Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 101
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Scand J Rheumatol ; 46(1): 56-63, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27191226

RESUMO

OBJECTIVES: Primary Sjögren's syndrome (pSS) is one of the most common autoimmune diseases, mainly affecting women during the fourth decade of life. During pregnancy, the presence of anti-Ro/SSa and anti-La/SSb antibodies increases the risk of congenital heart block (CHB). Foetal and pregnancy outcomes in pregnant women with pSS compared with the general population are difficult to evaluate because of confounding factors including age and body mass index (BMI). METHOD: The aim of this case-control study was to analyse the impact of pSS in pregnant women on foetal and pregnancy outcomes. RESULTS: We enrolled 19 women with pSS (54 pregnancies) matched by age and BMI to 216 controls. Patients with pSS delivered significantly earlier (38 weeks + 3 days vs. 39 weeks + 2 days) and experienced more spontaneous abortions [< 22 weeks of gestation (WG)] than the controls [n = 16/54 (30.0%) vs. n = 1/216 (0.4%); p < 0.00001]. Preterm delivery (≤ 37+6 WG) was significantly higher in the pSS group than in the control group (29% vs. 12%, p = 0.04). pSS activity significantly affected the birthweight percentile, which was lower in pregnancies occurring after the diagnosis of pSS than in those occurring before (32.43 ± 21.57 vs. 60.46 ± 27.37; p = 0.008). No case of CHB was observed. CONCLUSIONS: pSS is responsible for an increased risk of spontaneous abortion. The duration of pregnancy is lower in patients with than without pSS, with more premature deliveries. Pregnancies that occur after the onset of the disease result in lower birthweight percentile children than when pSS is not clinically overt.


Assuntos
Aborto Espontâneo/etiologia , Nascimento Prematuro/etiologia , Síndrome de Sjogren/complicações , Adulto , Feminino , Humanos , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Adulto Jovem
2.
Arch Gynecol Obstet ; 290(3): 465-9, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24728104

RESUMO

OBJECTIVE: The aim was to evaluate the agreement between and the reproducibility of transperineal and transvaginal ultrasound cervical length measurements performed by the duty obstetrical team in case of preterm labor. The acceptability of transperineal ultrasonography was also assessed. METHODS: Pregnant patients between 25 and 34 weeks of gestation with contractions and a clinically modified cervix were included. Order of ultrasonography examination (transperineal or transvaginal first) and rank of operator (resident or senior) were allocated randomly. Agreement was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman plot. The patient's discomfort and preference for either method were assessed with a questionnaire. RESULTS: 62 patients admitted for preterm labor between 25 and 34 weeks of gestation were included. Six seniors and nine residents took part in the study. Among the 51 patients with an interpretable transperineal ultrasound scan, median cervical length measurements with the transperineal and the transvaginal technique were, respectively, 25 mm (0-53) and 27 mm (4-51). Concordance was good with an ICC of 0.83 [IC 95 % = (0.73-0.90)]. Transperineal ultrasonography was preferred in 56.5 % of cases. CONCLUSION: In case of preterm labor, cervical length measurement with transperineal ultrasonography seems reproducible and can be performed by the obstetric team on duty.


Assuntos
Medida do Comprimento Cervical/métodos , Colo do Útero/diagnóstico por imagem , Trabalho de Parto Prematuro , Adolescente , Adulto , Feminino , Humanos , Preferência do Paciente/estatística & dados numéricos , Gravidez , Estudos Prospectivos , Reprodutibilidade dos Testes , Adulto Jovem
3.
Ann Dermatol Venereol ; 139(2): 103-8, 2012 Feb.
Artigo em Francês | MEDLINE | ID: mdl-22325748

