[Gynecological emergencies: A prospective study about patients purpose of consultation and outcome]. / Urgences gynécologiques : étude prospective sur les motifs de consultation et devenir des patientes.

OBJECTIVES: Aiming to evaluate the profile type, complaint and outcome of patients consulting a gynecologic emergency unit in order to enhance "real" emergencies and improve their management. MATERIALS AND METHODS: We enrolled prospectively 308 women consulting to Reims teaching hospital gynecologic emergency unit from the 15th of May to the 25th of June 2013. RESULTS: Two hundred and fifty-seven women (83.4%) spontaneously consulted without previous medical examination. Two hundred and thirty-eight of them (77.3%) had already been through gynecologic emergency units and 99 (32.1%) had no regular follow-up. Pelvic pain and/or metrorragia were registered as main complaint for 219 patients (71.1%). Median age was thirty years old (±11) and an average forty-minute wait was recorded. Gynecologic ultrasound was the first exam to be performed after clinical examination for 255 patients (82.8%). Twenty-two (7.1%) were hospitalized for surgical procedures or medical care, respectively 10 (3.2%) and 12 (3.9%). Among 51 women addressed by another healthcare professional, 9 were hospitalized (17.6%) versus 12 hospitalized (4.7%) out of 257, when consulting without initial professional expertise. A significant relationship between hospitalizations and general practitioner consultation was found with an OR=4.34 (95%CI: 1.51-12.05, P=0.002). Main motive of consultation involving home treatment turned out to be on-going pregnancies (92 patients, 29.9%). CONCLUSION: A large majority of gynecologic hospital consultations, responsible for time waste and professional monopolizing, can be treated by general practitioners and could contribute to a better management of life-threatening emergencies.

[Thyroid function for infertile women during ovarian hyperstimulation as part of IVF]. / Étude de la fonction thyroïdienne chez les femmes infertiles au cours de la stimulation ovarienne dans le cadre de FIV.

OBJECTIVES: Optimal thyroid function is necessary for an effective fertility. Many authors have suggested that thyroid function has an impact on IVF outcome. Conversely, IVF has been suggested to induce changes in thyroid function. The aim of this study was to determine the nature and the timing of alterations in thyroid function, throughout controlled ovarian hyperstimulation, from the beginning of therapy to the day of triggering ovulation. And make a clarification of the current recommendations of the thyroid function during hormonal stimulation. METHODS: Subjects were recruited from March 2013 to July 2013 at the Hospital of the University of Reims. The studied population consisted of 50 infertile patients who had undergone IVF/ICSI cycles. Thyroid axis exploration was realized before therapy and at every hormonal dosage during ovarian monitorage. RESULTS: Prematuary fluctuations were observed without impact on pregnancy rate. We could detect potential hypothyroid women thanks to this dosage and define a connection between pregnancy rate and TSH with a threshold closer to 1mUI/L than 2,5mUI/L defined by the endocrine society. CONCLUSIONS: The link between thyroid function, forecast of conception and pregnancy is well documented. Currently, there is no recommendation on the rate of TSH targets for the patients in medical assisted procreation.