Publications by authors named "Fernandez Herve"
Local and systemic methotrexate in management of caesarean scar pregnancy.
Eur J Obstet Gynecol Reprod Biol
November 2024
Study Objective: The aim is to analyze the management of cesarean scar pregnancy (CSP) based on local and systemic Methotrexate, a protocol implemented in a referral center.
Design: This is an observational, retrospective, monocentric, cohort study with a description of the local protocol, treatment results and tolerance profile. Design Classification III.
Article Synopsis
- Diminished ovarian reserve (DOR) and primary ovarian insufficiency (POI) significantly contribute to female infertility, with a recent study finding a genetic cause in 29.3% of POI cases.
- A prospective study of 120 patients with unexplained DOR revealed a 24.2% diagnostic yield using advanced sequencing technology to identify genes related to various biological pathways.
- Findings indicated that impaired oocyte quality is linked to meiosis/DNA repair genes, and the study supports the need for genetic testing as a routine part of infertility diagnosis and a potential predictor for progression to POI.
Article Synopsis
- The study aimed to assess the outcomes of vaginal surgery for women with symptomatic cesarean scar defects, comparing those with moderate and severe defects.
- The findings showed significant improvement in myometrial thickness and reduced abnormal uterine bleeding after surgery in both groups, though pelvic pain alleviation was only noted in the moderate group.
- Pregnancy rates and complications were comparable between the moderate and severe defect groups, with no cases of uterine rupture reported post-surgery.
Clues to revising the conventional diagnostic algorithm for endometriosis.
Int J Gynaecol Obstet
January 2025
Endometriosis is a complex gynecologic disorder characterized primarily by symptoms of pelvic pain, infertility, and altered quality of life. National and international guidelines highlight the diagnostic difficulties and lack of conclusive diagnostic tools for endometriosis. Furthermore, guidelines are becoming questionable at an increasingly rapid rate as new diagnostic techniques emerge.
View Article and Find Full Text PDFHysteroscopic metroplasty: Ultrasound parameters to optimize fertility benefits?
J Gynecol Obstet Hum Reprod
December 2024
Introduction: Metroplasty is a procedure used by some teams to correct certain uterine anomalies to improve fertility outcomes. Our goal was to evaluate hysteroscopic metroplasty in the management of nulliparous and infertile patients with a uterine anomalies.
Material And Methods: We conducted a single-center, retrospective, observational study of women who underwent hysteroscopic metroplasty for infertility between January 1, 2015 and December 31, 2019.
Article Synopsis
- A study was conducted to evaluate the effectiveness of the Womed Leaf, a degradable polymer film, for treating moderate to severe intrauterine adhesions (IUA) in women undergoing hysteroscopic surgery.
- The PREG-2 trial was a multicenter, double-blind, randomized controlled trial, involving 160 women who were divided into two groups: one received the Womed Leaf after surgery while the other did not.
- Results showed that the Womed Leaf significantly improved the reduction of IUAs compared to the control group, with a higher percentage of women showing no adhesions and no serious adverse events related to the device, confirming its safety and effectiveness.
BACKGROUND: The discovery of a saliva-based micro–ribonucleic acid (miRNA) signature for endometriosis in 2022 opened up new perspectives for early and noninvasive diagnosis of the disease. The 109-miRNA saliva signature is the product of miRNA biomarkers and artificial intelligence (AI) modeling. We designed a multicenter study to provide external validation of its diagnostic accuracy.
View Article and Find Full Text PDFArticle Synopsis
- The updated clinical practice guidelines aim to improve the first-line management of infertility in couples by revisiting existing recommendations based on recent research.
- A systematic review was conducted by expert working groups on five major themes, resulting in 28 PICO-formulated questions addressing both male and female infertility assessments, environmental factors, ovulation induction, and reproductive surgery techniques.
- Key recommendations include tailored fertility evaluations based on the woman's age, specific tests for both partners, and the dismissal of certain outdated procedures, with an emphasis on evidence-based approaches to optimize infertility treatment.
Indigo carmine dye for detecting urinary track damage during vaginal surgery.
Eur J Obstet Gynecol Reprod Biol
February 2024
Article Synopsis
- The study aims to evaluate the effectiveness of using intravenous carmine indigo to detect bladder injuries during gynecologic surgeries, particularly vaginal hysterectomies and anterior prolapse procedures for benign conditions.
- Conducted at a tertiary hospital from January 2018 to October 2021, the research included 443 hysterectomies and 95 prolapse surgeries, with a focus on intraoperative detection of injuries and complications related to the carmine indigo injection.
- Results showed low bladder injury rates (1.4% for hysterectomies, 1.1% for prolapse surgeries) with no ureteral injuries reported, and the total cost of carmine indigo usage for the gyne
Update on the management of endometriosis-associated pain in France.
J Gynecol Obstet Hum Reprod
November 2023
Article Synopsis
- The French National College of Obstetricians and Gynecologists updated their guidelines in 2018 to manage endometriosis pain, now incorporating new therapies and research up to 2021.
- A new diagnostic approach using patient questionnaires and saliva analysis may help identify pelvic pain issues without the need for surgery.
- Dienogest (DNG) is recognized as an effective first-line treatment for endometriosis pain, and new oral GnRH antagonists are expected to hit the French market soon, offering rapid results with easier administration compared to existing treatments.
Correlation between clinical examination and perineal ultrasound in women treated for pelvic organ prolapse.
