J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Dec 2003
Review[Physiopathology, diagnosis and therapeutic management of stage III and IV endometriosis].
Stage III endometriosis is defined by a r-AFS score respectively ranging from 16 to 40 and stage IV over 40. Deep pelvic endometriosis presents essentially in the form of a painful syndrome dominated by chronic pelvic painful, dysmenorrhea and deep dyspareunia. Pathophysiology of pelvic pain associated with endometriosis remains unknown. ⋯ Spontaneous pregnancy rates are significantly increased after surgical treatment. Recurrent ovarian surgery is not recommended in women with infertility, as it might be deleterious for ovarian reserve. Medical treatment using Gn-RH agonists is indicated when recurrence occurs after surgery.
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J Gynecol Obst Bio R · Dec 2003
Comparative Study[Verbal autopsy to measure maternal mortality in rural Senegal].
The aim of this paper is to study the use of verbal autopsy in order to assess maternal mortality indicators in rural settings and to determine the limits and difficulties related to that practice. ⋯ Verbal autopsy remains an interesting method for measuring maternal mortality. It has advantages in rural areas where many deliveries still occur at home. Further accuracy in data collection is needed for a precise analysis of each case.
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J Gynecol Obst Bio R · Dec 2003
[Modern algorithm for treating pudendal neuralgia: 212 cases and 104 decompressions].
Clinical signs and symptoms of the pudendal neuralgia are very rich, with a great individual variability. The clinical diagnosis is difficult. It is confirmed or invalidated by the electrophysiologicals tests. ⋯ The study of a total of 162 canal syndromes showed prevalent injury at the sacro-spino-tuberal ligamental grip which was observed in 68% of the cases, compared to the Alcock canal which was present in only 20% of the cases. One hundred four of these patients underwent surgical decompression via a trans-ischio-rectal approach after negative results of the infiltration therapy. We report here the surgical methodology, the post-op follow-up and the results, which appear quite successful: after one year 86% of the subjects are symptom-free or with a significant reduction of pain.
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J Gynecol Obst Bio R · Nov 2003
Review[Ectopic pregnancy: interest and value of clinical examination in management policy].
Clinical examination (history and physical examination) is not considered to be a useful tool in the diagnosis of ectopic pregnancy (EP). In this systematic review we aimed to evaluate its value when ancillary tests are not readily available or when they are equivocal. Suspicion of EP is based on the presence of one or more of the following signs: vaginal bleeding, acute pelvic pain, or any risk factors for EP occurring in a pregnant woman. ⋯ Absence of these signs does not rule out EP but tend to eliminate tubal rupture. In the presence of these signs one may consider an emergency transfer in a specialized center. In their absence, suspicion of EP may have outpatient diagnosis procedures.
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Examination of modalities and results of conservative treatment of placenta accreta. ⋯ Conservative treatment of placenta accreta appears to be a efficient way to preserve fertility. Antepartum diagnosis should be improved among patients with a high risk of placenta accreta in order to optimize conservative strategy.