroscopic fibroid resection at Lyon Sud University Hospital between January 2019 and January 2024.

Results

Fibroid size was the only factor significantly associated with the need for a two-step resection. For fibroids ≥ 3 cm in diameter, the odds ratio for requiring a second procedure was 13.3, with the risk increasing from 4.1% to 36.4%. Complication rates and fluid deficit were also higher in two-step resections.

Conclusions

Fibroid size appears to be the main predictor of two-step hysteroscopic resection. This finding has direct clinical relevance, as it allows for more accurate preoperative counseling of patients, more than one-third of whom may require a second intervention. Prospective multicenter studies are needed to confirm these results.

目的：宫腔镜下粘膜下肌瘤切除术是减少子宫出血和提高生育能力的有效技术。确定两步切除的预测因素对于优化术前咨询和手术计划至关重要。本回顾性研究的目的是评估先前文献中报道的预测因素。方法：我们分析了2019年1月至2024年1月在里昂南方大学医院接受宫腔镜子宫肌瘤切除术的106例患者。结果：子宫肌瘤大小是唯一与需要两步切除显著相关的因素。对于直径≥3cm的肌瘤，需要第二次手术的优势比为13.3，风险从4.1%增加到36.4%。两步切除的并发症发生率和体液不足也更高。结论：子宫肌瘤大小似乎是两步宫腔镜切除的主要预测因素。这一发现具有直接的临床意义，因为它允许对患者进行更准确的术前咨询，其中超过三分之一的患者可能需要第二次干预。需要前瞻性多中心研究来证实这些结果。

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引用次数: 0

Remerciements aux relecteurs 感谢校对

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 10.1016/j.gofs.2026.01.011

引用次数: 0

(Encore) moins de chirurgie axillaire pour le cancer du sein ? 乳腺癌的腋窝手术更少？］

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-02-01 DOI: 10.1016/j.gofs.2026.01.001

Catherine Uzan , Charlotte Vaysse , Carole Mathelin

引用次数: 0

[The cat, the women and the toxoplasma: what advice should be given to a pregnant woman who is seronegative for toxoplasmosis and owns a cat?] 猫、妇女和弓形虫：对养猫且弓形虫血清检测呈阴性的孕妇应给予什么建议？］

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-01-31 DOI: 10.1016/j.gofs.2026.01.015

Mohamed Gharbi, Hélène Yera, Jean Dupouy-Camet

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.

弓形虫病是由刚地弓形虫引起的世界性原虫病。几项研究表明，在同一时刻，大约1%的猫的粪便中会出现弓形虫卵囊。在人类中，除了免疫功能低下者和在怀孕期间感染的血清阴性孕妇外，这种寄生虫的感染通常无症状。这些妇女将寄生虫传染给胎儿，胎儿会受到重力变化的感染。在这种情况下，有两个问题：血清阴性的孕妇与猫一起生活的风险是什么？她应该对这只猫采取什么态度？应采取若干预防措施，以减少猫向孕妇传播弓形虫的风险。

引用次数: 0

[Impact of a dedicated day-hospital on breast cancer care timelines: A before-after study]. [专门的日间医院对乳腺癌护理时间表的影响：前后研究]。

IF 0.8 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie

Pub Date : 2026-01-30 DOI: 10.1016/j.gofs.2026.01.012

Julie Sellier, William Mutamba, Noémie Gassian, Baptiste Borraccino

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.

目的——评估欧塞尔总医院的UnyonSein日间医院对乳腺癌患者诊断和治疗时间表的组织影响。方法：对2024年（标准通路）和2025年（结构化HDJ通路）两个时期进行回顾性观察前后研究。分析11个关键时间间隔（D1 ~ D11）。结果以中位数（IQR）表示，并使用Mann-Whitney检验进行比较。结果：实施HDJ后，两个时间间隔显著改善：从预约到手术会诊的时间（D1）和从手术会诊到手术室的时间（D6）。诊断时间表（放射学、活检、病理学）保持稳定。化疗相关的时间线没有改善。结论：联盛日间医院显著提高了初始手术路径的流动性。将该模型扩展到肿瘤途径对于优化化疗起始时间至关重要。

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引用次数: 0

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Gynecologie Obstetrique Fertilite & Senologie

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