References of "Nisolle, Michelle"
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See detailTechniques comportementales et organisationnelles pour une prise en charge efficiente de l'activité physique des parturientes et/ou des accouchées
Askour, Anissa; Cloes, Marc ULiege; EMONTS, Patrick ULiege et al

in Guinhouya, Benjamin (Ed.) L'activité physique de la femme enceinte et de l'accouchée (2021)

L'activité physique est reconnue comme un des facteurs déterminants d'un style de vie sain, y compris pour les femmes enceintes et les accouchées. Les professionnels de la santé en charge de ce public ... [more ▼]

L'activité physique est reconnue comme un des facteurs déterminants d'un style de vie sain, y compris pour les femmes enceintes et les accouchées. Les professionnels de la santé en charge de ce public devraient être au cœur de la promotion d'une activité physique qui lui est appropriée. Cette contribution fait le point sur les outils susceptibles d'être utilisés dans cette perspective et souligne la nécessité de favoriser leur exploitation sur le terrain. [less ▲]

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See detailLethal metatropic dwarfism: a case report
GALOPIN, Catherine ULiege; Denoo, Xavier ULiege; JAMBLIN, PAUL et al

in European Gynecology and Obstetrics (2021), 3(1), 37-39

With the improved resolution of ultrasound machines, fetal limb studies can be conducted early in pregnancy. The finding of a “short femur” (<3rd centile) on ultrasound prompts obstetricians to initiate ... [more ▼]

With the improved resolution of ultrasound machines, fetal limb studies can be conducted early in pregnancy. The finding of a “short femur” (<3rd centile) on ultrasound prompts obstetricians to initiate antenatal investigations to allow better counseling about the prognosis of the newborn. The following workup is indicated: advanced ultrasound to identify various characteristics of the fetus, amniocentesis for karyotyping and genetic analysis for bone diseases, and serial imaging of the skeleton at birth. [less ▲]

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See detailFaut-il opérer un septum utérin ?
Di Bartolomeo, L.; BRICHANT, Géraldine ULiege; ROUSSEAU, Laetitia ULiege et al

in Revue medicale de Liege (2021), 76(12), 862-867

Uterine septum is the most common congenital uterine malformation and may cause obstetric problems such as repeated miscarriages, premature deliveries or dystocial presentations. It also appears to be ... [more ▼]

Uterine septum is the most common congenital uterine malformation and may cause obstetric problems such as repeated miscarriages, premature deliveries or dystocial presentations. It also appears to be associated with infertility. The uterine septum can be demonstrated by ultrasound, MRI and hysteroscopy. The benefit of hysteroscopic septoplasty remains controversial although most studies agree on the benefits of this treatment. It improves the fertility and obstetrical future of women by increasing the rate of pregnancies and live births and reducing the rate of miscarriages. Resection of the uterine septum is therefore encouraged in symptomatic patients but also in prophylaxis, in asymptomatic patients in order to increase the chances of carrying their pregnancy to term. [less ▲]

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See detailNew Therapeutics in Endometriosis: A Review of Hormonal, Non-Hormonal, and Non-Coding RNA Treatments.
Brichant, Géraldine ULiege; Laraki, Ines ULiege; Henry, Laurie ULiege et al

in International journal of molecular sciences (2021), 22(19),

Endometriosis is defined as endometrial-like tissue outside the uterine cavity. It is a chronic inflammatory estrogen-dependent disease causing pain and infertility in about 10% of women of reproductive ... [more ▼]

Endometriosis is defined as endometrial-like tissue outside the uterine cavity. It is a chronic inflammatory estrogen-dependent disease causing pain and infertility in about 10% of women of reproductive age. Treatment nowadays consists of medical and surgical therapies. Medical treatments are based on painkillers and hormonal treatments. To date, none of the medical treatments have been able to cure the disease and symptoms recur as soon as the medication is stopped. The development of new biomedical targets, aiming at the cellular and molecular mechanisms responsible for endometriosis, is needed. This article summarizes the most recent medications under investigation in endometriosis treatment with an emphasis on non-coding RNAs that are emerging as key players in several human diseases, including cancer and endometriosis. [less ▲]

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See detailPolycystic ovarian syndrome and infertility: overview and insights of the putative treatments.
Collée, Julie ULiege; Mawet, Marie; Tebache, Linda ULiege et al

in Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (2021), 37(10), 869-874

Infertility concerns 15% of the couples. Management of female infertility requires a complete history of the patient followed by a physical, gynecological and endocrine examination. Infertility etiology ... [more ▼]