J Gynecol Obstet Hum Reprod
November 2023
Introduction: Lifetime risk of surgery for female pelvic organ prolapse (FPOP) is estimated at 10 to 20%. Prolapse assessment is mostly done by clinical examination. Perineal ultrasound is easily available and performed to evaluate and stage FPOP.
View Article and Find Full Text PDFDiagnostic accuracy study of sonography in adenomyosis: A study of current practice.
J Gynecol Obstet Hum Reprod
September 2023
Objectives: To estimate diagnostic accuracy of sonography in the diagnosis of adenomyosis in current practice when compared to pathology as a "gold standard".
Methods: This diagnosis accuracy study was observational and retrospective, including women managed by hysterectomy for benign pathology from January 2015 to November 2018. Preoperative pelvic sonography reports were collected, including details on diagnosis criteria for adenomyosis.
Objective: To evaluate safety of prenatal corticosteroids in pregnancies of women with sickle cell disease.
Methods: A multicenter observational study of patients with sickle cell disease, comparing vaso-occlusive crises (VOC) requiring hospital care between pregnancies with versus without prenatal corticosteroids.
Results: In 40 pregnancies exposed to prenatal corticosteroids, compared with 370 unexposed pregnancies, VOC were not more frequent (62.
Article Synopsis
- The study compares two surgical methods—hysteroscopy and vacuum aspiration—for treating incomplete spontaneous abortions, with the goal of determining which method leads to better pregnancy outcomes for women planning to conceive in the future.* -
- Conducted as a randomized controlled trial with 574 participants across 15 French hospitals, the research specifically looked at pregnancies lasting at least 22 weeks over a two-year follow-up period.* -
- Results showed no significant difference in successful pregnancy rates between the two groups, with 62.8% from the hysteroscopy group and 67.6% from the vacuum aspiration group achieving the desired outcome, suggesting that neither method proved superior in promoting future fertility.*
Article Synopsis
- Women's preoperative hopes and fears about cystocele repair often differ from those of their surgeons, highlighting a gap in understanding.
- A study analyzed responses from 265 women, revealing prevalent hopes related to prolapse repair (60%) and fears of prolapse relapse (38%).
- Surgeons' expectations aligned closely with women's, but only 60% of women reported prolapse repair as a key expectation, suggesting the need for enhanced communication between patients and surgeons regarding individual concerns and goals.
Study Objective: To study the severity of intrauterine adhesions (IUA) after uterine arterial embolization and to evaluate fertility, pregnancy, and obstetrical outcomes after hysteroscopic treatment.
Design: Retrospective cohort.
Setting: French University Hospital.
Background: Ovarian drilling is a surgical technique for patients with dysovulatory polycystic ovarian syndrome. It is proposed as a second-line treatment in case of failure of medical treatment with Clomiphene citrate, Metformin or Letrozole. The 2020 Cochrane study comparing gonadotrophin stimulation and drilling has found the same pregnancy rate in both cases.
View Article and Find Full Text PDFStudy Objective: To evaluate the epidemiologic and economic burden related to adhesions and their complications for the French healthcare system.
Design: A descriptive and economic retrospective analysis.
Setting: Medicalized information system program (PMSI), national scale of costs.
Article Synopsis
- Primary Ovarian Insufficiency (POI) affects 1-3.7% of women under 40, leading to issues like infertility and reduced lifespan, with many causes remaining unidentified; recent studies are exploring genetic links to POI through a large cohort of patients.* -
- The research included 375 patients and uncovered a 29.3% success rate for clinical genetic diagnosis of POI, discovering new pathogenic genes and pathways previously unlinked to POI, while confirming the role of several known genes associated with cancer susceptibility and other genetic disorders.* -
- This genetic understanding enables personalized medicine approaches, which aim to prevent or treat related health issues, predict ovarian reserve, and identify candidates for innovative therapies like in vitro
Background: The occurrence of acute liver failure (ALF) in pregnant women due to an etiology unrelated to pregnancy (pregALF) that leads to liver transplantation (LT) has rarely been reported. The objective was to report the outcome of pregnant women and fetus and propose a strategy for the timing of delivery and of LT in these patients.
Methods: Five consecutive pregnant patients with ALF were admitted to our center between 1986 and 2018 and underwent an LT.
Introduction: Pelvic organ prolapse is a very frequent affection especially in elderly women. Vaginal pessary is a common conservative treatment and recommended as first line therapy. Guidelines recommend to do a regular follow up every 6 to 12 months with a healthcare professional.
View Article and Find Full Text PDFLoss of consciousness suddenly occurred in 2 healthy and nonsmoking patients undergoing bipolar resection for intramural myomas under spinal anesthesia. One patient had nystagmus and emesis. In both cases, neurological symptoms were of short duration.
View Article and Find Full Text PDFEmergencies in gynecological surgery: Feasibility of delayed day- care surgery management.
J Gynecol Obstet Hum Reprod
October 2022
Objective: Hospital-day-care surgery is currently a priority for the healthcare system and is booming due to its' favorable financial impact. In gynecology, the management of surgical interventions for patients who've come to the Hospital Emergency Department, could in a number of cases, be delayed for a few h or several days. It would be it possible to organize a specific hospital day-care management program for the delayed surgeries.
View Article and Find Full Text PDFStudy Objective: To show a new mini-invasive surgical technique of ovarian drilling and fertility workup using transvaginal natural orifice transluminal endoscopic surgery (vNOTES).
Design: Stepwise demonstration of the technique with narrated video footage.
Setting: Ovarian drilling is a surgical technique for patients with dysovulatory polycystic ovary syndrome.