RESUMO

BACKGROUND: The usual treatment for extramammary Paget's disease (EMPD) is surgery, but this approach may have grave functional and physical consequences, as well as high recurrence rates. Topical photodynamic therapy (PDT) offers an optional approach for EMPD; it has a high complete response rate and there is no dose restriction. The aim of this study was to evaluate the efficacy and safety of PDT in the treatment of EMPD. PATIENTS AND METHODS: This series of patients was seen at a single centre between 1 December 2005 and 31 December 2010. All patients with histologically confirmed EMPD were included. Patients received two courses of PDT 21 days apart: 3 hours after topical application of methyl aminolevulinic acid emulsion, they underwent illumination with red light (570-670 nm) at a dose of 37 J/cm(2) for 10 minutes. In the event of relapse, a further cycle was given at week 6. RESULTS: Eight patients (seven female, one male) of a mean age of 69 years were included. After two series of two illuminations, seven patients were in complete clinical remission at 3 months and one patient was in partial remission. Five patients were still in complete clinical remission at 6 months. All patients had relapsed after a mean 8.4 months (4-14 months). The limiting factor appears to be pain occurring during illumination. Patients reported satisfaction with the disappearance of symptoms and a notable improvement in quality of life. DISCUSSION: The complete clinical response rate to PDT at month 6, after two series of two illuminations, was equivalent to that for surgery. Although the recurrence rate was high, this treatment may be repeated without functional or physical consequences. PDT resulted in disappearance of pain and improved quality of life.


Assuntos
Doença de Paget Extramamária/tratamento farmacológico , Fotoquimioterapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Paget Extramamária/patologia
4.
J Gynecol Obstet Hum Reprod ; 51(1): 102234, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34571197

RESUMO

Native tissue cystocele repair has been the cornerstone of prolapse surgery, especially since the learned societies warned clinicians and patients about serious mesh related complications and recommend a vaginal route without prosthesis in first intention. Surgical techniques mainly consist in anterior colporraphy, vaginal patch plastron and para vaginal repair. However, in case of vaginal patch plastron, the vagina left in contact with the bladder is a material of much better quality than colporraphy alone. The multiplication of native tissues, generating post-operative fibrosis, associated with anchorage on a strong ligamentous structure, allows to expect better outcomes compared to anterior colporraphy. Indeed, vaginal plastron corrects median cystoceles with a vaginal strip as well as lateral cystoceles thanks to bilateral paravaginal suspension. Thereby, vaginal patch plastron appears to be a good compromise between the 3 autologous techniques with median and paralateral repair We aimed to describe the surgical technique of the vaginal patch plastron for vaginal native tissue repair for cystocele.


Assuntos
Cistocele/cirurgia , Implantação de Prótese/instrumentação , Telas Cirúrgicas/normas , Adulto , Cistocele/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Prolapso de Órgão Pélvico/cirurgia , Implantação de Prótese/métodos , Implantação de Prótese/tendências
5.
Gynecol Obstet Fertil Senol ; 50(1): 45-52, 2022 Jan.
Artigo em Francês | MEDLINE | ID: mdl-34530145

RESUMO

OBJECTIVES: The delivery of breech presentations remains controversial. Our study analysed the impact of a service protocol on the proportion of planned vaginal delivery and its success. Immediate neonatal morbidity and factors that may influence the success of vaginal delivery were studied. METHODS: Retrospective study, between 2009 and 2020 at the CHRU of Limoges, type 3 maternity hospital, on patients with a breech foetus at term. The proportion of planned vaginal delivery and the rate of effective vaginal delivery were compared before/after 2015. Neonatal morbidity was compared for planned vaginal delivery and planned cesarean delivery groups. RESULTS: We included 923 patients. The rate of planned vaginal delivery was significantly higher after 2015 from 5.2% to 19% (P<0.001), with a success rate increasing from 60% to 82.1% (P=0.06). The rate of vaginal breech deliveries significantly increased from 3.8% to 17% (P<0.001). We found significantly more newborns with moderate acidosis when a vaginal delivery was attempted (P<0.001). The success of vaginal delivery was correlated to the Magnin index (P=0.044), to gestational age (P=0.037), and to multiparity (OR 3.78 95% CI [1.42-10.03] P=0.006). CONCLUSION: Our study demonstrates the benefits of setting up a service protocol for the practice of breech vaginal delivery.


Assuntos
Apresentação Pélvica , Apresentação Pélvica/epidemiologia , Cesárea , Parto Obstétrico/métodos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos
6.
Hum Reprod ; 26(11): 3028-36, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21896546

