Publications by authors named "Pierre Emmanuel Bouet"
Background: The global increase in caesarean sections (CS), currently at 21.1% of all deliveries, has led to a rise in uterine scar defects, or 'niches', at the hysterotomy site. These niches, detectable in 13%-84% of cases via transvaginal ultrasound (TVS) and 42%-84% through sonohysterography (SHG), may contribute to gynaecological complications, including abnormal uterine bleeding, chronic pain and secondary infertility.
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- A study was conducted to evaluate the effects of a training program for oocyte retrieval (ORSTP) on the clinical performance of medical residents.
- Residents who completed the ORSTP showed similar rates of successful oocyte retrieval compared to those who did not receive the training.
- Although the training did not enhance the actual performance metrics, it was found that those who underwent the training experienced less stress and had greater confidence in their oocyte retrieval abilities.
The SYNAPPH Study: Uterine Synechiae Prevalence After a Postpartum Hemorrhage, a Pilot Study.
J Minim Invasive Gynecol
October 2024
Article Synopsis
- The study aimed to assess how common intrauterine synechiae (scar tissue) are after women undergo medically-treated postpartum hemorrhage (PPH) and how different treatment methods might influence this condition.
- Conducted at Angers University Hospital, the study involved 83 women who experienced PPH, with diagnostic hysteroscopy performed 12 weeks after delivery to check for synechiae.
- Findings showed that 24% of participants had mild synechiae, with second manual uterine examinations and bimanual massage identified as key risk factors, indicating a need for more research on the long-term effects of these complications.
Article Synopsis
- The study evaluated the effects of partial term prelabor rupture of membranes (TPROM) on the spontaneous onset of labor, comparing it with complete TPROM in over 389 women at a French maternity hospital.
- Findings revealed that only 45% of women with partial TPROM went into spontaneous labor within 24 hours, significantly lower than the 64% for those with complete TPROM.
- The study concluded that having a partial TPROM increases the likelihood of not going into labor within 24 hours, indicating that residual membranes might delay labor onset.
Article Synopsis
- - Cervical ectopic pregnancy is a rare condition, making up less than 1% of all ectopic pregnancies, and the case highlighted involves a successfully managed instance at 9 weeks gestation.
- - The management involved minimally invasive techniques, including uterine artery embolization and the administration of methotrexate, with no complications observed during follow-up.
- - After treatment, the patient's β-hCG levels normalized by Day 104, and the uterine cavity fully recovered within 6 months, along with a literature review on cervical ectopic pregnancy.
Article Synopsis
- The article outlines a transvaginal radiofrequency ablation of myomas (TRAM) procedure in 10 key steps aimed at treating a 38-year-old woman suffering from heavy menstrual bleeding and chronic anemia due to a large cervical myoma.
- Following a failed embolization, TRAM was chosen because of its minimal invasiveness and the patient's desire for future pregnancies.
- The authors conclude that while TRAM is a promising alternative to traditional surgical methods, there are concerns about its safety regarding infertility and pregnancy, as current devices are not recommended for women who wish to conceive.
Article Synopsis
- The study aimed to compare two different cancellation policies for COS-IUI cycles to reduce the risk of multiple pregnancies (MP).
- Conducted at two medical centers, it analyzed data from 7056 COS-IUI cycles from 2011 to 2019, using an algorithm in one group and a physician-dependent strategy in the other.
- Results showed that the algorithm-based strategy significantly lowered the MP rate (8.1% vs 13.3%) without affecting the live-birth rate, indicating its effectiveness in improving outcomes.
Article 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.
Background: Periventricular cysts are one of the most extensively documented antenatal brain lesions found through fetal ultrasound at the University Hospital of Angers. The main purpose of our study was to determine the contribution of fetal magnetic resonance imaging (MRI) and postnatal transfontanellar ultrasound (TFU) in the assessment of isolated periventricular cysts found on antenatal ultrasound at the University Hospital of Angers.
Methods: This retrospective, descriptive study was carried out over a 10-year period.
Background: The Obstetric Quality of Recovery-10 (ObsQoR-10) is a validated tool for assessing the quality of postpartum recovery. This study aimed to validate the French version of the ObsQoR-10 scale (ObsQoR-10-French).
Methods: After translating the ObsQoR-10 into French, we conducted a psychometric validation involving internal consistency, convergent validity, construct validity, reliability, responsiveness, scaling properties, acceptability, and feasibility.
Article Synopsis
- Assisted reproductive technology (ART) is linked to increased preterm births, but this study focuses on the neurodevelopmental outcomes of 4-year-old children born prematurely after ART compared to those conceived naturally.
- The study included 166 ART and 679 naturally conceived preterm infants, assessing their neurodevelopment at 4 years using the age and stage questionnaire (ASQ).
- Findings revealed that ART infants had a lower risk of difficulties in at least two ASQ domains, with male gender, lower socio-economic status, and gestational age between 25-30 weeks being associated with poorer outcomes; overall, ART preterm children showed similar, if not better, long-term neurodevelopment than their naturally conceived counterparts.
Male infertility has increased in the last decade. Pathophysiologic mechanisms behind extreme oligospermia (EO) are not yet fully understood. In new “omics” approaches, metabolomic can offer new information and help elucidate these mechanisms.
