Philippe Descamps

• University of Angers

Background Simulation‐based training has become a cornerstone in obstetrics education, offering valuable opportunities to practice rare and complex procedures in a controlled environment. The importance of simulation in obstetrics and gynecology is well documented internationally, particularly in improving clinical skills and patient safety.In some...

Objective To assess the impact of an oocyte retrieval simulation training program (ORSTP) on the clinical performance of residents. Methods We performed a prospective comparative study. The Simulation (S) group included oocyte retrieval (OR) performed by residents who had undergone an ORSTP before performing them on patients (n = 422 OR), and the...

Endometriosis is a complex gynecologic disorder characterized primarily by symptoms of pelvic pain, infertility, and altered quality of life. National and international guidelines highlight the diagnostic difficulties and lack of conclusive diagnostic tools for endometriosis. Furthermore, guidelines are becoming questionable at an increasingly rapi...

Objective To compare two cancellation policies in controlled ovarian stimulation‐intrauterine insemination (COS‐IUI) cycles to lower the risk of multiple pregnancies (MP). Design We performed a bicentric retrospective cohort study in two academic medical centers: Angers (group A) and Besançon (group B) University Hospitals. We included 7056 COS‐IU...

The French National College of Obstetricians and Gynecologists (CNGOF) published guidelines for managing endometriosis-associated pain in 2018. Given the development of new pharmacological therapies and a review that was published in 2021, most national and international guidelines now suggest a new therapeutic approach. In addition, a novel valida...

BACKGROUND: The discovery of a saliva-based micro–ribonucleic acid (miRNA) signature for endometriosis in 2022 opened up new perspectives for early and noninvasive diagnosis of the disease. The 109-miRNA saliva signature is the product of miRNA biomarkers and artificial intelligence (AI) modeling. We designed a multicenter study to provide external...

Simple Summary Ovarian cancer is the most lethal gynecologic cancer since it is often diagnosed at advanced stages. Current tools for diagnosis are currently insufficient and include physical examination, ultrasound and pelvic magnetic resonance imaging, as well as algorithms combining thoraco-abdomino-pelvic scans and blood markers. In this contex...

Introduction: Hemostasis Hysterectomy (HH) is a last resort surgical procedure performed in situations of uncontrolled post-partum hemorrhage in maternity wards. The chances of being confronted with this situation are scarce during residency, and the situation is not well suited for teaching. Nevertheless, every obstetrician-gynecologist can be co...

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...

Research question : We aimed to design and validate a saliva-based miRNA signature for endometriosis-associated infertility by analyzing the human miRNome. Design The prospective ENDOmiARN study (NCT04728152) included 200 saliva samples obtained between January and June 2021 from women with pelvic pain suggestive of endometriosis. All patients und...

Objective: To assess the impact of an oocyte retrieval simulation training program (ORSTP) on the clinical performance of residents. Design: Prospective comparative study. Setting: A tertiary care center. Population: All OR performed by residents between May 2017 and November 2020. Methods & main outcome measures: The Simulation (S) group included...

Late-term fetal demise including fetal death in utero, late miscarriage and late termination of pregnancy are relatively frequent occurrences. Post-traumatic stress disorder (PTSD) is a pathology that finds its roots in exposure to a life-threatening event or an event related to death. Exposure to fetal death during a late-term fetal demise is, the...

The aim of our study was to describe the bioinformatics approach to analyze miRNome with Next Generation Sequencing (NGS) of 200 plasma samples from patients with and without endometriosis. Patients were prospectively included in the ENDO-miRNA study that selected patients with pelvic pain suggestive of endometriosis. miRNA sequencing was performed...

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...

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:...

The objective was to assess whether the measurement of serum estradiol (E2) 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 p...

Background: Endometriosis diagnosis constitutes a considerable economic burden for the healthcare system with diagnostic tools often inconclusive with insufficient accuracy. We sought to analyze the human miRNAome to define a saliva-based diagnostic miRNA signature for endometriosis. Methods: We performed a prospective ENDO-miRNA study involving...

Endometriosis—a systemic and chronic condition occurring in women of childbearing age—is a highly enigmatic disease with unresolved questions. While multiple biomarkers, genomic analysis, questionnaires, and imaging techniques have been advocated as screening and triage tests for endometriosis to replace diagnostic laparoscopy, none have been imple...

