Doppler analysis of the umbilical artery: why we must prefer the free loop of the cord.

Aim: The main objective was to confirm with modern tools the former assertion that there is a vascular resistance gradient along the umbilical cord.

Methods: We performed a prospective observational study in a population of women with third trimester monofetal and uncomplicated pregnancies during two months. Pulsatility Index and Resistance Index were calculated on three sites: placental end, free loop and fetal end of the cord.

Late post-partum dyspareunia: does delivery play a role?

Objective: To study whether post-partum dyspareunia one year after a delivery is associated with characteristics of delivery: perineal trauma, obstetric interventions and women's experience.

Methods: A self-administered questionnaire on post-partum sexual function was mailed in May 2002 to all consecutive women who gave birth to a live-born term infant in a maternity unit, between January 2001 and June 2001. Obstetric data were abstracted from the hospital computerized medical database.

Mobile uterine retroversion is associated with dyspareunia and dysmenorrhea in an unselected population of women.

Objective: To determine if isolated retroversion is a cause of pelvic pain symptoms.

Study Design: One hundred and eleven premenopausal women consulting for routine examination in the gynecology department of two hospitals and two gynecologic private practices were evaluated for chronic pelvic pain symptoms with a self-administered questionnaire. Uterine position and mobility was assessed by pelvic examination.

Cervical assessment at 22 and 27 weeks for the prediction of spontaneous birth before 34 weeks in twin pregnancies: is transvaginal sonography more accurate than digital examination?

Objectives: This study compared the accuracy of ultrasound cervical assessment (cervical length and cervical index) and digital examination (Bishop score and cervical score) in the prediction of spontaneous birth before 34 weeks in twin pregnancies.

Methods: In a prospective multicenter study, digital examination and transvaginal sonography were performed consecutively in twin pregnancies attending for routine sonography at either 22 weeks (175 women) or 27 weeks (153 women). The digital examination took place first, and the Bishop score and cervical score (cervical length minus cervical dilatation) were calculated.

[Risk of very preterm delivery: can we refrain from in utero transfer and manage these patients in level I and II maternity wards?].

The frequency of premature delivery is estimated at 0.5% of births (approximately 2000 per year in France). The rate of in utero transfers before 28 weeks, although difficult to evaluate, is well above this percentage, raising the risk of overloading level III maternity wards.