[Risk of uterine rupture after cervical ripening with ballon catheter on uterus with previous cesarean section]. / Risque de rupture utérine après maturation des utérus cicatriciels par sonde à ballonnet.

OBJECTIVE: To evaluate the rate of uterine rupture after cervical ripening by mechanical methods using balloon catheter in patients with a previous cesarean section. MATERIALS AND METHODS: A literature search using the Medline database, Cochrane Library(®) database. RESULTS: We identified 13 studies evaluating four types of ballon catheter. One thousand two hundred and seventy-eight patients underwent cervical ripening by balloon catheter and 8 (0.62%) cases of uterine rupture were reported. The vaginal delivery rate was 741/1278 (58%). CONCLUSION: The use of balloon catheters in case of previous cesarean section does not appear to be associated with an increased risk of uterine rupture compared with spontaneous labor. However, further studies are required to evaluate correctly this risk.

[Obstetrical ultrasound simulator as a tool for improving teaching strategies for beginners: Pilot study and review of the literature]. / La simulation pour améliorer l'apprentissage de l'échographie obstétricale chez les débutants : étude pilote et revue de la littérature.

OBJECTIVES: The aim of this study was to evaluate the obstetrical ultrasound simulator as an initiation tool for teaching obstetrical ultrasound scanning for beginners. METHODS: Twenty medical students with no experience in ultrasound scan (US) received a basic theoretical ultrasonography course on US principles and 2nd trimester biometrical measurements. The participants were then divided into 2 groups (A, B). Only group A received a practical 2nd trimester scan training session on the simulator where they were asked to determine fetal and placental position, and to take the 3 biometrical standardized measurements. Group B had the same training session but with a real ultrasound machine and a pregnant volunteer. The 2 groups were then asked to perform an US session on real patients (22 weeks) during which they had to do the same US study. The time needed to complete the whole scan was analyzed. The quality of the measurements was compared based on the previously published Objective Quality Criteria scoring. RESULTS: The mean total score was significantly (P=0.001) better for group A (14.3±1.4) compared to group B 10.3 (±2.75) for group A and B respectively. The time needed to accomplish the whole exam tended to be longer for group A (569±174s) compared to group A (479±104s) (P=0.18). CONCLUSIONS: The simulator might be a useful initiation tool to obstetric ultrasound for those who never practiced. It might prove a time sparing procedure in the training process and allow trainees to reach a basic practice level before performing examinations on actual patients.

[Cervical ripening after previous cesarean section with Foley catheter: A prospective study of 41 patients]. / Maturation cervicale des utérus unicicatriciels par sonde de Foley : étude prospective de 41 patientes.

OBJECTIVES: Effectiveness of cervical ripening with Foley catheter for patients requiring labor induction with a previous cesarean section and unfavorable cervical conditions. PATIENTS AND METHODS: Prospective unicentric study conducted between 1 April 2011 and 31 October 2013 on 41 patients with medical indication for labor induction with a Bishop's score<7 and one previous cesarean section. Outcomes evaluated were mode of delivery, Bishop's score variations and maternal or neonatal complications. RESULTS: Cervical ripening was performed in 39 patients and 17 (43.5%) were delivered vaginally. A total of 24/39 (61.5%) patients were put into work and 10/39 (25.6%) came into work immediately after removal of the Foley catheter. The average score improvement Bishop was 2.7±0.6 points. No maternal or fetal complication was reported. CONCLUSION: Foley catheter is an interesting procedure in patients with previous cesarean section and unfavorable cervical conditions requiring labor induction.

[Surgical treatment of ectopic pregnancy by single port access with SILS® system: preliminary study]. / Traitement de la grossesse extra-utérine par accès endoscopique unique avec le système SILS® : expérience initiale.

AIM: To evaluate feasibility of surgical treatment for ectopic pregnancy with single laparoscopic access with SILS(®) system. PATIENTS AND METHODS: We conducted an open study from 1/7/2009 to 1/12/2010 in a single gynaecologic department. All procedures were performed by three operators. Procedures evaluated were corneal resection, salpingotomy, salpingectomy. Feasibility, per- and postoperative data were reported. RESULTS: We performed completely 31 over 32 (97%) surgical procedures with SILS(®) system (27 salpingectomies and five salpingotomies). In one case, conversion to conventional laparoscopy was required. No intra- or postoperative complications were reported. CONCLUSION: Laparoscopic surgery for ectopic pregnancy by single access seems feasible with SILS(®) system. Further study including larger number of patients and operators were necessary to confirm risks and advantages of this technique.