Publications by authors named "Lous M"

Objective: To assess the maternal and fetal benefits of delaying oxytocin perfusion by 24 h following labor induction by amniotomy after 41 weeks of gestation (WG).

Methods: We performed a retrospective review including all women with a vertex presentation fetus who had an indication for labor induction by amniotomy with or without oxytocin after 41 WG between 2015 and 2022. Patients who underwent an IOL by amniotomy followed by oxytocin perfusion within 0 to 4 hours (early oxytocin group: EO group) were compared with patients who underwent an IOL by amniotomy alone or followed by an oxytocin perfusion after an expectant period for up to 24 hours in the absence of a spontaneous onset of labor (delayed oxytocin group: DO group).

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In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network.

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  • This study investigates how ultrasound probe movement varies during mid-trimester anomaly scans in a UK teaching hospital.
  • Researchers recorded and analyzed video data of 17 scans, measuring various metrics like probe velocity, acceleration, and motion patterns in relation to the operators’ expertise and other factors.
  • Results showed that more experienced consultants had significantly slower probe speeds and smoother motion compared to fellows, but angular measurements showed no significant differences related to expertise or patient characteristics.
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  • Uterine innervation is crucial to female reproductive health and has significant implications for conditions like endometriosis; recent histological advances have revealed its complex structure and role in these disorders.
  • This review summarizes current research on uterine innervation, focusing on its effects on endometriosis and associated pain, using a systematic approach to analyze relevant studies.
  • The review identified 45 studies that highlighted a trend towards increased nerve fiber density in ectopic endometrial tissue, suggesting a link between this heightened innervation and the chronic pain seen in endometriosis patients.
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Objective: Pelvic examination including vaginal digital examination and speculum inspection are crucial medical skills that are challenging to teach for both professors and students, because of its intimate nature. Consequently, education has shifted from a traditional approach to a simulation-enhanced education. This literature review summarizes the level of evidence for these not-so-new training modalities.

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Objective: The aim of the study was a retrospective evaluation of labor induction in women with one previous cesarean section. The primary outcome was the mode of delivery. We also studied the severe maternal and neonatal morbidity and identify some prediction factors of vaginal delivery after labor induction after one previous cesarean section.

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Introduction: Environmental factors in the operating room during cesarean sections are likely important for both women/birthing people and their babies but there is currently a lack of rigorous literature about their evaluation. The principal aim of this study was to systematically examine studies published on the physical environment in the obstetrical operating room during c-sections and its impact on mother and neonate outcomes. The secondary objective was to identify the sensors used to investigate the operating room environment during cesarean sections.

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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.

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Introduction: Despite awareness of obstetricians to the constant increase in the number of cesarean sections in recent years, the fear of a uterine scar rupture is still present and influences the choice of the mode of delivery in patients with two previous cesarean sections. However, several clinical studies have suggested that, under certain conditions, vaginal birth after two cesarean sections is usually successful and safe.

Objective: The objective of this study was to compare maternal and neonatal issues according to the planned mode of delivery in patients with two previous cesarean sections.

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  • The objective of the guidelines is to standardize the pelvic clinical exam for gynecology and obstetrics, ensuring practices are evidence-based.
  • A committee of 45 experts, including patient representatives, developed these guidelines independently, focusing on high-quality recommendations using the GRADE® system.
  • They formulated 40 questions into a PICO format, yielding 27 recommendations, with differing levels of agreement, while highlighting the need for more research in areas lacking evidence.
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Differences of sex development (DSDs) are a group of congenital conditions characterized by a discrepancy between chromosomal, gonadal, and genital sex development of an individual, with significant impact on medical, psychological and reproductive life. The genetic heterogeneity of DSDs complicates the diagnosis and almost half of the patients remains undiagnosed. In this context, chromosomal imbalances in syndromic DSD patients may help to identify new genes implicated in DSDs.

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  • Hemostasis Hysterectomy (HH) is a rare but critical emergency procedure for post-partum hemorrhage, and all obstetrician-gynecologists should be prepared to perform it, despite limited training opportunities during residency.
  • A survey of French obstetrics and gynecology fellows revealed that only half had performed an HH during residency, with a majority having limited experience in scheduled hysterectomies.
  • The study concluded that lack of sufficient surgical exposure in residency hampers the development of competence in HH, highlighting a gap in training that needs to be addressed.
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  • About 15% of women in developed countries are exposed to solvents at work during pregnancy, but the effects on fetal growth vary based on the type of solvent (oxygenated, petroleum, chlorinated).
  • The study aims to explore how maternal exposure to different solvent families during pregnancy impacts the risk of neonatal outcomes, such as being small for gestational age (SGA) or having low birthweight.
  • Results indicate that exposure to petroleum and oxygenated solvents is linked to a higher risk of SGA and lower birth weights and head circumferences, highlighting potential risks of specific solvent types during pregnancy.
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Introduction: We set out to assess the compliance with a cesarean section color code protocol and its impact on maternal and neonatal outcomes since its implementation in our maternity ward.

