Comment j\u27ai découvert les vertus de l\u27entretien prénatal précoce et ne peux plus m\u27en passer

The French 2005-2007 perinatality plan anticipated the set-up of a new individual or couple counselling, that was planned to take place within the first trimester of pregnancy. This counselling belonged to a structured plan for preparation to childbirth and parenthood which aimed at enhancing the global health of pregnant women and newborn babies. This humanist approach to childbirth allows the couple to actively take part in their so called birth project. Although specific funding has been allocated to start up this counselling, it is still very slow to catch up. Through the analysis of a personal experience, this article explores a few hurdles to overcome and a few leads that can be followed to help care providers to better apprehend this new tool. It implies early detection of the most vulnerable parents and careful follow up, but above all, it requires strong coordination within the network of health professionals from each discipline

I\u27m an alien, I\u27m a legal alien; I\u27m a French doctor in New South Wales!

Migrating is a daunting but fascinating experience

Correspondence about Mowat A, Minuzzo L, Wilson J. A necrotic uterus after a B-Lynch Suture: Fertility sparing surgery. Aust N Z J Obstet Gynaecol 2013; 53: 408-409.

Dear Editor, I read with interest the case report of Mowat et al.1 and the original article of Ibrahim et al.2 There has recently been an increase in the number of publications in ANZJOG dealing with alternative techniques of uterine compression sutures (UCS),3-5 and those two articles are timely to balance the potential risks of these so-called fertility-sparing techniques

Isolement de cellules souches embryonnaires germinales (EG) humaines (aspects gynécologiques)

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Anterior approach to laparoscopic uterine artery ligation

Herein is described an anterior approach to uterine artery ligation during laparoscopic myomectomy and total laparoscopic hysterectomy. The anterior leaf of the broad ligament is opened and the uterine artery is clipped lateral to its crossing over the ureter. Outcome measures were completion of the procedure laparoscopically and the need for transfusion postoperatively. Thirty-eight myomectomies and 28 difficult total laparoscopic hysterectomies (primarily uteri with large myomas) were performed, with 1 conversion to laparotomy during myomectomy and 1 during hysterectomy, and 1 transfusion after total laparoscopic hysterectomy. The anterior approach to uterine artery ligation is an alternative method for treatment of uterine artery occlusion during laparoscopic myomectomy or hysterectomy performed to treat large myomas

Oocyte recovery post human follicular fluid centrifugation in modified natural cycle and achieving embryo

This case reports a successful live birth by intracytoplasmic sperm injection (ICSI) following human follicular fluid (HFF) centrifugation for oocyte retrieval in the modified natural cycle of a poor responder patient. A 37-year-old patient presenting with a severe ovarian defect underwent a modified natural cycle with HFF centrifugation prior to ICSI. As there was only one oocyte under direct binocular observation, HFF was centrifuged and a second oocyte was collected. ICSI was performed on both oocytes. Embryo quality and outcome were not compromised by HFF centrifugation. A live birth was achieved in April 2008. In a modified natural cycle, HFF centrifugation avoided loss of oocytes, optimized the IVF treatment, and achieved the development of two embryos

Endometriosis and in vitro fertilisation: a review

This review aims to evaluate whether severe endometriosis has an impact on the outcome of in vitro fertilisation (IVF), whether IVF is associated with specific complications in this context, whether a specific ovarian stimulation protocol is most appropriate, whether the endometrial condition progresses following ovarian stimulation, and whether endometrial cysts pose a specific problem for IVF. In patients with severe endometriosis, IVF represents an effective treatment option for infertility, as a complement to surgery. The prognostic parameters of IVF are identical to those of other patients. However, the risks related to the severity of endometriosis, particularly the risk of ovarian deficiency, need to be considered. Because of this issue, to which endometriosis-related pain often adds, IVF treatment should be initiated as early as possible, using appropriate protocols and after having fully informed the patient about the specific oocytes retrieval-related risks

Fertilité des patientes présentant une endométriose traitées par cœlioscopie et AMP

Objective To evaluate fertility outcomes after laparoscopic and ART management of endometriosis in an infertile population. Patients and methods Retrospective analysis including 79 infertile patients treated by laparoscopic surgery. Fertility was studied in relation to pregnancy\u27s mode (spontaneous or ART) and to endometriosis stages (rAFS). Results After laparoscopy, 8.9% of patients had a spontaneous pregnancy. IIU led to a cumulative rate of pregnant women of 21.5%. Then after laparoscopy, IIU and IVF, 68.4% of patients were pregnant. The average delay was 460 days between laparoscopy and spontaneous pregnancy, 271 days between surgery and IIU pregnancy and 600 days between surgery and IVF pregnancy. Among women with stages I-II endometriosis (62 cases), 11.3% patients obtained a spontaneous pregnancy, the cumulative rate of pregnant women after laparoscopy and IIU was 25,8%. After laparoscopy, IIU and IVF, 66.1% of patients were pregnant. The average post-surgical time to spontaneous pregnancy was 460 days. The average delay between surgery and IIU pregnancy was 279 days and 589 days between surgery and IVF pregnancy. In case of stages III-IV (17 patients), 76.4% of pregnancies were obtained. No spontaneous pregnancy was observed. 94.1% of patients were treated with IVF, leading to a global rate of pregnancy of 70.5%. The average delay between surgery and IVF pregnancy was 563 days. Conclusions With a combination of surgery and ART, two-third of patients were pregnant with an average time between surgery and pregnancy of less than two years. This combination (surgery and ART) increases the chances of becoming pregnant. At the moment, the delay between surgery and ART needs to be established

Rupture of membranes in case of internal podalic version: a risk for cesarean section on the second twin

Objectives To evaluate if internal version with ruptured membranes is a risk factor of cesarean section for the second twin. Patients and methods Two hundred and fifty-nine twins vaginal deliveries after 33 weeks of gestation from 1997 to 2009 in a level 3 maternity. A retrospective case-control study comparing two groups: cases of cesarean section on second twin and five twins vaginal deliveries following the case. Active management of the second twin delivery was performed with a short intertwin delivery. Results Eleven cesarean sections on the second twin were performed (4.2%). The main indication was failure of internal version. The risk of cesarean section was significantly greater when the internal version was performed with ruptured membranes (OR: 25.4 IC 95% [2.3-275.7] P \u3c 0.003) and when intertwin time delivery interval was increased (8.1 ± 5.1 vs 16.7 ± 6.3, P \u3c 0.001). Discussion and conclusion The rupture of amniotic membranes before or during the internal podalic version is associated with a risk of failure and cesarean for the second twin. We recommend to perform the internal podalic version with unruptured membranes according to the French recommendations