[Barriers to the use of emergency contraception in a population consulting for an abortion]. / Évaluation lors d'une IVG des freins à l'utilisation de la contraception d'urgence.

OBJECTIVES: In France, one pregnancy out of three is unplanned. Half of those pregnancies lead to abortion. However, the use of emergency contraception is far from systematic. It is therefore relevant to question the reasons and factors linked to the low rate of use of emergency contraception. METHODS: A retrospective observational study was conducted in the orthogenic service of the University hospital Center of Nice, over a six weeks period. Patients were consulting in the context of voluntary termination of pregnancy and were subjected to a questionnaire during a semi-structured interview. The collected data were: age, degree of education, profession, size of their home town municipality, legal status, obstetrical history, contraception used at the time of unplanned pregnancy, emergency contraception background and justification for not using an emergency contraception. RESULTS: A total of one hundred and five questionnaires were studied. The absence of emergency contraception was due to an underestimation of the risk of pregnancy in 81% of cases. Among characteristic variables of the studied population, none was related to the non-use of emergency contraception. CONCLUSIONS: Independently of the patient profile, underestimation of the risk of pregnancy is the main cause of non-use of emergency contraception. It seems crucial to inform women with childbearing age and their families about their fertility and the basic mechanisms of fertility in order to reduce the number of unplanned pregnancies in France.

[Training of residents in obstetrics and gynecology: Assessment of an educational program including formal lectures and practical sessions using simulators]. / Formation des internes de gynécologie obstétrique : évaluation d'un programme pédagogique intégrant cours théoriques et sessions pratiques sur simulateurs.

OBJECTIVES: Evaluate an educational program in the training of residents in gynecology-obstetrics (GO) with a theory session and a practical session on simulators and analyze their learning curve. METHODS: Single-center prospective study, at the university hospital (CHU). Two-day sessions were leaded in April and July 2013. An evaluation on obstetric and gynecological surgery simulator was available to all residents. Theoretical knowledge principles of obstetrics were evaluated early in the session and after formal lectures was taught to them. At the end of the first session, a satisfaction questionnaire was distributed to all participants. RESULTS: Twenty residents agreed to participate to the training sessions. Evaluation of theoretical knowledge: at the end of the session, the residents obtained a significant improvement in their score on 20 testing knowledge. Obstetrical simulator: a statistically significant improvement in scores on assessments simulator vaginal delivery between the first and second session. Subjectively, a larger increase feeling was seen after breech delivery simulation than for the cephalic vaginal delivery. However, the confidence level of the resident after breech delivery simulation has not been improved at the end of the second session. Simulation in gynecological surgery: a trend towards improvement in the time realized on the peg-transfer between the two sessions was noted. In the virtual simulation, no statistically significant differences showed, no improvement for in salpingectomy's time. Subjectively, the residents felt an increase in the precision of their gesture. Satisfaction: All residents have tried the whole program. They considered the pursuit of these sessions on simulators was necessary and even mandatory. CONCLUSION: The approach chosen by this structured educational program allowed a progression for the residents, both objectively and subjectively. This simulation program type for the resident's training would use this tool in assessing their skills and develop learning curves.