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Guillaume Legendre

Guillaume Legendre
University Hospital of Angers, France

MD, PhD

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109
Publications
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Publications

Publications (109)
Article
(1) Background: Intrauterine growth restriction (IUGR) involves metabolic changes that may be responsible for an increased risk of metabolic and cardiovascular diseases in adulthood. Several metabolomic profiles have been reported in maternal blood and urine, amniotic fluid, cord blood and newborn urine, but the placenta has been poorly studied so...
Article
Non-tubal ectopic pregnancies can be located in the uterine portion of the tube (interstitial or cornual), in the cervix (cervical), in a caesarean scar, in the ovary, or intra-abdominally. Even though they are rare, they are associated with a high mortality. Invasive surgeries such as cornuectomy and hysterectomy were common to treat them in case...
Article
BACKGROUND Miscarriage is a frequent problem that requires dilation and curettage in 30 % of cases. This routine surgery may lead to intrauterine adhesions and severe infertility. Hyaluronic acid gel is known to reduce intrauterine adhesions after hysteroscopic surgery. OBJECTIVE This study aimed to evaluate the rate of intrauterine adhesions afte...
Article
Background: Although prophylactic tranexamic acid administration at cesarean delivery resulted in a lower incidence of calculated estimated blood loss > 1000 mL or red-cell transfusion by day 2, its failure to reduce the incidence of hemorrhage-related secondary clinical outcomes (TRAAP2 trial) makes its use questionable. The magnitude of its effe...
Article
Full-text available
Background: To assess women's positive and negative perceptions after giving birth. The secondary objectives were to identify the women who had a negative perception of their delivery, define the risk factors, and propose actions that maternity units can take to improve their management. Methods/design: This study was a multicenter, prospective...
Article
Non-tubal ectopic pregnancies represent fewer than 10% of all ectopic pregnancies. However, they are associated with a high rate of mortality due to late diagnosis and uterine horn rupture which requires radical emergency surgical management. Cornuectomy via laparoscopy is a treatment of choice. We provide here a simple description of laparoscopic...
Article
Objectives The aim of the present study was to assess factors associated with a repeat operative vaginal delivery (OVD) in women with a previous history of OVD. Methods A single-centre retrospective observational study was performed in the maternity ward of the Angers University Hospital between 20/09/2010 and 01/04/2021. All the patients who unde...
Preprint
Objectives: To compare the neonatal morbidity of caesarean sections (CS) performed after conversion from neuraxial (NA) to general anaesthesia (GA) with CS performed under GA from the outset, and to assess whether the increase in DDI in urgent and extremely urgent cases with conversion from NA to GA increased the risk of neonatal morbidity. Design:...
Preprint
The objective was to assess whether the measurement of serum estradiol (E 2 ) level on trigger day in controlled ovarian stimulation with intrauterine insemination (COS-IUI) cycles helps lower the multiple pregnancy (MP) rate. We performed a unicentric observational study. We included all patients who underwent COS-IUI and had a subsequent clinical...
Article
Full-text available
Background Eating disorders (EDs) are common conditions that mainly affect women of reproductive age and have a major impact on fertility. Our systematic review focuses on the prevalence of EDs in patients in the process of assisted reproductive technique (ART) and describes the phenotypes of EDs identified. Methods Our systematic review is based...
Article
Introduction Non-tubal ectopic pregnancies (NTEP) in France constitute approximately 5% of ectopic pregnancies (EP). A NTEP can be abdominal, ovarian, cervical, interstitial, on a caesarean scar, or cornual. These pregnancies, which are sometimes difficult to diagnose and are often diagnosed late, carry a high risk of complications, particularly ha...
Article
Objective: to assess the relationship between anal incontinence (AI) 8 years after childbirth and the occurrence of Obstetrical Anal Sphincter Injury (OASI) and/or performance of an episiotomy during childbirth. Methods: This is a nationwide database analysis performed on two national medico-administrative databases, including all the women aged...