RESUMO

BACKGROUND: We investigated a novel allotransplantation model using an aortocava patch in ewes. METHODS AND RESULTS: We carried out 10 uterine orthotopic allotransplantations in ewes with end-to-side anastomosis of the aortocava donor patch on the left external iliac vessel recipient. The immunosuppressive protocol was a combination of cyclosporine (10 mg/kg/day) and mycophenolic acid (3 g/day). An estimation of the immunosuppressive therapy exposure was performed by measuring the area under the curve (AUC) of immunosuppressive plasma concentrations. The graft was assessed by vaginoscopy, magnetic resonance imaging (MRI) and second look laparotomy at 6, 8 and 10 weeks, respectively. The median (range) times for cold and warm ischemia were 95 min (75-130) and 91 min (55-165), respectively. All the vascular anastomoses were patent at the end of the surgery. The median AUC of cyclosporine and mycophenolic acid were 1.24 mg h/l (0.34-3.85) and 18.40 mg h/l (3.76-42.35), respectively. Of the 10 ewes receiving a transplant, 6 could be assessed. Cervical biopsies showed signs of necrosis in all six ewes. The MRI results correlated with the macroscopic observations of the 'second look' laparotomy. The aortocava vascular pedicles were thrombosed, adding to the peripheral neovascularization. Graft histology showed endometrial tissue in two out of six ewes. CONCLUSIONS: Mobility of the transplant within the pelvis, the length of the vascular pedicle and rejection can explain the high rate of transplant necrosis. The particular digestive anatomy and physiology of ruminants makes it difficult to administer an optimal immunosuppressive treatment. MRI appears to be a good non-invasive examination for graft estimation.


Assuntos
Aorta/patologia , Útero/transplante , Animais , Área Sob a Curva , Ciclosporina/farmacologia , Endométrio/patologia , Feminino , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Imunossupressores/uso terapêutico , Isquemia , Imageamento por Ressonância Magnética/métodos , Ácido Micofenólico/uso terapêutico , Ovinos , Fatores de Tempo , Transplante Homólogo/métodos , Vagina/patologia
7.
Eur J Gynaecol Oncol ; 31(6): 694-6, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21319520

RESUMO

We describe a case of right mammary homolateral recurrence with controlateral axillary invasion. The absence of occult involvement of the left breast was confirmed by MRI. A subsequent thoraco-abdomino-pelvic scan and bone scintigraphy did not reveal any metastases. Lymphoscintigraphy of the right breast, after periareolar injection, revealed lymphatic drainage from the right breast into the left contralateral axillary lymph node. Because of the changes in axillary drainage after mammary and axillary surgery observed by lymphoscintigraphy, contralateral axillary involvement could be considered as locoregional disease in the same way as homolateral lymph node involvement.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Axila/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/secundário , Carcinoma Ductal de Mama/cirurgia , Feminino , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Mastectomia Segmentar , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Cintilografia , Resultado do Tratamento
8.
J Gynecol Obstet Hum Reprod ; 49(7): 101730, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32234354

RESUMO

The main difficulty of ovarian tissue autograft (OTA) is to preserve as many follicles as possible because the ovarian tissue undergoes warm ischemia during grafting until revascularisation, resulting in significant follicular loss. We describe a two-stage grafting technique to stimulate new vascularisation in order to enhance the revascularization process to reduce the ischemic injuries. Furthermore we performed ovarian patchwork in the laboratory and then grafting with robotic laparoscopy to facilitate surgery and increase precision. This technique is used in the DATOR study with promising results, such as a 40% delivery rate.


Assuntos
Ovário/transplante , Procedimentos Cirúrgicos Robóticos/métodos , Autoenxertos , Criopreservação , Feminino , Preservação da Fertilidade , Humanos , Laparoscopia/métodos , Gravidez , Insuficiência Ovariana Primária/etiologia , Insuficiência Ovariana Primária/cirurgia
9.
Gynecol Obstet Fertil Senol ; 48(2): 167-173, 2020 02.
Artigo em Francês | MEDLINE | ID: mdl-31923643

RESUMO

OBJECTIVES: FullPIERS score (Pre-eclampsia Integrated Estimate of RiSk) is built in order to predict maternal outcomes among women with preeclampsia. Our objective is to assess external validity of this score among a population of French women. METHODS: A retrospective study was conducted for all patients with pre-eclampsia (severe or not) admitted to a tertiary hospital center. A receiver operating characteristic (ROC) curve was constructed to determine accuracy of the model at 48 hours and 7 days after admittance and area under the curve (AUC) was calculated. RESULTS: In total, 276 patients meet inclusions criterion. Among them, 217 were included and 61 (28 %) had one or more complication. Only 8 patients had two complications at two different moments (one at 48 hours and one at 7 days). The FullPiers score predicted maternels events at 48 hours with an area under the curve at 0.80 (IC95 % [0.74-0.85]). At 4.2 cut off, the sensitivity was 71 % and specifity 88 %. At 7 days, the area under the curve was 0.74 (IC95 % [0.67-0.79]), admiting a cutoff point for FullPIERS probability of 3.4, sensitivity was 59 % and specificity 85 %. CONCLUSIONS: Our study show utility of FullPIERS score in french maternity. This model might be a useful tool for predicting complications in women with pre-eclampsia. Using of this score in clinical practice might help improving optimization of patient's care.