Infertility concerns 15% of the couples. Management of female infertility requires a complete history of the patient followed by a physical, gynecological and endocrine examination. Infertility etiology will be investigated thanks to different tests including ovarian function and reserve assessment, search for uterine abnormalities and evaluation of tubal permeability. Polycystic ovarian syndrome (PCOS) is a predominant cause of infertility and a common gyne-endocrine disorder affecting 7 to 15% of women in reproductive age. Behavioral, medical and surgical treatments have been evaluated in order to improve the fertility of women with PCOS. Lifestyle modifications (stop smoking, physical exercise and weight loss when necessary) are of the utmost importance. Clomiphene citrate remains the first line of medical treatment of infertility in women with PCOS in absence of other male or female causes of infertility. Use of metformin solely for infertility is not recommended in absence of metabolic anomaly and new treatment as myoinositol is emerging. Surgical techniques aiming to enhance ovulation and pregnancy rate are an option when medical treatment failed. Ovarian drilling by laparoscopy or by transvaginal hydrolaparoscopy is taking a larger place in the treatment of infertility. In vitro maturation and fertilization remain the third-line of treatment in PCOS. [less ▲]

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See detailL’activité physique de la femme enceinte et de l'accouchée
GUINHOUYA, BENJAMIN C.; BARIBEAU, ANISSA; BISSON, MICHELE et al

Book published by LAVOISIER (2021)

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See detailIndocyanine green in gynecological surgery
Grobet, Marie ULiege; TEBACHE, Linda ULiege; BRICHANT, Géraldine ULiege et al

in EUROPEAN GYNECOLOGY AND OBSTETRICS (2021), 3(1), 13-21

Indocyanine green (ICG) is a complex amphiphilic, tricarbocyanine iodide dye initially developed during World War II for infrared photography. It was tested and FDA approved for use in human medicine in ... [more ▼]

Indocyanine green (ICG) is a complex amphiphilic, tricarbocyanine iodide dye initially developed during World War II for infrared photography. It was tested and FDA approved for use in human medicine in the mid-fifties. When injected intravenously and revealed by near infrared light (NIR), ICG can highlight vascularization. ICG-NIR has emerged as an efficient technology, valuably implemented intraoperatively in many gynecological surgeries. Although additional data are needed to optimize protocols, it already stands as an excellent diagnostic and screening tool, which may advantageously replace some established methods, especially for perfusion monitoring and sentinel lymph node mapping. In endometriosis detection, ICG-NIR maps deep infiltrating occult lesions more efficiently than current white light (WL) does. Yet ICG-NIR seems to show lower sensitivity for detecting peritoneal superficial nodules, which suggests that WL and ICG-NIR should be used jointly to achieve optimal intraoperative endometriosis nodule detection. [less ▲]

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See detailImpact of Surgical Management of Endometrioma on AMH Levels and Pregnancy Rates: A Review of Recent Literature.
Pais, Ana Sofia; Flagothier, Clara ULiege; Tebache, Linda ULiege et al

in Journal of clinical medicine (2021), 10(3),

Ovarian endometrioma are found in up to 40% of women with endometriosis and 50% of infertile women. The best surgical approach for endometrioma and its impact on pregnancy rates is still controversial ... [more ▼]

Ovarian endometrioma are found in up to 40% of women with endometriosis and 50% of infertile women. The best surgical approach for endometrioma and its impact on pregnancy rates is still controversial. Therefore, we conducted a literature review on surgical management of ovarian endometrioma and its impact on pregnancy rates and ovarian reserve, assessed by anti-Müllerian hormone (AMH) serum levels. Ovarian cystectomy is the preferred technique, as it is associated with lower recurrence and higher spontaneous pregnancy rate. However, ablative approaches and combined techniques are becoming more popular as ovarian reserve is less affected and there are slightly higher pregnancy rates. Preoperative AMH level might be useful to predict the occurrence of pregnancy. In conclusion, AMH should be included in the preoperative evaluation of reproductive aged women with endometriosis. The surgical options for ovarian endometrioma should be individualized. The endometrioma ablation procedure seems to be the most promising treatment. [less ▲]

