[Evolution of contraceptive practices in France: An overview from 2014 to 2019]. / Évolution des pratiques contraceptives en France : un état des lieux de 2014 à 2019.

OBJECTIVES: To study the use of reimbursed contraceptive methods in France between 2014 and 2019, with an analysis of the profile of users by age group and an analysis by type of prescriber. METHODS: We conducted a national descriptive study using data from the Assurance Maladie Open Data database on the use of contraceptive methods reimbursed in France from January 1, 2014, to December 31, 2019. We analyzed the number of users by year, by age group (<20years, 20-60years), and by prescriber (liberal general practitioner, liberal gynecologist, hospital practitioner, liberal midwife). RESULTS: In 2019, 50.1% (5,345,122) of women of childbearing age used a reimbursed contraceptive method. Hormonal oral contraception was the leading contraceptive method used (42.3%), followed by the intrauterine device (6.2%) and the implant (1.6%). Use of combined estrogen-progestogen oral contraception had been declining since 2015 (-8.1 points), to the benefit of the micro progestin pill (+9.1 points) and the copper intrauterine device (+1.4 points). Among women under 20, the hormonal implant was the second most popular contraceptive method (1.2%), followed by the copper intrauterine device (0.8%) and the hormonal intrauterine system (0.2%). Among women over 20years of age of childbearing age, the copper IUD was the second most-reimbursed contraceptive method (2.4%), followed by the hormonal intrauterine system (1.6%) and the hormonal implant (1.2%). There are disparities in prescribing practices: in 2019, 51% of prescribers were general practitioners and 97% of them prescribed hormonal oral contraception. CONCLUSION: The contraceptive supply in France is diversifying, although oral contraception remains predominant. Disparities exist between age groups of users and there is great heterogeneity in practices among contraceptive prescribers.

A Case of Umbilical Artery Thrombosis in the Third Trimester of Pregnancy.

BACKGROUND Umbilical artery thrombosis is an extremely rare complication during pregnancy. Umbilical artery thrombosis has a poor prognosis and is associated with increased rates of perinatal morbidity, including intrauterine growth restriction (IUGR), and fetal mortality. CASE REPORT We report a rare case of umbilical artery thrombosis, diagnosed by ultrasound, at 33 weeks gestation in a 30-year-old woman who had previously had an uneventful pregnancy. CONCLUSIONS Umbilical artery thrombosis is a rare complication of pregnancy that is associated with high fetal mortality. Management may include planned elective delivery by cesarean section, following antenatal corticosteroid therapy for fetal lung maturation.