Assuntos
Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/fisiopatologia , Resultado da Gravidez/epidemiologia , Medição de Risco/estatística & dados numéricos , Adulto , Área Sob a Curva , Feminino , França/epidemiologia , Humanos , Gravidez , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos
10.
Trials ; 21(1): 624, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641096

RESUMO

BACKGROUND: Native tissue cystocele repair has been the cornerstone of prolapse surgery, especially since the learned societies warned clinicians and patients about serious mesh-related complications. Surgical techniques mainly consist in anterior colporraphy and vaginal patch plastron. However, success rates of native tissue cystocele repair are heterogeneous, depending on the design of studies and definition of outcomes. To date, high-quality data comparing vaginal native tissue procedures are still lacking. METHODS: Herein we aimed to describe the design of the first randomized controlled trial (TAPP) comparing anterior colporraphy (plication of the muscularis and adventitial layers of the vaginal wall) and vaginal patch plastron (bladder support anchored on the tendinous arch of the pelvic fascia by lateral sutures) techniques. Our aim is to assess the effectiveness of vaginal native tissue repair at 1 year for cystocele with a combined definition of success-anatomic and functional. The primary endpoint will be the success rate 1 year after surgery with a composite of objective and subjective measures (Aa and Ba points < 0 from POP-Q (Pelvic Organ Prolapse Quantification System) and a negative answer to question 3 of Pelvic Floor Distress Inventory and no need for additional treatment). DISCUSSION: A prospective study has found a success rate at 35% for anterior colporraphy based on a combined definition, both anatomic and functional, as recently recommended. However, the definition of anatomic was strict (POP-Q< 2), while it seems that the best definition of anatomic success is "no prolapse among the hymen", that is to say Aa and Ba points from the POP-Q classification < 0. We hypothesize that vaginal patch plastron will have a better anatomic and functional success comparatively to anterior colporraphy because native tissue is added, as it corrects both median and lateral cystoceles thanks to bilateral paravaginal suspension. TRIAL REGISTRATION: CHU LIMOGES is the sponsor of this research (n°87RI18_0013). This research is supported by the French Department of Health (PHRC 2018-A03476-49) and will be conducted with the support of DGOS (PHRC interregional - GIRCI SOHO). The study protocol was approved by the Human Subjects Protection Review Board (Comité de Protection des Personnes) on May 16, 2019. The trial is registered in the ClinicalTrials.gov registry ( NCT03875989 ).


Assuntos
Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Vagina/cirurgia , Feminino , França , Humanos , Estudos Multicêntricos como Assunto , Satisfação do Paciente , Estudos Prospectivos , Desenho de Prótese , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
11.
Trials ; 21(1): 51, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915047

RESUMO

BACKGROUND: Labor is induced in over 20% of women in France. Prostaglandins, especially intravaginal dinoprostone (Propess®), are widely used to initiate cervical ripening. If labor does not start within 24 h, there is uncertainty about whether to administer a second dinoprostone pessary or to use oxytocin to induce labor in order to achieve a vaginal delivery. METHODS: RE-DINO is a prospective, open-label, multicenter, randomized superiority trial with two parallel arms running in six French hospitals. A total of 360 patients ≥ 18 years of age at > 37 weeks of gestation who exhibit unfavorable cervical conditions (Bishop score < 6) 24 h after placement of the first Propess®, with fetuses in cephalic presentation, will be included. Patients with premature membrane rupture, uterine scars, or multiple pregnancies will be excluded. Our principal objective is to determine whether placement of a second Propess® (followed by oxytocin [Syntocinon®], if necessary) in women for whom the first Propess® failed to induce cervical ripening increases the vaginal delivery rate compared to direct oxytocin injection. The vaginal delivery rate is therefore the primary outcome. The secondary outcomes are the induction failure rates and maternofetal morbidity and mortality. DISCUSSION: This study may help in determining the optimal way to induce labor after failure of a first Propess®, an unresolved problem to date. This trial explores the effectiveness and safety of placing a second Propess® and may contribute to development of an obstetric consensus. TRIAL REGISTRATION: Registered on 2 September 2016 at clinicaltrials.gov (identification number NCT02888041).


