[Efficacy and safety of oral misoprostol 25µg vs. vaginal dinoprostone in induction of labor at term]. / Efficacité et tolérance du misoprostol oral 25µg vs dinoprostone vaginale dans le déclenchement du travail à terme.

OBJECTIVE: To compare the efficacy and safety of oral misoprostol 25µg compared to vaginal dinoprostone in the induction of labor at term. METHODS: Analytic, retrospective study of patients induced at term by prostaglandins with an unfavorable cervix, over two consecutive periods from 01/01/2019 to 19/02/2020 and from 20/02/2020 to 07/04/2021, within a regional level III university hospital center. We compared the safety and the efficacy between the oral misoprostol Angusta® used since 20/02/2020 and the vaginal dinoprostone previously used in gel or diffuser. The primary endpoint was the rate of vaginal deliveries within 24h. Secondary endpoints were cesarean section rate, indications for cesarean section, uterine contractility abnormalities and neonatal outcomes. RESULTS: Our study found no difference in terms of efficacy with similar rates of vaginal deliveries within 24h (51.88% vs. 51.25%; P=0.87) and caesarean sections (misoprostol group: 19.42% vs. dinoprostone group: 16.62%; P=0.33). However, the tolerance criteria revealed in the dinoprostone group an increase in tachysystole (misoprostol group: 9.28% vs. dinoprostone group: 16.90%; P=0.003) and acidosis (arterial pH<7.10, misoprostol group: 3.83% vs. dinoprostone group: 9.29%; P=0.006). CONCLUSION: No difference in efficacy was found between the two induction techniques. Oral misoprostol 25µg seems to be better tolerated from a maternal and fetal point of view.

[COVID-19 and lockdown: Impact on pregnancy complications]. / COVID-19 et confinement : impact sur les complications de la grossesse.

OBJECTIVE: The COVID-19 lockdown led to the establishment of a national lockdown in France from March 17th to May 11th, 2020. The purpose of our study is to evaluate the impact of lockdown on the rate of hospitalization for threatened preterm delivery and on the rate of preterm delivery. METHODS: Multicenter retrospective epidemiological study carried out over the lockdown period from March 15th to May 31st, 2020 compared to the same period over the previous two years (2018 and 2019) in Picardy hospitals (University Hospital center Amiens Picardie, Hospital Center of Beauvais, Compiègne and Saint-Quentin). RESULTS: In total, 608 patients were included. Our study shows a decrease in hospitalisations (207 in 2019 vs. 176 in 2020). We find a significant reduction in Premature Ruptures of Membranes (16.9% [73/432] in 2018/2019 vs. 9.7% [17/176] in 2020; P=0.02) and also in the preterm delivery rate (9.3% (276/2961) in 2018/2019 vs. 6.8% [96/1416] in 2020; P<0.05). CONCLUSION: A reduction in the rate of preterm birth is observed during the first lockdown's period. It would also be interesting to evaluate the psychological impact of lockdown.

Epidemiological investigation of a human leptospirosis case reported in a suburban area near Marseille.

Leptospirosis has been re-emerging in both developed and developing countries, including in Europe, where the phenomenon has notably been associated with urban transmission. In this work, we describe an epidemiological investigation that demonstrated a case of human infection due to peri-urban transmission of Leptospira interrogans serovar icterohaemorrhagiae in southeastern France.