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After publication of this work [1], the authors noticed that the first names and last names of all the authors were inverted. In the original manuscript, they appear on PubMed as.After publication of this work [1], the authors noticed that the first names and last names of all the authors were inverted. In the original manuscript, they appear on PubMed as.

Fertility-sparing surgery for borderline ovarian tumors (BOT) is feasible and effective and does not seem to have a negative effect on survival. Specific data on the effect of cystectomy, and notably on recurrence, are lacking. This was a French retrospective multicenter study of 313 women with stage I BOT treated from 1990 to 2000 in 13 specialized gynecological units and 1 cancer center. Diagnosis and staging were based on International Federation of Gynecology and Obstetrics (1989) criteria. Surgery consisted of cystectomy, unilateral salpingo-oophorectomy (USO), or bilateral salpingo-oophorectomy (BSO). After cystectomy, persistent BOT and benign ovarian cysts on the operated ovary were observed in 15% and 65% of patients, respectively. Mean follow-up did not differ among patients receiving the three types of surgery. The recurrences after cystectomy, USO, and BSO treatment were 30.3%, 11%, and 1.7%, respectively (P<.0001). Recurrences were more frequent after cystectomy than after USO (P=.0001) and BSO (P=.0001) and when intraoperative cyst rupture occurred (P=.04). These results suggest that cystectomy for BOT is associated with a high risk of intraoperative cyst rupture and of recurrence compared with USO or BSO.

A prenatal and postnatal follow‐up of a child with Pai syndrome, especially till toddler age, allows a better understanding of the evolution of this syndrome. This offers insight on possible outcomes especially in what concerns the neurodevelopment. A prenatal and postnatal follow‐up of a child with Pai syndrome, especially till toddler age, allows a better understanding of the evolution of this syndrome. This offers insight on possible outcomes especially in what concerns the neurodevelopment.

Hepatic endometriosis has an extremely rare occurrence characterized by the presence of ectopic endometrium in the liver. A diagnosis of hepatic endometriosis is established after surgery. A 51-year-old multiparous female was referred to our unit for investigation of a liver tumor. The patient reported a 6-month history of epigastric pain and vomiting. She had undergone conservative hysterectomy for uterine leiomyomas several years earlier. The results of liver function tests and the levels of tumor markers (CA 19.9, CEA, CA125, αFP) were normal. Radiological imaging (USS, CT and MRI) suggested the presence of liver cystadenoma, liver cystadenocarcinoma or cystic metastasis of the liver in the left liver lobe extending to the diaphragm with left hepatic vein compression. Laparotomy was performed. The intraoperative frozen sections suggested a diagnosis of endometriosis. Anatomical resection was performed, including left lobectomy with diaphragm resection. The final histology confirmed the presence of hepatic endometrioma without malignant transformation. Fourteen cases of hepatic endometrioma have been described in the medical literature. We herein report the 15th case. Making a preoperative diagnosis of hepatic endometriosis is very difficult, despite conducting a complete investigation, in the absence of clinical and radiological characteristics. The diagnosis is made according to a histological examination of the whole surgical sample.

Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. We report a case of a woman who presented an ileocecal intussusception due to a cecal endometriosis. The patient gave two months history of chronic periombilical pain requiring regular hospital admission and analgesia. The symptoms were not related to menses. A laparotomy was performed and revealed an ileocolic intussusception. The abdominal exploration did not find any endometriosis lesion. Ileocaecal resection was performed. Microscopic examination showed a cystic component, lined by a regular cylindric epithelium. Foci of endometrial tissu were oberved in the cecal subserosa and muscularis mucosal, with irregular endometrial glands lined by cylindric epithelium without atypia immunostained with CK7, and characteristic endometrial stroma immunostained with CD10. Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. Diagnose of etiology remains challenging due to the absence of clinical and radiological specific characteristics. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2975867306869166

Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9–9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0–7.0] and diabetes [aOR2.2, 95% CI 1.1–4.5]. Pregnant women with severe maternal outcomes were at higher risk of caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease.

Background Prolonged pregnancies are a frequent indication for induction of labour. When the cervix is unfavourable, cervical ripening before oxytocin administration is recommended to increase the likelihood of vaginal delivery, but no particular method is currently recommended for cervical ripening of prolonged pregnancies. This trial evaluates whether the use of mechanical cervical ripening with a silicone double balloon catheter for induction of labour in prolonged pregnancies reduces the cesarean section rate for nonreassuring fetal status compared with pharmacological cervical ripening by a vaginal pessary for the slow release of dinoprostone (prostaglandin E2). Methods and findings This is a multicentre, superiority, open-label, parallel-group, randomised controlled trial conducted in 15 French maternity units. Women with singleton pregnancies, a vertex presentation, ≥41+0 and ≤42+0 weeks’ gestation, a Bishop score <6, intact membranes, and no history of cesarean delivery for whom induction of labour was decided were randomised to either mechanical cervical ripening with a Cook Cervical Ripening Balloon or pharmacological cervical ripening by a Propess vaginal pessary serving as a prostaglandin E2 slow-release system. The primary outcome was the rate of cesarean for nonreassuring fetal status, with an independent endpoint adjudication committee determining whether the fetal heart rate was nonreassuring. Secondary outcomes included delivery (time from cervical ripening to delivery, number of patients requiring analgesics), maternal and neonatal outcomes. Between January 2017 and December 2018, 1,220 women were randomised in a 1:1 ratio, 610 allocated to a silicone double balloon catheter, and 610 to the Propess vaginal pessary for the slow release of dinoprostone. The mean age of women was 31 years old, and 80% of them were of white ethnicity. The cesarean rates for nonreassuring fetal status were 5.8% (35/607) in the mechanical ripening group and 5.3% (32/609) in the pharmacological ripening group (proportion difference: 0.5%; 95% confidence interval (CI) −2.1% to 3.1%, p = 0.70). Time from cervical ripening to delivery was shorter in the pharmacological ripening group (23 hours versus 32 hours, median difference 6.5 95% CI 5.0 to 7.9, p < 0.001), and fewer women required analgesics in the mechanical ripening group (27.5% versus 35.4%, difference in proportion −7.9%, 95% CI −13.2% to −2.7%, p = 0.003). There were no statistically significant differences between the 2 groups for other delivery, maternal, and neonatal outcomes. A limitation was a low observed rate of cesarean section. Conclusions In this study, we observed no difference in the rates of cesarean deliveries for nonreassuring fetal status between mechanical ripening with a silicone double balloon catheter and pharmacological cervical ripening with a pessary for the slow release of dinoprostone. Trial registration ClinicalTrials.gov NCT02907060 .

