Journal de gynécologie, obstétrique et biologie de la reproduction
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Shoulder dystocia: Guidelines for clinical practice--Short text].
To determine the available evidence to prevent and treat shoulder dystocia to attempt to decrease its related neonatal and maternal morbidity. ⋯ Shoulder dystocia remains a non-predictable obstetrics emergency. All physicians and midwives should know and perform obstetric maneuvers if needed quickly but without precipitation. A training program using simulation for the management of shoulder dystocia is encouraged for the initial and continuing formation of different actors in the delivery room (professional consensus).
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Post-partum: Guidelines for clinical practice--Short text].
To determine the post-partum management of women and their newborn whatever the mode of delivery. ⋯ Postpartum is, for clinicians, a unique and privileged opportunity to address the physical, psychological, social and somatic health of their patients.
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Delivery management for the prevention of shoulder dystocia in case of identified risk factors].
To determine the impact of (i) computed tomographic (CT) pelvimetry for the choice of the mode of delivery, (ii) cesarean, (iii) induction of labor, and of (iv) various delivery managements on the risk of shoulder dystocia in case of fetal macrosomia, with or without maternal diabetes, and in women with previous history of shoulder dystocia. ⋯ To avoid shoulder dystocia and its complications, only two measures are proposed. Induction of labor is recommended in case of impending macrosomia if the cervix is favourable and gestational age greater than 39 weeks of gestation (Professional consensus). Cesarean delivery is recommended before labor in case of (i) EFW greater than 4500 g if associated with maternal diabetes (grade C), (ii) EFW greater than 5000 g in the absence of maternal diabetes (grade C), and finally (iii) during labor, in case of fetal macrosomia and failure to progress in the second stage, when the fetal head is above a +2 station (grade C). Finally, cesarean delivery should be discussed when history of shoulder dystocia has been associated with severe neonatal or maternal complications (Professional consensus).
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To evaluate the diagnostic value of clinical examination and additional tests in the exploration of breast pain, to evaluate the strategy of their care and to provide recommendations. ⋯ Clinical examination and interrogation, with the use of visual analog scale used to differentiate non-cyclical breast pain from mastodynia (LE2). A calendar can be used to characterize the cyclical breast pain (LE3). Using a questionnaire can help to characterize the pain (LE3). In the absence of palpable abnormality, it is not recommended to modify systematic or individual screening modalities (LE2). MRI is not recommended in case of normal mammography and sonography. Explorations biopsy is guided by imaging. The therapeutic management includes reassurance after a normal clinical evaluation and/or normal radiological findings (LE2), and precise fitting of a brassière. In case of failure of this first approach, NSAIDs gel can be proposed (LE1-2).
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J Gynecol Obstet Biol Reprod (Paris) · Dec 2015
Review[Postnatal visit: Routine and particularity after complicated pregnancy--Guidelines for clinical practice].
To propose guidelines for clinical practice for routine postnatal visit and after pathological pregnancies. ⋯ A postpartum visit is recommended 6 to 8 weeks after delivery, including mother physical and psychological evaluation and information about contraception, short interval between pregnancy, weight loss, smoking cessation (Professional consensus). To ensure continuity in the management of women health, relevant medical elements will be pass on to the corresponding physicians (Professional consensus).