Double Balloon Catheter (Plus Oxytocin) versus Dinoprostone Vaginal Insert for Term Rupture of Membranes: A Randomized Controlled Trial (RUBAPRO).

Background: The aim of this study is to demonstrate that a double balloon catheter combined with oxytocin decreases time between induction of labor and delivery (TID) as compared to a vaginal dinoprostone insert in cases of premature rupture of membranes at term. Methods: This is a prospective, randomized, controlled trial including patient undergoing labor induction for PROM at term with an unfavorable cervix in Clermont-Ferrand university hospital. We compared the double balloon catheter over a period of 12 h with adjunction of oxytocin 6 h after catheter insertion versus dinoprostone vaginal insert.

Induction of labour in case of premature rupture of membranes at term with an unfavourable cervix: protocol for a randomised controlled trial comparing double balloon catheter (+oxytocin) and vaginal prostaglandin (RUBAPRO) treatments.

Introduction: Premature rupture of membranes (PROM) occurs at term in 8% of pregnancies. Several studies have demonstrated that the risk of chorioamnionitis and neonatal sepsis increases with duration of PROM. Decreasing the time interval between PROM and delivery is associated with lower rates of maternal infections.

Effects of low intraperitoneal pressure and a warmed, humidified carbon dioxide gas in laparoscopic surgery: a randomized clinical trial.

Laparoscopic surgery technology continues to advance. However, much less attention has been focused on how alteration of the laparoscopic surgical environment might improve clinical outcomes. We conducted a randomized, 2 × 2 factorial trial to evaluate whether low intraperitoneal pressure (IPP) (8 mmHg) and/or warmed, humidified CO (WH) gas are better for minimizing the adverse impact of a CO pneumoperitoneum on the peritoneal environment during laparoscopic surgery and for improving clinical outcomes compared to the standard IPP (12 mmHg) and/or cool and dry CO (CD) gas.

Trauma and endometriosis. A review. May we explain surgical phenotypes and natural history of the disease?

Objective: The study was performed to evaluate whether trauma is an initial event of development of endometriosis.

Method: Using Medline database from January 1960 up to December 2014, a systematic review was made of all published studies using the keywords trauma, healing, injury, infection, hyperperistaltism, stretch and endometriosis, adenomyosis and trauma. Studies and review articles written in French and/or in English related to the topic were included and reviewed independently by two authors.

[About a case of uterine per-partum rupture, 37months after resection of a rectovaginal endometriosis nodule].

Endometriosis is a common condition in women, whose main repercussions are painful symptoms. In addition, it was shown that endometriosis was a major cause of infertility and various obstetric complications could be related to this pathology. Uterine rupture is a rare but serious complication whose incidence tends to decrease with the screening of women at risk, however, its fetal, maternal morbidity and mortality causes remains important.

[Predictors of failed trial of labor in obese nulliparous].

Objectives: To identify predictors of failed trial of labour (TOL) in obese nulliparous at term.

Patients And Methods: Retrospective study about 213 nulliparous with a body mass index (BMI) greater than 30kg/m(2) who delivered a vertex singleton after 37 weeks of gestation (WG). Planned caesarean sections were excluded.

[Interest of a structured laparoscopy training in a simulation center: survey of resident's point of view].

Objective: Assess residents satisfaction within their participation to a short and structured training to laparoscopy, gathering theoretical and practical issues.

Methods: This course was divided in two periods of 3days including an individual prospective evaluation. For each period, the residents have answered to three questionnaires trying to evaluate their experience in laparoscopy and their short term and medium term satisfaction.

Analysis of risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for ovarian endometriosis.

Background: The aim of this study was to identify risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for endometriosis.

Methods: A total of 121 patients who had histologically confirmed ovarian endometriosis and 56 control patients who had other histologically confirmed benign cysts were included for the present analysis. The blocks of removed tissue were sectioned at 120 microm intervals and a total of five sections were analyzed for each ovarian cyst.

Excision of the posterior vaginal fornix is necessary to ensure complete resection of rectovaginal endometriotic nodules of more than 2 cm in size.

The minimum distance between the vaginal mucosal epithelium and the endometriotic glands was <1,000 microm in 30 patients (49.2%), <2,000 microm in 44 patients (72.1%), and <5,000 microm in 60 patients (98.

[Autoimmune hepatitis and pregnancy: about a patient's three consecutive pregnancies].

Spontaneous evolution of autoimmune hepatitis during pregnancy is not well known, nor are its consequences on pregnancy evolution. Immunosuppressive treatment during pregnancy is sometimes necessary but the long- and short-term consequences are unrecognized. We relate a patient's disease with autoimmune hepatitis and cirrhosis and three consecutive pregnancies with different obstetrical and medical complications.

[Breech presentation and vaginal delivery: evolution of acceptability by obstetricians and patients].

Objective: To investigate the influence of obstetrician and patient respectively on mode of delivery in case of breech presentation at term.

Patients And Methods: This retrospective study included all women with a singleton pregnancy in a breech presentation delivered at term in a tertiary care maternity unit from January 1998 to December 2004. Mode of delivery was suggested by a score based on maternal age, parity, obstetrical past history, radiopelvimetry and cephalopelvic confrontation.

[Neonatal morbidity after conservative management followed by systematic delivery at thirty-four weeks of gestation in preterm rupture of membranes].

Objective: To evaluate the neonatal morbidity and its risks factors in case of uncomplicated preterm rupture of membranes managed conservatively with subsequent planned delivery at 34 weeks of gestation.

Patients And Methods: We studied retrospectively 42 consecutive neonates systematically delivered at 34 weeks of gestation after more than 48 hours of conservative management for uncomplicated preterm rupture of membranes. Conservative management was conducted in a single tertiary care center and consisted in corticotherapy and in antibiotherapy (amoxycilline during 7 days).

[Obstetrical prognosis of labour induction with mifepristone after 41 weeks of gestation].

Objective: To compare the mode of delivery in two groups of patients selected by their response after induction of labour with mifepristone.

Patients And Methods: We studied retrospectively 89 cases of labour induction with viable children after 41 weeks of gestation. Bishop scores were less than 6.

Laparoscopic management of adnexal masses: a gold standard?

Purpose Of Review: To review recent literature on the laparoscopic management of adnexal masses, when this approach may be considered as a gold standard.

Recent Findings: Cyst rupture was recently demonstrated to be a significant prognostic factor in stage I invasive epithelial carcinoma, and it was recommended to restrict the laparoscopic approach to patients with preoperative evidence that the cyst was benign. The laparoscopic approach is still highly controversial in masses suspicious at ultrasound.

[Laparoscopy and gynecologic cancer: is it still necessary to debate or only convince the incredulous?].

Many papers suggested that laparoscopic treatment of cancer could be achieved and taught safely. Although cases reports about trocar site metastasis and national survey about inadequate management of early ovarian cancer suggested that laparoscopic management of cancer may be dangerous. The current literature may be summarized as follows.

[Prevention of peritoneal adhesions].

Peritoneal adhesions are a major problem for health and economy. An adequate and atraumatic surgical technique is essential in the prevention of peritoneal adhesions. Laparoscopic microsurgery should be developed and promoted.