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See detailPreservation of female fertility: The current therapeutic strategy.
Henry, Laurie ULiege; LABIED, Soraya ULiege; Jouan, Caroline ULiege et al

in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2021)

BACKGROUND: Preservation of female fertility is a relatively new field in medicine that has grown very rapidly in recent decades. At the beginning, embryo freezing remained the most effective technique ... [more ▼]

BACKGROUND: Preservation of female fertility is a relatively new field in medicine that has grown very rapidly in recent decades. At the beginning, embryo freezing remained the most effective technique. Thereafter, cryopreservation of oocytes and ovarian tissue was considered a secure tool in human fertility preservation. Storage of cortical ovarian tissue is moreover relevant for children, prepubertal girls, and adult patients who cannot benefit from cryopreservation of oocytes. OBJECTIVE: To analyze and review recent and relevant scientific literature on medical and social reasons for preservation of fertility. METHODS: The review was conducted based on articles identified from PubMed databases using keywords. MAIN RESULTS: Oocyte vitrification allows women to preserve their fertility without the need for fertilization. Nowadays, thousands of healthy children have been born from this procedure. Occurrence of pregnancy depends on two main factors: the number of mature oocytes in storage and the age of the patient at the time of vitrification. Numerous adaptations have been developed to suit the ovarian stimulation regiments to patients with cancer. In young prepubertal girls, freezing of ovarian tissue remains the best and only option. CONCLUSION: Oocyte vitrification therefore appears to be the gold standard technique of preserving fertility in young women. [less ▲]

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See detailAnti-adhesion Gel versus No gel following Operative Hysteroscopy prior to Subsequent fertility Treatment or timed InterCourse (AGNOHSTIC), a randomised controlled trial: protocol
Van Wessel, S.; Hamerlynck, T.; Schutyser, V. et al

in Human Reproduction Open (2021), 00(0), 1-8

STUDY QUESTIONS: Does the application of anti-adhesion gel, compared to no gel, following operative hysteroscopy to treat intrauterine pathology in women wishing to conceive increase the chance of ... [more ▼]

STUDY QUESTIONS: Does the application of anti-adhesion gel, compared to no gel, following operative hysteroscopy to treat intrauterine pathology in women wishing to conceive increase the chance of conception leading to live birth? WHAT IS KNOWN ALREADY: Intrauterine adhesions (IUAs) following operative hysteroscopy may impair reproductive success in women of reproductive age. Anti-adhesion barrier gels may decrease the occurrence of IUAs, but the evidence on their effectiveness to improve reproductive outcomes is sparse and of low quality. STUDY DESIGN, SIZE, DURATION: This multicentre, parallel group, superiority, blinded and pragmatic randomised controlled trial is being carried out in seven participating centres in Belgium. Recruitment started in April 2019. Women will be randomly allocated to treatment with anti-adhesion gel (intervention group) or no gel (control group). Sterile ultrasound gel will be applied into the vagina as a mock-procedure in both treatment arms. The patient, fertility physician and gynaecologist performing the second-look hysteroscopy are unaware of the allocated treatment. Power analysis, based on a target improvement of 15% in conception leading to live birth using anti-adhesion gel, a power of 85%, a significance level of 5%, and a drop-out rate of 10%, yielded a number of 444 patients to be randomised. The baseline rate of conception leading to live birth in the control group is expected to be 45%. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women of reproductive age (18–47 years), wishing to conceive (spontaneously or by fertility treatment) and scheduled for operative hysteroscopy to treat intrauterine pathology (endometrial polyps, myomas with uterine cavity deformation, uterine septa, IUAs or retained products of conception) are eligible for recruitment. Women may try to conceive from 3 to 6 weeks after receiving allocated treatment with follow-up ending at 30 weeks after treatment. If the woman fails to conceive within this timeframe, a second-look hysteroscopy will be scheduled within 2–6 weeks to check for IUAs. The primary endpoint is conception leading to live birth, measured at 30 weeks after randomisation. The secondary endpoints are time to conception, clinical pregnancy, miscarriage and ectopic pregnancy rates, measured at 30 weeks after receiving allocated treatment. The long-term follow-up starts when the patient is pregnant and she will be contacted every trimester. STUDY FUNDING/COMPETING INTEREST(S): This work is funded by the Belgian Healthcare Knowledge Centre (KCE). The antiadhesion gel is supplied at no cost by Nordic Pharma and without conditions. Dr. Tomassetti reports grants and non-financial support from Merck SA, non-financial support from Ferring SA, personal fees and non-financial support from Gedeon-Richter, outside the submitted work. None of the other authors have a conflict of interest. [less ▲]

