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Champ-sur-Drac, France

Fauconnier A.,CHI Poissy St Germain | Fauconnier A.,University of Versailles | Goltzene A.,Hertford British Hospital | Issartel F.,Hertford British Hospital | And 5 more authors.
Progres en Urologie | Year: 2012

Objective: To study whether post-partum dyspareunia one year after a delivery is associated with characteristics of delivery: perineal trauma, obstetric interventions and women's experience. Methods: A self-administered questionnaire on post-partum sexual function was mailed in May 2002 to all consecutive women who gave birth to a live-born term infant in a maternity unit, between January 2001 and June 2001. Obstetric data were abstracted from the hospital computerized medical database. Late dyspareunia was defined as pain during intercourse, one year after delivery. Multiple logistic regression modeling was used to select independent predictors of late post-partum dyspareunia. Results: Seventy (27.6%) of the 254 women studied experienced late dyspareunia. There was no relation between late post-partum dyspareunia and neither the mode of delivery nor state of the perineum, including perineal laceration or episiotomy. Multiple logistic regression analysis showed that late post-partum dyspareunia was associated with dyspareunia before pregnancy, low satisfaction with delivery, and employment status. © 2012 Published by Elsevier Masson SAS. Source

Huchon C.,CHI Poissy St Germain | Huchon C.,University of Versailles | Koskas M.,University of Versailles | Koskas M.,University Paris Diderot | And 17 more authors.
Trials | Year: 2015

Background: Incomplete spontaneous abortions are defined by the intrauterine retention of the products of conception after their incomplete or partial expulsion. This condition may be managed by expectant care, medical treatment or surgery. Vacuum aspiration is currently the standard surgical treatment in most centers. However, operative hysteroscopy has the advantage over vacuum aspiration of allowing the direct visualization of the retained conception product, facilitating its elective removal while limiting surgical complications. Inadequately powered retrospective studies reported subsequent fertility to be higher in patients treated by operative hysteroscopy than in those treated by vacuum aspiration. These data require confirmation in a randomized controlled trial comparing fertility rates between women undergoing hysteroscopy and those undergoing vacuum aspiration for incomplete spontaneous abortion. Methods: After providing written informed consent, 572 women with incomplete spontaneous abortion recruited from 15 centers across France will undergo randomization by a centralized computer system for treatment by either vacuum aspiration or operative hysteroscopy. Patients will not be informed of the type of treatment that they receive and will be cared for during their hospital stay in accordance with standard practices at each center. The patients will be monitored for pregnancy or adverse effects by a telephone conversation or questionnaire sent by e-mail or post over a period of two years. In cases of complications, failure of the intervention or diagnosis of uterine cavity disease, patient care will be left to the discretion of the medical center team. Discussion: If our hypothesis is confirmed, this study will provide evidence that the use of operative hysteroscopy can increase the number of pregnancies continuing beyond 22 weeks of gestation in the two-year period following incomplete spontaneous abortion without increasing the incidence of morbidity and peri- and postoperative complications. The standard surgical treatment of this condition would thus be modified. This study would therefore have a large effect on the surgical management of incomplete spontaneous abortion. Trial registration: ClinicalTrials.gov Identifier: NCT02201732 ; registered on 17 July 2014. © 2015 Huchon et al. Source

Grati F.R.,TOMA Advanced Biomedical Assays S.p.A. | Molina Gomes D.,CHI Poissy St Germain | Ferreira J.C.P.B.,Medical University of Warsaw | Dupont C.,Hopital Robert Debre AP HP | And 21 more authors.
Prenatal Diagnosis | Year: 2015

