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  • 1
    Language: English
    In: Scientific reports, 2021-03-19, Vol.11 (1), p.6839-6839
    Description: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
    Subject(s): Vagina ; Epidemiology ; Risk factors ; Index Medicus
    ISSN: 2045-2322
    E-ISSN: 2045-2322
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
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  • 2
    Language: English
    In: Scientific reports, 2020-11-19, Vol.10 (1), p.20208-20208
    Description: Episiotomy use has decreased due to the lack of evidence on its protective effects from maternal obstetric anal sphincter injuries. Indications for episiotomy vary considerably and there are a great variety of factors associated with its use. The aim of this article is to describe the episiotomy rate in France between 2013 and 2017 and the factors associated with its use in non-operative vaginal deliveries. In this retrospective population-based cohort study, we included vaginal deliveries performed in French hospitals (N = 584) and for which parity was coded. The variable of interest was the rate of episiotomy, particularly for non-operative vaginal deliveries. Trends in the episiotomy rates were studied using the Cochran-Armitage test. Hierarchical logistic regression was used to identify variables associated with episiotomy according to maternal age and parity. Between 2013 and 2017, French episiotomy rates fell from 21.6 to 14.3% for all vaginal deliveries (p 〈 0.01), and from 15.5 to 9.3% (p 〈 0.01) for all non-operative vaginal deliveries. Among non-operative vaginal deliveries, epidural analgesia, non-reassuring fetal heart rate, meconium in the amniotic fluid, shoulder dystocia, and newborn weight (≥ 4,000 g) were risk factors for episiotomy, both for nulliparous and multiparous women. On the contrary, prematurity reduced the risk of its use. For nulliparous women, breech presentation was also a risk factor for episiotomy, and for multiparous women, scarred uterus and multiple pregnancies were risk factors. In France, despite a reduction in episiotomy use over the last few years, the factors associated with episiotomy have not changed and are similar to the literature. This suggests that the decrease in episiotomies in France is an overall tendency which is probably related to improved care strategies that have been relayed by hospital teams and perinatal networks.
    Subject(s): Episiotomy - adverse effects ; Humans ; Risk Factors ; Episiotomy - trends ; Practice Patterns, Physicians' - trends ; Pregnancy ; Practice Patterns, Physicians' - statistics & numerical data ; Episiotomy - statistics & numerical data ; Adult ; Female ; Retrospective Studies ; France ; Infant, Newborn ; Episiotomy ; Pain perception ; Fetuses ; Vagina ; Population studies ; Sphincter ; Epidemiology ; Risk factors ; Heart rate ; Analgesia ; Uterus ; Amniotic fluid ; Meconium ; Parity ; Index Medicus ; Psychology ; Humanities and Social Sciences ; Episiotomy / trends ; Practice Patterns, Physicians' / statistics & numerical data ; Episiotomy / statistics & numerical data ; Episiotomy / adverse effects ; Practice Patterns, Physicians' / trends
    ISSN: 2045-2322
    E-ISSN: 2045-2322
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
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  • 3
    Language: English
    In: BMC pregnancy and childbirth, 2018-06-04, Vol.18 (1), p.208-208
    Description: Since the 2000s, selective episiotomy has been systematically recommended worldwide. In France, the recommended episiotomy rate in vaginal deliveries is less than 30%. The aims of this study were to describe the evolution of episiotomy rates between 2007 and 2014, especially for vaginal deliveries without instrumental assistance and to assess individual characteristics and birth environment factors associated with episiotomy. This population-based study included all hospital discharge abstracts for all deliveries in France from 2007 to 2014. The use of episiotomy in vaginal deliveries was identified by one code in the French Common Classification of Medical Procedures. The episiotomy rate per department and its evolution is described from 2007 to 2014. A mixed model was used to assess associations with episiotomy for non-operative vaginal deliveries and the risk factors related to the women's characteristics and the birth environment. There were approximately 540,000 non-operative vaginal deliveries per year, in the study period. The national episiotomy rate for vaginal deliveries overall significantly decreased from 26.7% in 2007 to 19.9% in 2014. For non-operative deliveries, this rate fell from 21.1% to 14.1%. For the latter, the use of episiotomy was significantly associated with breech vaginal delivery (aOR = 1.27 [1.23-1.30]), epidural analgesia (aOR = 1.45 [1.43-1.47]), non-reassuring fetal heart rate (aOR = 1.47 [1.47-1.49]), and giving birth for the first time (aOR = 3.85 [3.84-4.00]). The episiotomy rate decreased throughout France, for vaginal deliveries overall and for non-operative vaginal deliveries. This decrease is probably due to proactive changes in practices to restrict the number of episiotomies, which should be performed only if beneficial to the mother and the infant.