Article
Résumé Objectifs. Évaluer la révision méthodologique des recommandations pour la pratique clinique (RPC) du collège national des gynécologues obstétriciens français (CNGOF). Méthode. Trois RPC ont été organisées en 2020 sur les thèmes de la pré-éclampsie sévère, des ménorragies et de la chirurgie prophylactique selon AGREE II (Apraisal of Guideline...
Article
A congenital malformation of the head, neck or thorax can lead to upper airway compression with a risk of asphyxia or neonatal death. To secure and protect the upper airway, the Ex Utero Intrapartum Therapy (EXIT) procedure has been developed. The procedure allows delivery of the fetus via a hysterotomy while relying on the placenta as the organ of...
Article
Objectives: Early management of perineal disorders after obstetric anal sphincter injury (OASI) may improve the functional prognosis. The objective was to assess the acceptability of the consultation and to report on its results. Methods: This unicentric retrospective study included 64 women who had LOSA 3 or 4 and who were offered a 3-month rou...
Article
Objective To validate a mathematical model to predict the mean time to delivery (TTD) following cervical ripening with dinoprostone vaginal insert (DVI), and assess its impact on the risk of nocturnal deliveries. Methods We performed a case-control retro-prospective study at Angers University Hospital. In the control group, we retrospectively incl...
Article
Resume Objectif : Déterminer l’intérêt ou non de la réalisation de certains gestes prophylactiques en association à une procédure chirurgicale gynécologique. Conception : Un comité de consensus de 19 experts a été constitué. Une politique de déclaration et de suivi des liens d’intérêts a été appliquée et respectée durant tout le processus de réalis...
Article
(Abstracted from N Engl J Med 2021;384:1623–1634) Uterotonic agents are recommended to prevent postpartum hemorrhage (PPH). Tranexamic acid (TXA) has emerged as another medical approach to prevent blood loss after delivery.
Article
Objective To provide guidelines from the French College of Obstetricians and Gynecologists (CNGOF), based on the best currently available evidence, for the prophylactic procedures associated with gynecological surgery for benign disease such as superficial endometriosis lesions and adhesions. Methods The CNGOF has decided to adopt the AGREE II and...
Article
Study Objective : Evaluation of the efficacy of different injection sites of methotrexate in the treatment of non-tubal ectopic pregnancies. Design : Retrospective multicenter study. Setting : Multicenter, including three teaching hospitals, an intercommunal hospital and a clinic. Patients : A total of 106 patients with non-tubal ectopic pregnan...
Article
Introduction Serum oestradiol concentration at the time of frozen embryo transfer (FET) in artificial cycle are lower when using transdermal administration of oestrogen for endometrial preparation compared to the vaginal route. This difference could have consequences for placentation and establishment of maternal-foetal circulation. The aim of our...
Article
Objective To provide guidelines from the French College of Obstetricians and Gynaecologists (CNGOF), based on the best evidence available, concerning the impact of endometrial destruction on bleeding and endometrial cancer risk reduction in patients candidates for operative hysteroscopy. Methods Recommendations were made according to AGREE II and...
Article
Objective: To evaluate whether manual rotation of fetuses in occiput posterior positions at full dilation increases the rate of spontaneous vaginal delivery. Methods: In an open, single-center, randomized controlled trial, patients with a term, singleton gestation, epidural analgesia, and ultrasonogram-confirmed occiput posterior position at the...
Article
Objectives : The objective of this study was to identify the factors predictive of the success of external cephalic version (ECV). Methods : A single-centre retrospective observational study was performed in the maternity ward of the Angers University Hospital, France, between January 2010 and May 2020. The study included all patients (n=613) for...
Article
Objective This study examined the impact of lockdown for SARS-CoV-2 on breast cancer management via an online survey in a French multicentre setting Material and methods This is a multicentre retrospective study, over the strict lockdown period from March 16th to May 11th, 2020 in metropolitan France. 20 centres were solicited, of which 12 respond...