Assuntos
Dinoprostona/administração & dosagem , Trabalho de Parto Induzido , Ocitócicos/administração & dosagem , Ocitocina/administração & dosagem , Administração Intravaginal , Adulto , Maturidade Cervical/efeitos dos fármacos , Ensaios Clínicos Fase III como Assunto , Estudos de Equivalência como Asunto , Feminino , França , Humanos , Infusões Intravenosas , Estudos Multicêntricos como Assunto , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Retratamento/métodos , Resultado do Tratamento , Adulto Jovem
12.
Gynecol Obstet Fertil ; 37(6): 481-7, 2009 Jun.
Artigo em Francês | MEDLINE | ID: mdl-19457697

RESUMO

OBJECTIVE: Because of variability in histopathological interpretations in studies, it's difficult to elucidate the risk of non-sentinel lymph node involvement in case of sentinel node nanometastases (lesions not larger than 0.2 mm) and micrometastases (lesions not larger than 2 mm but larger than 0.2 mm) in breast cancer. In this study, we have evaluated this risk according to the European Working Group for Breast Screening Pathology (EWGBSP) recommendations. PATIENTS AND METHODS: Among patients who underwent sentinel lymph node dissection between February 2001 and April 2008 in our unit, we reviewed the files of patients who had sentinel lymph node involvement smaller than 2mm. A second interpretation of all sentinel lymph node sections was made according to the EWGBSP recommendations. Each patient had complete axillary dissection. RESULTS: Among 608 patients who had sentinel lymph node dissection for breast cancer, 72 (11.84%) had sentinel lymph node involvement smaller than 2 mm (27 pN0i+ and 45 pN1mi). The percentage of pN1mi patients who had non sentinel involvement is 8.89%. None of pN0i+ patients had non sentinel involvement. DISCUSSION AND CONCLUSION: After making a minimal sentinel lymph node involvement strict interpretation according to EWGBSP restrictive recommendations, nanometastases rate was smaller. Any non sentinel involvement was detected in case of sentinel lymph node nanometastases.


Assuntos
Neoplasias da Mama/patologia , Metástase Linfática , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila , Neoplasias da Mama/cirurgia , Feminino , Humanos , Excisão de Linfonodo/métodos , Linfonodos/patologia , Linfonodos/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica , Metástase Neoplásica , Guias de Prática Clínica como Assunto , Medição de Risco , Fatores de Risco , Biópsia de Linfonodo Sentinela
13.
Gynecol Obstet Fertil ; 36(12): 1218-23, 2008 Dec.
Artigo em Francês | MEDLINE | ID: mdl-19026586

RESUMO

Many cases of not life saving transplanted organs were described with the aim of improving quality of life. Uterus graft could be an alternative solution to adoption or surrogacy for women who have uterine factor infertility. Different animals' studies with mouse, sheep or monkey showed feasibility of the surgical technique with large vessels patch. One case of human uterine transplant has been reported but failed. Cold storage of the uterus in protective solution has been explored with mouse, sheep and human. Only pregnancy after uterus graft by syngenic mouse has been published. Results about pregnancy after allograft with sheep or monkey are necessary before pregnancy after human uterus graft becomes a reality.


Assuntos
Infertilidade Feminina/cirurgia , Útero/transplante , Animais , Criopreservação , Feminino , Humanos , Infertilidade Feminina/etiologia , Camundongos , Qualidade de Vida , Ovinos , Resultado do Tratamento , Útero/anormalidades , Útero/irrigação sanguínea
14.
J Radiol ; 89(1 Pt 2): 142-61, 2008 Jan.
Artigo em Francês | MEDLINE | ID: mdl-18288040

RESUMO

Thanks to a superior resolution and contrast, MRI allows recognizing the post therapeutic modifications of female pelvis, often very subtle and nonvisible by the other imaging modalities. The main surgical or medical therapies in the female pelvis will be described as well as the normal post therapeutic anatomical aspects. The main complications and failures will be mentioned and informed. Finally the keys that will allow to understand these complications and failures will be boarded.


