J Gynecol Obst Bio R
-
J Gynecol Obst Bio R · Dec 2003
Review[Physiopathology, diagnosis and therapeutic management of stage III and IV endometriosis].
Stage III endometriosis is defined by a r-AFS score respectively ranging from 16 to 40 and stage IV over 40. Deep pelvic endometriosis presents essentially in the form of a painful syndrome dominated by chronic pelvic painful, dysmenorrhea and deep dyspareunia. Pathophysiology of pelvic pain associated with endometriosis remains unknown. ⋯ Spontaneous pregnancy rates are significantly increased after surgical treatment. Recurrent ovarian surgery is not recommended in women with infertility, as it might be deleterious for ovarian reserve. Medical treatment using Gn-RH agonists is indicated when recurrence occurs after surgery.
-
J Gynecol Obst Bio R · Nov 2003
Review[Ectopic pregnancy: interest and value of clinical examination in management policy].
Clinical examination (history and physical examination) is not considered to be a useful tool in the diagnosis of ectopic pregnancy (EP). In this systematic review we aimed to evaluate its value when ancillary tests are not readily available or when they are equivocal. Suspicion of EP is based on the presence of one or more of the following signs: vaginal bleeding, acute pelvic pain, or any risk factors for EP occurring in a pregnant woman. ⋯ Absence of these signs does not rule out EP but tend to eliminate tubal rupture. In the presence of these signs one may consider an emergency transfer in a specialized center. In their absence, suspicion of EP may have outpatient diagnosis procedures.
-
J Gynecol Obst Bio R · Apr 2003
Review[Clinical and molecular diagnosis of inherited breast-ovarian cancer].
The aim of this work was to pinpoint familial breast and/or ovarian cancer risk. Clinical cancer genetics include: diagnostic cancer genetics, cancer genetic counseling and management of women at high risk of developing breast and/or ovarian cancer. ⋯ Inherited BC or OC due to a mutation in BRCA1 or BRCA2 are rare in the general population. However, women and men have the right to be informed of the possibilities concerning presymptomatic testing, risk assessment, surveillance, prevention and psychological support with respect to the potential benefits and limitations. Other large prospective studies are needed to validate rapidly the methods of surveillance and prevention in this group at "high risk" in order to adapt them to very large populations. However, predictive medicine should be used with care.
-
J Gynecol Obst Bio R · Feb 2003
Review[Smoking, fetal pulmonary development and lung disease in children].
Prenatal exposure to tobacco smoke is associated with a significant increase in respiratory symptoms and a decrease in lung function in children. Epidemiological studies have demonstrated that tobacco smoke exposure represents one of the most important respiratory risk factors in childhood. Nicotine crosses the placenta and activates the nicotinic receptors which are present in a wide range of lung cells during the prenatal period. ⋯ These structural and functional disturbances explain why these infants are more susceptible to respiratory irritants. The alterations in ventilatory control induced by prenatal exposure to nicotine explain the link between tobacco smoke exposure and the sudden infant death syndrome. This underlines the importance of adequate information and preventative measures to decrease this major and avoidable cause of respiratory morbidity and mortality in infants.
-
J Gynecol Obst Bio R · Nov 2002
Review Case Reports[Gas embolism and hyperbaric oxygen treatment during pregnancy: a case report and a review of the literature].
We report the first case of a pregnant woman presenting with a paradoxical air embolism due to accidental removal of a central venous catheter. Secondary right hemiplegia associated with a confused state justified emergency hyperbaric oxygen therapy, which was followed by complete neurological recovery. The aim of this case report is to assess risk situations of gas embolism during pregnancy and puerperium, as well as indications and fetal effects of hyperbaric oxygen therapy.