    Subject(s): Pregnancy ; Young Adult ; Humans ; Risk Factors ; Delivery, Obstetric - trends ; Vagina ; Adult ; Female ; Retrospective Studies ; France ; Episiotomy - trends ; Fecal incontinence ; Hospitals ; Womens health ; Decision making ; Medical procedures ; Gynecology ; Trauma ; Childbirth & labor ; Index Medicus ; Life Sciences ; Human health and pathology ; Gynecology and obstetrics ; Santé publique et épidémiologie ; Episiotomy ; Hospital discharge abstracts ; Vaginal deliveries ; Birth
    ISSN: 1471-2393
    E-ISSN: 1471-2393
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
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  • 4
    Language: English
    In: BMC pregnancy and childbirth, 2019-08-16, Vol.19 (1), p.300-300
    Description: Though the rate of episiotomy has decreased in France, the overall episiotomy rate was 20% in the 2016 national perinatal survey. We aimed to develop a classification to facilitate the analysis of episiotomy practices and to evaluate whether episiotomy is associated with a reduction in the rate of obstetric anal sphincter injuries (OASIS) for each subgroup. This population-based study included all the deliveries that occurred in the Burgundy Perinatal Network from 2011 to 2016. The main outcome was episiotomy, which was identified thanks to the French Common Classification of Medical Procedures. An ascending hierarchical cluster analysis was performed to build the classification. A clinical audit using the classification was conducted yearly in all obstetric units. The episiotomy rates were described throughout the study period for each subgroup of the classification. The OASIS rates were evaluated by subgroup and the association between mediolateral episiotomy and OASIS was investigated for each subgroup. Our analyses included 81,290 pregnant women. The classification comprised 7 subgroups: nulliparous single cephalic at term, nulliparous single cephalic at term with instrumental delivery, multiparous single cephalic at term, multiparous single cephalic at term with instrumental delivery, all preterm deliveries (〈 37 weeks gestation), all breech deliveries, all multiple deliveries. Episiotomy rates ranged from 6.2% in Group 3 to 40.9% in Group 2. From 2011 to 2016, every group except breech deliveries experienced a significant decrease in episiotomy rates, ranging from - 28.1 to - 61.0%. The prevalence of OASIS was the highest in Groups 2 (3.0%) and 4 (2.2%). Overall OASIS rates did not significantly differ with episiotomy use (P = 0.25). However, we found that the use of episiotomy was associated with a reduction in OASIS rates in Groups 1 and 2 (odds ratio 0.6 [95% CI 0.4-0.9] and 0.4 [0.3-0.5], respectively). This reduction was only observed in Group 4 with forceps delivery (odds ratio 0.4 [0.1-0.9]). We developed the first classification for the evaluation of episiotomy practices based on 7 clinically relevant subgroups. This easy-to-use tool can help obstetricians and midwives improve their practices through self-assessment.
    Subject(s): France - epidemiology ; Humans ; Obstetric Labor Complications - prevention & control ; Obstetrics - statistics & numerical data ; Clinical Audit ; Pregnancy ; Young Adult ; Obstetric Labor Complications - epidemiology ; Episiotomy - statistics & numerical data ; Adult ; Female ; Delivery, Obstetric - statistics & numerical data ; Odds Ratio ; Anal Canal - injuries ; Index Medicus ; Life Sciences ; Human health and pathology ; Gynecology and obstetrics ; Santé publique et épidémiologie ; Ascending hierarchical classification ; Episiotomy ; Vaginal delivery ; OASIS
    ISSN: 1471-2393
    E-ISSN: 1471-2393
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
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  • 5
    Language: English
    In: Fertility and sterility, 2016, Vol.107 (1), p.97-103.e4
    Description: Objective To determine the prognostic impact of the nuclear status at the two-cell stage on intracytoplasmic sperm injection (ICSI) outcomes. Design Retrospective study. Setting Hospital. Patient(s) Only ICSI cycles with time-lapse monitoring of transferred embryos with known implantation/delivery data from November 2012 to December 2014 were included. A total of 2,449 embryos were assessed for multinucleation rates at the two- and four-cell stage, and 608 transferred embryos were studied for ICSI outcomes. Intervention(s) None. Main Outcome Measure(s) Implantation rate (IR) and live birth rate (LBR) according to the number of multinucleated blastomeres at the two-cell stage: none (Without-MNB2cell ), one (MNB1/2cell ), and two (MNB2/2cell ); morphokinetics of MNB2cell embryos. Result(s) Embryos with MNB1/2cell led to lower IR (27.7%) and LBR (22.7%) than embryos Without-MNB2cell (33.4% and 29.8%, respectively). The MNB2/2cell embryos led to significantly lower IR (18.3%) and LBR (13.4%) than embryos Without-MNB2cell . This difference remained significant in multivariate analysis for implantation (odds ratio 0.57; 95% confidence interval 0.34–0.94) and birth (odds ratio 0.46; 95% confidence interval 0.26–0.80), independently of the other significant parameters (women's age, time of two-cell formation, and multinucleation at the four-cell stage). Among implanted MNB2cell , if cleavage into four cells occurred later than 37 hours after insemination, embryos were significantly more likely to lead to birth. Conclusion(s) The presence of multinucleation at the two-cell stage and more specifically in both blastomeres had a significant negative impact on birth potential. Thus, embryo multinucleation at the two-cell stage should be used as an additional noninvasive criterion for embryo selection.
