Jean-Marc Levaillant

Assessment of Abdominal Ultrasound Guidance in Hysteroscopic Metroplasty

STUDY OBJECTIVESnTo compare the rates of re-intervention, and immediate and later complications associated with abdominal ultrasound-guided versus unguided hysteroscopic metroplasty in the surgical repair of European Society of Human Reproduction and Embryology/European Society for Gynecological Endoscopy class II intrauterine septa.nnnDESIGNnWe performed a large observational retrospective study (Canadian Task Force Classification II-2) in a selection of patients who underwent metroplasty in a tertiary university center between 2009 andxa02013.nnnPATIENTSnA total of 108 patients were included in the study.nnnINTERVENTIONSnPatients were categorized as having abdominal ultrasound-guided metroplasty (nxa0=xa046) or unguided metroplasty (nxa0=xa062).nnnMEASUREMENTS AND MAIN RESULTSnData were collected with regard to medical and reproductive histories, diagnosis of septate uterus, surgical procedures, and complications. Using these data, the need for re-intervention and complication rates were compared between groups. Statistical analysis was performed using Fishers exact test and Students t-test. The characteristics of the 2 groups were comparable. A persistent septum of >10xa0mm, defined by 3-dimensional ultrasound hysterosonography, with a need for re-intervention, was found in 16 patients (39.0 %) in the unguided group versus 7 patients (18.4 %) in the ultrasound guidance group (pxa0=xa0.04). Risk of a persistent septum after resection (>10xa0mm) was reduced with ultrasound guidance (odds ratioxa0=xa00.35; 95% confidence interval 0.13-0.99). Two uterine perforations occurred in our series; both were in the unguided group.nnnCONCLUSIONSnA systematic abdominal ultrasound-guided metroplasty by hysteroscopy seems to reduce the rates of re-intervention.

Clefts and Pierre-Robin Syndrome

Facial clefts are found in 272 different syndromes, the frequency of cleft lips and palate is 0.5/1000, or 1/500, 41 % of which are associate with other organ anomalies, and only 6/10 being isolated.

Cystic Adenomyosis: Place of Hysteroscopic Approach

Cystic adenomyosis is not very common. Primary complains are chronic pelvic pain, severe dysmenorrhea, and heavy menstrual bleeding when they are associated with superficial or diffuse adenomyosis. The introduction of 3D-TransVaginal UltraSound (3D-TVUS) with coronal view and/or Magnetic Resonance Imaging (MRI) increased the number of cases reported. Despite the severity of symptoms in symptomatic forms, it is unclear whether cystic adenomyosis impairs reproductive outcome. Therefore, for women wishing to become pregnant, evaluation of uterine cavity by hysteroscopy and exploration of the sub-endometrial zone by 3D-TVUS is becoming a gold standard.

Introduction Craniofacial Epigenesis in Vertebrates

The facial bones, as they appear in a fetal ultrasound image, result from a continuous process of development, regulated and sequenced by genetic and molecular embryology, which progressively constructs the face like epigenesis.