Impact of the COVID-19 pandemic and the emergency measures on abortion care taken during this period in a French region (Provence Alpes Côte d'Azur).

INTRODUCTION: On March 17, 2020, the first mandatory national lockdown was implemented in France, followed by an adaptation of health services to ensure access to abortion care. The objective of this study is to evaluate the impact of COVID-19 and the emergency measures on abortion care taken during this period in the Provence Alpes Côte d'Azur region (PACA) in France. MATERIALS AND METHODS: This retrospective study was based on the health insurance information system national database (SNDS), which included all women who had an abortion between January 1, 2019 and December 31, 2020 in the PACA region. We compared the total number of abortions, the distribution (surgical abortion, medical abortion (MA) at home (MAH) or in a clinic between 2019 and 2020 and the use of teleconsultation (TC) in 2020. RESULTS: The total number of abortions in the PACA region decreased by 3.5% between 2019 and 2020. The rate of MA was higher in 2020 than in 2019 [17,489/22,444 (79.3%) vs. 17,042/22,354 (74.5%) (P < 0.0001)]. The rate of MAH was higher in 2020 than in 2019 [(8,177/17,489 (46.8%) vs. 7,264/17,042 (42.6%) (P < 0.0001)]. TC was used in 96 MAH in 2020. CONCLUSION: A decrease in the number of abortions in the PACA region was observed in 2020. There was an increase in MA, mainly MAH, allowing easier and more adapted access to the health situation. TC was poorly used.

Metoclopramide Test in Hyperprolactinemic Women With Polycystic Ovarian Syndrome: Old Wine Into New Bottles?

INTRODUCTION: Polycystic ovarian syndrome (PCOS) is the most frequent etiology of anovulation, hyperandrogenism and infertility in women. Its pathophysiology remains poorly elucidated. Hyperprolactinemia (hPRL) is common in women of reproductive age and may partially mimic the clinical phenotype of PCOS. The simultaneous finding of both conditions is therefore not rare, however there are conflicting studies on whether a link exists between them. MATERIALS AND METHODS: We conducted a retrospective monocentric study between 2015 and 2021 and among women who were referred for possible PCOS, we selected those who met the ESHRE/Rotterdam definition criteria. hPRL was defined as two values above the upper limit of normal with at least one measurement in our centre. RESULTS: A total of 430 women were selected, of whom 179 met the PCOS criteria. 50 out of 179 patients (27.9%) had at least one elevated value of PRL and 21 (11.7%) had hPRL according to our definition. Among the 21 women of the PCOS/hPRL cohort, 5 (23.8%) had a microprolactinoma and all of them had PRL level ≥ 60 ng/ml. The remaining cases were macroprolactinemia (n=5), iatrogenic hPRL (n=4), primary hypothyroidism (n=1) or unexplained (n=6) despite exhaustive investigations. The metoclopramide test resulted in an increase of basal PRL < 300% in all prolactinomas and ≥ 300% in all the other etiologies. CONCLUSION: hPRL was a common finding in PCOS women, secondary to a microprolactinoma in a quarter of cases. Metoclopramide test performed in women with hPRL below 60 ng/ml appeared as a helpful tool 1) to discriminate pituitary causes from others etiologies, 2) to potentially avoid unnecessary pituitary MRI.