Journal de gynécologie, obstétrique et biologie de la reproduction
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To evaluate the diagnostic value of clinical examination and additional tests in the exploration of breast pain, to evaluate the strategy of their care and to provide recommendations. ⋯ Clinical examination and interrogation, with the use of visual analog scale used to differentiate non-cyclical breast pain from mastodynia (LE2). A calendar can be used to characterize the cyclical breast pain (LE3). Using a questionnaire can help to characterize the pain (LE3). In the absence of palpable abnormality, it is not recommended to modify systematic or individual screening modalities (LE2). MRI is not recommended in case of normal mammography and sonography. Explorations biopsy is guided by imaging. The therapeutic management includes reassurance after a normal clinical evaluation and/or normal radiological findings (LE2), and precise fitting of a brassière. In case of failure of this first approach, NSAIDs gel can be proposed (LE1-2).
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Explorations of breast microcalcifications: Guidelines].
To assess imaging performances for the detection, characterization and biopsy of breast microcalcifications and make recommendations. ⋯ Digital mammography (DR [Direct Radiography] and CR [Computed Radiography]) and screen-film mammography demonstrate good performances for the detection and the characterization of breast microcalcifications. Systematic use of the 2013 edition of the BI-RADS lexicon is recommended for description and characterization of microcalcifications. Faced with BI-RADS 4 or 5 microcalcifications, breast ultrasound is recommended but a normal result does not eliminate the diagnosis of cancer and other examination should be performed. Literature review does not allow recommending digital breast tomosynthesis, elastography or MRI to analyze microcalcifications. In case of probably benign microcalcifications (BI-RADS 3), six months, one year and at least two years follow-up are recommended. In case a biopsy is indicated, it is recommended to use a vacuum-assisted macrobiopsy system with 11-gauges needles or bigger. If no calcification is visible on the radiography of the specimen, it is recommended to obtain additional samples.
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Postpartum pelvic floor muscle training and abdominal rehabilitation: Guidelines].
Provide guidelines for clinical practice concerning postpartum rehabilitation. ⋯ Pelvic floor muscle therapy is recommended for persistent postpartum urinary (grade A) or anal (grade C) incontinence (3 months after delivery).
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Post-partum management after cesarean delivery. Guidelines for clinical practice].
To determine guidelines for post-partum management after cesarean delivery regarding patient monitoring, organization, postoperative analgesia, time of urinary catheter removal, resumption of feeding and drinking, timing of ambulation, indication and modalities of thromboprophylaxis. ⋯ Harmonization of care according to these recommendations is expected to enhance recovery after cesarean delivery.
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Postnatal visit: Routine and particularity after complicated pregnancy--Guidelines for clinical practice].
To propose guidelines for clinical practice for routine postnatal visit and after pathological pregnancies. ⋯ A postpartum visit is recommended 6 to 8 weeks after delivery, including mother physical and psychological evaluation and information about contraception, short interval between pregnancy, weight loss, smoking cessation (Professional consensus). To ensure continuity in the management of women health, relevant medical elements will be pass on to the corresponding physicians (Professional consensus).