Article
Background Prophylactic administration of tranexamic acid has been associated with reduced postpartum blood loss after cesarean delivery in several small trials, but evidence of its benefit in this clinical context remains inconclusive. Methods Download a PDF of the Research Summary. In a multicenter, double-blind, randomized, controlled trial, we...
Article
Objective In a menopausal woman scheduled for curative surgery for pelvic organ prolapse (POP) by sacral colpopexy (SC), the question of concomitant hysterectomy is frequently considered by the surgeon. The risk of endometrial cancer (EC) exists in this population, and increases with age and body mass index. The French college of gynecologists and...
Article
Introduction: Initially dispensed in specialized simulation centers, simulation training has recently begun to take place directly in healthcare facilities, that is, in situ. The objective of this study is to assess the effect of training by in situ simulation in obstetrics. Material and methods: The training program, dispensed over a 2-day peri...
Article
Full-text available
Introduction The coronavirus SARS-CoV-2 (COVID-19) pandemic has put tremendous pressure on the French healthcare system. Almost all hospital departments have had to profoundly modify their activity to cope with the crisis. In this context, the surgical management of cancers has been a topic of debate as care strategies were tailored to avoid any de...
Article
Objective To provide guidelines from the French College of Obstetricians and Gynecologists (CNGOF), based on the best evidence available, concerning subtotal or total hysterectomy, for benign disease. Methods The CNGOF has decided to adopt the AGREE II and GRADE systems for grading scientific evidence. Each recommendation for practice was allocate...
Article
Résumé Objectif: Analyser les pratiques professionnelles au sein d’un réseau de périnatalité sur la prise en charge des grossesses prolongées. L’objectif secondaire était d’évaluer la morbidité néonatale et maternelle en cas de grossesse prolongée. Méthodes: Étude observationnelle, rétrospective réalisée dans les 23 maternités du réseau de périnata...
Article
Full-text available
Background: Thrombotic microangiopathies (TMAs) are highly suspected in patients showing mechanical hemolytic anemia, thrombocytopenia, and haptoglobin consumption. Primary [thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome] and secondary TMA are considered. Even if ADAMTS13 measurements and alternative complement pat...
Article
Résumé Anciennement appelées « périnée complet » ou « périnée incomplet », les lésions obstétricales du sphincter anal (LOSA) sont une complication fréquente des accouchements. Les conséquences peuvent être d’ordre digestif (incontinence anale et fistule ano-génitale) ou sexuel (dyspareunie et douleurs génitales). La complexité de la prise en charg...
Article
Obstetrical anal sphincter injuries (OASI), formerly referred to as “complete” or “incomplete” perineal tears, are a frequent complication of childbirth. They can lead to intestinal consequences (anal incontinence, ano-genital fistula) or sexual consequences (dyspareunia, genital pain). The complexity of management of OASI lies in the multi-factori...
Article
Résumé But de l’étude Faire une enquête de pratique sur la prise en charge des lésions obstétricales du sphincter anal (LOSA) et comparer les pratiques à court, moyen et long terme en fonction de la filière de prise en charge. Patients et méthodes Un questionnaire de 50 questions a été adressé aux différents spécialistes via les sociétés savantes...
Article
Aim of the study To conduct a survey of current practice in the management of obstetrical anal sphincter injuries (OASI) and to compare short, medium and long-term practices according to the specialty of the surgeon. Patients and methods A 50-item questionnaire was addressed by mail to various specialists via the national learned societies. The qu...
Article
Objective To evaluate the effect of a 10 mg per day 12 week treatment of ulipristal acetate (UPA) on abnormal uterine bleeding due to adenomyosis. Design A double-blind phase 2 randomized controlled pilot study.Setting: From May 2015 to February 2018 in five teaching hospitals. Population Premenopausal women with abnormal uterine bleeding (with a...
Article
The requesting of medical termination of pregnancy (MTP) for psychosocial reasons invites several questions concerning progress in medicine as well raising necessary and legitimate ethical questions. The law currently permits MTP for maternal reasons at any stage of pregnancy if the woman's health is at a significant risk. However, conceptions of m...