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- The study investigates whether women with Diminished Ovarian Reserve (DOR) experience not only a decline in the number of available eggs but also a decrease in the quality of those eggs and embryos.
- A total of 1314 embryos were analyzed from couples undergoing IVF or ICSI, divided into groups based on ovarian reserve (DOR and Normal Ovarian Reserve - NOR) and various factors were controlled for in the analysis.
- Results indicated no significant differences in embryo development metrics between DOR and NOR groups, though older maternal age seemed to correlate with slower embryo development, highlighting possible biases in existing literature.
Article Synopsis
- The study aimed to determine if measuring serum estradiol levels on trigger day in controlled ovarian stimulation with intrauterine insemination (COS-IUI) could decrease the rate of multiple pregnancies.
- Conducting an observational study from 2011 to 2019, researchers analyzed data from 455 clinical pregnancies out of 3387 COS-IUI cycles, noting a multiple pregnancy rate of 8.1%.
- Results indicated that estradiol levels were not predictive of multiple pregnancies, suggesting that measuring these levels does not effectively reduce multiple pregnancy risks when strict cancellation criteria are used.
Article Synopsis
- The study investigates the effectiveness of a half-dose of antenatal betamethasone (11.4 mg) compared to the standard full dose (24 mg) in preventing respiratory distress syndrome in preterm infants while minimizing potential side effects.
- It is a randomized, double-blind, placebo-controlled trial conducted in 37 perinatal centers in France involving pregnant women at risk of preterm delivery who had already received the first injection of the medication.
- The primary outcome measured was the need for additional surfactant treatment within 48 hours of birth, with the researchers aiming to demonstrate that the half dose was non-inferior to the full dose based on specific statistical criteria.
Article Synopsis
- * At two weeks post-demise, 44.2% of women showed significant PTSD symptoms, decreasing to 34.1% at one month and 9.1% at three months.
- * Key risk factors for developing PTSD included experiencing peritraumatic dissociation, seeing or holding the fetus, and organizing a funeral service. Care providers should be alert to these risk factors for better patient support.
Background: Preterm delivery is a risk factor for suboptimal neurodevelopment. Pregnancies conceived after medically assisted reproduction-which includes in vitro fertilization, with or without intracytoplasmic insemination, and induction of ovulation followed by intrauterine insemination or timed intercourse-have a higher risk of preterm delivery. Few studies have evaluated the outcome at >2 years of age of such preterm-born children.
View Article and Find Full Text PDFIntroduction: Non-tubal ectopic pregnancies (NTEP) in France constitute approximately 5% of ectopic pregnancies (EP). A NTEP can be abdominal, ovarian, cervical, interstitial, on a caesarean scar, or cornual. These pregnancies, which are sometimes difficult to diagnose and are often diagnosed late, carry a high risk of complications, particularly haemorrhages.
View Article and Find Full Text PDFTime-lapse systems (TLS) and associated algorithms are interesting tools to improve embryo selection. This study aimed to evaluate how TLS and KIDScore™ algorithm changed our practices of embryo selection, as compared to a conventional morphological evaluation, and improved clinical pregnancy rates (CPR). In the study group (year 2020, = 303 transfers), embryos were cultured in an EmbryoScope+ time-lapse incubator.
View Article and Find Full Text PDFObjective: To validate a mathematical model to predict the mean time to delivery (TTD) following cervical ripening with dinoprostone vaginal insert (DVI), and assess its impact on the risk of nocturnal deliveries.
Methods: We performed a case-control retro-prospective study at Angers University Hospital. In the control group, we retrospectively included 405 patients who underwent cervical ripening with DVI between 01/2015 and 09/2016.
Study Objective: Evaluation of the efficacy of different injection sites of methotrexate in the treatment of nontubal ectopic pregnancies.
Design: Retrospective multicenter study.
Setting: Multicenter, including 3 teaching hospitals, an intercommunal hospital, and a clinic.
Objective: To provide guidelines from the French College of Obstetricians and Gynecologists (CNGOF), based on the best currently available evidence, for the prophylactic procedures associated with gynecological surgery for benign disease such as superficial endometriosis lesions and adhesions.
Methods: The CNGOF has decided to adopt the AGREE II and GRADE systems for grading scientific evidence. Each recommendation for practice was allocated a grade that reflects the quality of evidence (QE) (clinical practice guidelines).
Introduction: Serum oestradiol concentration at the time of frozen embryo transfer (FET) in artificial cycle are lower when using transdermal administration of oestrogen for endometrial preparation compared to the vaginal route. This difference could have consequences for placentation and establishment of maternal-foetal circulation. The aim of our study was to compare the birth weight of newborns and the perinatal issues after FET in an artificial cycle with regard to the route of administration of oestrogens.
View Article and Find Full Text PDFObjective: To evaluate whether manual rotation of fetuses in occiput posterior positions at full dilation increases the rate of spontaneous vaginal delivery.
Methods: In an open, single-center, randomized controlled trial, patients with a term, singleton gestation, epidural analgesia, and ultrasonogram-confirmed occiput posterior position at the start of the second stage of labor were randomized to either manual rotation or expectant management. Our primary endpoint was the rate of spontaneous vaginal delivery.