[Management of endometriosis: CNGOF-HAS practice guidelines (short version)]. / Prise en charge de l'endométriose : recommandations pour la pratique clinique CNGOF-HAS (texte court).

First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.

[Pregnancy in a patient with Gitelman syndrome: a case report and review of literature]. / Syndrome de Gitelman et grossesse: à propos d'un cas et revue de la littérature.

Gitelman syndrome (GS) is a tubulopathy characterized by hypokaliemia, hypomagnesiemia, metabolic alkalosis and hypocalciuria. We report a case of a 33-year-old pregnant woman with Gitelman Syndrome. Oral potassium chloride and magnesium citrate were prescribed and the course of the pregnancy was uneventful with vaginal delivery at term. The impact of GS on the physiologic adaptations to pregnancy is not well-known, with few reports to date. Monitoring of serum potassium and magnesium levels with supplementation, amniotic fluid and fetal growth is required to prevent obstetrical and fetal complications in a patient with GS.

[Paraclinical studies of endometriosis]. / Exploration paraclinique des endométrioses.

Investigations are performed in women with external endometriosis to confirm the diagnosis and to evaluate extension of the disease before treatment. Elevated serum CA 125 level is correlated with the severity of the disease. CA 125 may be a helpful to assess the efficacy of the treatment or to detect recurrences. Imaging diagnosis of endometriosis have a good sensitivity to detect cysts and nodes forms of the disease. Magnetic resonance imaging is more sensitive than ultrasonography to detect small nodular lesion and is able to made the diagnosis of deeply infiltrating endometriosis (sometimes not visualised by laparoscopy). Rectal endosonography, barium enema or excretion urography can be usefull if an involvement of the rectosigmoid or the bladder is suspected. Hysterosalpingography is an integral part of the initial fertility survey, but shows only indirect signs of endometriosis. Laparoscopy is the definitive diagnosis procedure for endometriosis, and permit to classify the lesions and to draw-up a therapeutic strategy.