Article
Objectives To investigate the perinatal outcomes of women with a history of female genital mutilation (FGM) who underwent clitoral reconstruction (CR) compared with women with FGM who did not undergo CR. Material and methods Retrospective case-control study at Angers University Hospital, between 2005 and 2017. Inclusion criteria: pregnant women >1...
Article
The aim of this study was to evaluate an oocyte pick-up (OPU) simulation training program for residents using the high fidelity PickUpSimTM (Accurate, Cesena, Italy) simulator. The authors carried out an observational study during an OPU simulation workshop. A successful scenario was defined as an oocyte retrieval rate ≥70% without any complication...
Article
Full-text available
Endometriosis and infertility are closely linked, but the underlying mechanisms are still poorly understood. This study aimed to evaluate the impact of endometriosis on in vitro fertilization (IVF) parameters, especially on embryo quality and IVF outcomes. A total of 1124 cycles with intracytoplasmic sperm injection were retrospectively evaluated,...
Article
Purpose To determine the risk of multiple pregnancies (MP) following conversion of in vitro fertilization (IVF) cycles to intrauterine insemination (IUI) when a poor ovarian response (POR) is diagnosed during controlled ovarian stimulation (COS). Methods We undertook a retrospective study in our teaching hospital from January 2012 to December 2017...
Article
Objectives To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy and the post-partum period. Study Design A systematic review of the international literature was undertaken between January 2003 and April 2019. MEDLINE, EMBASE databases and the Cochrane library were searched for a range of predefin...
Article
Full-text available
Objectives: To evaluate the impact of pre-operative Music Therapy (MT) on pain in first-trimester abortion under local anaesthesia (ALA). Design: Randomised controlled trial comparing patients undergoing a first-trimester ALA with or without a pre-operative MT session. Setting: University hospital of Angers from November 2016 to August 2017....
Article
Resumen Los miomas uterinos están presentes en el 20-50% de las mujeres en edad fértil y son el tumor benigno más común. El descubrimiento de un mioma en una paciente en edad de procrear o embarazada es un hecho común que suscitará preguntas y preocupaciones. El fibroma puede interferir en todas las etapas de la concepción, pero también puede compl...
Article
Full-text available
To determine if a modification of the cytokine profile occurs in the follicular fluid (FF) of women with endometriosis undergoing in vitro fertilization (IVF), we performed a prospective observational study from January 2018 to February 2019. In total, 87 women undergoing IVF were included: 43 for severe endometriosis-related infertility and 40 con...
Article
Résumé Objectifs: Evaluer les connaissances sur le tabagisme en cours de grossesse et élaborer les recommandations de prise en charge, en utilisant la littérature fondée sur les niveaux de preuve. Méthodes: Revue systématique de la littérature internationale. Nous avons identifié des articles publiés entre janvier 2003 et avril 2019 dans les bases...
Article
Full-text available
The objective was to compare the endometrial thickness (ET) in a frozen embryo transfer (FET) cycle between transdermal and vaginal estrogen. Our secondary objectives were to compare the patient satisfaction and the pregnancy outcomes. Prospective monocentric cohort study between 01/2017 and 12/2017 at a single institution. Choice of administration...
Article
Full-text available
Intrauterine Growth Restriction (IUGR) affects 8% of newborns and increases morbidity and mortality for the offspring even during later stages of life. Single omics studies have evidenced epigenetic, genetic, and metabolic alterations in IUGR, but pathogenic mechanisms as a whole are not being fully understood. An in-depth strategy combining methyl...
Article
Aim: The main aim of this study is to evaluate the interest of three-dimensional ultrasound perineal in the measurement of the levator hiatus area as an objective reflection of the surgical correction of pelvic organ prolapse (POP). Our hypothesis is that POP surgery decreases the size of the levator hiatus area. Materials and methods: A longitu...