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See detailImportance des acides gras polyinsaturés oméga-3 durant la grossesse: mode ou réalité scientifique?
Hoge, Axelle ULiege; Nisolle, Michelle ULiege; Guillaume, Michèle ULiege et al

in Gunaïkeia. Société Royale Belge de Gynécologie et d'Obstétrique (2020), 25(2),

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See detailHuman chorionic gonadotrophin (hCG): new pleiotropic functions for an "old" hormone during pregnancy
Gridelet, Virginie ULiege; PERRIER d'HAUTERIVE, Sophie ULiege; Polese, Barbara ULiege et al

in Frontiers in Immunology (2020), 11

Human chorionic gonadotrophin (hCG) is the first specific molecule synthesized by the embryo. hcg RNA is transcribed as early as the 8-cell stage and the blastocyst produces the protein before its ... [more ▼]

Human chorionic gonadotrophin (hCG) is the first specific molecule synthesized by the embryo. hcg RNA is transcribed as early as the 8-cell stage and the blastocyst produces the protein before its implantation. hCG in the uterine microenvironment binds with its cognate receptor LHCGR on the endometrial surface. This binding stimulates LIF production and inhibits IL-6 production by epithelial cells of the endometrium. These effects ensure essential help in the preparation of the endometrium for initial embryo implantation. hCG also effects angiogenic and immunomodulatory actions as reported in many articles by our laboratories and other ones. By stimulating angiogenesis and vasculogenesis, hCG provides the placenta with an adequate maternal blood supply and optimal embryo nutrition during the invasion of the uterine endometrium. The immunomodulatory properties of hCG are numerous and important for programming maternal immune tolerance towards the embryo. The reported effects of hCG on uterine NK, Treg and B cells, three major cell populations for the maintenance of pregnancy, demonstrate the role of this embryonic signal as a crucial immune regulator in the course of pregnancy. Human embryo rejection for hCG-related immunological reasons has been studied in different ways, and a sufficient dose of hCG seems to be necessary to maintain maternal tolerance. Different teams have studied the addition of hCG in patients suffering from recurrent miscarriages or implantation failures. HCG could also have a beneficial or a negative impact on autoimmune diseases during pregnancy. In this review, we will discuss the immunological impacts hCG during pregnancy and if this hormone might be used therapeutically. [less ▲]

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See detailAbnormal vascular architecture at the placental-maternal interface in preeclampsia
Tack, Justine ULiege; Munaut, Carine ULiege; Blacher, Silvia ULiege et al

in European Gynecology and Obstetrics (2020), 2(1), 42-46

Background and purpose: The aim of this study was to characterize the vascular architecture in the placental bed in pregnancies complicated by preeclampsia and in normal pregnancies. Methods: Vessel ... [more ▼]

Background and purpose: The aim of this study was to characterize the vascular architecture in the placental bed in pregnancies complicated by preeclampsia and in normal pregnancies. Methods: Vessel numbers and cross-section area density in 11 preeclamptic placental beds were compared with 10 normal placental beds using computer-assisted image analysis of whole-slide CD31-immunolabeled sections. Results: The total surface occupied by vessels was significantly reduced in preeclamptic placental beds compared with controls beds. However, the number of vessels/section and average surface were similar in all cases. Vessel size distribution differed between the two groups: more smaller vessels were found in preeclamptic placental beds. Conclusions: Using a whole slide scanning and computer-assisted analysis method, we demonstrated a different morphological architecture of vessels in the placental beds of preeclamptic patients which might reflect the previously reported findings of insufficient trophoblast invasion and incomplete vascular remodeling. [less ▲]

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See detailCould Training in an Anatomical Model Be Useful to Teach Different Neovagina Surgical Techniques? A Descriptive Study about Knowledge and Experience of Techniques for Neovagina Surgery.
Sanchez-Ferrer, María Luísa; Grimbizis, Grigoris; Nisolle, Michelle ULiege et al

in Journal of clinical medicine (2020), 9(11),

Neovagina surgery in patients with vaginal agenesis is rare. No consensus exists regarding the best surgical technique. The aims of the current study were to show a new Thiel-embalmed cadaveric model to ... [more ▼]

