Journal de gynécologie, obstétrique et biologie de la reproduction
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J Gynecol Obstet Biol Reprod (Paris) · May 2013
Review[Adenocarcinoma of the uterine cervix: particularities in diagnosis and treatment].
The adenocarcinoma of the uterine cervix accounts for 10 to 20% of the premalignant and malignant lesions and is different from the cervical intraepithelial neoplasia and invasive squamous cell carcinoma. ⋯ Adenocarcinoma in situ is an induced HPV lesion (role of HPV 18) of the glandular epithelium: its preferential endocervical situation explains the difficulties in the diagnosis and follow-up after conservative treatment. If the hysterectomy remains the gold standard for treatment, the conservative treatments (resection in sano of the lesions with margins of more than 1cm, meticulous study of the operative specimen, compliance with the follow-up) are possible in the young patients who desire to preserve their fertility. The invasive adenocarcinoma is characterized by a more difficult diagnosis because of its endocervical development, and a prognosis less favorable when compared to squamous cell carcinoma with a greater frequency of the lymphatic node involvement and metastatic diffusion. Its treatment must take into account the particular gravity of the factors of worse prognosis (FIGO stage, tumor size, lymphatic node spreading, adenosquamous histological subtype) in particular in the advanced stages and includes beside the surgery, radiotherapy and chemotherapy.
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J Gynecol Obstet Biol Reprod (Paris) · Feb 2013
Review[Early detection of ovarian cancer: tomorrow? A review].
Ovarian cancer is the most lethal of the gynaecological malignancies because this «silent killer» is almost always diagnosed at an advanced stage. Precursor lesions have at least been discovered. This review will describe in details specific features of tubal and ovarian preinvasive lesions and the old and novel techniques that could be used for early detection of ovarian cancer.
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J Gynecol Obstet Biol Reprod (Paris) · Feb 2013
[Women's motivations to give birth with or without epidural analgesia].
This study aimed to question pregnant women about motivations to give birth with and without epidural analgesia, and about their perceptions of childbirth and pain. ⋯ Various motivations and differences between women observed in this study show the necessity to take into account wishes and expectancies of the women concerning childbirth pain relief.
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2012
Review[Induction of labor and intrapartum management for women with uterine scar].
To evaluate the benefits and risks of labor induction in patients previously delivered by at least one low transverse cesarean section. To define how labor should be managed in patients attempting a vaginal birth after cesarean section (VBAC). ⋯ Women attempting a VBAC should be aware of the modalities of labor management. When labor induction is warranted, women should also be informed of the indication and the increased risk of uterine rupture. The choice of labor induction method should take into consideration maternal and obstetrical characteristics.
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2012
Review[Anesthetic management in case of previous cesarean section].
An efficient communication between the obstetrics and anesthesiology teams is a prerequisite for an optimal management of a woman with a previous cesarean section (professional agreement). Epidural analgesia should be encouraged in this context due to a high risk of emergency obstetrical procedures, in order to avoid general anesthesia (professional agreement). When possible, spinal anesthesia is the technique of choice for elective repeat cesarean delivery even in case of morbidly adherent placenta (professional agreement).