Objectives: The implementation of chromosomal microarray analysis (CMA) in prenatal testing for all patients has not achieved a consensus. Technical alternatives such as Prenatal BACs-on-BeadsTM (PNBoBsTM) have thus been applied. The aim of this study was to provide the frequencies of the submicroscopic defects detectable by PNBoBsTM under different prenatal indications. Methods: A total of 9648 prenatal samples were prospectively analyzed by karyotyping plus PNBoBsTM and classified by prenatal indication. The frequencies of the genomic defects and their 95%CIs were calculated for each indication. Results: The overall incidence of cryptic imbalances was 0.7%. The majority involved the DiGeorge syndrome critical region (DGS). The additional diagnostic yield of PNBoBsTM in the population with a low a priori risk was 1/298. The prevalences of DGS microdeletion and microduplication in the low-risk population were 1/992 and 1/850, respectively. Conclusions: The constant a priori risk for common pathogenic cryptic imbalances detected by this technology is estimated to be ~0.3%. A prevalence higher than that previously estimated was found for the 22q11.2 microdeletion. Their frequencies were independent of maternal age. These data have implications for cell-free DNA screening tests design and justify prenatal screening for 22q11 deletion, as early recognition of DGS improves its prognosis. © 2015 John Wiley & Sons, Ltd. Source

Vialard F.,CHI Poissy St Germain | Simoni G.,TOMA Advanced Biomedical Assays S.p.A. | Gomes D.M.,CHI Poissy St Germain | Abourra A.,Obstetrics and Gynecology | And 13 more authors.
Prenatal Diagnosis | Year: 2012

Objective: We previously reported on the validation of Prenatal BACs-on-BeadsTM on retrospectively selected and prospective prenatal samples. This bead-based multiplex assay detects chromosome 13, 18, 21 and X/Y aneuploidies and the nine most frequent microdeletion syndromes. We demonstrated that Prenatal BACs-on-BeadsTM is a new-generation, prenatal screening tool. Here, we describe the experience of five European prenatal diagnosis laboratories concerning the ongoing use of Prenatal BACs-on-BeadsTM. Methods: Some 1653 samples were analyzed. All results were confirmed by conventional karyotyping or another appropriate technique. All indications for invasive prenatal diagnosis were included. Amniotic fluid and chorionic villus samples were analyzed in equivalent proportions. Results: The failure rate was 3.3% and the overall abnormality detection rate was ~1/10. Eighty-five percent of the detected abnormalities were common aneuploidies. Eleven microdeletions and duplications were identified, thus giving an overall yield for microdeletion and microduplication detection of 1/145. Compared with QF-PCR, Prenatal BACs-on-BeadsTM provides an additional detection rate of ~1/250 for low-risk pregnancies. The false positive and negative rates were both <1%. Conclusion: When associated with conventional karyotyping, the Prenatal BACs-on-BeadsTM assay combines a short turnaround time (typical of rapid aneuploidy detection tests) with valuable detection of the most frequent microdeletion syndromes that cannot be detected in cytogenetic analyses. © 2012 John Wiley & Sons, Ltd. Source

Hammoud I.,CHI Poissy St Germain | Molina-Gomes D.,CHI Poissy St Germain | Albert M.,CHI Poissy St Germain | Bergere M.,CHI Poissy St Germain | And 4 more authors.
Journal of Assisted Reproduction and Genetics | Year: 2010

Introduction: Preconception diagnosis requires first polar body biopsy. When the hole in the zona pellucida is made with a laser beam, heat propagation could, like the biopsy itself, be deleterious. Our aim was to evaluate the effect of this technique on human in vitro matured oocyte and embryo development. Methods: One hunded fifty five retrieved immature oocytes from 75 women, matured in vitro, were distributed in 3 groups: 50 oocytes in a control group, without laser drilling and first polar body biopsy, 52 oocytes in a group with only laser drilling, and 53 oocytes in a group with both laser drilling and first polar body biopsy. Safety was evaluated using four criteria: [1] oocyte lysis rate, [2] oocyte activation rate, [3] oocyte development after calcium ionophore treatment, [4] and embryo chromosome breakage incidence after Tarkowski preparation. Results: No difference in the four criteria was observed between the 3 oocyte groups. Conclusions: We did not find evidence of deleterious effect of laser drilling and first polar body biopsy on in vitro matured oocytes, according to our criteria. © 2010 Springer Science+Business Media, LLC. Source

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