Methods: This was a retrospective study including a sample of 200 patients per year who underwent a non-elective cesarean section delivery in Rennes University Hospital from January 1, 2015 to December 31, 2018. Patients were grouped by year and by color code (red, orange or green).

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Objective: The objective was to assess the predictive value of head-perineum distance measured at the initiation of the active second stage of labor on the mode of delivery.

Material And Methods: It was a prospective cohort study in an academic Hospital of Rennes, France, from July 1, 2020 to April 4, 2021 including 286 full-term parturients who gave birth to a newborn in cephalic presentation. A double-blind ultrasound measurement of the head-perineum distance was performed during the second phase of labor within five minutes after the onset of pushing efforts.

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  • This study compares outcomes for women with low-lying placenta who either chose a trial of labor or an elective cesarean delivery, focusing on severe postpartum hemorrhage and maternal/neonatal morbidity.
  • Conducted in France from 2007-2012, it involved 171 women out of 128,233 births, with similar rates of severe postpartum hemorrhage and morbidity between both delivery modes.
  • The findings suggest that a trial of labor may be safe for women with an internal os distance of 11-20 mm after 35 weeks, although those with a distance of 1-10 mm showed lower rates of vaginal delivery.
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  • Tranexamic acid (TXA) after cesarean delivery may reduce blood loss and transfusions, but it doesn’t significantly help with other hemorrhage-related issues, making its routine use uncertain.
  • The study aimed to see if TXA is effective in preventing blood loss specifically for women with multiple pregnancies undergoing cesarean deliveries.
  • Results showed no significant difference in blood loss between women receiving TXA and those on placebo, indicating that TXA may not be beneficial in this high-risk group.
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Background: Prophylactic administration of tranexamic acid has been associated with reduced postpartum blood loss after cesarean delivery in several small trials, but evidence of its benefit in this clinical context remains inconclusive.

Methods: In a multicenter, double-blind, randomized, controlled trial, we assigned women undergoing cesarean delivery before or during labor at 34 or more gestational weeks to receive an intravenously administered prophylactic uterotonic agent and either tranexamic acid (1 g) or placebo. The primary outcome was postpartum hemorrhage, defined as a calculated estimated blood loss greater than 1000 ml or receipt of a red-cell transfusion within 2 days after delivery.

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  • Preeclampsia is a pregnancy-related condition linked to abnormal placentation, and there is growing suspicion that environmental chemicals like pesticides may contribute to this syndrome, although research has been limited.
  • This study examined the relationship between non-occupational pesticide exposure during pregnancy and preeclampsia risk in a cohort of 195 women with and 17,181 without the condition, using various data collection methods.
  • The findings indicated that higher levels of prochloraz near the homes of women with preeclampsia were associated with an increased risk, particularly for early diagnoses, while exposure to cypermethrin seemed to have a protective effect; no significant link was found between dietary pesticide exposure and preeclampsia
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Background: Uterine transplant (UT) represents an opportunity to treat absolute uterine infertility. However, the use of uterine veins for venous return, in addition to ovarian veins, significantly increases the risk of ureteral wounds in the living donor and UT time for the recipient. Our aim was to demonstrate that dual ovarian venous return is sufficient for graft viability and survival.

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Obstetric ultrasound simulators are now used for training and evaluating OB/GYN students but there is a lack of literature about evaluation metrics in this setting. In this literature review, we searched MEDLINE and the COCHRANE database using the keywords: (Obstetric OR Fetal) AND (Sonography OR Ultrasound) AND Simulation. Of a total of 263 studies screened, we selected nine articles from the title and the abstract in PubMed, in the past 5 years.

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Introduction: We aimed to assess the diagnostic yield of ultrasonography in the identification of the etiology of hydramnios, and the added value of MRI or amniocentesis.

Methods: We conducted a single-center retrospective study including pregnancies with confirmed hydramnios (defined as deepest pocket ≥8 cm) between January 2013 and May 2017. Twin pregnancies, secondary hydramnios discovered after the diagnosis of a causal pathology, and pregnancies of unknown outcome were excluded.

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Introduction: Endocrine disruptors (ED) such as phthalates or bisphenol A are ubiquitous and pregnant women and children are particularly vulnerable. Perinatal health professionals are well-placed to inform pregnant women about the risks. We set out to evaluate perinatal health professionals' knowledge of ED and the information they give during pregnancy.

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