Assuntos
Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/terapia , Imageamento por Ressonância Magnética , Adulto , Diagnóstico Diferencial , Feminino , Doenças dos Genitais Femininos/tratamento farmacológico , Doenças dos Genitais Femininos/cirurgia , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/tratamento farmacológico , Neoplasias dos Genitais Femininos/cirurgia , Neoplasias dos Genitais Femininos/terapia , Procedimentos Cirúrgicos em Ginecologia , Humanos , Histerectomia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Resultado do Tratamento
15.
J Gynecol Obstet Hum Reprod ; 47(8): 409-411, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29793037

RESUMO

Prenatal diagnosis of cystic fibrosis (CF) is difficult and is mainly considered upon identification of digestive sonographic signs. Although such an association has never been described until now to our knowledge, we report two cases of fetal arrhythmia associated with cystic fibrosis. This association may be explained by the physiopathology of heart in the context of CF, but nevertheless needs to be confirmed by other reports. The prenatal diagnosis of CF is important in order to implement early appropriate care, with better prognosis. The finding of possibly new associated prenatal signs may then improve the global management of the disease.


Assuntos
Fibrose Cística/diagnóstico , Doenças Fetais/diagnóstico , Diagnóstico Pré-Natal/métodos , Taquicardia Supraventricular/diagnóstico , Adulto , Feminino , Humanos , Gravidez , Ultrassonografia Pré-Natal/métodos
16.
Gynecol Obstet Fertil Senol ; 46(6): 509-513, 2018 06.
Artigo em Francês | MEDLINE | ID: mdl-29776842

RESUMO

OBJECTIVES: In case of large breast cancer, neoadjuvant chemotherapy (NAC) can be performed to reduce the size of the tumor and thus perform a conservative surgery. The place of the sentinel lymph node biopsy (SLNB) in case of NAC is still debated. The main aim of this study is to assess the risk of axillary recurrence after negative SLNB before NAC. METHODS: It is a retrospective, observational and uni-centric study. We included 18 to 80-year-old patients with unilateral breast cancer requiring a NAC and with a negative SLNB before NAC. Our primary endpoint was axillary recurrence. RESULTS: Between August 2006 and October 2016, 64 patients had a negative GS performing before a NAC and did not benefit from axillary dissection after NAC. The average duration of follow-up was 37 months. During our follow-up, we did not find any cases of axillary recurrence. CONCLUSION: This study supports the reliability of lymph node status assessment using the SLNB before CNA.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Quimioterapia Adjuvante/métodos , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/epidemiologia , Biópsia de Linfonodo Sentinela/métodos , Adolescente , Adulto , Idoso , Axila , Feminino , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
17.
Gynecol Obstet Fertil Senol ; 45(2): 77-82, 2017 Feb.
Artigo em Francês | MEDLINE | ID: mdl-28368799

RESUMO

OBJECTIVES: Because, to date in France, 20 % of pregnant women had a scared uterus and because the best mean of cervical ripening is unknown and controversial, we want to evaluate efficacy and safety of dinoprostone for cervical ripening in women with previous cesarean. MATERIALS AND METHODS: We conducted a retrospective unicentric study, from 2010 to 2014, at Limoges regional university hospitals. Two hundred and sixty nine patients, with medical indication for induction of labor and scared uterus, were included and ripened with dinoprostone (Propess® and/or Prostine®). Women had unfavorable cervix with Bishop score inferior to 6. RESULTS: Overall rate of vaginal delivery was 62 %. Patients have had more of one prostaglandin in 19 % of cases; the cesarean rate was significantly higher in this case (cesarean: 55.6 % vs. vaginal delivery: 44.4 %; P=0.0043). Overall, there were respectively 4 % and 0.7 % of post-partum hemorrhage and uterine rupture. One percent of newborns had a severe acidosis (pH<7 in umbilical artery) and 1 % was admitted to the Intensive Neonatal Care Unit. CONCLUSION: Dinoprostone is an effective procedure in patients with previous cesarean section requiring labor induction, with a morbidity comparable to other methods of induction of labor.