    Subject(s): Internal Medicine ; Obstetrics and Gynecology ; Birth rate ; implantation ; ICSI outcomes ; embryo multinucleation ; time-lapse system ; Multivariate Analysis ; Humans ; Microscopy, Video ; Cleavage Stage, Ovum ; Embryo Transfer - adverse effects ; Fertility ; Female ; Infertility - physiopathology ; Time-Lapse Imaging - methods ; Retrospective Studies ; Odds Ratio ; Infertility - therapy ; Pregnancy Rate ; Live Birth ; Risk Factors ; Logistic Models ; Treatment Outcome ; Blastomeres - cytology ; Chi-Square Distribution ; Embryo Implantation ; Pregnancy ; Infertility - diagnosis ; Embryo, Mammalian - cytology ; Sperm Injections, Intracytoplasmic - adverse effects ; Cell Nucleus ; Embryonic development ; Spermatozoa ; Embryo ; Analysis ; Index Medicus
    ISSN: 0015-0282
    E-ISSN: 1556-5653
    Source: Alma/SFX Local Collection
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  • 6
    Language: English
    In: Cost effectiveness and resource allocation, 2018, Vol.16 (1), p.21-21
    Description: Previous studies have showed that the early diagnosis of threatened preterm labor decreases neonatal morbidity and mortality, avoids maternal morbidity induced by antepartum bed rest and unnecessary treatment, and reduces costs. Although there are many diagnostic tests, none is clearly recommended by international guidelines. The aim of our study was to compare seven diagnostic methods in terms of effectiveness and cost using a decision analysis model in singleton pregnancy presenting threatened preterm labor, between 24 and 34 weeks of gestation. Seven diagnostic strategies based on individual or combined use of the following tests: cervical length, cervical fibronectin test, cervical interleukin test and protein in maternal serum, were compared using a decision analysis model. Effectiveness was expressed in terms of serious adverse neonatal events avoided (neonatal morbidity and mortality) at the hospital discharge. The economic analysis was performed from the health care system perspective. Deterministic and probabilistic analyses were performed to test the robustness of the model. At 24-34 weeks of gestation, the association of cervical length and qualitative fibronectin was the most efficient strategy dominating all alternatives, reducing the perinatal death or severe neonatal morbidity rate up to 15% and the costs up to 31% according to the gestational age. This result was confirmed by the deterministic sensitivity analyses. The probabilistic analysis showed that the association of cervical length and qualitative fibronectin dominated cervical length 〈 15 mm in more than 90% of the simulations. The comparison with the other tests revealed more uncertainty. A test using cervical length and qualitative fetal fibronectin appears to be the best diagnostic strategy. Decisions regarding its generalization and funding in France in this population of women should take into account the high, lifetime costs induced by prematurity.