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...

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...

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...

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...

Introduction Pelvic lymph node dissection has been the standard of care for patients with early cervical cancer. Sentinel node (SN) mapping is safe and feasible and may increase the detection of metastatic disease, but benefits of omitting pelvic lymph node dissection in terms of decreased morbidity have not been demonstrated. Materials and method...

Study objectives To describe the surgical management and the risks of postoperative complications of patients suffering from urinary tract endometriosis (UTE) in France in 2017. Design Multicentric retrospective cohort pilot study. Setting Department of Gynecology in 31 expert endometriosis centers. Patients All women managed surgically for UTE,...

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...

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...

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...

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,...

Objectives In 2016, the European Society of Gynecology Oncology (ESGO) published indicators defining the quality of surgical management of advanced ovarian cancer. The objective of the study was to assess the quality of ovarian cancer patient management in regional centers authorized for gynecological cancer, based on the ESGO list of quality indic...

Résumé Objectifs En appui sur les données issues d’une vaste recherche médico-psychopathologique proposée à des jeunes filles atteintes d’une agénésie utéro-vaginale — syndrome de Rokitansky ou Mayer-Rokitansky-Küster-Hauser (MRKH) — notre travail propose l’analyse psychodynamique de la valeur et de la fonction pour l’économie psychosomatique d’un...

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...

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...

In established tumors, tumor-associated macrophages (TAM) orchestrate nonresolving cancer-related inflammation and produce mediators favoring tumor growth, metastasis, and angiogenesis. However, the factors conferring inflammatory and protumor properties on human macrophages remain largely unknown. Most solid tumors have high lactate content. We th...

Objective: Ovarian ageing is one of the commonest causes of infertility in patients consulting for assisted reproductive technology. The composition of the follicular fluid (FF), which reflects the exchanges between the oocyte and its microenvironment, has been extensively investigated to determine the metabolic pathways involved in various ovaria...

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...

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...

Background: To date, there is no consensus on the ideal management strategy of patients with poor ovarian response (POR) to controlled ovarian stimulation (COS) for in vitro fertilization (IVF). Currently, these patients are given the choice of: (1) canceling the cycle; (2) proceeding with COS regardless of the poor response, and performing the oo...

Septate uterus is the most common congenital uterine malformation in women with infertility. Several criteria are available for the definition of septate uteri, such as the one proposed by the European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynecological Endoscopy (ESGE) (ESHRE/ESGE), or by the American Society fo...

Background: Vaginal agenesis in Mayer-Rokitanski-Küster-Hauser (MRKH) syndrome can be managed either by various surgeries or dilation. The choice still depends on surgeon's preferences rather than on quality comparative studies and validated protocols. Objective(s): To compare dilation and surgical management of vaginal agenesis in MRKH syndrome...

Objective: The principal objective of our study was to assess women's quality of life (QoL) after surgery for Deep Endometriosis (DE), according to the surgical technique used. Material and methods: Qualitative single-center survey in the department of obstetrics and gynecology, Angers University Hospital Center, France. All women who underwent...

Endometriosis is a common condition that causes pain and infertility. It can lead to absenteeism and also to multiple surgeries with a consequent risk of impaired fertility, and constitutes a major public health cost. Despite the existence of numerous national and international guidelines, the management of endometriosis remains suboptimal. To addr...

Recurrent pregnancy loss is an important reproductive health issue, affecting 2%–5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inh...

Résumé But L’objectif de notre étude était d’évaluer les résultats anatomiques, fonctionnels et la morbidité liée à une nouvelle technique opératoire de transposition clitoridienne dans le service de gynécologie obstétrique du CHUYO. Matériel et méthodes Une cohorte de 68 femmes victimes de mutilation génitale a bénéficié d’une reconstruction cli...

BACKGROUND There is a great inter-individual variability of ovarian ageing, and almost 20% of patients consulting for infertility show signs of premature ovarian ageing. This feature, taken together with delayed childbearing in modern society, leads to the emergence of age-related ovarian dysfunction concomitantly with the desire for pregnancy. Ass...