Assuntos
Maturidade Cervical/efeitos dos fármacos , Maturidade Cervical/fisiologia , Cesárea , Dinoprostona/administração & dosagem , Ocitócicos , Administração Intravaginal , Cesárea/efeitos adversos , Cicatriz/complicações , Dinoprostona/efeitos adversos , Feminino , França , Humanos , Trabalho de Parto Induzido/métodos , Hemorragia Pós-Parto/epidemiologia , Gravidez , Estudos Retrospectivos , Ruptura Uterina/epidemiologia , Útero , Nascimento Vaginal Após Cesárea/estatística & dados numéricos
18.
Gynecol Obstet Fertil ; 34(4): 337-40, 2006 Apr.
Artigo em Francês | MEDLINE | ID: mdl-16627000

RESUMO

Primary ovarian abscess is a rare infection. A new case has led us to carry out a literature review in order to optimize the treatment. Exceptionally isolated, primary ovarian abscess usually belongs to the postoperative complications. Nevertheless, its etiopathogenies are numerous. The symptoms are often poor; therefore the diagnosis is difficult to establish. The curative treatment must associate surgery and antibiotherapy. Even if laparoscopic surgery is the first line treatment in many cases, laparotomy remains the choice procedure. Ultrasonographically-guided evacuation has to be further evaluated. Preventive treatment is of major importance.


Assuntos
Abscesso/diagnóstico , Abscesso/terapia , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/terapia , Adolescente , Adulto , Anti-Infecciosos/uso terapêutico , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Histerectomia , Pessoa de Meia-Idade , Doenças Ovarianas/microbiologia , Ultrassonografia
19.
Gynecol Obstet Fertil ; 34(6): 506-9, 2006 Jun.
Artigo em Francês | MEDLINE | ID: mdl-16677840

RESUMO

Chilaïditi's syndrome is the association of a radiological and clinical semiology of the interposition of large colon or small intestine between the lower side of diaphragm and liver. We report the case of a 32-year-old woman, primigravida, who undergone a caesarean section at 39 weeks of amenorrhoea, for a clinical picture of persistent abdominal pain and a beginning hepatic cytolysis. The patient presented one day after the ceasarean section an occlusive syndrome of the small intestine. The etiology of the occlusion of the small intestine in post-partum was a Chilaïditi's syndrome with inter hepatodiaphragmatic incarceration of the small intestine discovered at the computed tomography. An exploratory laparotomy confirmed and permitted to treat Chilaïditi's syndrome complicated by an occlusion.


Assuntos
Cesárea/efeitos adversos , Obstrução Intestinal/etiologia , Intestino Delgado/anormalidades , Dor Abdominal , Adulto , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Intestino Delgado/patologia , Necrose , Gravidez , Síndrome , Tomografia Computadorizada por Raios X
20.
Eur J Obstet Gynecol Reprod Biol ; 205: 7-10, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27552172

RESUMO

OBJECTIVE: Uterine infertility (UI), which can be caused by a variety of congenital or acquired factors, affects several thousand women in Europe. Uterus transplantation (UTx), at the current stage of research, offers hope for these women to be both the biological mother and the carrier of their child. However, the indications of UTx still need to be defined. The main aim of the study was to describe the different etiologies of UI and other data as marital and parental status from women requesting UTx who contacted us in the framework of a UTx clinical trial. Secondarily, we discussed the potential indications of UTx and their feasibility. STUDY DESIGN: This is an observational study. RESULTS: Of a total of 139 patients with UI, 105 patients (75.5%) had uterine agenesis, making it the leading cause of UI in this sample. Among the patients with uterine agenesis, 25% had a solitary kidney and 44.7% had undergone vaginal reconstruction. Peripartum hysterectomy, hysterectomy for cancer, and hysterectomy for benign pathologies accounted for 9.4%, 7.2% and 5% of cases, respectively. Less common causes of UI included complete androgen insensitivity syndrome (2.2% of patients) and prenatal diethylstilbestrol exposure (0.7%). Approximately 14% of the women already had at least one child and 66% were in a couple living together for at least 2 years. CONCLUSION: UTx is still under evaluation and further research is under way. Nulliparous patients with no major medical or surgical history and with normal ovarian function, who meet the legal criteria for medically assisted reproduction, represent the best indications for UTx at this stage of its development.


Assuntos
Infertilidade Feminina/cirurgia , Seleção de Pacientes , Anormalidades Urogenitais/cirurgia , Útero/anormalidades , Útero/transplante , Adulto , Feminino , França , Humanos , Infertilidade Feminina/etiologia , Estado Civil , Resultado do Tratamento , Anormalidades Urogenitais/complicações , Útero/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA