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Sentilhes L, Schmitz T, Arthuis C, Barjat T, Berveiller P, Camilleri C, Froeliger A, Garabedian C, Guerby P, Korb D, Lecarpentier E, Mattuizzi A, Sibiude J, Sénat MV, Tsatsaris V. [Preeclampsia: Guidelines for clinical practice from the French College of Obstetricians and Gynecologists]. Gynecol Obstet Fertil Senol 2024; 52:3-44. [PMID: 37891152 DOI: 10.1016/j.gofs.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To identify strategies to reduce maternal and neonatal morbidity related to preeclampsia. MATERIAL AND METHODS The quality of evidence of the literature was assessed following the GRADE® method with questions formulated in the PICO format (Patients, Intervention, Comparison, Outcome) and outcomes defined a priori and classified according to their importance. An extensive bibliographic search was performed on PubMed, Cochrane, EMBASE and Google Scholar databases. The quality of the evidence was assessed (high, moderate, low, very low) and recommendations were formulated as a (i) strong, (ii) weak or (iii) no recommendation. The recommendations were reviewed in two rounds with external reviewers (Delphi survey) to select the consensus recommendations. RESULTS Preeclampsia is defined by the association of gestational hypertension (systolic blood pressure≥140mmHg and/or diastolic blood pressure≥90mmHg) and proteinuria≥0.3g/24h or a Proteinuria/Creatininuria ratio≥30mg/mmol occurring after 20 weeks of gestation. Data from the literature do not show any benefit in terms of maternal or perinatal health from implementing a broader definition of preeclampsia. Of the 31 questions, there was agreement between the working group and the external reviewers on 31 (100%). In general population, physical activity during pregnancy should be encouraged to reduce the risk of preeclampsia (Strong recommendation, Quality of the evidence low) but an early screening based on algorithms (Weak recommendation, Quality of the evidence low) or aspirin administration (Weak recommendation, Quality of the evidence very low) is not recommended to reduce maternal and neonatal morbidity related to preeclampsia. In women with preexisting diabetes or hypertension or renal disease, or multiple pregnancy, the level of evidence is insufficient to determine whether aspirin administration during pregnancy is useful to reduce maternal and perinatal morbidity (No recommendation, Quality of the evidence low). In women with a history of vasculo-placental disease, low dose of aspirin (Strong recommendation, Quality of the evidence moderate) at a dosage of 100-160mg per day (Weak recommendation, Quality of the evidence low), ideally before 16 weeks of gestation and not after 20 weeks of gestation (Strong recommendation, Quality of the evidence low) until 36 weeks of gestation (Weak recommendation, Quality of the evidence very low) is recommended. In a high-risk population, additional administration of low molecular weight heparin is not recommended (Weak recommendation, Quality of the evidence moderate). In case of preeclampsia (Weak recommendation, Quality of the evidence low) or suspicion of preeclampsia (Weak recommendation, Quality of the evidence moderate, the assessment of PlGF concentration or sFLT-1/PlGF ratio is not routinely recommended) in the only goal to reduce maternal or perinatal morbidity. In women with non-severe preeclampsia antihypertensive agent should be administered orally when the systolic blood pressure is measured between 140 and 159mmHg or diastolic blood pressure is measured between 90 and 109mmHg (Weak recommendation, Quality of the evidence low). In women with non-severe preeclampsia, delivery between 34 and 36+6 weeks of gestation reduces severe maternal hypertension but increases the incidence of moderate prematurity. Taking into account the benefit/risk balance for the mother and the child, it is recommended not to systematically induce birth in women with non-severe preeclampsia between 34 and 36+6 weeks of gestation (Strong recommendation, Quality of evidence high). In women with non-severe preeclampsia diagnosed between 37+0 and 41 weeks of gestation, it is recommended to induce birth to reduce maternal morbidity (Strong recommendation, Low quality of evidence), and to perform a trial of labor in the absence of contraindication (Strong recommendation, Very low quality of evidence). In women with a history of preeclampsia, screening maternal thrombophilia is not recommended (Strong recommendation, Quality of the evidence moderate). Because women with a history of a preeclampsia have an increased lifelong risk of chronic hypertension and cardiovascular complications, they should be informed of the need for medical follow-up to monitor blood pressure and to manage other possible cardiovascular risk factors (Strong recommendation, Quality of the evidence moderate). CONCLUSION The purpose of these recommendations was to reassess the definition of preeclampsia, and to determine the strategies to reduce maternal and perinatal morbidity related to preeclampsia, during pregnancy but also after childbirth. They aim to help health professionals in their daily clinical practice to inform or care for patients who have had or have preeclampsia. Synthetic information documents are also offered for professionals and patients.
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Affiliation(s)
- Loïc Sentilhes
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Bordeaux, Bordeaux, France.
| | - Thomas Schmitz
- Service de gynécologie-obstétrique, hôpital Robert-Debré, AP-HP, Paris, France
| | - Chloé Arthuis
- Service d'obstétrique et de médecine fœtale, Elsan Santé Atlantique, 44819 Saint-Herblain, France
| | - Tiphaine Barjat
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Saint-Etienne, Saint-Etienne, France
| | - Paul Berveiller
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Poissy St-Germain, Poissy, France
| | - Céline Camilleri
- Association grossesse santé contre la pré-éclampsie, Paris, France
| | - Alizée Froeliger
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Bordeaux, Bordeaux, France
| | - Charles Garabedian
- Service de gynécologie-obstétrique, University Lille, ULR 2694-METRICS, CHU de Lille, 59000 Lille, France
| | - Paul Guerby
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Toulouse, Toulouse, France
| | - Diane Korb
- Service de gynécologie-obstétrique, hôpital Robert-Debré, AP-HP, Paris, France
| | - Edouard Lecarpentier
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Créteil, Créteil, France
| | - Aurélien Mattuizzi
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Bordeaux, Bordeaux, France
| | - Jeanne Sibiude
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, AP-HP, Colombes, France
| | - Marie-Victoire Sénat
- Service de gynécologie-obstétrique, hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - Vassilis Tsatsaris
- Maternité Port-Royal, hôpital Cochin, GHU Centre Paris cité, AP-HP, FHU PREMA, Paris, France
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Girault A, Sentilhes L, Desbrière R, Berveiller P, Korb D, Bertholdt C, Carrara J, Winer N, Verspyck E, Boudier E, Barjat T, Levy G, Roth GE, Kayem G, Massoud M, Bohec C, Guerby P, Azria E, Blanc J, Heckenroth H, Rousseau J, Garabedian C, Le Ray C. Impact of discontinuing oxytocin in active labour on neonatal morbidity: an open-label, multicentre, randomised trial. Lancet 2023; 402:2091-2100. [PMID: 37952548 DOI: 10.1016/s0140-6736(23)01803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Oxytocin is effective in reducing labour duration but can be associated with fetal and maternal complications that could potentially be reduced by discontinuing the treatment during labour. We aimed to assess the impact of discontinuing oxytocin during active labour on neonatal morbidity. METHODS STOPOXY was a multicentre, randomised, open-label, controlled, superiority trial conducted in 21 maternity units in France. Participants who received oxytocin before 4 cm dilation were randomly assigned 1:1 to either discontinuous oxytocin (oxytocin infusion stopped beyond a cervical dilation equal to or greater than 6 cm) or continuous oxytocin (administration of oxytocin continued until delivery). Randomisation was stratified by centre and parity. The primary outcome, neonatal morbidity, was assessed at birth using a composite variable defined by an umbilical arterial pH at birth less than 7·10, a base excess greater than 10 mmol/L, umbilical arterial lactates greater than 7 mmol/L, a 5-min Apgar score less than 7, or admission to the neonatal intensive care unit. Efficacy and safety was assessed in participants who were randomly assigned (excluding those who withdrew consent or were deemed ineligible after randomisation) and had reached a cervical dilation of at least 6 cm. This trial is registered with ClinicalTrials.gov, NCT03991091. FINDINGS Of 2459 participants randomly assigned between Jan 13, 2020, and Jan 24, 2022, 2170 were eligible to receive the intervention and were included in the final modified intention-to-treat analysis. The primary outcome occurred for 102 (9·6%) of 1067 participants (95% CI 7·9 to 11·5) in the discontinuous oxytocin group and for 101 (9·2%) of 1103 participants (7·6 to 11·0) in the continuous oxytocin group; absolute difference 0·4% (95% CI -2·1 to 2·9); relative risk 1·0 (95% CI 0·8 to 1·4). There were no clinically significant differences in adverse events between the two groups of the safety population. INTERPRETATION Among participants receiving oxytocin in early labour, discontinuing oxytocin when the active phase is reached does not clinically or statistically significantly reduce neonatal morbidity compared with continuous oxytocin. FUNDING French Ministry of Health and the Département de la Recherche Clinique et du Développement de l'Assistance Publique-Hôpitaux de Paris.
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Affiliation(s)
- Aude Girault
- Université Paris Cité, Inserm UMR 1153, Equipe EPOPé, Paris, France; Department of Obstetrics and Gynecology, Port-Royal Maternity Hospital, AP-HP, Cochin Hospital, FHU PREMA, Paris, France.
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Raoul Desbrière
- Department of Obstetrics and Gynecology, Hôpital Saint Joseph, Marseille, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Poissy/Saint-Germain-en-Laye, Rue du Champ Gaillard, Poissy Cedex, France
| | - Diane Korb
- Department of Obstetrics and Gynecology, Robert Debré Hospital, AP-HP, Paris, France
| | - Charline Bertholdt
- University of Lorraine, CHRU NANCY, Obstetrics and Gynecology Department, NANCY, France
| | - Julie Carrara
- Department of Obstetrics and Gynecology, Antoine Béclère Hospital, AP-HP, Paris, France; Paris Saclay University, Paris, France
| | - Norbert Winer
- Department of Obstetrics and Gynecology, University Hospital of Nantes, Nantes, France
| | - Eric Verspyck
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Eric Boudier
- Department of Obstetrics and Gynecology, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Tiphaine Barjat
- Department of Obstetrics and Gynecology, Saint Etienne University Hospital, Saint Etienne, France
| | - Gilles Levy
- Department of Obstetrics and Gynecology, Hôpital Nord Franche Comté, Belfort, France
| | - Georges Emmanuel Roth
- CHU de Strasbourg, Pôle de Gynécologie-Obstétrique et Fertilité, Université de Strasbourg, Strasbourg, France
| | - Gilles Kayem
- Université Paris Cité, Inserm UMR 1153, Equipe EPOPé, Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, Sorbonne University, APHP, Paris, France
| | - Mona Massoud
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Université Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Caroline Bohec
- Department of Obstetrics and Gynecology, François Mitterrand Hospital, Pau, France
| | - Paul Guerby
- Department of Obstetrics and Gynecology, Infinity CNRS Inserm UMR 1291, CHU Toulouse, Toulouse, France
| | - Elie Azria
- Université Paris Cité, Inserm UMR 1153, Equipe EPOPé, Paris, France; Maternity Unit, Groupe Hospitalier Paris Saint Joseph, FHU PREMA, Paris, France
| | - Julie Blanc
- Department of Obstetrics and Gynecology, Nord Hospital, APHM, Marseille, France
| | - Hélène Heckenroth
- Department of Gynaecology and Obstetrics, Gynépole, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Jessica Rousseau
- Clinical Research Unit, Center for Clinical Investigation P1419, AP-HP, Paris, France
| | - Charles Garabedian
- CHU Lille, Department of Obstetrics, Lille, France; Univ Lille, ULR 2694-METRICS, Lille, France
| | - Camille Le Ray
- Université Paris Cité, Inserm UMR 1153, Equipe EPOPé, Paris, France; Department of Obstetrics and Gynecology, Port-Royal Maternity Hospital, AP-HP, Cochin Hospital, FHU PREMA, Paris, France
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Loibl S, Azim HA, Bachelot T, Berveiller P, Bosch A, Cardonick E, Denkert C, Halaska MJ, Hoeltzenbein M, Johansson ALV, Maggen C, Markert UR, Peccatori F, Poortmans P, Saloustros E, Saura C, Schmid P, Stamatakis E, van den Heuvel-Eibrink M, van Gerwen M, Vandecaveye V, Pentheroudakis G, Curigliano G, Amant F. ESMO Expert Consensus Statements on the management of breast cancer during pregnancy (PrBC). Ann Oncol 2023; 34:849-866. [PMID: 37572987 DOI: 10.1016/j.annonc.2023.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/14/2023] Open
Abstract
The management of breast cancer during pregnancy (PrBC) is a relatively rare indication and an area where no or little evidence is available since randomized controlled trials cannot be conducted. In general, advances related to breast cancer (BC) treatment outside pregnancy cannot always be translated to PrBC, because both the interests of the mother and of the unborn should be considered. Evidence remains limited and/or conflicting in some specific areas where the optimal approach remains controversial. In 2022, the European Society for Medical Oncology (ESMO) held a virtual consensus-building process on this topic to gain insights from a multidisciplinary group of experts and develop statements on controversial topics that cannot be adequately addressed in the current evidence-based ESMO Clinical Practice Guideline. The aim of this consensus-building process was to discuss controversial issues relating to the management of patients with PrBC. The virtual meeting included a multidisciplinary panel of 24 leading experts from 13 countries and was chaired by S. Loibl and F. Amant. All experts were allocated to one of four different working groups. Each working group covered a specific subject area with two chairs appointed: Planning, preparation and execution of the consensus process was conducted according to the ESMO standard operating procedures.
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Affiliation(s)
- S Loibl
- GBG c/o GBG Forschungs GmbH, Neu-Isenburg; Centre for Haematology and Oncology Bethanien, Frankfurt am Main, Frankfurt; Goethe University Frankfurt, Frankfurt am Main, Frankfurt, Germany.
| | - H A Azim
- Breast Cancer Center, School of Medicine, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - T Bachelot
- Department of medical oncology, Centre Léon Bérard, Lyon, France
| | - P Berveiller
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy; UMR 1198 - BREED, INRAE, Paris Saclay University, RHuMA, Montigny-Le-Bretonneux, France
| | - A Bosch
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund; Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - E Cardonick
- Cooper Medical School at Rowan University, Camden, USA
| | - C Denkert
- Philipps-University Marburg and Marburg University Hospital (UKGM), Marburg, Germany
| | - M J Halaska
- Department of Obstetrics and Gynaecology, Third Faculty of Medicine, Charles University in Prague and Universital Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - M Hoeltzenbein
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy, Berlin, Germany
| | - A L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Oslo, Norway
| | - C Maggen
- Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Brussels, Belgium
| | - U R Markert
- Placenta Lab, Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - F Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - P Poortmans
- Iridium Netwerk, Antwerp; University of Antwerp, Antwerp, Belgium
| | - E Saloustros
- Department of Oncology, University General Hospital of Larissa, Larissa, Greece
| | - C Saura
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - P Schmid
- Cancer Institute, Queen Mary University London, London, UK
| | - E Stamatakis
- Department of Anesthesiology, 'Alexandra' General Hospital, Athens, Greece
| | | | - M van Gerwen
- Gynecologic Oncology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, University of Amsterdam; Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - V Vandecaveye
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Curigliano
- Division of Early Drug Development, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Amant
- Gynecologic Oncology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam; Division Gynaecologic Oncology, UZ Leuven, Belgium
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Crochet P, Mousty E, Le Lous M, Chauleur C, Berveiller P, Ceccaldi PF, Deffieux X, Hanssens S, Gauthier T, Le Ray C, Legendre G, Rabischong B, Winer N, Tsatsaris V, Ghesquiere L, Rubod C. [Simulation training for French obstetrics and gynecology residents: A national survey in 2022]. Gynecol Obstet Fertil Senol 2023; 51:393-399. [PMID: 37295716 DOI: 10.1016/j.gofs.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/15/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To evaluate the use of simulation among French Obstetrics and Gynecology residency programs. METHODS A survey was conducted with all 28 French residency program directors. The questionnaire covered equipment and human resources, training programs, types of simulation tools and time spent. RESULTS Of the cities hosting a residency program, 93% (26/28) responded regarding equipment and human resources, and 75% (21/28) responded regarding training program details. All respondents declared having at least one structure dedicated to simulation. A formal training program was reported by 81% (21/26) of cities. This training program was mandatory in 73% of the cases. There was a median number of seven senior trainers involved, three of whom had received a specific training in medical education. Most of declared simulation activities concerned technical skills in obstetrics and surgery. Simulations to practice breaking bad news were offered by 62% (13/21) of cities. The median number of half-days spent annually on simulation training was 55 (IQR: 38-83). CONCLUSION Simulation training is now widely available among French residency programs. There remains heterogeneity between centers regarding equipment, time spent and content of simulation curricula. The French College of Teachers of Gynecology and Obstetrics has proposed a roadmap for the content of simulation-based training based on the results of this survey. An inventory of all existing "train the trainers" simulation programs in France is also provided.
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Affiliation(s)
- P Crochet
- Service de gynécologie-obstétrique, université de Rouen, CHU Charles-Nicolle, Rouen, France; Univ Rouen Normandie, INSERM, NORDIC UMR 1239 - Team Adrenal and Gonadal Pathophysiology (AGoPath), 76000 Rouen, France.
| | - E Mousty
- Service de gynécologie-obstétrique, université de Montpellier-Nîmes, CHU de Nîmes, Nîmes, France.
| | - M Le Lous
- Service de gynécologie-obstétrique, hôpital Sud, université de Rennes, CHU de Rennes, Rennes, France.
| | - C Chauleur
- Inserm, U 1059, service de gynécologie-obstétrique, université Jean-Monnet, CHU de Saint-Étienne, 42023 Saint-Étienne, France.
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI de Poissy St-Germain, 78300 Poissy, France.
| | - P-F Ceccaldi
- Université Paris Cité, Paris, France; Service de gynécologie-obstétrique, hôpital Beaujon, Assistance publique-Hôpitaux de Paris, Clichy, France.
| | - X Deffieux
- Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
| | - S Hanssens
- Department of neonatology, Jeanne-de-Flandre hospital, université de Lille, CHU de Lille, Lille, France.
| | - T Gauthier
- Service de gynécologie-obstétrique, hôpital mère-enfant, CHU de Limoges, 87000 Limoges, France.
| | - C Le Ray
- Maternité Port-Royal, Groupe hospitalier Paris Centre, FHU Prema, université Paris Cité, AP-HP, 75014 Paris, France.
| | - G Legendre
- Département de médecine, service de gynécologie-obstétrique, faculté de santé, Angers, France.
| | - B Rabischong
- Department of gynecological surgery, CHU Estaing, Clermont-Ferrand, France.
| | - N Winer
- Service de gynécologie-obstétrique, NUN INRAE PhAN, UMR 1280, CHU de Nantes, 44000 Nantes, France.
| | - V Tsatsaris
- Maternité Port-Royal, Groupe hospitalier Paris Centre, FHU Prema, université Paris Cité, AP-HP, 75014 Paris, France.
| | - L Ghesquiere
- Department of neonatology, Jeanne-de-Flandre hospital, université de Lille, CHU de Lille, Lille, France.
| | - C Rubod
- Department of neonatology, Jeanne-de-Flandre hospital, université de Lille, CHU de Lille, Lille, France.
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Sentilhes L, Allart JB, Berveiller P, Bibes A, Schaeverbeke T. FRENCH-ARRIVE: a serious, evidence-free, and false accusation of unethical research. Lancet 2023; 401:819-820. [PMID: 36906343 DOI: 10.1016/s0140-6736(23)00133-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/09/2023] [Indexed: 03/12/2023]
Affiliation(s)
- Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux 33000, France.
| | | | - Paul Berveiller
- Groupe de Recherche en Gynécologie Obstétrique, Paris, France
| | - Aline Bibes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux 33000, France
| | - Thierry Schaeverbeke
- Department of Clinical Research and Innovation, Bordeaux University Hospital, Bordeaux 33000, France
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Loussert L, Berveiller P, Magadoux A, Allouche M, Vayssiere C, Garabedian C, Guerby P. Association between marked fetal heart rate variability and neonatal acidosis: A prospective cohort study. BJOG 2023; 130:407-414. [PMID: 36398385 PMCID: PMC10108100 DOI: 10.1111/1471-0528.17345] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/08/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the association between marked variability in fetal heart rate (FHR) and neonatal acidosis. DESIGN Bicentric prospective cohort study. SETTING From January 2019 to December 2019, in two French tertiary care maternity units. POPULATION Women in labour at ≥37 weeks of gestation, with continuous FHR monitoring until delivery and with the availability of umbilical arterial pH. Women with intrauterine fetal death or medical termination, multiple pregnancies, non-cephalic presentation or planned caesarean delivery were excluded. METHODS The exposure was marked variability in FHR in the 60 minutes before delivery, defined as a variability greater than 25 beats per minute, with a minimum duration of 1 minute. To assess the association between marked variability and neonatal acidosis, we used multivariable modified Poisson regression modelling. We then conducted subgroup analyses according to the US National Institute of Child Health and Human Development (NICHD) category of the associated fetal heart rate. MAIN OUTCOME MEASURES Neonatal acidosis, defined as an umbilical artery pH of ≤7.10. RESULTS Among the 4394 women included, 177 (4%) had marked variability in fetal heart rate in the 60 minutes before delivery. Acidosis occurred in 6.0% (265/4394) of the neonates. In the multivariable analysis, marked variability was significantly associated with neonatal acidosis (aRR 2.30, 95% CI 1.53-3.44). In subgroup analyses, the association between marked variability and neonatal acidosis remained significant in NICHD category-I and category-II groups. CONCLUSIONS Marked variability was associated with a twofold increased risk of neonatal acidosis.
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Affiliation(s)
- Lola Loussert
- Department of Obstetrics and Gynecology, CHU Toulouse, Toulouse, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, CHI Poissy, Paris, France
| | - Alexia Magadoux
- Department of Obstetrics and Gynecology, CHI Poissy, Paris, France
| | - Michael Allouche
- Department of Obstetrics and Gynecology, CHU Toulouse, Toulouse, France
| | - Christophe Vayssiere
- Department of Obstetrics and Gynecology, CHU Toulouse, Toulouse, France.,CERPOP, UMR 1295, Team SPHERE (Study of Perinatal, Pediatric and Adolescent Health: Epidemiological Research and Evaluation) Toulouse III University, Toulouse, France
| | | | - Paul Guerby
- Department of Obstetrics and Gynecology, CHU Toulouse, Toulouse, France.,Toulouse Institute for Infectious and Inflammatory Diseases, Inserm UMR 1291 - CNRS UMR 5051, University Toulouse III, Toulouse, France
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Loussert L, Berveiller P, Magadoux A, Allouche M, VAYSSIERE C, Garabedian C, Guerby P. Association between marked variability and neonatal acidosis: a prospective cohort of fetal heart rate monitoring. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Maggen C, Wolters VERA, Van Calsteren K, Cardonick E, Laenen A, Heimovaara JH, Mhallem Gziri M, Fruscio R, Duvekot JJ, Painter RC, Masturzo B, Shmakov RG, Halaska M, Berveiller P, Verheecke M, de Haan J, Gordijn SJ, Amant F. Impact of chemotherapy during pregnancy on fetal growth. J Matern Fetal Neonatal Med 2022; 35:10314-10323. [PMID: 36202393 DOI: 10.1080/14767058.2022.2128645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Chemotherapy crosses the placenta, however, it remains unclear to what extent it affects fetal growth. The current literature suggests up to 21% of the offspring of women receiving chemotherapy are small for gestational age (SGA, birth weight <10th percentile). Limiting research to birth weights only might misjudge fetal growth restriction (FGR) in this high-risk population with multiple risk factors for impaired fetal growth. Moreover, the role of the duration of chemotherapy and gestational age at initiation of chemotherapy in fetal growth is yet poorly understood. OBJECTIVE This retrospective cohort study evaluates fetal growth and neonatal birthweights in pregnant women receiving chemotherapy. STUDY DESIGN All pregnant patients, registered by the International Network of Cancer, Infertility and Pregnancy (INCIP), treated with chemotherapy with at least two ultrasounds reporting on fetal growth, were eligible for this study. Duration and gestational age at initiation of chemotherapy were our major determinants, followed by cancer type and stage, maternal characteristics (parity, BMI, ethnicity hypertension, and diabetes) and individual cytotoxic agents (anthracycline, taxanes, and platinum). Fetal growth outcomes were described using the following mutually exclusive groups (1) FGR, based on a Delphi consensus (2016); (2) "low risk SGA" (birth weight below the 10th percentile), but an estimated growth above the 10th percentile; (3) "fetal growth disturbance", which did not meet all FGR criteria; (4) "non-FGR". Obstetric and oncological characteristics were compared between the growth impaired groups and non-FGR group. We calculated estimated fetal weight (EFW) according to Hadlock's formula (1991) and birth weight percentile according to Nicolaides (2018). We used univariable and multivariable regression, and linear mixed effect models to investigate the effect of duration and gestational age at initiation of chemotherapy on birth weight, and fetal growth, respectively. RESULTS We included 201 patients, diagnosed with cancer between March 2000 and March 2020. Most patients were diagnosed with breast cancer (n = 132, 66%). Regimens included anthracyclines (n = 121, 60%), (anthracyclines and) taxanes (n = 45, 22%) and platinum (n = 35, 17%). Fetal growth abnormalities were detected in 75 pregnancies: 43 (21%) FGR, 10 (5%) low risk SGA and 22 (8.5%) fetal growth disturbance. Chemotherapy prior to 20 weeks of gestation (47% vs. 25%, p = .04) and poor maternal gestational weight gain (median percentile 15 (range 0-97) vs. 8 (0-84), p = .03) were more frequent in the FGR group compared to the non-FGR group, whereas no difference was seen for specific chemotherapy or cancer types. Univariable regression identified gestational weight gain, hypertension, systemic disease, parity, neonatal sex and maternal BMI as confounders for birth weight percentiles. Multivariable regression revealed that each additional week of chemotherapy was associated with lower birth weight percentiles (-1.06; 95%CI -2.01; -0.04; p = .04), and that later initiation of chemotherapy was associated with an increase in birth weight percentile (1.10 per week; 95%CI 0.26; 1.95; p = .01). Each additional week of chemotherapy was associated with lower EFW and abdominal circumference (AC) percentiles (-1.77; 95%CI -2.21; -1.34, p < .001; -1.64; 95%CI -1.96; -1.32, p < .001, respectively). CONCLUSIONS This study demonstrates that FGR is common after chemotherapy in pregnancy, and that the duration of chemotherapy has a negative impact. Sonographic follow-up of fetal growth and well-being is recommended.
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Affiliation(s)
- Charlotte Maggen
- Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Brussels, Belgium
| | - Vera E R A Wolters
- Department of Gynecology, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Department of Development and regeneration, KU Leuven, Leuven, Belgium
| | - Elyce Cardonick
- Department of Obstetrics and Gynecology, Cooper, University Health Care, Camden, NJ, USA
| | | | | | - Mina Mhallem Gziri
- Department of Obstetrics, Cliniques Universitaires St Luc, UCL, Sint-Lambrechts-Woluwe, Belgium
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan - Bicocca, San Gerardo Hospital, Monza, Italy
| | - Johannes J Duvekot
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Rebecca C Painter
- Department of Obstetrics and Gynecology, Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bianca Masturzo
- Department Surgical Sciences, University of Torino, Torino, Italy
| | - Roman G Shmakov
- National Medical Research Centre for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Michael Halaska
- Faculty Hospital Kralovske, Vinohrady and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Poissy Saint Germain, Poissy, Université Paris Saclay, Gif-sur-Yvette, France
| | - Magali Verheecke
- Department of Obstetrics and Gynecology, General Hospital, Turnhout, Belgium
| | - Jorine de Haan
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sanne J Gordijn
- Department of Obstetrics and Gynecology, University Medical Center Groningen, Groningen, The Netherlands
| | - Frédéric Amant
- Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Gynecology, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Obstetrics & Gynecology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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9
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Bagou G, Sentilhes L, Mercier FJ, Berveiller P, Blanc J, Cesareo E, Dewandre PY, Douai B, Gloaguen A, Gonzalez M, Le Conte P, Le Gouez A, Madar H, Maisonneuve E, Morau E, Rackelboom T, Rossignol M, Sibiude J, Vaux J, Vivanti A, Goddet S, Rozenberg P, Garnier M, Chauvin A. Guidelines for the management of urgent obstetric situations in emergency medicine, 2022. Anaesth Crit Care Pain Med 2022; 41:101127. [PMID: 35940033 DOI: 10.1016/j.accpm.2022.101127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To provide recommendations on the management of urgent obstetrical emergencies outside the maternity ward. DESIGN A group of 24 experts from the French Society of Emergency Medicine (SFMU), the French Society of Anaesthesia and Intensive Care Medicine (SFAR) and the French College of Gynaecologists and Obstetricians (CNGOF) was convened. Potential conflicts of interest were formally declared at the outset of the guideline development process, which was conducted independently of industry funding. The authors followed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method to assess the level of evidence in the literature. The potential drawbacks of strong recommendations in the presence of low-level evidence were highlighted. Some recommendations with an insufficient level of evidence were not graded. METHODS Eight areas were defined: imminent delivery, postpartum haemorrhage (prevention and management), threat of premature delivery, hypertensive disorders in pregnancy, trauma, imaging, cardiopulmonary arrest, and emergency obstetric training. For each field, the expert panel formulated questions according to the PICO model (population, intervention, comparison, outcomes) and an extensive literature search was conducted. Analysis of the literature and formulation of recommendations were conducted according to the GRADE method. RESULTS Fifteen recommendations on the management of obstetrical emergencies were issued by the SFMU/SFAR/CNGOF panel of experts, and 4 recommendations from formalised expert recommendations (RFE) established by the same societies were taken up to answer 4 PICO questions dealing with the pre-hospital context. After two rounds of voting and several amendments, strong agreement was reached for all the recommendations. For two questions (cardiopulmonary arrest and inter-hospital transfer), no recommendation could be made. CONCLUSIONS There was significant agreement among the experts on strong recommendations to improve practice in the management of urgent obstetric complications in emergency medicine.
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Affiliation(s)
- Gilles Bagou
- SAMU-SMUR of Lyon, University Hospital Edouard Herriot, Lyon, France.
| | - Loïc Sentilhes
- Gynaecology and Obstetrics Department, University Hospital Pellegrin, Bordeaux, France
| | - Frédéric J Mercier
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Antoine Béclère, Clamart, France
| | - Paul Berveiller
- Gynaecology and Obstetrics Department, CHI Poissy Saint-Germain, Poissy, France
| | - Julie Blanc
- Gynaecology and Obstetrics Department, University Hospital Hôpital Nord, Marseille, France
| | - Eric Cesareo
- SAMU-SMUR 69, University Hospital Hospices Civils de Lyon, Lyon, France
| | - Pierre-Yves Dewandre
- Department of Anaesthesiology and Critical Care Medicine, University hospital of Liège, Liège, Belgium
| | | | - Aurélie Gloaguen
- Emergency Department, Hospital William Morey, Chalon-sur-Saone, France
| | - Max Gonzalez
- Department of Anaesthesiology and Critical Care Medicine in Gynaecology and Obstetrics, University Hospital Jeanne de Flandre, Lille, France
| | | | - Agnès Le Gouez
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Antoine Béclère, Clamart, France
| | - Hugo Madar
- Gynaecology and Obstetrics Department, University Hospital Pellegrin, Bordeaux, France
| | | | - Estelle Morau
- Department of Anaesthesiology, Critical Care, Pain and Emergency, University hospital Carémeau, Nîmes, France
| | - Thibaut Rackelboom
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Pellegrin, Bordeaux, France
| | - Mathias Rossignol
- University Paris Cité - APHP Nord, Department of Anaesthesiology and Critical Care Medicine, University Hospital Lariboisière, Paris, France
| | - Jeanne Sibiude
- Gynaecology and Obstetrics Department, University Hospital Louis Mourier, Colombes, France
| | - Julien Vaux
- SMUR 94, University Hospital Henri Mondor, Créteil, France
| | - Alexandre Vivanti
- Gynaecology and Obstetrics Department, Antoine Béclère University Hospital, Clamart, France
| | - Sybille Goddet
- SAMU-SMUR 21 and Emergency Department, University Hospital of Dijon, Dijon, France
| | - Patrick Rozenberg
- Gynaecology and Obstetrics Department, CHI Poissy Saint-Germain, Poissy, France
| | - Marc Garnier
- Sorbonne University, GRC29, DMU DREAM, Department of Anesthesiology and Critical Care Medicine, Tenon University Hospital, Paris, France
| | - Anthony Chauvin
- SAMU-SMUR 75 and Emergency Department, Lariboisière University Hospital, Paris, France; Université de Paris, INSERM U942 MASCOT, Paris, France
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10
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Bagou G, Sentilhes L, Mercier FJ, Berveiller P, Blanc J, Cesareo E, Dewandre PY, Douay B, Gloaguen A, Gonzalez M, Le Conte P, Le Gouez A, Madar H, Maissonneuve E, Morau E, Rackelboom T, Rossignol M, Sibiude J, Vaux J, Vivanti A, Goddet S, Rozenberg P, Garnier M, Chauvin A. Recommandations de pratiques professionnelles 2022 Prise en charge des urgences obstétricales en médecine d’urgence. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Hini JD, Kayem G, Quibel T, Berveiller P, De Carne Carnavale C, Delorme P. Risk of preterm delivery after medically indicated termination of pregnancy with induced vaginal delivery: a case-control study. J OBSTET GYNAECOL 2022; 42:1693-1702. [PMID: 35653800 DOI: 10.1080/01443615.2022.2071147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated whether nonsurgical termination of pregnancy after 14 weeks of gestation increases the risk of preterm delivery in a subsequent pregnancy. We conducted a two-centre retrospective case-control study. Patients who underwent non-surgical termination of pregnancy after 14 weeks of gestation between 2012 and 2015 and who gave birth after 14 weeks of gestation to a live-born singleton infant were included. Control patients were those who gave birth after 37 weeks of gestation (the same month as a case patient) and had a second delivery of a singleton foetus after 14 weeks of gestation. The primary outcome was preterm delivery during the second pregnancy period. We included 151 cases and 302 controls and observed 13 (8.6%) preterm births during the second pregnancy in the case group versus 8 (2.6%) (odds ratio: 3.62; 95% confidence interval: 1.40-8.65, p < .001) in the control group. This result remained significant after multivariate analysis. Impact statementWhat is already known about this topic? Many studies have evaluated the association between first-trimester surgical or non-surgical termination of pregnancy and the risk of preterm birth in the subsequent pregnancy. However, no study has evaluated the association between second- or third-trimester non-surgical termination of pregnancy due to foetal disease and the risk of preterm birth in the subsequent pregnancy. A small number of studies have included a small proportion of patients who previously underwent non-surgical termination of pregnancy after 14 weeks of gestation and later experienced first-trimester termination during their second pregnancy. These studies focussed on the impact of the interpregnancy interval or pharmacological induction of labour on the risk of preterm delivery in the subsequent pregnancy.What did the results of this study add? This is the first study to specifically evaluate the association between second- and third-trimester non-surgical terminations of pregnancy and the risk of preterm birth in the subsequent pregnancy. When compared with term birth, nonsurgical termination of pregnancy was associated with the risk of spontaneous preterm birth and hospitalisation in the neonatal intensive care unit in the subsequent pregnancy.What are the implications of these findings for clinical practice and further research? Further studies are required to confirm our results, but information delivered to patients with a late termination of pregnancy and during their pregnancy follow-up for the subsequent pregnancy could be modified to provide this information.
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Affiliation(s)
- Jean-Daniel Hini
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.,Sorbonne Université, Paris, France
| | - Gilles Kayem
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.,Sorbonne Université, Paris, France
| | - Thibaud Quibel
- Department of Obstetrics and Gynecology, Poissy-Saint Germain en Laye Hospital Center, Poissy, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint Germain en Laye Hospital Center, Poissy, France
| | | | - Pierre Delorme
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.,Sorbonne Université, Paris, France
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12
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Hernández MH, Dos Santos E, Rodriguez Y, Priou C, Berveiller P, Vialard F, Dieudonné MN. Influence of maternal obesity on human trophoblast differentiation: The role of mitochondrial status. Reprod Biol 2022; 22:100650. [DOI: 10.1016/j.repbio.2022.100650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
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13
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Garabedian C, Plurien A, Benoit L, Kyheng M, Thuillier C, Sanchez M, Turcsak A, Rozenberg P, Berveiller P. Is sonographic measurement of head-perineum distance useful to predict obstetrical anal sphincter injury in case of vacuum delivery? Int J Gynaecol Obstet 2022; 159:751-756. [PMID: 35262188 DOI: 10.1002/ijgo.14170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/17/2022] [Accepted: 03/01/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Determine if head-perineum distance (HPD) measurement before vacuum extraction (VE) was predictive of an obstetric anal sphincter injury (OASIS) occurrence. METHODS Retrospective, bicentric (Lille and Poissy, France) cohort study conducted from January 2019 to June 2020. All VE in singleton pregnancies of ≥34 weeks were included. HPD measurement was performed without compression of the tissues before each VE. The judgment criterion was the occurrence of an OASIS. RESULTS Of 12 568 deliveries, VE was performed in 1093 (8.6%). Among these 1093 women undergoing VE, 675 (61.7%) with HPD measurement were included. OASIS was found in 6.5% of women (n = 44; 95% CI 4.5-8.7). HPD was not associated with OASIS (38.5 ± 12.6 mm in women with OASIS vs 37.4 ± 12.0 mm in women without; adjusted OR [aOR] per 5 mm increase = 0.92; 95% CI 0.79-1.06). Increased HPD was associated with higher risk of sequential extraction (aOR = 1.19; 95% CI 1.06-1.32), extraction duration >10 min (aOR = 1.12; 95% CI 1.02-1.23) and shoulder dystocia (aOR = 1.20; 95% CI 1.03-1.40). CONCLUSION Ultrasound-measured head-perineum distance does not predict the occurrence of obstetric anal sphincter injury during a VE. The interest of HPD is more about predicting the success or difficulty of VE rather its specific complications.
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Affiliation(s)
- Charles Garabedian
- Department of Obstetrics, CHU Lille, Lille, France.,ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, University of Lille, Lille, France
| | - Alix Plurien
- Department of Obstetrics, CHU Lille, Lille, France.,ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, University of Lille, Lille, France
| | - Laure Benoit
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France
| | - Maeva Kyheng
- ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, University of Lille, Lille, France.,Department of Biostatistics, CHU Lille, Lille, France
| | - Claire Thuillier
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France
| | | | | | - Patrick Rozenberg
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France
| | - Paul Berveiller
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France.,UMR 1198 - BREED, INRAE, Paris Saclay University, RHuMA, Montigny-Le-Bretonneux, France
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14
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Plurien A, Berveiller P, Drumez E, Hanssens S, Subtil D, Garabedian C. Ultrasound assessment of fetal head position and station before operative delivery: can it predict difficulty? J Gynecol Obstet Hum Reprod 2022; 51:102336. [DOI: 10.1016/j.jogoh.2022.102336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/29/2022]
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15
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Bonnet MP, Garnier M, Keita H, Compere V, Arthuis C, Raia-Barjat T, Berveiller P, Burey J, Bouvet L, Bruyère M, Castel A, Clouqueur E, Estevez MG, Faitot V, Fischer C, Fuchs F, Lecarpentier E, Le Gouez A, Rigouzzo A, Rossignol M, Simon E, Vial F, Vivanti AJ, Zieleskewicz L, Sénat MV, Schmitz T, Sentilhes L. [Reprint of: Severe pre-eclampsia: guidelines for clinical practice from the French Society of anesthesiology and intensive care (SFAR) and the French College of gynaecologists and obstetricians (CNGOF)]. ACTA ACUST UNITED AC 2021; 50:2-25. [PMID: 34781016 DOI: 10.1016/j.gofs.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To provide national guidelines for the management of women with severe preeclampsia. DESIGN A consensus committee of 26 experts was formed. A formal conflict of interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized. METHODS The last SFAR and CNGOF guidelines on the management of women with severe preeclampsia was published in 2009. The literature is now sufficient for an update. The aim of this expert panel guidelines is to evaluate the impact of different aspects of the management of women with severe preeclampsia on maternal and neonatal morbidities separately. The experts studied questions within 7 domains. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analyzed according to the GRADE® methodology. RESULTS The SFAR/CNGOF experts panel provided 25 recommendations: 8 have a high level of evidence (GRADE 1±), 9 have a moderate level of evidence (GRADE 2±), and for 7 recommendations, the GRADE method could not be applied, resulting in expert opinions. No recommendation was provided for 3 questions. After one scoring round, strong agreement was reached between the experts for all the recommendations. CONCLUSIONS There was strong agreement among experts who made 25 recommendations to improve practices for the management of women with severe preeclampsia.
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Affiliation(s)
- M-P Bonnet
- Sorbonne Université, GRC 29, DMU DREAM, Department of Anaesthesiology and Intensive Care, Armand Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Centre de Recherche épidémiologie et Statistiques Sorbonne Paris Cité (CRESS) U1153, INSERM, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé) Research Team, Université de Paris, Paris, France.
| | - M Garnier
- Sorbonne Université, APHP, GRC 29, DMU DREAM, Département d'Anesthesie-réanimation, CHU Tenon, Paris, France
| | - H Keita
- Département d'anesthésie-réanimation pédiatrique et obstétricale, hôpital Necker-Enfants malades, université de Paris, AP-HP, Paris, France
| | - V Compere
- Département d'anesthésie-réanimation, CHU de Rouen, Rouen, France
| | - C Arthuis
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nantes, hôpital Mère-Enfant, Nantes, France
| | - T Raia-Barjat
- Inserm, U 1059 SainBioSE, département de gynécologie, obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42023 Saint-Étienne, France
| | - P Berveiller
- Service de gynécologie-obstétrique, école nationale vétérinaire d'Alfort, CHI Poissy Saint-Germain, UVSQ, INRAE, BREED, Jouy-en-Josas, BREED, Poissy université Paris-Saclay, Maisons-Alfort, France
| | - J Burey
- Service d'anesthésie-réanimation chirurgicale, hôpital Tenon, AP-HP, Paris, France
| | - L Bouvet
- Service d'anesthésie-réanimation, groupement hospitalier Est, hospices civils de Lyon, Bron, Claude-Bernard Lyon 1, hôpital Femme Mère-Enfant, université de Lyon, Villeurbanne, France
| | - M Bruyère
- Service d'anesthésie-réanimation médecine périopératoire, hôpital Bicêtre, AP-HP, université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - A Castel
- Département d'anesthésie-réanimation, hôpital Paule-de-Viguier, Toulouse, France
| | - E Clouqueur
- Service de gynécologie-obstétrique, centre hospitalier de Tourcoing, Tourcoing, France
| | - M Gonzalez Estevez
- Service d'anesthésie-réanimation et de médecine périopératoire, hôpital Jeanne-de-Flandre, CHU de Lille, Lille, France
| | - V Faitot
- Département d'anesthésie-réanimation, hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, France
| | - C Fischer
- Département d'anesthésie-réanimation chirurgicale, hôpital Cochin, Paris, France
| | - F Fuchs
- UMR Inserm, service de gynécologie-obstétrique, institut Desbrest d'épidémiologie et de santé publique (IDESP), IURC, CHU de Montpellier, hôpital Arnaud-de-Villeneuve, université de Montpellier, Campus Santé, Montpellier, France
| | - E Lecarpentier
- Inserm U955, département de gynécologie-obstétrique et médecine de la reproduction, CHIC de Créteil, institut biomédical Henri-Mondor, université Paris Est Créteil, Créteil, France
| | - A Le Gouez
- Département d'anesthésie-réanimation, hôpital Antoine-Béclère, AP-HP, Clamart, France
| | - A Rigouzzo
- Service d'anesthésie-réanimation chirurgicale, hôpital Armand Trousseau, AP-HP, Paris, France
| | - M Rossignol
- Département d'anesthésie-réanimation et SMUR, hôpital Lariboisière, AP-HP, université de Paris, Paris, France
| | - E Simon
- Pôle de gynécologie-obstétrique et biologie de la reproduction, CHU de Dijon-Bourgogne, UFR Sciences de santé Dijon, université de Bourgogne, Bourgogne, France
| | - F Vial
- Service d'anesthésie-réanimation, maternité régionale universitaire-CHRU de Nancy, Nancy, France
| | - A J Vivanti
- Université Paris Saclay, service de gynécologie-obstétrique, hôpital Antoine Béclère, AP-HP, Paris, France
| | - L Zieleskewicz
- Inserm, INRA, département d'anesthésie-réanimation, centre de recherche cardiovasculaire et de nutrition (C2VN), hôpital Nord, université d'Aix-Marseille, université Aix-Marseille, Marseille, France
| | - M-V Sénat
- Inserm, service de gynécologie-obstétrique, UVSQ, CESP, hôpital Bicêtre, université Paris-Saclay, AP-HP, Villejuif, France
| | - T Schmitz
- Inserm, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), service de gynécologie-obstétrique, centre de recherche épidémiologie et statistique Sorbonne Paris Cité (CRESS), hôpital Robert-Debré, université de Paris, AP-HP, 75004 Paris, France
| | - L Sentilhes
- Service de gynécologie-obstétrique, maternité Aliénor d'Aquitaine, CHU de Bordeaux, Bordeaux, France
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Bonnet MP, Garnier M, Keita H, Compère V, Arthuis C, Raia-Barjat T, Berveiller P, Burey J, Bouvet L, Bruyère M, Castel A, Clouqueur E, Gonzalez Estevez M, Faitot V, Fischer C, Fuchs F, Lecarpentier E, Le Gouez A, Rigouzzo A, Rossignol M, Simon E, Vial F, Vivanti AJ, Zieleskiewicz L, Sénat MV, Schmitz T, Sentilhes L. [Reprint of: Severe pre-eclampsia: guidelines for clinical practice from the French Society of Anesthesiology and Intensive Care (SFAR) and the French College of Gynaecologists and Obstetricians (CNGOF)]. Gynecol Obstet Fertil Senol 2021:S2468-7189(21)00246-4. [PMID: 34772654 DOI: 10.1016/j.gofs.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Marie-Pierre Bonnet
- Sorbonne Université, GRC 29, DMU DREAM, Department of Anaesthesiology and Intensive Care, Armand Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Centre de Recherche épidémiologie et Statistiques Sorbonne Paris Cité (CRESS) U1153, INSERM, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé) Research Team, Université de Paris, Paris, France.
| | - Marc Garnier
- Sorbonne Université, APHP, GRC 29, DMU DREAM, Department of Anesthesiology and Critical Care Medicine, Tenon University Hospital, Paris, France
| | - Hawa Keita
- Université de Paris, Department of Anaesthesiology and Intensive Care, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Vincent Compère
- Department of Anaesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Chloé Arthuis
- Department of Obstetrics and Gynaecology, Nantes University Hospital, Mother and Child Hospital, Nantes, France
| | - Tiphaine Raia-Barjat
- Department of Gynaecology, Obstetrics, and Reproductive Medicine, Saint Etienne University Hospital, Université de Saint Etienne Jean Monnet, INSERM, U 1059 SainBioSE, F-42023 Saint Etienne, France
| | - Paul Berveiller
- Department of Obstetrics and Gynaecology - Poissy Saint-Germain Hospital, Poissy, France; Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, Maison-Alfort, France
| | - Julien Burey
- Sorbonne Université, APHP, GRC 29, DMU DREAM, Department of Anesthesiology and Critical Care Medicine, Tenon University Hospital, Paris, France
| | - Lionel Bouvet
- Department of Anaesthesiology and Intensive Care, Mother and Child Hospital, Hospices Civils de Lyon, Bron, France; Université de Lyon, Claude Bernard Lyon 1, Villeurbanne, France
| | - Marie Bruyère
- Department of Anaesthesiology, Intensive Care and Perioperative Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Le Kremlin- Bicêtre, France
| | - Adeline Castel
- Department of Anaesthesiology and Intensive Care, Paule de Viguier University Hospital, Toulouse, France
| | - Elodie Clouqueur
- Department of Obstetrics and Gynaecology, Tourcoing Hospital, France
| | - Max Gonzalez Estevez
- Department of Anaesthesiology, Intensive Care and Perioperative Medicine, Jeanne de Flandre Maternity Hospital, Lille University Hospital, Lille, France
| | - Valentina Faitot
- Department of Anaesthesiology and Intensive Care, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - Catherine Fischer
- Department of Anaesthesiology and Intensive Care, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florent Fuchs
- Department of Obstetrics and Gynaecology, Montpellier University Hospital, Arnaud de Villeneuve Hospital, Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP), UMR INSERM - Université de Montpellier, Campus Santé, IURC, Montpellier, France
| | - Edouard Lecarpentier
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Université de Paris Est Créteil, CHIC of Créteil, Créteil, France; INSERM U955 Institut Biomédical Henri Mondor, Créteil, France
| | - Agnès Le Gouez
- Department of Anaesthesiology and Intensive Care, Antoine Béclère Hospital, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Agnès Rigouzzo
- Sorbonne Université, GRC 29, DMU DREAM, Department of Anaesthesiology and Intensive Care, Armand Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mathias Rossignol
- Department of Anaesthesiology and Intensive Care and SMUR, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Emmanuel Simon
- Department of Gynaecology, Obstetrics and Reproductive Biology, Dijon Bourgogne University Hospital, France; UFR Sciences de santé Dijon, Université de Bourgogne, France
| | - Florence Vial
- Department of Anaesthesiology and Intensive Care, Nancy University Hospital, Nancy, France
| | - Alexandre J Vivanti
- Division of Obstetrics and Gynaecology, Antoine Béclère University Hospital, Université de Paris Saclay, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laurent Zieleskiewicz
- Department of Anaesthesiology and Intensive Care, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Université de Aix Marseille, France; Centre for Cardiovascular and Nutrition Research (C2VN), INSERM, INRA, Université de Aix Marseille, Marseille, France
| | - Marie-Victoire Sénat
- Department of Gynaecology and Obstetrics, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, University de Paris-Saclay, UVSQ, CESP, INSERM, Villejuif, France
| | - Thomas Schmitz
- Centre de Recherche épidémiologie et Statistiques Sorbonne Paris Cité (CRESS) U1153, INSERM, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé) Research Team, Université de Paris, Paris, France; Department of Gynaecology and Obstetrics, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Aliénor d'Aquitaine Maternity Hospital, Bordeaux University Hospital, Bordeaux, France
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Bonnet MP, Garnier M, Keita H, Compère V, Arthuis C, Raia-Barjat T, Berveiller P, Burey J, Bouvet L, Bruyère M, Castel A, Clouqueur E, Gonzalez Estevez M, Faitot V, Fischer C, Fuchs F, Lecarpentier E, Le Gouez A, Rigouzzo A, Rossignol M, Simon E, Vial F, Vivanti AJ, Zieleskiewicz L, Camilleri C, Sénat MV, Schmitz T, Sentilhes L. Guidelines for the management of women with severe pre-eclampsia. Anaesth Crit Care Pain Med 2021; 40:100901. [PMID: 34602381 DOI: 10.1016/j.accpm.2021.100901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To provide national guidelines for the management of women with severe pre-eclampsia. DESIGN A consensus committee of 26 experts was formed. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. METHODS The last SFAR and CNGOF guidelines on the management of women with severe pre-eclampsia were published in 2009. The literature is now sufficient for an update. The aim of this expert panel guidelines is to evaluate the impact of different aspects of the management of women with severe preeclampsia on maternal and neonatal morbidities separately. The experts studied questions within 7 domains. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analysed according to the GRADE® methodology. RESULTS The SFAR/CNGOF experts panel provided 25 recommendations: 8 have a high level of evidence (GRADE 1+/-), 9 have a moderate level of evidence (GRADE 2+/-), and for 7 recommendations, the GRADE method could not be applied, resulting in expert opinions. No recommendation was provided for 3 questions. After one scoring round, strong agreement was reached between the experts for all the recommendations. CONCLUSIONS There was strong agreement among experts who made 25 recommendations to improve practices for the management of women with severe pre-eclampsia.
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Affiliation(s)
- Marie-Pierre Bonnet
- Sorbonne Université, GRC 29, DMU DREAM, Department of Anaesthesiology and Intensive Care, Armand Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Centre de Recherche Épidémiologie et Statistiques Sorbonne Paris Cité (CRESS) U1153, INSERM, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé) Research Team, Université de Paris, Paris, France.
| | - Marc Garnier
- Sorbonne Université, APHP, GRC 29, DMU DREAM, Department of Anesthesiology and Critical Care Medicine, Tenon University Hospital, Paris, France
| | - Hawa Keita
- Université de Paris, Department of Anaesthesiology and Intensive Care, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Vincent Compère
- Department of Anaesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Chloé Arthuis
- Department of Obstetrics and Gynaecology, Nantes University Hospital, Mother and Child Hospital, Nantes, France
| | - Tiphaine Raia-Barjat
- Department of Gynaecology, Obstetrics, and Reproductive Medicine, Saint Etienne University Hospital, Université de Saint Etienne Jean Monnet, INSERM, U 1059 SainBioSE, F-42023 Saint Etienne, France
| | - Paul Berveiller
- Department of Obstetrics and Gynaecology - Poissy Saint-Germain Hospital, Poissy, France; Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, Maison-Alfort, France
| | - Julien Burey
- Sorbonne Université, APHP, GRC 29, DMU DREAM, Department of Anesthesiology and Critical Care Medicine, Tenon University Hospital, Paris, France
| | - Lionel Bouvet
- Department of Anaesthesiology and Intensive Care, Mother and Child Hospital, Hospices Civils de Lyon, Bron, France; Université de Lyon, Claude Bernard Lyon 1, Villeurbanne, France
| | - Marie Bruyère
- Department of Anaesthesiology, Intensive Care and Perioperative Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Le Kremlin- Bicêtre, France
| | - Adeline Castel
- Department of Anaesthesiology and Intensive Care, Paule de Viguier University Hospital, Toulouse, France
| | - Elodie Clouqueur
- Department of Obstetrics and Gynaecology, Tourcoing Hospital, France
| | - Max Gonzalez Estevez
- Department of Anaesthesiology, Intensive Care and Perioperative Medicine, Jeanne de Flandre Maternity Hospital, Lille University Hospital, Lille, France
| | - Valentina Faitot
- Department of Anaesthesiology and Intensive Care, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - Catherine Fischer
- Department of Anaesthesiology and Intensive Care, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florent Fuchs
- Department of Obstetrics and Gynaecology, Montpellier University Hospital, Arnaud de Villeneuve Hospital, Montpellier, France; Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP), UMR INSERM - Université de Montpellier, Campus Santé, IURC, Montpellier, France
| | - Edouard Lecarpentier
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Université de Paris Est Créteil, CHIC of Créteil, Créteil, France; INSERM U955 Institut Biomédical Henri Mondor, Créteil, France
| | - Agnès Le Gouez
- Department of Anaesthesiology and Intensive Care, Antoine Béclère Hospital, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Agnès Rigouzzo
- Sorbonne Université, GRC 29, DMU DREAM, Department of Anaesthesiology and Intensive Care, Armand Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mathias Rossignol
- Department of Anaesthesiology and Intensive Care and SMUR, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Emmanuel Simon
- Department of Gynaecology, Obstetrics and Reproductive Biology, Dijon Bourgogne University Hospital, France; UFR Sciences de santé Dijon, Université de Bourgogne, France
| | - Florence Vial
- Department of Anaesthesiology and Intensive Care, Nancy University Hospital, Nancy, France
| | - Alexandre J Vivanti
- Division of Obstetrics and Gynaecology, Antoine Béclère University Hospital, Université de Paris Saclay, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laurent Zieleskiewicz
- Department of Anaesthesiology and Intensive Care, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Université de Aix Marseille, France; Centre for Cardiovascular and Nutrition Research (C2VN), INSERM, INRA, Université de Aix Marseille, Marseille, France
| | - Céline Camilleri
- "Grossesse et Santé, Contre la Prééclampsie" Association, Paris, France
| | - Marie-Victoire Sénat
- Department of Gynaecology and Obstetrics, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, University de Paris-Saclay, UVSQ, CESP, INSERM, Villejuif, France
| | - Thomas Schmitz
- Centre de Recherche Épidémiologie et Statistiques Sorbonne Paris Cité (CRESS) U1153, INSERM, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé) Research Team, Université de Paris, Paris, France; Department of Gynaecology and Obstetrics, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Aliénor d'Aquitaine Maternity Hospital, Bordeaux University Hospital, Bordeaux, France
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Hernandez MH, Priou C, Santos ED, Berveiller P, Vialard F. Maternal obesity disrupts biochemical trophoblast differentiation. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pauchet M, Berveiller P, Garabedian C. [How I do… an evaluation of the proper placement and effectiveness of an intrauterine tamponade balloon for postpartum hemorrhage?]. Gynecol Obstet Fertil Senol 2021; 49:703-705. [PMID: 33515848 DOI: 10.1016/j.gofs.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Indexed: 06/12/2023]
Affiliation(s)
- M Pauchet
- CHU Lille, Hôpital Jeanne de Flandres, Département Obstétrique, Avenue Eugène Avinée, 59000 Lille, France; University Lille, ULR 2994-METRICS, 59000 Lille, France
| | - P Berveiller
- Département de Gynécologie et d'Obstétrique, Centre Hospitalier Intercommunal de Poissy, Saint-Germain, France; INRAE, Université de Paris-Saclay, UMR 1198-BREED, RHuMA, Montigny-Le-Bretonneux, France
| | - C Garabedian
- CHU Lille, Hôpital Jeanne de Flandres, Département Obstétrique, Avenue Eugène Avinée, 59000 Lille, France; University Lille, ULR 2994-METRICS, 59000 Lille, France.
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Jourdren G, Berveiller P, Rousseau A. Practices for RhD alloimmunization prevention: a vignette-based survey of midwives. J Matern Fetal Neonatal Med 2021; 35:7629-7639. [PMID: 34433367 DOI: 10.1080/14767058.2021.1957822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Despite the availability guidelines to prevent RhD alloimmunization, severe hemolytic disease of fetus and newborn still occurs in high-income countries. The aim of the study was (1) To assess variations in practices for the prevention of RhD alloimmunization, and (2) to understand midwives' acceptance and appropriation of fetal RhD genotyping. METHODS Descriptive cross-sectional survey of French midwives from September 2017 through January 2018. Participants were asked to complete an internet-based questionnaire that included three clinical vignettes. They were questioned about their practices concerning early pregnancy visit by RhD-negative women, prevention of RhD alloimmunization in women with second-trimester metrorrhagia, and RhD fetal genotyping. RESULTS A total of 827 midwives completed the questionnaire. Only 21.1% reported that they practice all the preventive measures recommended in early pregnancy. In a situation at high risk of RhD alloimmunization during pregnancy, 97.2% of midwives would perform immunoprophylaxis. Nearly, all midwives reported providing information about RhD alloimmunization (92.4%) at the beginning of pregnancy, although only 11.3% offered both written and verbal information; at the time of systematic anti-D immunoprophylaxis (28 weeks), 78% provided information, but only 2.7% both verbally and in writing. Finally, only 50.8% of midwives preferred to include RhD fetal genotyping in routine prenatal prophylaxis. DISCUSSION This study showed significant variations in French midwives' practices to prevent RhD alloimmunization. Better dissemination of guidelines is needed to improve both consistent use of these practices and the quality of information delivered to RhD-negative pregnant women.
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Affiliation(s)
- Guenola Jourdren
- Midwifery Department, Versailles Saint Quentin University, Paris-Saclay University, Montigny-le-Bretonneux, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint-Germain en Laye Hospital, Poissy, France.,INRAE, Paris Saclay University, UMR 1198 - BREED, RHuMA, Montigny-Le-Bretonneux, France
| | - Anne Rousseau
- Midwifery Department, Versailles Saint Quentin University, Paris-Saclay University, Montigny-le-Bretonneux, France.,Department of Obstetrics and Gynecology, Poissy-Saint-Germain en Laye Hospital, Poissy, France.,Paris-Saclay University, UVSQ, CESP, Equipe Epidémiologie clinique, Montigny-le-Bretonneux, France
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Gilbert M, Ghesquiere L, Drumez E, Subtil D, Fague V, Berveiller P, Garabedian C. How to reduce fetal scalp blood sampling? A retrospective study evaluating the diagnostic value of scalp stimulation to predict fetal wellbeing assessed by scalp blood sampling. Eur J Obstet Gynecol Reprod Biol 2021; 263:153-158. [PMID: 34216939 DOI: 10.1016/j.ejogrb.2021.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Fetal Blood Sample (FBS) is used as an indicator of fetal acidosis during labor. Its place is discussed through the lack of randomized trials, as well as the limitations related to the technical procedure. An alternative could be the Fetal Scalp Stimulation (FSS). AIM Our objective was to describe the FSS diagnostic value to predict fetal wellbeing defined from FBS. METHODS The FSS consisted in a digital scalp stimulation for 15 s. Test was negative when an acceleration and/or a normal variability were elicited in the 2 min following. FSS was performed before each FBS which was classified as normal when pH was > 7.25. The diagnostic value was assessed by sensibility, specificity, positive and negative predictive values. FINDINGS 148 women were included in our center from February to December 2019. Of the 191 FBS procedures, when accelerations were elicited sensibility was 58,3 (36.8-77.1), specificity was 67,5 (59.3-75), positive predictive value was 20,9 (12.5-32.9) and negative predictive value was 91.7 % (95 %CI, 85-95.5). DISCUSSION FBS is considered as the gold standard in our study which could be discussed as it is abandoned in some countries because of its questioned reliability and the lack of controlled randomized trials. CONCLUSION This study suggests that FSS could be an interesting alternative adjunctive test to perform in the first instance as it seems to be reliable, non-invasive and easy to perform in order to limit FBS only to absence of acceleration after FSS.
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Affiliation(s)
- M Gilbert
- CHU Lille, Department of Obstetrics, F-59000, Lille, France.
| | - L Ghesquiere
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - E Drumez
- Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France; CHU Lille, Department of Biostatistics, F-59000, Lille, France
| | - D Subtil
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - V Fague
- CH Valenciennes, Department of Obstetrics, F-59300, Valenciennes, France
| | - P Berveiller
- CH Poissy, Department of Obstetrics, F-78300, Poissy, France
| | - C Garabedian
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
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Grandjean GA, Bertholdt C, Zuily S, Fauvel M, Hossu G, Berveiller P, Morel O. Fetal biometry in ultrasound: A new approach to assess the long-term impact of simulation on learning patterns. J Gynecol Obstet Hum Reprod 2021; 50:102135. [PMID: 33798748 DOI: 10.1016/j.jogoh.2021.102135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/18/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Simulation-based education (SBE) has demonstrated its acceptability and effectiveness in improving ultrasound training. Because of the high cost of its implementation (investment in equipment and supervision), a pragmatic assessment of the transfer of skills learned in SBE to clinical practice and the identification of its optimal scheduling conditions have been requested to optimize its input. OBJECTIVES To quantify the long-term impact of simulation-based education (SBE) on the adequate performance of ultrasound fetal biometry measurements (I). The secondary objective was to identify the temporal patterns that enhanced SBE input in learning (II). METHODS Trainees were arbitrarily assigned to a 6-month course in obstetric ultrasound with or without an SBE workshop. In the SBE group, the workshop was implemented 'before' or at an 'early' or a 'late-stage' of the course. Those who did not receive SBE were the control group. The ultrasound skills of all trainees were prospectively collected, evaluated by calculating the delta between OSAUS (Objective Structured Assessment of Ultrasound Skills) scores before and after the course (I). Concomitantly, the accuracy of trainees' measurements was assessed throughout the course by verifying their correlation with the corresponding measurements by their supervisors. The percentage of trainees able to perform five consecutive sets of correct measurements in the control group and in each SBE subgroup were compared (II). RESULTS The study included 61 trainees (39 SBE and 22 controls). Comparisons between groups showed no significant difference in the quantitative assessment of skill enhancement (difference in the pre- and post-internship OSAUS score: 1.09 ± 0.87 in the SBE group and 0.72 ± 0.98 in the control group) (I). Conversely, the predefined acceptable skill level was reached by a significantly higher proportion of trainees in the 'early' SBE subgroup (74%, compared with 30% in the control group, P<0.01)(II). CONCLUSIONS The quantitative assessment does not support the existence of long-term benefits from SBE training, although the qualitative assessment confirmed SBE helped to raise the minimal level within a group when embedded in an 'early' stage of a practical course.
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Affiliation(s)
- G Ambroise Grandjean
- Université de Lorraine, IADI - INSERM, F-54000 Nancy, France; Department of Obstetrics and Gynecology, CHRU Nancy, F-54000 Nancy, France; Midwifery Department, Université de Lorraine, Nancy F-54000, France.
| | - C Bertholdt
- Université de Lorraine, IADI - INSERM, F-54000 Nancy, France; Department of Obstetrics and Gynecology, CHRU Nancy, F-54000 Nancy, France
| | - S Zuily
- Université de Lorraine, Hôpital virtuel de Lorraine, Nancy F-54000, France
| | - M Fauvel
- CHRU Nancy, Université de Lorraine, CIC-IT, F-54000 Nancy, France
| | - G Hossu
- CHRU Nancy, Université de Lorraine, CIC-IT, F-54000 Nancy, France
| | - P Berveiller
- Department of Obstetrics and Gynecology, CHI Poissy Saint-Germain-en-Laye, F-78300 Poissy, France; Université Versailles Saint-Quentin, EA 7404 - GIG, F-78180 Montigny le Bretonneux, France
| | - O Morel
- Université de Lorraine, IADI - INSERM, F-54000 Nancy, France; Department of Obstetrics and Gynecology, CHRU Nancy, F-54000 Nancy, France
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Nogues P, Dos Santos E, Couturier-Tarrade A, Berveiller P, Arnould L, Lamy E, Grassin-Delyle S, Vialard F, Dieudonne MN. Maternal Obesity Influences Placental Nutrient Transport, Inflammatory Status, and Morphology in Human Term Placenta. J Clin Endocrinol Metab 2021; 106:e1880-e1896. [PMID: 32936881 DOI: 10.1210/clinem/dgaa660] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/15/2020] [Indexed: 01/04/2023]
Abstract
CONTEXT Maternal obesity has a significant impact on placental development. However, this impact on the placenta's structure and function (ie, nutrient transport and hormone and cytokine production) is a controversial subject. OBJECTIVE We hypothesized that maternal obesity is associated with morphologic, secretory, and nutrient-related changes and elevated levels of inflammation in the placenta. DESIGN We collected samples of placental tissue from 2 well-defined groups of pregnant women from 2017 to 2019. We compared the 2 groups regarding placental cytokine and hormone secretion, immune cell content, morphology, and placental nutrient transporter expressions. SETTING Placenta were collected after caesarean section performed by experienced clinicians at Centre Hospitalier Intercommunal (CHI) of Poissy-Saint-Germain-en-Laye. PATIENTS The main inclusion criteria were an age between 27 and 37 years old, no complications of pregnancy, and a first-trimester body mass index of 18-25 kg/m2 for the nonobese (control) group and 30-40 kg/m2 for the obese group. RESULTS In contrast to our starting hypothesis, we observed that maternal obesity was associated with (1) lower placental IL-6 expression and macrophage/leukocyte infiltration, (2) lower placental expression of GLUT1 and SNAT1-2, (3) a lower placental vessel density, and (4) lower levels of placental leptin and human chorionic gonadotropin production. CONCLUSION These results suggest that the placenta is a plastic organ and could optimize fetal growth. A better understanding of placental adaptation is required because these changes may partly determine the fetal outcome in cases of maternal obesity.
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Affiliation(s)
- Perrine Nogues
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Esther Dos Santos
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
- Service de Biologie Médicale, Centre Hospitalier Intercommunal de Poissy-Saint-Germain, Poissy, France
| | - Anne Couturier-Tarrade
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Paul Berveiller
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
- Service de Gynécologie-Obstétrique, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Lucie Arnould
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
| | - Elodie Lamy
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation, Département de Biotechnologie de la Santé, Montigny le Bretonneux, France
| | - Stanislas Grassin-Delyle
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation, Département de Biotechnologie de la Santé, Montigny le Bretonneux, France
- Hôpital Foch, Département des maladies des voies respiratoires, Suresnes, France
| | - François Vialard
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
- Département de Biologie de la Reproduction, Cytogénétique, Gynécologie et Obstétrique, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Marie-Noëlle Dieudonne
- Université Paris-Saclay, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d'Alfort, BREED, Maisons-Alfort, France
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Benoit L, Mir O, Vialard F, Berveiller P. Cancer during Pregnancy: A Review of Preclinical and Clinical Transplacental Transfer of Anticancer Agents. Cancers (Basel) 2021; 13:1238. [PMID: 33799824 PMCID: PMC8000411 DOI: 10.3390/cancers13061238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/19/2021] [Accepted: 03/01/2021] [Indexed: 12/27/2022] Open
Abstract
The occurrence of cancer during pregnancy is observed in 1 in 1000 pregnancies and is expected to increase given the trend of delaying childbearing. While breast cancer is the most common, the incidence of other cancers, such as cervical, ovarian, and lung cancers as well as hemopathies and melanomas, is also increasing. Thus, cancer occurrence in pregnant women raises questions of management during pregnancy and, especially, assessment of the treatment benefit-risk ratio to ensure optimal management for the mother while ensuring the safety of the fetus. Chemotherapy remains a cornerstone of cancer management. If the use of anticancer agents appears possible during pregnancy, while avoiding the first trimester, the extent of placental transfer of different anticancer agents varies considerably thereafter. Furthermore, the significant physiological pharmacokinetic variations observed in pregnant women may have an impact on the placental transfer of anticancer agents. Given the complexity of predicting placental transfer of anticancer agents, preclinical studies are therefore mandatory. The aim of this review was to provide updated data on in vivo and ex vivo transplacental transfer of anticancer agents used in the management of the most common pregnancy-associated cancers to better manage these highly complex cases.
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Affiliation(s)
- Laure Benoit
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Department of Gynecology and Obstetrics, 78300 Poissy, France;
| | - Olivier Mir
- Department of Ambulatory Cancer Care, Gustave Roussy, 94800 Villejuif, France;
| | - François Vialard
- Université Paris-Saclay, UMR 1198, INRAE, BREED, RHuMA, 78350 Jouy-en-Josas, France;
- Ecole Nationale Vétérinaire d’Alfort, BREED, 94700 Maisons-Alfort, France
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Department of Genetics, 78300 Poissy, France
| | - Paul Berveiller
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Department of Gynecology and Obstetrics, 78300 Poissy, France;
- Université Paris-Saclay, UMR 1198, INRAE, BREED, RHuMA, 78350 Jouy-en-Josas, France;
- Ecole Nationale Vétérinaire d’Alfort, BREED, 94700 Maisons-Alfort, France
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Maggen C, Wolters V, Van Calsteren K, Cardonick E, Laenen A, Gziri MM, Fruscio R, Duvekot JJ, Painter R, Masturzo B, Shmakov R, Halaska M, Berveiller P, Verheecke M, de Haan J, Gordijn S, Heimovaara J, Amant F. 402 Impact of chemotherapy during pregnancy on neonatal birthweight. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2020.12.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ambroise Grandjean G, Berveiller P, Hossu G, Bertholdt C, Judlin P, Morel O. [Skills assessment for the practice of fetal ultrasound biometry: Prospective validation of the OSAUS METHOD score]. ACTA ACUST UNITED AC 2021; 49:275-281. [PMID: 33453459 DOI: 10.1016/j.gofs.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To develop and validate a customized variant for fetal biometry of the generic OSAUS score (Objective Structured Assessment of Ultrasound Skills) METHODS: The 5-points OSAUS METHOD grid was elaborated by defining five target skills specific to fetal biometry for each thematic item of the generic score. The level of skills of 43 trainees was prospectively assessed during an ultrasound examination by using this grid. The results of the "novice" level group (experience<10 ultrasounds) were compared to those of the "intermediate" level group (experience≥10 ultrasounds) (I). The reached/non-reached skills ratio within the different items composing the score allowed the identification of priority areas of improvement (II). Previously published distribution and actual distribution of ratings according to the generic pass/fail score were compared (III). RESULTS Median scores of "novices" (n=29) and "intermediates" (n=14) groups were statistically different, 1.87 (±0.75) and 3.31 (±0.83) (P=1.85-5), respectively and corresponded to the pre-existing experience (I). A lower ratio of reached skill allowed the identification of "documentation of the examination" item as a priority area of improvement for both groups (II). The relevance of the pass/fail score is consolidated, even if an overlap was observed between novices and intermediates groups (III). CONCLUSIONS The relevancy and feasibility of using OSAUS scoring method for fetal biometry are supported. In addition, the possibility of comparisons with generic OSAUS remains.
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Affiliation(s)
- G Ambroise Grandjean
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, Université de Lorraine, IADI, rue du Morvan, 54000 Vandoeuvre-les-Nancy, France; Département universitaire de Maïeutique, université de Lorraine, 54000 Nancy, France.
| | - P Berveiller
- Département d'Obstétrique, CHI de Poissy Saint-Germain-en-Laye, 78300 Poissy, France; Université Versailles Saint-Quentin, 78180 Montigny-le-Bretonneux, France
| | - G Hossu
- Inserm, CHRU de Nancy, université de Lorraine, CIC, 54000 Nancy, France
| | - C Bertholdt
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, Université de Lorraine, IADI, rue du Morvan, 54000 Vandoeuvre-les-Nancy, France
| | - P Judlin
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France
| | - O Morel
- Département d'Obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, Université de Lorraine, IADI, rue du Morvan, 54000 Vandoeuvre-les-Nancy, France
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Cheloufi M, Picard J, Hoffmann P, Bosson JL, Allenet B, Berveiller P, Albaladejo P. How to agree on what is fundamental to optimal teamwork performance in a situation of postpartum hemorrhage? A multidisciplinary Delphi French study to develop the Obstetric Team Performance Assessment Scale (OTPA Scale). Eur J Obstet Gynecol Reprod Biol 2020; 256:6-16. [PMID: 33161212 DOI: 10.1016/j.ejogrb.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The objective of this study was to develop a new interdisciplinary teamwork scale, the Obstetric Team Performance Assessment (OTPA), for the management of the post-partum hemorrhage, through consensus agreement of obstetric caregivers. The goal is to provide a reliable tool for teaching and evaluating teams in high-fidelity simulation. METHODS This prospective study is based on an expert consensus, using a Delphi method. The authors developed the "OTPA» specifically related to the management of post-partum hemorrhage, using existing recommendations. For the Delphi survey, the scale was distributed to a selected group of experts. After each round of Delphi, authors quantitatively analyzed each element of the scale, based on the percentages of agreement received, and reviewed each comment. This blind examination then led to the modification of the scale. The rounds were continued until 80-100 % agreement with a median overall response score equal to or greater than 8 was obtained for at least 60 % of items. Repeated 3 times, the process led to consensus and to a final version of the OTPA scale. RESULTS From February to October 2018, 16 of the 33 invited experts participated in four Delphi cycles. Of the 37 items selected in the first round, only 19 (51.3 %) had an agreement of 80-100% with a median overall response score equal to or greater than 8 in the second round, and a third round was conducted. During this third round, 24 of the 37 items were validated (64.9 %) and 82 of the 88 sub-items obtained 80 %-100 % agreement (93.2 %). The fourth round consisted of proposing a weighting of the different items. CONCLUSION Using a structured Delphi method, we provided a new interdisciplinary teamwork scale (OTPA), for the management of the post-partum hemorrhage. Thus, this scale will be able to be used during high-fidelity scenarii to assess performances of various teams facing a scenari of PPH. Moreover, this scale, focusing some crucial aspects of interdisciplinary teamwork will be useful for teaching purpose.
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Affiliation(s)
- Meryam Cheloufi
- Department of Obstetrics and Gynecology, Armand Trousseau Children's Hospital, AP-HP, Paris, France.
| | - Julien Picard
- Department of Anesthesia and Critical Care, Simulation Center, Grenoble Alps University Hospital, Grenoble, France; TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
| | - Pascale Hoffmann
- Department of Obstetrics and Gynecology, Armand Trousseau Children's Hospital, AP-HP, Paris, France
| | - Jean-Luc Bosson
- TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
| | - Benoit Allenet
- TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France
| | - Pierre Albaladejo
- Department of Anesthesia and Critical Care, Simulation Center, Grenoble Alps University Hospital, Grenoble, France; TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
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Deruelle P, Lelorain S, Deghilage S, Couturier E, Guilbert E, Berveiller P, Sénat MV, Vayssière C, Sentilhes L, Perrotin F, Gallot D, Chauleur C, Sananes N, Roth E, Luton D, Caputo M, Lorio E, Chatelet C, Couster J, Timbely O, Doret-Dion M, Duhamel A, Pigeyre M. Rationale and design of ePPOP-ID: a multicenter randomized controlled trial using an electronic-personalized program for obesity in pregnancy to improve delivery. BMC Pregnancy Childbirth 2020; 20:602. [PMID: 33028261 PMCID: PMC7542973 DOI: 10.1186/s12884-020-03288-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/27/2020] [Indexed: 11/29/2022] Open
Abstract
Background Pre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for adverse pregnancy, delivery and birth outcomes. Pregnancy is an ideal moment for nutritional interventions in order to establish healthier lifestyle behaviors in women at high risk of obstetric and neonatal complications. Methods Electronic-Personalized Program for Obesity during Pregnancy to Improve Delivery (ePPOP-ID) is an open multicenter randomized controlled trial which will assess the efficacy of an e-health web-based platform offering a personalized lifestyle program to obese pregnant women in order to reduce the rate of labor procedures and delivery interventions in comparison to standard care. A total of 860 eligible pregnant women will be recruited in 18 centers in France between 12 and 22 weeks of gestation, randomized into the intervention or the control arm and followed until 10 weeks of postpartum. The intervention is based on nutrition, eating behavior, physical activity, motivation and well-being advices in which personalization is central, as well as the use of a mobile/tablet application. Inputs includes data from the medical record of participants (medical history, anthropometric data), from the web platform (questionnaires on dietary habits, eating behavior, physical activity and motivation in both groups), and adherence to the program (time of connection for the intervention group only). Data are collected at inclusion, 32 weeks, delivery and 10 weeks postpartum. As primary outcome, we will use a composite endpoint score of obstetrical interventions during labor and delivery, defined as caesarean section and instrumental delivery (forceps and vacuum extractor). Secondary outcomes will consist of data routinely collected as part of usual antenatal and perinatal care, such as GWG, hypertension, preeclampsia, as well as fetal and neonatal outcomes including premature birth, gestational age at birth, birth weight, macrosomia, Apgar score, arterial umbilical cord pH, neonatal traumatism, hyperbilirubinemia, respiratory distress syndrome, transfer in neonatal intensive care unit, and neonatal adiposity. Post-natal outcomes will be duration of breastfeeding, maternal weight retention and child weight at postnatal visit. Discussion The findings of the ePPOP-ID trial will help design e-health intervention program for obese women in pregnancy. Trial registration ClinicalTrials.gov Identifier: NCT02924636 / October 5th 2016.
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Affiliation(s)
- Philippe Deruelle
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France. .,Pôle Gynécologie, Obstétrique et Fertilité, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg cedex, France.
| | - Sophie Lelorain
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Cognitive and Affective Sciences, Lille, France
| | - Sylvie Deghilage
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Emmanuelle Couturier
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Elodie Guilbert
- Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy Saint Germain hospital, Poissy, France
| | - Marie Victoire Sénat
- Assistance Publique-Hôpitaux de Paris, Department of Gynecology-Obstetrics, Bicêtre Hospital, University of Paris-Sud, University of Medicine Paris- Saclay Le Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Christophe Vayssière
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse, Toulouse, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Franck Perrotin
- Department of Gynecology and Obstetrics, Inserm U1253 « Imaging and Brain » (iBrain). CHU Bretonneau, Tours, France
| | - Denis Gallot
- Pôle Femme Et Enfant, CHU Estaing, Clermont-Ferrand cedex 1, France.,R2D2-EA7281, Université d'Auvergne, Faculté de Médecine, Place Henri Dunant, Clermont-Ferrand, France
| | - Céline Chauleur
- INSERM, SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, CIC1408, F- 42055, Saint-Etienne, France
| | - Nicolas Sananes
- Pôle Gynécologie, Obstétrique et Fertilité, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg cedex, France.,Maternal Fetal Medicine Department, INSERM 1121 "Biomaterials and Bioengineering", Strasbourg University Hospital, Strasbourg, France
| | - Emmanuel Roth
- Pôle Gynécologie, Obstétrique et Fertilité, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg cedex, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, AP-HP, Bichat hospital, Paris, France
| | - Marie Caputo
- Department of Obstetrics and Gynecology, Lens general hospital, Lens, France
| | - Elodie Lorio
- Department of Obstetrics and Gynecology, Valenciennes general hospital, Valenciennes, France
| | - Carla Chatelet
- Department of Obstetrics and Gynecology, Béthune general hospital, Béthune, France
| | - Julien Couster
- Department of Obstetrics and Gynecology, Boulogne general hospital, Boulogne, France
| | - Oumar Timbely
- Department of Obstetrics and Gynecology, Meaux general hospital, Meaux, France
| | - Muriel Doret-Dion
- Department of obstetrics and gynecology surgery, Femme mere enfant university hospital, hospices civils de Lyon, Bron, France
| | - Alain Duhamel
- Univ. Lille, CHU Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000, Lille, France
| | - Marie Pigeyre
- Department of medicine, endocrinology division, Mc Master university, Hamilton, Canada
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Plurien A, Berveiller P, Guerby P, Legendre G, Raimond E, Riethmuller D, Garabedian C. Ultrasound in delivery room: Does it have a place for the younger generation? J Gynecol Obstet Hum Reprod 2020; 49:101915. [PMID: 32949784 DOI: 10.1016/j.jogoh.2020.101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Alix Plurien
- CHU Lille, Department of Obstetrics, avenue Eugène Avinée, F59000, Lille, France; Academy of Excellence, French National College of Obstetricians and Gynecologists, France.
| | - Paul Berveiller
- Academy of Excellence, French National College of Obstetricians and Gynecologists, France; Poissy Saint Germain Intercity Hospital Center, Department of Obstetrics and Gynecology, 10 rue du Champ Gaillard, F78300, Poissy, France
| | - Paul Guerby
- Academy of Excellence, French National College of Obstetricians and Gynecologists, France; Toulouse University Hospital, Department of Obstetrics and Gynecology, 9 place Lange, F31059, Toulouse, France
| | - Guillaume Legendre
- Academy of Excellence, French National College of Obstetricians and Gynecologists, France; Angers University Hospital, Department of Obstetrics and Gynecology, 4 rue Larrey, F49933, Angers, France
| | - Emilie Raimond
- Academy of Excellence, French National College of Obstetricians and Gynecologists, France; Reims University Hospital, Alix de Champagne Maternity, Department of Obstetrics and Gynecology, 45 rue de Cognacq-Jay, F51092, Reims, France
| | - Didier Riethmuller
- Academy of Excellence, French National College of Obstetricians and Gynecologists, France; Besançon Regional University Hospital Center, Jean Minjoz Hospital, Department of Obstetrics and Gynecology, 3 boulevard Alexandre Fleming, F25030, Besançon, France
| | - Charles Garabedian
- CHU Lille, Department of Obstetrics, avenue Eugène Avinée, F59000, Lille, France; Academy of Excellence, French National College of Obstetricians and Gynecologists, France; Univ. Lille, ULR 2694 METRICS - Environnement perinatal et santé, F 59000 Lille, France
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Affiliation(s)
- Paul Guerby
- Department of Gynecology and Obstetrics, Paule de Viguier Hospital, CHU Toulouse, INSERM UMR 1048, I2MC, Université de Toulouse, Toulouse, France
| | - Charles Garabedian
- Department of Obstetrics, CHU Lille, University of Lille, ULR 2694-METRICS, Lille, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint-Germain Hospital, Poissy, France
| | - Guillaume Legendre
- Department of Gynecology & Obstetrics, Angers University Hospital (CHU d'Angers), Angers, France
| | - Gilles Grangé
- Department of Obstetrics, Port-Royal Maternity Unit, Paris, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ivan Berlin
- Département de Pharmacologie, Hôpital Pitié-Salpêtrière, Paris, France; and Centre Universitaire de Médecine Générale et Santé Publique, UNISANTE, Université de Lausanne, Switzerland
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Affiliation(s)
| | | | - Olivier Mir
- Gustave Roussy Cancer Institute, Villejuif, France
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Grangé G, Berlin I, Bretelle F, Bertholdt C, Berveiller P, Blanc J, DiGuisto C, Dochez V, Garabedian C, Guerby P, Koch A, Le Lous M, Perdriolle-Galet E, Peyronnet V, Rault E, Torchin H, Legendre G. [CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy-Short Text]. Gynecol Obstet Fertil Senol 2020; 48:539-545. [PMID: 32289497 DOI: 10.1016/j.gofs.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy. METHODS Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest). RESULTS "Counseling", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child's development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression. CONCLUSIONS Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.
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Affiliation(s)
- G Grangé
- Maternité Port-Royal, université de Paris, AP-HP, 75014 Paris, France.
| | - I Berlin
- Département de pharmacologie, AP-HP, 75000 Paris, France; Centre universitaire de médecine générale et de santé publique, 1000 Lausanne, Suisse
| | - F Bretelle
- Department of obstetrics and gynecology, conception hospital, Aix Marseille université, prenatal diagnosis Timone Conception, IHU, IRD, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - C Bertholdt
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France; IADI, Inserm U1254, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain-en-Laye, 78300 Poissy, France
| | - J Blanc
- Service de gynécologie obstétrique, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; EA3279, CEReSS, health service research and quality of life center, université Aix-Marseille, 13284 Marseille, France
| | - C DiGuisto
- Université de Paris, epidemiology and statistics research center/CRESS, Inserm (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)), INRA, hôpital Tenon, bâtiment Recherche, rue de la Chine, 75020 Paris, France; Maternité Olympe de Gouges, centre hospitalier régional universitaire Tours, Tours, France; Université François-Rabelais, 37000 Tours, France
| | - V Dochez
- Service de gynécologie-obstétrique, CHU de Nantes, 44093 Nantes, France
| | - C Garabedian
- EA 4489 - Perinatal Environment and Health, université de Lille, hôpital Jeanne-de-Flandre, clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - P Guerby
- Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - A Koch
- Service de gynécologie-obstétrique, CHU de Strasbourg, 67000 Strasbourg, France
| | - M Le Lous
- Département de gynécologie obstétrique et médecine de la reproduction, CHU de Rennes, Rennes, France; LTSI-Inserm, université de Rennes 1, UMR 1099, 35000 Rennes, France
| | - E Perdriolle-Galet
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France
| | - V Peyronnet
- Service de gynécologie obstétrique, hôpital L.-Mourier, AP-HP, 92700 Colombes, France
| | - E Rault
- Hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - H Torchin
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, 75014 Paris, France; Université de Paris, epidemiology and statistics research center/CRESS, Inserm, INRA, 75004 Paris, France
| | - G Legendre
- CESP-Inserm, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris-Sud University, Paris-Saclay University, UVSQ, Inserm, 94800 Villejuif, France; Department of obstetrics and gynecology, Angers university hospital, 49000 Angers, France
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Berveiller P, Rault E, Guerby P. [Physiological and Psychological Data influencing Pregnant Women Smoking Behavior - CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy]. Gynecol Obstet Fertil Senol 2020; 48:551-558. [PMID: 32247097 DOI: 10.1016/j.gofs.2020.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Nicotine is the main addictive substance in tobacco and its addictive effects mainly involve dopamine. Nicotine is mainly metabolized (C-oxidation) in the liver to cotinine by the cytochrome P450 enzyme system. Nicotine half-life is short being about 2hours. Nicotine metabolism appears to be increased during pregnancy, mainly due to an increased cytochrome activity and maternal cardiac output. Thus, the smoking behavior of the pregnant woman is subsequently modified with an increase in withdrawal syndromes and an increased desire to smoke. These pharmacological elements should be taken into account when prescribing nicotine replacement therapy. Regarding the markers of tobacco intoxication, there is a good correlation between the importance of smoking and the measurement of expired air carbon monoxide. Although there is no evidence of decreased obstetrical complications related to its use, it is simple and non-invasive and therefore may be useful in routine practice. It gives an instantaneous value of tobacco intoxication, and represents a starting point for dialogue and management and can help to highlight the reality of withdrawal. Regarding the evaluation of tobacco addiction, the most commonly used questionnaires are the Fagerström tests (FTCD, HSI…), which are well correlated with cotinine concentration. However, there is insufficient evidence of their usefulness in reducing tobacco consumption during pregnancy to recommend them in current practice. DSM-V diagnostic criteria for addiction should be known as they can also be used to characterize the intensity of this addiction.
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Affiliation(s)
- P Berveiller
- Service de gynécologie-obstétrique, CHI de Poissy St-Germain, 78300 Poissy, France.
| | - E Rault
- Service d'obstétrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant Lyon, 69500 Bron, France
| | - P Guerby
- Service de gynécologie-obstétrique, CHU de Toulouse, 31300 Toulouse, France
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Garabedian C, Berveiller P, Guerby P. [Other Methods of Consumption: Electronic Cigarette, Heated Tobacco, Shisha and Snus - CNGOF-SFT Expert Report and Guidelines on the management for Smoking Management During Pregnancy]. Gynecol Obstet Fertil Senol 2020; 48:583-586. [PMID: 32247094 DOI: 10.1016/j.gofs.2020.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Other methods of cigarette consumption include a variety of electronic products, as well as heated tobacco, snus and shisha. The questions in this chapter are: what other methods of consumption are used during pregnancy (either electronic or containing tobacco) and what is their prevalence? What is their benefit/risk balance? Can their use during pregnancy be proposed? Although the fetus is not exposed to the combustible toxins of tobacco, e-cigarette products may contain nicotine, which maintains the exposure of the fetus. Further research is needed on the other components of the electronic cigarette, such as flavorings and propylene glycol and/or glycerol, in order to assess the benefit/risk balance. In addition, some solvents contain ethanol. In the current state of knowledge, the precautionary principle should be respected and not recommend the initiation or continuation of the electronic cigarette during pregnancy (professional agreement). For smoking cessation or electronic cigarette cessation, it is recommended to provide the same advice and to use methods that have already been evaluated (professional agreement). For the JUUL, there are currently no data on obstetrical outcome when used. The use of shisha during pregnancy is associated with decreased fetal growth. It is recommended not to use shisha during pregnancy (GradeC). There are currently no data on the use of heated tobacco and obstetrical outcome.
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Affiliation(s)
- C Garabedian
- CHU Lille, clinique d'obstétrique, 1, avenue Eugène-Avinée, 59000 Lille, France; Univ. Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, 59000 Lille, France.
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI de Poissy St-Germain, 78300 Poissy, France
| | - P Guerby
- Service de gynécologie-obstétrique, CHU de Toulouse, 31300, Toulouse, France
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Grangé G, Berlin I, Bretelle F, Bertholdt C, Berveiller P, Blanc J, DiGuisto C, Dochez V, Garabedian C, Guerby P, Koch A, Le Lous M, Perdriolle-Galet E, Peyronnet V, Rault E, Torchin H, Legendre G. Smoking and smoking cessation in pregnancy. Synthesis of a systematic review. J Gynecol Obstet Hum Reprod 2020; 49:101847. [PMID: 32619725 DOI: 10.1016/j.jogoh.2020.101847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy and the post-partum period. STUDY DESIGN A systematic review of the international literature was undertaken between January 2003 and April 2019. MEDLINE, EMBASE databases and the Cochrane library were searched for a range of predefined key words. All relevant reports in English and French were classified according to their level of evidence ranging from 1(highest) to 4(lowest). The strength of each recommendation was classified according to the Haute Autorité de Santé (French National Authority for Health) ranging from A (highest) to C (lowest). RESULTS "Counselling", including all types of non-pharmacological interventions, has a moderate benefit on smoking cessation, birth weight and prematurity. The systematic use of measuring expired air CO concentration does not influence smoking abstinence, however, it may be useful in assessing smoked tobacco exposure prior to and after quitting. The use of self-help therapies and health education are recommended in helping pregnant smokers quit and should be advised by healthcare professionals. Nicotine replacement therapies (NRT) may be prescribed to pregnant women who have failed to stop smoking after trying non-pharmacological interventions. Different modes of delivery and dosages can be used in optimizing their efficacy. Smoking in the postpartum period is essential to consider. The same treatment options as during pregnancy can be used. CONCLUSION Smoking during pregnancy concerns more than a hundred thousand women each year in France resulting in a major public health burden. Healthcare professionals should be mobilised to employ a range of methods to reduce or even eradicate it.
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Affiliation(s)
- G Grangé
- Maternité Port-Royal, Université de Paris, AP-HP.Centre, FHU Prema, 75014, Paris, France.
| | - I Berlin
- Département de Pharmacologie, AP-HP, 75000, Paris, France; Centre Universitaire de Médecine Générale et de Santé Publique, 1011 Lausanne, Switzerland
| | - F Bretelle
- Department of Obstetrics and Gynecology, Conception Hospital, Aix Marseille Université, Prenatal Diagnosis Timone Conception, IHU, IRD, Assistance Publique des Hôpitaux de Marseille (AP-HM), 13005, Marseille, France
| | - C Bertholdt
- Pôle de la Femme, Maternité Régionale du CHRU de Nancy, 10, Rue Dr-Heydenreich, 54000, Nancy, France; IADI, Inserm U1254, Rue du Morvan, 54500, Vandœuvre-lès-Nancy, France
| | - P Berveiller
- Service de Gynécologie-Obstétrique, CHI Poissy-St-Germain-en-Laye, 78300, Poissy, France
| | - J Blanc
- Service de Gynécologie Obstétrique, Hôpital Nord, AP-HM, Chemin des Bourrely, 13015, Marseille, France; EA3279, CEReSS, Health Service Research and Quality of Life Center, Université Aix-Marseille, 13284, Marseille, France
| | - C DiGuisto
- Centre Universitaire de Médecine Générale et de Santé Publique, 1011 Lausanne, Switzerland; Université de Paris, Epidemiology and Statistics Research center/CRESS, Inserm (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)), INRA, Hôpital Tenon, Bâtiment Recherche, Rue de la Chine, 75020, Paris, France; Maternité Olympe de Gouges, Centre Hospitalier Régional Universitaire Tours, Tours, France; Université François-Rabelais, 37000, Tours, France
| | - V Dochez
- Service de Gynécologie-Obstétrique, CHU de Nantes, 44093, Nantes, France
| | - C Garabedian
- CHU Lille Clinique d'obstetrique Univ. LILLE ULR 2694 Évaluation des technologies de santé. F-59000 Lille, France
| | - P Guerby
- Service de Gynécologie Obstétrique, Hôpital Paule-de-Viguier, CHU de Toulouse, 330, Avenue de Grande-Bretagne, 31059, Toulouse, France
| | - A Koch
- Service de Gynécologie-Obstétrique, CHU de Strasbourg, 67000, Strasbourg, France
| | - M Le Lous
- Département de Gynécologie Obstétrique et Médecine de la Reproduction, CHU de Rennes, Rennes, France; LTSI-Inserm, Université de Rennes 1, UMR 1099, 35000, Rennes, France
| | - E Perdriolle-Galet
- Pôle de la Femme, Maternité Régionale du CHRU de Nancy, 10, Rue Dr-Heydenreich, 54000 Nancy, France
| | - V Peyronnet
- Service de Gynécologie Obstétrique, Hôpital L.-Mourier, AP-HP, 92700 Colombes, France; Université de Paris, Paris, France
| | - E Rault
- Hôpital Femme-Mère-Enfant, 69500, Bron, France
| | - H Torchin
- Service de Médecine et Réanimation Néonatales de Port-Royal, AP-HP, 75014 Paris, France; Université de Paris, Epidemiology and Statistics Research center/CRESS, Inserm, INRA, 75004, Paris, France
| | - G Legendre
- CESP-Inserm, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris-Sud University, Paris-Saclay University, UVSQ, Inserm, 94800, Villejuif, France; Department of Obstetrics and Gynecology, Angers University Hospital, 49000, Angers, France
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Kervella L, Berveiller P, Bourdillon M, Rousseau A. Midwives' practices related to cervical cancer screening during pregnancy: A vignette-based study. Sex Reprod Healthc 2020; 26:100539. [PMID: 32623314 DOI: 10.1016/j.srhc.2020.100539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/03/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe midwives' practices related to cervical cancer screening and women's eligibility for screening during pregnancy. STUDY DESIGN Cross-sectional vignette-based study of French midwives during February-May 2018. MAIN OUTCOME MEASURES Participants were asked to complete an internet-based questionnaire: a clinical case-vignette about a woman eligible for cervical cancer screening during pregnancy and a short self-administered questionnaire. RESULTS We obtained 273 complete questionnaires from eligible midwives. Of those responding, 15% reported that they never screened for cervical cancer during pregnancy, 63.7% did so for women 25 years or older, and 51% adhered to the recommended intervals between tests. Overall, 110 (40%) midwives adhered to the complete screening protocol (age at initiation and interval). In this clinical case vignette of a woman meeting the criteria for screening, only 29% of midwives reported they would perform a Pap test at 25 weeks of gestation, while 91% would at 10 weeks. CONCLUSION Midwives' practices of cervical cancer screening and their determination of women's eligibility during pregnancy vary, especially according to gestational age; Nevertheless, pregnancy is an appropriate time to screen women who meet the criteria for cervical cancer screening, especially if they are not receiving regular gynaecological care.
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Affiliation(s)
- Léa Kervella
- Midwifery Department, Versailles Saint Quentin University, Montigny-le-Bretonneux, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint-Germain en Laye Hospital, Poissy, France; EA7404 GIG, UFR S. Veil-Santé, Versailles Saint Quentin University, Montigny-le-Bretonneux, France
| | - Marie Bourdillon
- Midwifery Department, Versailles Saint Quentin University, Montigny-le-Bretonneux, France
| | - Anne Rousseau
- Midwifery Department, Versailles Saint Quentin University, Montigny-le-Bretonneux, France; Department of Obstetrics and Gynecology, Poissy-Saint-Germain en Laye Hospital, Poissy, France; EA 7285 RISCQ, UFR S. Veil-Santé, Versailles Saint Quentin University, Montigny-le-Bretonneux, France.
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Ambroise Grandjean G, Gabriel P, Hossu G, Zuily S, Morel O, Berveiller P. [Training in fetal ultrasound biometry: Prospective assesment of Objective Structured Assessment of Ultrasound Skills (OSAUS) efficiency]. ACTA ACUST UNITED AC 2020; 48:800-805. [PMID: 32461028 DOI: 10.1016/j.gofs.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Fetal biometry quality directly influences obstetrical care relevance. However, obstetrician proficiencies are heterogeneous in particular during initial training. OBJECTIVES To assess the predictive value of OSAUS scale to identify operators with enough command to perform a valid estimation of fetal weight (EFW) (I). This study also assesses OSAUS intra-operator inter-exams variability (II) and pass/fail score relevancy (III). METHODS Lecturers in Nancy University Hospital assessed trainees' proficiency for EWF systematically and prospectively through OSAUS scale. The trainee assessment was performed right after the one of the senior operator (reference EFW) on three consecutive patients during standard care ultrasounds. To ensure variability in proficiency within the sample, previous practice was taken into account during enrollment ("novices" and "intermediates" for<20 and 20 past exams, respectively). Correlation between mean OSAUS and validity of EFW (a valid EFW was defined by a difference with the reference EWF<0.8 Z-score) and variability between consecutive assessments were assessed. RESULTS The study population was constituted of 8 "novice" and 8 "intermediate" trainees. Association between OSAUS and EFW validity was significant (P<0.03) (I). Intra-operator inter-exams variability was majored in the "novice" group (coefficients of variation were 25% vs. 10% in "novice" and "intermediate" group respectively) (II). Within the sample, specificity and positive predictive value of a pass/fail score OSAUS>3.5 to predict EFW validity were 77% and 71%, respectively (III). CONCLUSION A 3.5 OSAUS pass/fail score could provide a relevant threshold to estimate operator proficiency in assessing fetal biometry in an autonomous and secure way.
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Affiliation(s)
- G Ambroise Grandjean
- Département d'obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, IADI, université de Lorraine, 54000 Nancy, France; Département universitaire de maïeutique, université de Lorraine, 54000 Nancy, France.
| | - P Gabriel
- Inserm, IADI, université de Lorraine, 54000 Nancy, France
| | - G Hossu
- Inserm, CIC, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | - S Zuily
- Hôpital Virtuel, université de Lorraine, 54000 Nancy, France
| | - O Morel
- Département d'obstétrique, CHRU de Nancy, 54000 Nancy, France; Inserm, IADI, université de Lorraine, 54000 Nancy, France
| | - P Berveiller
- Département d'obstétrique, CHI Poissy Saint-Germain-en-Laye, 78300 Poissy, France; Université Versailles Saint-Quentin, 78180 Montigny-le-Bretonneux, France
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Salvator M, Veyrie N, Rozenberg P, Berveiller P. [Which management of pregnancy after bariatric surgery?]. ACTA ACUST UNITED AC 2020; 48:746-753. [PMID: 32387764 DOI: 10.1016/j.gofs.2020.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Indexed: 11/16/2022]
Abstract
Obesity represents a major public health issue and a potential threat for people health. Moreover, the incidence of obesity has been increasing and therefore, the incidence of women with an history of bariatric surgery with a pregnancy desire has been also increased. Although the weight loss after bariatric surgery has positive effects on pregnancy outcomes, these surgical procedures may be associated with adverse outcomes as well, for example micronutrient deficiencies, dumping syndrome, surgical complications such as internal hernias, and obstetrical complications such as small for gestational age as instance. Nevertheless, physician knowledge about pregnancy management after bariatric surgery is currently insufficient and a multidisciplinary approach is therefore mandatory. The aim of this article is to provide to readers general and recent data regarding the management of pregnancy after bariatric surgery.
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Affiliation(s)
- M Salvator
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Poissy Saint-Germain, Poissy, France
| | - N Veyrie
- International Obesity Center of Paris - IOCP, Paris, France
| | - P Rozenberg
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Poissy Saint-Germain, Poissy, France
| | - P Berveiller
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Poissy Saint-Germain, Poissy, France; UVSQ, INRAE, BREED, université Paris-Saclay, 78350 Jouy-en-Josas, France; BREED, école nationale vétérinaire d'Alfort, 94700 Maisons-Alfort, France.
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Ambroise Grandjean G, Berveiller P, Hossu G, Noble P, Chamagne M, Morel O. Prospective assessment of reproducibility of three-dimensional ultrasound for fetal biometry. Diagn Interv Imaging 2020; 101:481-487. [PMID: 32241702 DOI: 10.1016/j.diii.2020.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/18/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare fetal ultrasound measurements performed by two observers with different levels of experience and evaluate the potential contribution of the use of three-dimensional (3D) ultrasound on repeatability, reproducibility and agreement of two-dimensional (2D) and 3D-derived measurements. MATERIALS AND METHODS Two observers (one senior and one junior) measured head circumference (HC), abdominal circumference (AC) and femur length (FL) in 33 fetuses (20 to 40 weeks of gestation). Each observer performed two series of 2D measurements and two series of 3D measurements (i.e., measurements derived from triplane volume processing). Measurements were converted into Z-scores according to gestational age. Variability between the different series of measurements was studied using Bland-Altmann plots and intra-class correlation coefficients (ICC). RESULTS Agreement with the 2D measurements of the senior observer was higher in 3D than in 2D for the junior observer (systematic differences of -0.4, -0.2 and -0.8 Z-score vs. -0.1, -0.1 and -0.6 for HC, AC and FL on 2D and 3D datasets, respectively). The use of 3D ultrasound improved junior observer repeatability (ICC=0.94, 0.88, 0.90 vs. 0.94, 0.94 and 0.96 for HC, AC and FL in 2D and 3D, respectively). The reproducibility was greater using the junior observer 3D datasets (ICC=0.75, 0.60 and 0.45 vs. 0.79, 0.89 and 0.63 for HC, AC and FL, respectively). CONCLUSION The use of 3D ultrasound improves the consistency of the measurements performed by a junior observer and increases the overall repeatability and reproducibility of measurements performed by observers with different levels of experience.