Background and objective Extremely preterm infants are at very high risk of neonatal death and disabilities. Their survival rate is much variable in developed countries and in France is much lower than other countries. Our objective is to evaluate the impact of an intervention to standardize the perinatal management of extremely preterm infants. Population Women hospitalized between 22 and 26 weeks for risk of preterm delivery with a alive fetus or a stillbirth at admission and with a delivery between 22 and 26 completed weeks. Intervention Our complex intervention aimed at standardizing the organization of care based on the following principles: A collective obstetric-pediatric prognostic assessment, in a non-emergency setting, with a consensus decision about the obstetric and neonatal management proposed—either active or palliative care; An interview with the parents to inform them, answer their questions, propose either active or palliative care and then ask their opinion. Methods A Stepped-wedge cluster-randomized trial. Perinatal networks will be randomly allocated to the intervention in 5 waves every 3 months, with a total recruitment period of 21 months (including 3-month transition periods). All perinatal networks will have a period with and without the intervention. After the allocation of clusters to the intervention period, the teams will be trained in the intervention protocol and then will undergo a 3-month transition period to learn the protocol thoroughly. Sample size We hypothesis hypothesized is that survival without severe morbidity will could rise from 20 to 35% after the intervention, but envisaged different scenarios with varying survival without severe morbidity in the control and intervention periods. The intraclass correlation coefficients was set to 0.07. With an average number of 60 to 70 extremely preterm infants recruited per year, a number of 20 clusters (perinatal networks) were was sufficient to provide at least 80% power in most scenarios, and 25 clusters would provide at least 80% power in all scenarios envisaged. Setting Twenty-five perinatal networks including 34 neonatal level-3 hospital, and 285 maternity units overall. Outcome Child's survival without severe morbidity at hospital discharge. Expected results Improvement of the health of extremely preterm infants and, if the intervention shows that it is effective, equitable access to care according to place of birth in France. Ethics The protocol was approved by the Committee for Protection of Persons Involved in Biomedical Research (CPP Ile de France V PARIS), and the French Data Protection Authority (30/12/2021, N°21.03700000050-MS02). Trial registration The trial was registered before the beginning of the study at ClinicalTrials.gov (December 20, 2021—NCT05248477).

Aims: To describe heart rate (HR) variations in surgical residents during laparoscopy and to assess their intraoperative stress. Methods: We performed a prospective, multicentric, observational, blinded, and comparative analysis of the HR in 75 obstetrics and gynecology residents during planned laparoscopy for infertility in five teaching hospitals with assisted reproductive technology centers. The surgical residents had neither heart disease nor were under medical treatment or using tobacco or drugs. We describe HR variations at 9 preselected operative steps using real-time noninvasive measures of the HR during laparoscopy. Results: Residents performed 124 laparoscopies for unexplained infertility. Their HR increased significantly during the introduction of the Palmer needle, umbilical port and second port, and during abdominopelvic exploration and dye test compared to the baseline HR, the HR after hand washing, at the end of surgery and during skin suture (91.6 ± 1.9, 104.8 ± 2.3, 95.3 ± 2.2, 93.7 ± 2.5, 90.7 ± 1.7 vs. 83.2 ± 1.6, 88.6 ± 1.9, 87.4 ± 2.1, 88.2 ± 1.9 bpm, respectively, p < 0.02). Conclusion: Our results point to a potential stress for the surgeon assessed by HR variations during planned laparoscopy compared to the baseline HR before surgery. This ‘static' stress can be repeated on the same day.

International guidelines are published to provide standardized information and fertility preservation (FP) care for adults and children. The purpose of the study was to conduct a modified Delphi process for generating FP guidelines for BGD. A steering committee identified 42 potential FP practices for BGD. Then 114 key stakeholders were asked to participate in a modified Delphi process via two online survey rounds and a final meeting. Consensus was reached for 28 items. Among them, stakeholders rated age-specific information concerning the risk of diminished ovarian reserve after surgery as important but rejected proposals setting various upper and lower age limits for FP. All women should be informed about the benefit/risk balance of oocyte vitrification—in particular about the likelihood of live birth according to age. FP should not be offered in rASRM stages I and II endometriosis without endometriomas. These guidelines could be useful for gynecologists to identify situations at risk of infertility and to better inform women with BGDs who might need personalized counseling for FP.