    Subject(s): Decision-making ; Infants (Newborn) ; Fibronectins ; Usage ; Patient outcomes ; Economic aspects ; Infants ; Mothers ; Premature labor ; Pregnancy ; Interleukins ; Pregnant women ; Analysis ; Medical tests ; Diagnosis ; Health aspects ; Plasma ; Economic analysis ; Cytokines ; Premature birth ; Mortality ; Diagnostic tests ; Hospitalization ; Obstetrics ; Morbidity ; Studies ; Ultrasonic imaging ; Womens health ; Cost analysis ; Public health ; Life Sciences ; Human health and pathology ; Gynecology and obstetrics ; Santé publique et épidémiologie ; Diagnostic test ; Preterm birth ; Threatened preterm labor ; Cost-effectiveness ; Economic evaluation
    ISSN: 1478-7547
    E-ISSN: 1478-7547
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
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  • 7
    Language: English
    In: Nature communications, 2018-04-12, Vol.9 (1), p.1431-1431
    Description: Heat shock protein 27 (HSP27/HSPB1) is a stress-inducible chaperone that facilitates cancer development by its proliferative and anti-apoptotic functions. The OGX-427 antisense oligonucleotide against HSP27 has been reported to be beneficial against idiopathic pulmonary fibrosis. Here we show that OGX-427 is effective in two murine models of thrombopoietin- and JAKV617F-induced myelofibrosis. OGX-427 limits disease progression and is associated with a reduction in spleen weight, in megakaryocyte expansion and, for the JAKV617F model, in fibrosis. HSP27 regulates the proliferation of JAK2V617F-positive cells and interacts directly with JAK2/STAT5. We also show that its expression is increased in both CD34 circulating progenitors and in the serum of patients with JAK2-dependent myeloproliferative neoplasms with fibrosis. Our data suggest that HSP27 plays a key role in the pathophysiology of myelofibrosis and represents a new potential therapeutic target for patients with myeloproliferative neoplasms.
    Subject(s): Leukocytes - pathology ; Whole-Body Irradiation ; Humans ; STAT5 Transcription Factor - immunology ; Primary Myelofibrosis - pathology ; Molecular Targeted Therapy ; HSP27 Heat-Shock Proteins - genetics ; Leukocytes - immunology ; STAT5 Transcription Factor - genetics ; Thrombopoietin - immunology ; Oligonucleotides - pharmacology ; Bone Marrow Cells - immunology ; Bone Marrow Transplantation ; HEK293 Cells ; Female ; Disease Models, Animal ; Primary Myelofibrosis - drug therapy ; Janus Kinase 2 - immunology ; Transduction, Genetic ; Mice, Inbred C57BL ; Primary Myelofibrosis - immunology ; Bone Marrow Cells - pathology ; Janus Kinase 2 - genetics ; Mice, Transgenic ; HSP27 Heat-Shock Proteins - immunology ; Thrombopoietin - genetics ; Primary Myelofibrosis - genetics ; Animals ; K562 Cells ; Cell Line, Tumor ; Leukocytes - drug effects ; Mice ; Mutation ; Index Medicus ; Life Sciences ; Cancer
    ISSN: 2041-1723
    E-ISSN: 2041-1723
    Source: Nature Open Access
    Source: PubMed Central
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  • 8
    Language: English
    In: Journal of chemical ecology, 2017-01, Vol.43 (1), p.106-117
    Description: Conjugated forms of odorants contributing to sweat odor occur not only in human sweat but also in amniotic fluid, colostrum, and milk. However, it is unclear whether the released odorants are detected and hedonically discriminated by human newborns. To investigate this issue, we administered highly diluted solutions of (R)/(S)-3-methyl-3-sulfanylhexan-1-ol (MSH), (R)/(S)-3-sulfanylhexan-1-ol (SH), (E)/(Z)-3-methylhex-2-enoic acid (3M2H), and (R)/(S)-3-hydroxy-3-methylhexanoic acid (HMHA) to 3-d-old infants while their respiratory rate and oro-facial movements were recorded. Adult sensitivity to these odorants was assessed via triangle tests. Whereas no neonatal stimulus-specific response was found for respiratory rate, oro-facial reactivity indicated orthonasal detection of MSH and SH by male neonates, and of HMHA by the whole group of neonates. Dependent on the dilution of odorants, newborns evinced neutral responses or longer negative oro-facial expressions compared with the reference stimuli. Finally, newborns appeared to be more sensitive to the target odorants than did adults.
    Subject(s): Life Sciences ; Biochemistry, general ; 3-methyl-2-hexenoic acid ; Entomology ; Biological Microscopy ; Olfaction ; 3-methyl-3-sulfanylhexan-1-ol ; 3-hydroxy-3-methylhexanoic acid ; 3-sulfanyl-1-hexanol ; Ecology ; Agriculture ; Human newborn ; Sulfhydryl Compounds - pharmacology ; Respiratory Rate - drug effects ; Caproates - pharmacology ; Humans ; Facial Expression ; Infant Behavior ; Male ; Odorants ; Sulfanilic Acids - pharmacology ; Young Adult ; Smell - physiology ; Hexanols - pharmacology ; Adult ; Female ; Sweat ; Infant, Newborn ; Infants (Newborn) ; Intermedin ; Index Medicus ; Food and Nutrition
    ISSN: 0098-0331
    E-ISSN: 1573-1561
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: Fertility and sterility, 2014, Vol.101 (6), p.1618-1623.e3
    Description: Objective To determine the impact of the time interval from the end of sperm preparation (TSP) to intrauterine insemination (IUI) on the outcome. Design Prospective multicentre cohort study. Setting Seven French centers (assisted reproduction group in northeastern France, four academic centers, and three clinics). Patient(s) Eight hundred sixty-two IUI cycles (709 patients) managed by gonadotropins were studied. Intervention(s) Cycles were stimulated by either FSH or hMG, and hCG was administrated when the leading follicle diameter measured 〉15 mm. IUIs were performed ∼36 hours after ovulation triggering. Main Outcome Measure(s) Generalized linear mixed models for binary outcomes were used to model clinical pregnancy (CP) to assess the effect of TSP adjusted for other predictors (such as maternal age, semen quality, and indication of IUI treatment). Result(s) The TSP effect was significant, featuring an inverse U-shaped curve admitting an optimum interval of ∼40–80 minutes improving CP compared with other values. Other significant predictors were total motile spermatozoa inseminated, maternal age, and unexplained infertility. Conclusion(s) The observance of TSP in the range of 40–80 minutes has a potential positive effect on pregnancy rate, while not requiring the investment of supplemental resources. This finding awaits confirmation in randomized trials.
