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International audience; Objectives. - To propose a protocol for induction of labor to terminate pregnancy after 22 weeks of amenorrhea allowing to decrease the duration of labor and of hospitalization but also, allowing to reduce the number of emergency pretreatment-induced fetal death, to improve the experience of the patients and to limit the cost. Methods. - We realized a retrospective single-center study including 269 patients and comparing three protocols, with and without laminaria and with various intervals mifepristone-misoprostol (14 and 38 hours). The outcome measures were the misoprostol-delivery interval, the delivery time and the number of emergency pretreatment-induced fetal death. Results. - We showed that the misoprostol-delivery interval and the delivery time were comparable for the three periods of our study, even after decrease of 24 hours of the mifepristone-misoprostol interval and in the absence of laminaria. The misoprostol-delivery interval was between 7 h 30 and 8 h 35 between protocols (P=0.055). The delivery time was between 5:18 pm and 6:48 pm between protocols (P=0.252). The early administration of misoprostol allowed the patients to give birth earlier (P=0.001). Finally, we showed that the increase of the size and the number of laminarias were risk factors of emergency pretreatment-induced fetal death (respectively P=0.013 and P=0.002). Conclusion. - The absence of laminaria and the reduction of the interval mifepristone-misoprostol of 24 hours do not change the time to delivery and allow to reduce the duration of hospitalization, the number of emergency pretreatment-induced fetal death and the cost of the TOP. (C) 2015 Elsevier Masson SAS. All rights reserved.

International audience; Objective. To assess the consequences of loop electrosurgical excision ă procedure (LEEP) on the quality of sexual life. ă Material and methods. A prospective observational study in two ă university hospital departments in Marseille, France, including women ă requiring a LEEP. Sexual quality of life was assessed before LEEP and ă three months after the procedure with a self-administered validated ă questionnaire: the Brief Index of Sexual Functioning for Women (BISF-W). ă Results. Among the 100 women included, 69 filled both questionnaires. ă Among the 69 women whose outcomes were available, composite BISF-W score ă was significantly lower before LEEP than three months after LEEP (28.3 ă +/- 13 vs 30.1 +/- 13.2; P=0.01). The items scores concerning desire ă (D1) and orgasm (D5) were significantly improved after LEEP (4.3 +/- 2.3 ă vs 5 +/- 2.2 [P

International audience; no abstract

International audience; Objective. To evaluate what is the proportion of surgery rooms from Marseilles' area that do perform excisional therapies for CIN without any use of colposcopic guidance. Materials and methods. From November 2012 to January 2013, a survey was conducted among all surgery rooms from Marseilles' area practicing excisional therapies for CIN. In addition, answers from gynecologists from Marseilles' area who participated to a national survey that evaluated practices of excisional therapies in France were specifically analyzed. Results. Among the 55 surgery rooms from Marseilles' area practicing excisional therapies, 52 (94.1%) participated to the current survey. A colposcope was available in only 19 (36.5%) surgery rooms and was systematically used for the guidance of excisional therapies in only 4 (21%) of these surgery rooms. Finally, 36 (69.2%) surgery rooms answered performing excisional therapies without any use of colposcopic guidance. Colposcopy was occasionally and systematically used in 12 (23.1%) and 4 (7.7%) surgery rooms, respectively. Among the 116 gynecologists from Marseilles' area who answered to the national survey, 88 (75.9%) answered not using colposcopy when performing excision for CIN. Only 6% answered performing excision systematically under direct colposcopic vision and 18.1% occasionally. Conclusion. No colposcopic guidance is used when performing excision for ON in the majority of surgery rooms from Marseilles' area. (C) 2015 Elsevier Masson SAS. All rights reserved.

BACKGROUND AND STUDY AIMS Rectovaginal septal endometriosis (RVSE) can pose serious therapeutic problems when there is infiltration of the rectal septum (which occurs in approximately half of the cases). The aim of this study was to assess the value of endoscopic ultrasonography in diagnosing rectal wall involvement by pelvic endometriosis. PATIENTS AND METHODS A prospective study was carried out from May 1998 to March 2003 at a single hospital center. The 30 patients included in the study presented with suspected RVSE and underwent systematic anorectal endoscopic ultrasonographic exploration prior to the surgical intervention. The endoscopic ultrasonography was carried out under general anesthesia with a 7.5-MHz miniprobe equipped with a distal balloon. RESULTS The anorectal endoscopic ultrasonographic examination (EUS) showed the presence of endometriosis in the rectovaginal septum in 26 patients (88 %), in the uterosacral ligaments in 10 patients (33 %), and in the ovaries in two patients (6 %). At EUS, the nodules were infiltrating the rectal wall in 17 patients (56 %). The surgical exploration demonstrated endometriosis in the rectovaginal septum in 26 cases, the uterosacral ligaments in 22 cases, and the ovaries in 16 cases. The rectal wall was completely infiltrated in 12 cases and only partly in four cases, and intestinal tract resection was required in 10 cases. The sensitivity, specificity, and positive and negative predictive value of anorectal endoscopic ultrasonography as a means of diagnosing endometriosis of the rectovaginal septum and infiltration of the rectal wall were found to be 96 %, 100 %, 100 % and 83 %, and 92 %, 66 %, 64 % and 92 %, respectively; and the diagnostic accuracy was at 96 % and 80 %, respectively. The sensitivity for detecting nodules in the uterosacral ligaments or in the ovaries was 42 % and 14 %, respectively, leading to diagnostic accuracy rates of 56 % and 53 %. CONCLUSIONS In terms of its sensitivity and its negative predictive value, anorectal endoscopic ultrasonography is a very effective means of detecting endometriosis of the rectovaginal septum and assessing possible infiltration of the rectal wall. However, this method is not as accurate for nodules located far from the EUS probe, as is the case with the uterosacral ligaments and ovaries.

Resume L’enterocolite necrosante est une complication rare et grave de la maladie de Hirschsprung. La grossesse est une circonstance aggravante d’une maladie de Hirschsprung meconnue ou incompletement traitee dans l’enfance. Nous rapportons la premiere observation, a notre connaissance, combinant ces deux elements : une enterocolite necrosante en fin de grossesse chez une femme de 20 ans operee pour maladie de Hirschsprung a l’âge de six mois. Le diagnostic de cet episode qui a mis en jeu le pronostic vital a ete retarde de 24 heures. Le traitement definitif a ete une anastomose ileo-anale en trois temps.