Introduction Voluntary termination of pregnancy (TOP) is a social issue; however, even if it is one of the most common procedures performed in the world, few studies evaluated sexual function changes after medical or surgical TOP. Aim The aim of this study was to evaluate how first trimester TOP by either surgical (group 1) or medical procedure (group 2) affects sexual function. Methods This prospective observational study included 211 patients (132 in group 1 and 79 in group 2) who requested first trimester TOP between September 2010 and May 2012. Medical TOP (mifepristone and misoprostol) was offered to patients up to 49 days of gestation. Surgical TOP was performed up to 12 weeks. The Female Sexual Function Index (FSFI) was used to evaluate sexual function before TOP, after 1, 3, and 6 months from TOP. Main Outcome Measures Changes in the FSFI values and number of sexual active patients after 1, 3, and 6 months from the TOP and the self-reported quality of sexual life at 6 months, with the two different procedures, were the main outcome measures. Results At 4-week follow-up, 23.6% of women in group 1 did not resume sexual intercourse compared with 5.4% of women in group 2 (P = 0.003). At 6 months, 3.3% of women in the group 1 and no women in the group 2 did not resume sexual intercourses (P = 0.123). Compared with women in group 2, those in group 1 had lower FSFI score and number of sexual intercourses at 1, 3, and 6 months follow-up (P < 0.001). Conclusions This study shows that the number of sexually active women and the overall FSFI are reduced in women undergoing surgical TOP compared with those undergoing medical TOP. Counseling regarding sexual function changes should be included in the discussion of morbidity related to medical or surgical TOP.
Introduction: Macrosomia is usually defined by the delivery of a child over 4000 g at term. Because of the margins of error, the obstetrician must take into account, in addition to ultrasound, the constitutional and acquired factors of the mother in order to be able to prevent the complications expected during the delivery of a large fetus. Material and method: We carried out a cross-sectional, descriptive, 12-month study in a level 2 hospital in southern France (Montélimar). The aim of the study was to assess the prevalence of macrosomia, to identify the epidemiological characteristics of the patients, to specify the management of obstetrics and complications in this hospital. Results: We recorded 141 births with a weight greater than or equal to 4000 g. That is a rate of 7.95%. The average age of our patients is 30 years. Half of them had a BMI of less than 25 and were not diabetic. 75% of the patients gave birth by a low-dose route. The sex ratio of the children is male to female 2:1. The main maternal complications were the perineovaginal tears (39 cases) and the hemorrhages of the deliverance (6 cases). Conclusion: The delivery of macrosomia is not uncommon at the Hospital Center of Montélimar. It predominates among Caucasians. Usual risk factors have rarely been found. Overall management was without major complications for both the mother and the child.
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