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Affiliation(s)
- G Ambroise Grandjean
- Inserm, IADI, Université de Lorraine, 54000 Nancy, France; Department of Obstetrics and Gynecology, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France; Midwifery Department, Université de Lorraine, 54000 Nancy, France.
| | - P Berveiller
- Department of Obstetrics and Gynecology, Centre hospitalier intercommunal de Poissy Saint-Germain-en-Laye, 78300 Poissy, France; Université Versailles-Saint-Quentin, 78180 Montigny-le-Bretonneux, France
| | - G Hossu
- CIC-IT, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France
| | - P Noble
- Department of Obstetrics and Gynecology, Port-Royal, hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France
| | - M Chamagne
- Department of Obstetrics and Gynecology, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France
| | - O Morel
- Inserm, IADI, Université de Lorraine, 54000 Nancy, France; Department of Obstetrics and Gynecology, Centre hospitalier regional universitaire de Nancy, 54000 Nancy, France
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Berveiller P, Rousseau A, Rousseau M, Bitumba I, Goffinet F, Rozenberg P. Risk of preterm birth in a twin pregnancy after an early‐term birth in the preceding singleton pregnancy: a retrospective cohort study. BJOG 2020; 127:591-598. [DOI: 10.1111/1471-0528.16071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2019] [Indexed: 11/28/2022]
Affiliation(s)
- P Berveiller
- Department of Obstetrics and Gynaecology Poissy/Saint‐Germain Hospital Poissy France
| | - A Rousseau
- EA 7285 Paris Saclay University Montigny‐Le‐Bretonneux France
- Department of Maieutic Paris Saclay University Montigny‐Le‐Bretonneux France
| | - M Rousseau
- Department of Obstetrics and Gynaecology Poissy/Saint‐Germain Hospital Poissy France
| | - I Bitumba
- Department of Obstetrics and Gynaecology Poissy/Saint‐Germain Hospital Poissy France
| | - F Goffinet
- Department of Obstetrics and Gynaecology Cochin Port‐Royal Hospital Paris France
| | - P Rozenberg
- Department of Obstetrics and Gynaecology Poissy/Saint‐Germain Hospital Poissy France
- EA 7285 Paris Saclay University Montigny‐Le‐Bretonneux France
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Berveiller P, Rousseau A, Daher A, Artagoita J, Rozenberg P. Maternal intuition of fetal gender: Can we trust in? A prospective study. J Psychosom Res 2020; 128:109886. [PMID: 31786337 DOI: 10.1016/j.jpsychores.2019.109886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Paul Berveiller
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France; GIG - EA 7404, Paris Saclay University, Montigny-Le-Bretonneux, France.
| | - Anne Rousseau
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France; EA 7285, Paris Saclay University, Montigny-Le-Bretonneux, France; Midwifery Department, Paris Saclay University, Montigny-Le-Bretonneux, France
| | - Adèle Daher
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France
| | - Juliette Artagoita
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France
| | - Patrick Rozenberg
- Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France; EA 7285, Paris Saclay University, Montigny-Le-Bretonneux, France
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Mir O, Ropert S, Morice P, Berveiller P. Clinical Activity of Sunitinib and Regorafenib in Endometriosis. Mayo Clin Proc 2019; 94:2591-2593. [PMID: 31806110 DOI: 10.1016/j.mayocp.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Olivier Mir
- Gustave Roussy Cancer Campus, Villejuif, France
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Amant F, Berveiller P, Boere IA, Cardonick E, Fruscio R, Fumagalli M, Halaska MJ, Hasenburg A, Johansson ALV, Lambertini M, Lok CAR, Maggen C, Morice P, Peccatori F, Poortmans P, Van Calsteren K, Vandenbroucke T, van Gerwen M, van den Heuvel-Eibrink M, Zagouri F, Zapardiel I. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Ann Oncol 2019; 30:1601-1612. [PMID: 31435648 DOI: 10.1093/annonc/mdz228] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We aimed to provide comprehensive protocols and promote effective management of pregnant women with gynecological cancers. New insights and more experience have been gained since the previous guidelines were published in 2014. Members of the International Network on Cancer, Infertility and Pregnancy (INCIP), in collaboration with other international experts, reviewed existing literature on their respective areas of expertise. Summaries were subsequently merged into a manuscript that served as a basis for discussion during the consensus meeting. Treatment of gynecological cancers during pregnancy is attainable if management is achieved by collaboration of a multidisciplinary team of health care providers. This allows further optimization of maternal treatment, while considering fetal development and providing psychological support and long-term follow-up of the infants. Nonionizing imaging procedures are preferred diagnostic procedures, but limited ionizing imaging methods can be allowed if indispensable for treatment plans. In contrast to other cancers, standard surgery for gynecological cancers often needs to be adapted according to cancer type and gestational age. Most standard regimens of chemotherapy can be administered after 14 weeks gestational age but are not recommended beyond 35 weeks. C-section is recommended for most cervical and vulvar cancers, whereas vaginal delivery is allowed in most ovarian cancers. Breast-feeding should be avoided with ongoing chemotherapeutic, endocrine or targeted treatment. More studies that focus on the long-term toxic effects of gynecologic cancer treatments are needed to provide a full understanding of their fetal impact. In particular, data on targeted therapies that are becoming standard of care in certain gynecological malignancies is still limited. Furthermore, more studies aimed at the definition of the exact prognosis of patients after antenatal cancer treatment are warranted. Participation in existing registries (www.cancerinpregnancy.org) and the creation of national tumor boards with multidisciplinary teams of care providers (supplementary Box S1, available at Annals of Oncology online) is encouraged.
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Affiliation(s)
- F Amant
- Center for Gynecologic Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek and Amsterdam University Medical Centers, the Netherlands; Department of Oncology, KU Leuven, Leuven, Belgium.
| | - P Berveiller
- Department of Obstetrics and Gynecology, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - I A Boere
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - E Cardonick
- Department of Obstetrics and Gynecology, Cooper University Health Care, Camden, USA
| | - R Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy
| | - M Fumagalli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M J Halaska
- Department of Obstetrics and Gynaecology, 3rd Medical Faculty, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - A Hasenburg
- Department of Obstetrics and Gynecology, Mainz University Medical Center, Mainz, Germany
| | - A L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M Lambertini
- Department of Medical Oncology, IRCCS Policlinico San Martino Hospital, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - C A R Lok
- Center for Gynecologic Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek and Amsterdam University Medical Centers, the Netherlands
| | - C Maggen
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - P Morice
- Department of Gynecologic Surgery, Institute de Cancérologie Gustave Roussy, Villejuif, France
| | - F Peccatori
- Department of Gynecologic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - P Poortmans
- Department of Radiation Oncology, Institut Curie and Paris Sciences & Lettres - PSL University, Paris, France
| | - K Van Calsteren
- Department of Development and Regeneration, University Hospitals Leuven, Leuven, Belgium
| | | | - M van Gerwen
- Center for Gynecologic Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek and Amsterdam University Medical Centers, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - F Zagouri
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, University of Athens, Athens, Greece
| | - I Zapardiel
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
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Garabedian C, Berveiller P, Maisonneuve E. [Interpretation of fetal heart rate with a simple mnemonic]. ACTA ACUST UNITED AC 2019; 48:627-628. [PMID: 31562925 DOI: 10.1016/j.gofs.2019.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 11/15/2022]
Affiliation(s)
- C Garabedian
- EA 4489 - Perinatal Environment and Health, université de Lille, 59000 Lille, France; Hôpital Jeanne-de-Flandre, clinique d'obstétrique, CHU de Lille, 59000 Lille, France.
| | - P Berveiller
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Poissy Saint-Germain, 78300 Poissy, France; EA7404 (GIG) - UFR Simone Veil, université Versailles Saint-Quentin-en-Yvelines, Montigny-Le-Bretonneux, France
| | - E Maisonneuve
- Service de médecine fœtale, CHU d'Armand-Trousseau, 26, avenue du Dr Arnold-Netter, 75012 Paris, France
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Berveiller P, Rousseau A, Tastard M, Raynal P. [An introduction to human factors: From aeronautic to obstetrics]. Gynecol Obstet Fertil Senol 2019; 47:527-534. [PMID: 31003012 DOI: 10.1016/j.gofs.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 06/09/2023]
Abstract
The theme of human factors is becoming more and more prominent in the healthcare field. Indeed, despite their expertise, healthcare providers display the same limits, those of any human being working in a team, in a system that requires high-reliability. Error is inherent in all human activity. Therefore, the study of human factors makes a perfect sense. The aim of our article is to provide to readers general and recent information on the concept of human factors, and to introduce other related notions such as "error", "fault", non-punishment of error, leadership, crew resource management, situation awareness. Indeed, in some teams, a lack of situation awareness, a poor communication, or an inadequate leadership may lead to a deteriorated clinical situation, leading to a significant and unbearable risk to our pregnant patients. We have a lot to learn from other professional systems that require high-reliability such as aeronautic, military and nuclear field for example. Thus, understanding a teamwork running and the genesis of the errors, developing some notions as illustrated by non-punishment of the error occurrence, debriefings, maintenance of regular staffs, high-fidelity simulation may allow the teams to evolve in a safer system for our pregnant patients.
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Affiliation(s)
- P Berveiller
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Poissy Saint Germain, 10, rue du champ Gaillard, 78300 Poissy, France; EA7404 (GIG) - UFR Simone Veil, Montigny-Le-Bretonneux, France; Réseau de périnatalité Maternité en Yvelines et Périnatalité Active (MYPA).
| | - A Rousseau
- Département de Maïeutique, UFR Simone Veil, 78180 Montigny-Le-Bretonneux, France; Unité EA 7285 RISCQ « Risques cliniques et sécurité en santé des femmes et en santé périnatale », 78180 Montigny-Le-Bretonneux, France
| | - M Tastard
- Officier Pilote de ligne, Boeing 777, Air France, 45 rue de Paris, 95747 Roissy CDG Cedex, France
| | - P Raynal
- Réseau de périnatalité Maternité en Yvelines et Périnatalité Active (MYPA); Service de gynéologie-obstétrique, centre hospitalier de Versailles, 78150 Le Chesnay, France
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Affiliation(s)
- Laure Benoit
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France
| | - Olivier Mir
- Department of Ambulatory Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France.,Research Unit EA7404 - Gamètes-implantation-Gestation, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-Le-Bretonneux, France
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Nogues P, Dos Santos E, Jammes H, Berveiller P, Arnould L, Vialard F, Dieudonné MN. Maternal obesity influences expression and DNA methylation of the adiponectin and leptin systems in human third-trimester placenta. Clin Epigenetics 2019; 11:20. [PMID: 30732639 PMCID: PMC6367801 DOI: 10.1186/s13148-019-0612-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/09/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND It is well established that obesity is associated with dysregulation of the ratio between the two major adipokines leptin and adiponectin. Furthermore, it was recently reported that maternal obesity has a significant impact on placental development. Leptin and adiponectin are present at the fetal-maternal interface and are involved in the development of a functional placenta. However, less is known about leptin and adiponectin's involvement in the placental alterations described in obese women. Hence, the objective of the present study was to characterize the placental expression and DNA methylation of these two adipokine systems (ligands and receptors) in obese women. RESULTS Biopsies were collected from the fetal and maternal sides of third-trimester placenta in obese and non-obese (control) women. In both groups, leptin levels were higher on the fetal side than the maternal side, suggesting that this cytokine has a pivotal role in fetal growth. Secondly, maternal obesity (in the absence of gestational diabetes) was associated with (i) elevated DNA methylation of the leptin promoter on fetal side only, (ii) hypomethylation of the adiponectin promoter on the maternal side only, (iii) significantly low levels of leptin receptor protein (albeit in the absence of differences in mRNA levels and promoter DNA methylation), (iv) significantly low levels of adiponectin receptor 1 mRNA expression on the maternal side only, and (v) elevated DNA methylation of the adiponectin receptor 2 promoter on the maternal side only. CONCLUSION Our present results showed that maternal obesity is associated with the downregulation of both leptin/adiponectin systems in term placenta, and thus a loss of the beneficial effects of these two adipokines on placental development. Maternal obesity was also associated with epigenetic changes in leptin and adiponectin systems; this highlighted the molecular mechanisms involved in the placenta's adaptation to a harmful maternal environment.
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Affiliation(s)
- Perrine Nogues
- GIG-EA 7404, Université de Versailles-St Quentin, Université Paris-Saclay, Unité de Formation et de Recherche des Sciences de la Santé Simone Veil, 2 avenue de la Source de la Bièvre, F-78180, Montigny-le-Bretonneux, France
| | - Esther Dos Santos
- GIG-EA 7404, Université de Versailles-St Quentin, Université Paris-Saclay, Unité de Formation et de Recherche des Sciences de la Santé Simone Veil, 2 avenue de la Source de la Bièvre, F-78180, Montigny-le-Bretonneux, France.,Service de Biologie Médicale, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Hélène Jammes
- UMR BDR, INRA, ENVA, Université Paris Saclay, Jouy en Josas, France
| | - Paul Berveiller
- GIG-EA 7404, Université de Versailles-St Quentin, Université Paris-Saclay, Unité de Formation et de Recherche des Sciences de la Santé Simone Veil, 2 avenue de la Source de la Bièvre, F-78180, Montigny-le-Bretonneux, France.,Service de Gynécologie-Obstétrique, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Lucie Arnould
- GIG-EA 7404, Université de Versailles-St Quentin, Université Paris-Saclay, Unité de Formation et de Recherche des Sciences de la Santé Simone Veil, 2 avenue de la Source de la Bièvre, F-78180, Montigny-le-Bretonneux, France
| | - François Vialard
- GIG-EA 7404, Université de Versailles-St Quentin, Université Paris-Saclay, Unité de Formation et de Recherche des Sciences de la Santé Simone Veil, 2 avenue de la Source de la Bièvre, F-78180, Montigny-le-Bretonneux, France.,Département de Biologie de la Reproduction, Cytogénétique, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Marie-Noëlle Dieudonné
- GIG-EA 7404, Université de Versailles-St Quentin, Université Paris-Saclay, Unité de Formation et de Recherche des Sciences de la Santé Simone Veil, 2 avenue de la Source de la Bièvre, F-78180, Montigny-le-Bretonneux, France.
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Berveiller P, Mir O, Degrelle SA, Tsatsaris V, Selleret L, Guibourdenche J, Evain-Brion D, Fournier T, Gil S. Chemotherapy in pregnancy: exploratory study of the effects of paclitaxel on the expression of placental drug transporters. Invest New Drugs 2018; 37:1075-1085. [PMID: 30367323 DOI: 10.1007/s10637-018-0677-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 10/02/2018] [Indexed: 12/19/2022]
Abstract
Introduction The use of paclitaxel in pregnant cancer patients is feasible in terms of fetal safety, but little is known about the effects of paclitaxel on the placenta. Using three experimental models, we aimed to assess the effects of paclitaxel on the expression of placental drug transporters. Methods In the in vitro model (human primary trophoblast culture), trophoblasts were isolated from normal term placentas and subsequently exposed to paclitaxel. The transcriptional regulation of 84 genes encoding for drug transporters, and the protein expression of ABCB1/P-gp and ABCG2/BCRP were assessed. In the in vivo model, placental tissues isolated from pregnant cancer patients treated with paclitaxel were analyzed to assess the protein expression of ABCB1/P-gp and ABCG2/BCRP. The same parameters were assessed in extracts from human placental cotyledons perfused ex vivo with paclitaxel. Results In the in vitro model, the expression of twelve drug-transporters genes was found to be significantly down-regulated after exposure to paclitaxel, including ABCC10, SLC28A3, SLC29A2, and ATP7B (involved in the transport of taxanes, antimetabolites, and cisplatin, respectively). The protein expression of ABCB1/P-gp increased by 1.3-fold after paclitaxel administration. Finally, the protein expression of ABCB1/P-gp and ABCG2/BCRP was higher in cotyledons from mothers treated with multiple doses of paclitaxel during pregnancy than in cotyledons perfused with a single dose of paclitaxel. Discussion Paclitaxel modulates the expression of placental drug transporters involved in the disposition of various anticancer agents. Further studies will be needed to assess the impact of repeated or prolonged exposure to paclitaxel on the expression and function of placental drug transporters.
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Affiliation(s)
- Paul Berveiller
- INSERM, UMR-S1139, Paris, France.
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
- Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal de Poissy Saint Germain, 10, rue du champ Gaillard, F78300, Poissy, France.
| | - Olivier Mir
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Séverine A Degrelle
- INSERM, UMR-S1139, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Vassilis Tsatsaris
- INSERM, UMR-S1139, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Obstetrics, Port-Royal Maternity, Cochin Teaching Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
- PremUp Foundation, Paris, France
| | - Lise Selleret
- Department of Obstetrics and Gynecology, Tenon Teaching Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean Guibourdenche
- Department of Hormonal Biology, Cochin Teaching Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Danièle Evain-Brion
- INSERM, UMR-S1139, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- PremUp Foundation, Paris, France
| | - Thierry Fournier
- INSERM, UMR-S1139, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- PremUp Foundation, Paris, France
| | - Sophie Gil
- INSERM, UMR-S1139, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- PremUp Foundation, Paris, France
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Letouzey M, Berveiller P. Massive congenital depression of neonate's skull. Arch Dis Child Fetal Neonatal Ed 2018; 103:F316. [PMID: 29853472 DOI: 10.1136/archdischild-2018-315095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/10/2018] [Accepted: 05/14/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Mathilde Letouzey
- Department of Neonatal Medicine, Poissy-Saint-Germain Hospital, Poissy, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France
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