Tumor-associated macrophages (TAM) are immunosuppressive cells that can massively accumulate in the tumor microenvironment. In patients with ovarian cancer, their density is correlated with poor prognosis. Targeting mediators that control the generation or the differentiation of immunoregulatory macrophages represents therapeutic challenge to overc...

Objective Laparoscopy allows hysterectomies after chemoradiation to be performed without opening the abdominal wall. We measured the costs and quality of life for locally advanced cervical cancer patients operated on via laparoscopy compared to laparotomy. Study design We conducted an observational prospective multicenter study on locally advanced...

The aim of this study was to identify predictive factors of urolithiasis etiology for acute renal colic (ARC) during pregnancy. We performed a retrospective review of all pregnant women hospitalized for an ARC between January 2007 and October 2012 in the department of Obstetrics and Gynecology of a University Hospital. Univariate and multivariate r...

To compare neonatal mortality and morbidity in very preterm twins with the first twin in cephalic presentation in hospitals with a policy of planned vaginal delivery (PVD) and those with a policy of planned cesarean delivery (PCD). Women with preterm cephalic first twins delivered after preterm labor and/or premature preterm rupture of membranes fr...

To assess whether a policy of routine administration of high-dose tranexamic acid (TA) at the diagnosis of postpartum hemorrhage (PPH) reduces blood loss after vaginal birth. This controlled single-center before-and-after study of all women with PPH ≥ 500 ml after vaginal birth took place from January 2011 through March 2012; the control group incl...

Objectives Positron emission tomography with 16α-[18F]fluoro-17β-œstradiol (PET-[18F]FES) is used to evaluate the in vivo tissue density in estrogen receptor (ER). We report here the first cases in the diagnosis of endometriosis. Patients and methods Four patients with clinical and morphological signs (pelvic ultrasound ± MRI) consistent with endo...

Macrophages orchestrate the immune response via the polarization of CD4+ T helper cells. Different subsets of macrophages with distinct phenotypes, and sometimes opposite functions, have been described. M-CSF and IL-34 induce the differentiation of monocytes into IL-10high IL-12low immunoregulatory macrophages, which are similar to tumor-associated...

The objective of this study was to evaluate the relationship between psychology and pregnancy loss. A literature review was conducted by consulting Medline until April 2014. Psychological factors appear to be significantly associated with the risk of recurrent miscarriage. Depression and anxiety are common symptoms after miscarriage. A return to no...

Objective: The objective of this multicenter, randomized study was to investigate the efficacy of the hydrophilic resorbable film PREVADH™ in preventing postoperative adhesions following myomectomy. Study design: Women scheduled for laparotomic myomectomy with intramural and/or subserous myomas of >60mm in diameter, and who wished to preserve fe...

Medical and surgical simulation is in high demand. It is widely used in North America as a method of education and training of medical students and surgical residents. Learning anatomy and vaginal surgery are based on palpation recognition of different structures. The absence of visual control of actions learners is a limiting factor for the reprod...

Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this con...

Betremieux P, Gold F, Parat S, Moriette G, Huillery M.-L Chabernaud J-L et al. Imagining a palliative care project for newborns. Part two of Palliative care in the neonatal period

The relationship between ovarian cysts and infertility is a subject of debate, mainly because it is difficult to determine the real impact of the cyst and its treatment on later fertility. For a long time it was hoped that surgical treatment could prevent potential complications (such as rupture or malignancy). For presumed benign ovarian tumors, f...

Unexpected out-of-hospital delivery accounts for 0.5% of the total number of delivery in France. The parturient is placed under constant multiparametric monitoring. Fetus heart rate is monitored thanks to fetal doppler. A high concentration mask containing a 50-to-50 percent mix of O2 and NO performs analgesia. Assistance of mobile pediatric servic...

Introduction Medical and surgical simulation is in high demand. It is widely used in North America as a method of education and training of medical students and surgical residents. Learning anatomy and vaginal surgery are based on palpation recognition of different structures. The absence of visual control of actions learners is a limiting factor f...

Cervical pessary is a promising tool to prevent preterm birth in high risk pregnant women with shortened midtrimester ultrasonographic cervical length. It is well tolerated by women. PECEP and ProTWIN trials have opened new fields of clinical research. Their results suggest that cervical pessary may prevent preterm birth in women with (i) singleton...