    Subject(s): Internal Medicine ; Obstetrics and Gynecology ; sperm process ; Intrauterine insemination ; timing ; pregnancy ; Multivariate Analysis ; Prospective Studies ; Age Factors ; Ovulation Induction ; Humans ; Male ; Time Factors ; Fertility ; Adult ; Female ; Infertility - physiopathology ; France ; Infertility - etiology ; Odds Ratio ; Fertility Agents, Female - administration & dosage ; Infertility - therapy ; Pregnancy Rate ; Spermatozoa - pathology ; Semen Analysis ; Specimen Handling - methods ; Linear Models ; Treatment Outcome ; Insemination, Artificial, Homologous ; Pregnancy ; Tissue Donors ; Spermatozoa ; Index Medicus
    ISSN: 0015-0282
    E-ISSN: 1556-5653
    Source: Alma/SFX Local Collection
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  • 10
    Language: English
    In: American journal of obstetrics and gynecology, 2014, Vol.210 (1), p.70.e1-70.e9
    Description: Objectives To study the influence of pregnancy and labor on the proportion and level of activation of monocyte subpopulations in human pregnancy. Study Design Peripheral blood samples were obtained from healthy nonpregnant women (n = 6); women in the third-trimester of healthy pregnancies (n = 18) and women with preterm premature rupture of membranes (n = 46), just before delivery for the last 2 groups. Monocyte subpopulations were characterized by flow cytometry using CD14, CD16, and activation level using macrophage chemoattractant protein-1 (MCP-1) and CCR2 antibodies. Results The relative proportion of each monocyte subset in nonpregnant women was similar to that in women with healthy or complicated pregnancies. However, pregnancy was associated with a significant decrease in MCP-1 expressing monocytes (79.5% ± 19.8% vs 9.3% ± 6.8% and 11.9% ± 8.3% for nonpregnant, healthy pregnancy, and preterm premature rupture of membranes (respectively, P 〈 .05). Spontaneous labor was associated with a return to nonpregnant values for the proportion of MCP-1 expressing monocytes in both normal (74.4% ± 16.9) and preterm premature rupture of membranes pregnancy (68.4% ± 35.6), irrespective of the mode of delivery (vaginal or cesarean section). This was not observed in women who delivered without spontaneous labor onset. CCR-2 (MCP-1 receptor) expression was not modified in monocytes at the time of labor, but was significantly increased in granulocytes (3646 ± 1080 vs 7338 ± 2718 for nonlaboring and laboring preterm premature rupture of membranes, respectively, P 〈 .05) Conclusion In light of previous reports of a role for MCP-1 in labor, our results suggest the downregulation of activation levels of monocytes, via MCP-1 expression might be involved in maternofetal immune tolerance. Monocyte reactivation might be associated with labor.
    Subject(s): Obstetrics and Gynecology ; preterm rupture of membrane ; preterm labor ; monocytes ; human pregnancy ; prospective study ; Receptors, IgG - blood ; Prospective Studies ; Humans ; Fetal Membranes, Premature Rupture - blood ; Monocytes - metabolism ; Biomarkers - blood ; Chemokine CCL2 - blood ; Lipopolysaccharide Receptors - blood ; Pregnancy ; Young Adult ; Labor, Obstetric - blood ; Flow Cytometry ; Adolescent ; Obstetric Labor, Premature - blood ; Adult ; Female ; Pregnancy Trimester, Third - blood
    ISSN: 0002-9378
    E-ISSN: 1097-6868
    Source: Alma/SFX Local Collection
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