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1.
Gynecol Obstet Fertil Senol ; 47(10): 713-717, 2019 10.
Article in French | MEDLINE | ID: mdl-31356891

ABSTRACT

OBJECTIVES: Acute Bartholinitis is a common pathology affecting nearly 2% of women in their lifetime. Many treatments are used, although their effectiveness is not demonstrated in the literature. The main objective was to evaluate the success rate of first-line antibiotic therapy. The secondary objective was to identify factors associated with successful treatment. METHODS: We conducted a retrospective unicentric study between January 2014 and June 2018 at the University Hospital Center of Nancy. Inclusion criteria were the presence of acute bartholinitis treated with first-line antibiotic therapy. Exclusion criteria were patients lost to follow-up after initiation of treatment. The primary endpoint was the absence of surgical treatment within 30 days of initiation of antibiotic therapy. Factors associated with successful medical treatment were sought. RESULTS: Thirty-three patients were included. The success rate of medical treatment was 48.5% at 30 days. In the case of symptoms that had been evolving for less than 3 days, the success of medical treatment was more frequent (75% vs. 35.3%, P=0.02). Medical treatment was more effective in lesions of less than 2cm (68.7% vs. 23.5%, P=0.01). After adjustment, the only factor associated with successful medical treatment was lesion size≤2cm [ORa=5.31 (1.05-26.81)]. CONCLUSION: First-line antibiotic therapy for acute bartholinitis seems effective but should be targeted according to certain eligibility criteria.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bartholin's Glands , Vulvitis/drug therapy , Acute Disease , Adult , Female , France , Humans , Retrospective Studies
2.
Gynecol Obstet Fertil Senol ; 46(9): 653-657, 2018 09.
Article in French | MEDLINE | ID: mdl-30174174

ABSTRACT

OBJECTIVES: In recent years, active neonatal care in case of prematurity leads to an increase of cesarean delivery rate. Data remains sparse on maternal morbidity induced by preterm cesareans and especially before 32 weeks of gestation. The main aim of this study was to evaluate per-partum maternal morbidity in case of cesarean performed before 32 week of gestation. As secondary objectives, we assessed post-partum maternal morbidity and factors associated with maternal morbidity. METHODS: This is a retrospective single-center study conducted in a tertiary care unit between 2014 and 2016 including cesareans performed before 32 week of gestation in the study period. The primary outcome was a composite criterion of per partum maternal morbidity including post-partum hemorrhage, blood transfusion, general anesthesia, surgical wounds and maternal death. The secondary outcome was the post-partum maternal morbidity, defined by a composite criterion including hospitalization more than 7 days, infectious disease, wall and digestive complication and venous thromboembolic disease. RESULTS: Two hundred and eleven women were included. Maternal morbidity occurred in 21.3% in per partum and in 20.4% in post-partum. The factors associated with per partum morbidity were low-lying placenta (OR=4.40 [1.01-19.09]) and non-fetal indication of cesarean (OR=2.10[1.01-4.42]). The factors associated with post-partum morbidity were twin-pregnancy (OR=2.90 [1.12-7.54]), general anesthesia (OR=4.19 [1.68-10.49]) and non-cephalic fetal presentation (OR= 2.70 [1.23-5.93]). CONCLUSION: The maternal morbidity of cesareans before 32 week of gestation is more than 20%. This study confirms the high maternal morbidity associated with caesareans performed before 32 weeks of gestation.


Subject(s)
Cesarean Section/adverse effects , Gestational Age , Pregnancy Outcome/epidemiology , Adult , Anesthesia, Obstetrical/adverse effects , Female , Humans , Labor Presentation , Maternal Mortality , Morbidity , Pregnancy , Pregnancy, Twin , Retrospective Studies , Risk Factors
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