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Biomedical subjects

Olivier Garbin

Publications and source records attributed to Olivier Garbin.

5 recordsLinked to original sources
PubMed2005

Consistency of medical abortion efficacy from 5 through 14 weeks' gestation.

OBJECTIVE: To assess the efficacy of medical abortion performed according to a single protocol from 5 through 14 weeks. STUDY DESIGN: Retrospective observational study of medical abortions through 14 weeks performed from January 2000 through August 2001. The protocol combined 400mg of mifepristone orally, followed 48 h later by 800 microg of misoprostol, administered vaginally, and repeated after 4 h if the patient did not begin to abort. Outcome measures were the abortion rate, the rates of immediate manual uterine revision and of secondary vacuum aspiration, the time to expulsion, the misoprostol dose, and analgesic use. RESULTS: The study included 512 medical abortions. The abortion rate was 98.4% and the secondary vacuum aspiration rate 8.2%. The uterine exploration rate was 1.4%, but these occurred only at gestations above 13 weeks. The mean time to expulsion was 4.4+/-1.9 h (1-28), and the mean misoprostol dose 860+/-180 microg (0-2000). None of the characteristics studied differed significantly as a function of gestation. 1.6% of patients had complications. CONCLUSION: Medical abortion was consistently effective through 14 weeks and can be offered as an alternative to the surgical technique.

Abortifacient Agents, Nonsteroidal↗
PubMed2004

Sacro-spinous ligament fixation peri-operative complications in 195 cases: visual approach versus digital approach of the sacro-spinous ligament.

OBJECTIVE: To evaluate sacro-spinous ligament fixation (SLF) peri-operative complications. STUDY DESIGN: Monocentric, retrospective study. Department of Gynecology, SIHCUS-CMCO, University Hospital, Strasbourg, France. Between January 1990 and December 2000, 195 women, mean age 63.2 years old (40-90), underwent a vaginal SLF. Ninety point eight percent of women were post-menopaused and 27.9% of these had a hormonal substitution. About 24% of patients had prior hysterectomy, 20% vaginal prolapse repair and 22% urinary stress incontinence repair. SLF was performed in 1.5% of cases without any other procedures and it was combined with the following: rectocele and elytrocele repair in 89.2%, hysterectomy in 72.3%, cystocele repair in 52.8% and stress incontinence repair in 15.3% of cases. In 107 cases, the SLF attachment was placed under digital control and in 88 cases under visual control. RESULTS: The mean hospitalisation stay was of 8.5 +/- 2.6 days (4-26). About 41% of women presented a complication. Major complications were represented by 3.6% of bladder injury, 0.5% of uretero-vaginal fistula, 0.5% of vascular injuries, 0.5% of thromboembolic events. In 38% of cases patients had minor complications: urinary tract infections (29%), temporary urinary retention (5.6%), local complications (4.5%), and other complications (3%). The only specific SLF complication in this data was a vascular injury and in this case the SLF was performed under digital control. CONCLUSIONS: The global peri-operative complication frequency of SLF is high. It is mainly represented by non-specific complications, secondary to the combined procedures and not to the SLF itself. The specific complications due to SLF, all of which are major ones, can be avoided or diagnosed earlier, by using the visual approach technique.

Adult↗
PubMed2003

Medical treatment of ectopic pregnancies: a randomized clinical trial comparing methotrexate-mifepristone and methotrexate-placebo.

BACKGROUND: Medical treatment of ectopic pregnancies is common. To increase the efficacy of methotrexate, the association of mifepristone has been proposed. METHODS: We performed a large prospective multicentre double-blind sequential randomized trial in order to compare the efficacy of methotrexate and mifepristone (600 mg given orally) versus methotrexate and placebo. RESULTS: A total of 212 ectopic pregnancies was randomized. There was no significant difference in the initial characteristics between the two groups. There was no significant difference in the success rate of medical treatment between the methotrexate-mifepristone (n = 113) and the methotrexate-placebo group (n = 99): 79.6% (90/113) versus 74.2% (72/97) respectively, RR (95% CI): 1.07 (0.92-1.25), P = 0.41, non-significant. However, there was a quantitative interaction between progesterone level and effect of treatment: when progesterone level was >/=10 ng/l, the efficacy of the combination of mifepristone and methotrexate was significantly higher than the combination of methotrexate and placebo, with an 83.3% success rate (15/18) versus 38.5% (5/13) respectively. CONCLUSIONS: Our study failed to demonstrate any benefit of the addition of mifepristone to methotrexate. By contrast, the quantitative interaction between treatment effect and baseline serum progesterone suggested that this combination could be limited to ectopic pregnancies associated with high serum progesterone concentrations.

Abortifacient Agents, Nonsteroidal↗
PubMedDate not supplied

Tubal perforation by ESSURE microinsert.

Female tubal sterilization remains the most widely used method of permanent contraception worldwide. Recent studies have shown the new sterilization technique by ESSURE microinsert to be an effective method with decided advantages for the patient in terms of morbidity associated to a quick recovery. We discuss the possible hysteroscopic signs of tubal perforation and the right measures to take if a perforation is suspected, with respect to the possible complications and contraceptive failure.

Fallopian Tubes↗