Journal de gynécologie, obstétrique et biologie de la reproduction
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J Gynecol Obstet Biol Reprod (Paris) · Nov 2011
[Lessons and impact of two audits on postpartum hemorrhages in 24 maternity hospitals of the network "Sécurité Naissance - Naître Ensemble" in "Pays-de-la-Loire" area].
The aim of the study is to assess the compliance rate of treatment of postpartum hemorrhage (PPH) according to guidelines developed by the CNGOF within our network by a first audit, and evaluate the impact of this first audit by conducting a second audit. ⋯ There is a general improvement in prevention and care, with critical points and persistent disparities between pregnancies. In the aftermath of the completion of the audit, the overall results were sent to officials with the rank of each maternity, inviting each responsible to analyze weaknesses and implement corrective actions. Further action is planned within the network.
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J Gynecol Obstet Biol Reprod (Paris) · Oct 2011
Review[Fertility preservation in cancer women: a multidisciplinary approach].
Over the past two decades, major advances in diagnostic modalities and treatment have markedly improved rates of cure for adult cancers. As a consequence, the number of long-term survivors is increasing, and fertility preservation has become a major issue for young patient about to start treatment for cancer. ⋯ Patients should be aware that no method guarantees success. Psychological and ethical impacts of fertility preservation are major concerns and should be included in the multidisciplinary approach of the patients.
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J Gynecol Obstet Biol Reprod (Paris) · May 2011
Review[Retroperitoneal lymphadenectomy and survival of patients treated for an advanced ovarian cancer: the CARACO trial].
The standard management for advanced-stage epithelial ovarian cancer is optimum cytoreductive surgery followed by platinum based chemotherapy. However, retroperitoneal lymph node resection remains controversial. The multiple directions of the lymph drainage pathway in ovarian cancer have been recognized. ⋯ Further randomised trials are needed to balance risks and benefits of systematic lymphadenectomy in advanced-stage disease. CARACO is a French ongoing trial, built to bring a reply to this important question. A huge effort for inclusion of the patients, and involving new teams, are mandatory.
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J Gynecol Obstet Biol Reprod (Paris) · May 2011
[Surgical decompression of pudendal nerve by transperineal approach using a probe with a small balloon].
Describe and analyze the surgical decompression of pudendal nerve by transperineal approach using a probe with a small balloon. ⋯ Surgical methodology, post-operation follow-up and results are reported hereby, which appear quite successful: after two days 77%, after one month 84% and after three months 89% of the subjects are symptom-free or with a significant reduction of pain.
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J Gynecol Obstet Biol Reprod (Paris) · Apr 2011
[The confidential enquiries into maternal deaths, 1996-2006 in France: what consequences for the obstetrical care?].
The national confidential enquiry into maternal deaths (ENCMM) and its committee (CNEMM) have the target to study all maternal deaths occurring in France, in order to expertise the care provided. The current report covers the 1996--year of the ENCMM establishment--to 2006 years. After being informed of the potential maternal deaths by the Epidemiological center on medical causes of deaths (CépiDC), and agreement from the medical doctors concerned, two assessors (one anesthetist and one obstetrician) gather the medical or obstetrical information near the team involved in the care of the women, by the mean of a detailed and specific questionnaire. ⋯ Half of maternal deaths were considered preventable by the CNEMM, particularly haemorrhage and sepsis. The factors of avoidability are delay to treat (31%) inadapted therapeutics (28%), even professional default (20%) no diagnosis (15%) or reluctant patient (7%). Seven deaths are discussed in a specific section including a detailed description of, and recommendations on how the quality of care may be improved.