Article
Full-text available
Objective To evaluate the use of new bipolar vessel sealing system like LigaSure™ compared to the standard surgical technique (suture) during emergency peripartum hysterectomy (EPH). Methods A retrospective observational bicentric study was conducted from February 2005 to August 2018 in the maternity wards of the University Hospital of Toulouse an...
Article
Full-text available
Objective Maternal obesity is associated with an increase in maternal, foetal and neonatal morbidity and mortality. The aim of our study was to evaluate the relationships between maternal pre-pregnancy body mass index and (1) neonatal outcome in preterm infants, and (2) neurodevelopmental outcome at 2 years of corrected age. Method We conducted a...
Article
Aims: To analyze factors related to the incidence and remission of stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) among women at midlife. Methods: A total of 2115 women participants in a prospective longitudinal survey (GAZEL cohort) were included. In 2000 and 2008, a specific questionnai...
Article
Study Objective To evaluate efficacy of a 3 months course of ulipristal acetate on abnormal uterine bleeding in adenomyosis Design A multicenter randomized trial with a 3:1 ratio. Setting In five different teaching hospitals Patients or Participants Women with adenomyosis confirmed on MRI or sonography and abnormal uterine bleeding with PBAC sco...
Article
Study Objective To evaluate the rate of intrauterine adhesions (IUA) after dilatation and curettage (D&C) for miscarriage with and without hyaluronic acid gel. Design Multicentric prospective randomized controlled trial, with two years of follow up for each patient. Setting Eight hospitals, in France. Patients or Participants 343 patients who ha...
Article
Full-text available
The main objective of our study was to analyze the mean time to delivery following cervical ripening with a 10 mg dinoprostone vaginal insert. We performed a retrospective observational study at the level III maternity ward of Angers university hospital. We included all women who had cervical ripening with dinoprostone between January 1st, 2015 and...
Article
Background: The objective of the study was to assess perinatal grief experienced after continuing pregnancy and comfort care in women diagnosed with lethal fetal condition compared with termination of pregnancy for fetal anomaly (TOPFA). Methods: This was a retrospective observational study which included women who chose to continue their pregna...
Article
Las sinequias son una de las principales causas de infertilidad secundaria. La prevalencia de las sinequias probablemente esté subestimada debido a la heterogeneidad de la sintomatología. Existen varias clasificaciones de las sinequias. Es preciso realizar una actualización sobre el origen, las consecuencias, el diagnóstico, el tratamiento y los mé...
Article
Résumé Objectifs La nymphoplastie est une intervention consistant en la résection partielle des petites lèvres. Les motivations des patientes à la réalisation de cet acte chirurgical sont fonctionnelles (gêne lors des rapports, lors des activités sportives, etc.) ou esthétiques. À ce jour, peu de données concernent la satisfaction des patientes en...
Article
The rupture of the ureter during pregnancy is a rare complication and is most frequently observed in the right ureter. We report below the case of a rupture in the left ureter. A 36-year old woman gave birth vaginally to a 3010-g girl without operative vaginal delivery or episiotomy. The following day, the patient exhibited a sudden pain in the lef...
Article
Objective To test if the evaluation of body dissatisfaction by images could be an interesting tool to detect perinatal depression early in pregnancy, questioning patients about their body image instead of their depressive symptoms. Methods A sample of 457 women was recruited in a longitudinal study. Three evaluations were performed at the 4th and...
Article
Aim Women's knowledge of contraception is incomplete and a wide variety of information sources are used. Since the advent of smartphones, 325,000 healthcare apps have become available. Our aim is to conduct a literature review on smartphone applications for contraception. Methods 15 databases in English, Spanish and French were examined, which inc...
Article
Full-text available
Objective To identify the predictors of intrauterine balloon tamponade (IUBT) failure for persistent postpartum hemorrhage (PPH) after vaginal delivery. Design Retrospective case-series in five maternity units in a perinatal network. Setting All women who underwent IUBT for persistent PPH after vaginal delivery from January 2011 to December 2015...
Data
A de-identified data set of women with IUBT. (XLSX)