Neovagina surgery in patients with vaginal agenesis is rare. No consensus exists regarding the best surgical technique. The aims of the current study were to show a new Thiel-embalmed cadaveric model to teach the surgical steps for different techniques of neovagina surgery and to evaluate opinions of this surgical teaching procedure. Four techniques-modified McIndoe, Vecchietti, Davydov, and vulvoperineal pediculated flaps-were recorded using an external camera and/or laparoscopic vision during their execution in a dissection room on "feminized" male cadavers. To determine the opinion of this teaching model, we designed an anonymous online survey that was available to participants via a computer application. After watching the video, more than 92% of participants agreed that feminized male cadavers were an excellent procedure for teaching these surgical techniques. Before watching this video, the most employed techniques were the McIndoe and Vecchietti procedures. After watching the video, modified McIndoe and vulvoperineal flaps were preferred by participants because they were considered to be easier to perform. It was considered that this model was useful for training neovagina techniques and, moreover, it should be recommended before techniques were performed on a real patient. Further investigation is needed to validate this model. [less ▲]

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See detailCoronavirus-induced severe acute respiratory syndrome and obstetrics
Nisolle, Michelle ULiege; BRICHANT, Géraldine ULiege; GENEZZANI, ANDREA R.

in EUROPEAN GYNECOLOGY AND OBSTETRICS (2020), 2(2), 71-72

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See detailCurative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease.
Vandewal, A.; Delbecque, Katty ULiege; Van Rompuy, A. S. et al

in European journal of obstetrics, gynecology, and reproductive biology (2020), 257

OBJECTIVE: We assessed the curative effect of a second curettage in patients with persistent hCG serum levels after first curettage for a gestational trophoblastic disease (GTD). STUDY DESIGN: This ... [more ▼]

OBJECTIVE: We assessed the curative effect of a second curettage in patients with persistent hCG serum levels after first curettage for a gestational trophoblastic disease (GTD). STUDY DESIGN: This prospective observational study used the data of the Belgian register for GTD between July 2012 and January 2017. We analysed the data of patients who underwent a second curettage. We included 313 patients in the database. Primary endpoints were need for second curettage and chemotherapy. RESULTS: Thirty-seven patients of the study population (12 %) underwent a second curettage. 20 had persistent human chorionic gonadotropin hormone (hCG) elevation before second curettage. Of them, 9 patients (45 %) needed no further treatment afterwards. Eleven patients (55 %) needed further chemotherapy. Nine (82 %) were cured with single-agent chemotherapy and 2 patients (18 %) needed multi-agent chemotherapy. Of the 37 patients, patients with hCG levels below 5000 IU/L undergoing a second curettage were cured without chemotherapy in 65 % versus 45 % of patients with hCG level more than 5000 IU/L. Of the ten patients with a hCG level below 1000 IU/L, eight were cured without chemotherapy. CONCLUSIONS: Patients with post-mole gestational trophoblastic neoplasia can benefit from a second curettage to avoid chemotherapy, especially when the hCG level is lower than 5000 IU/L. [less ▲]

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See detailUse of methotrexate in the treatment of ectopic pregnancies: a retrospective single center study.
BEGUIN, Charline ULiege; Brichant, Géraldine ULiege; DE LANDSHEERE, Laurent ULiege et al

in Facts, views & vision in ObGyn (2020), 11(4), 329-335

INTRODUCTION: The aim of this study was to evaluate the efficacy of methotrexate (MTX) in the treatment of ectopic pregnancies. We identified predictive factors of success or failure and compared our ... [more ▼]

INTRODUCTION: The aim of this study was to evaluate the efficacy of methotrexate (MTX) in the treatment of ectopic pregnancies. We identified predictive factors of success or failure and compared our results with previous studies to make recommendations for its use. MATERIAL AND METHODS: A cohort of 61 patients from a single center was retrospectively analyzed. Inclusion criteria were a diagnosis of ectopic pregnancy and treatment with a single-dose injection of MTX. The need to perform surgery despite MTX was defined as treatment failure while needing a second MTX injection was not. RESULTS: In our cohort, MTX demonstrated a success rate of 80%. This rate rose to 84% when patients with human Chorionic Gonadotropin (hCG ) > 5,000 IU/L were excluded. Twenty percent underwent surgery for pain, increased mass size and/or suboptimal hCG kinetics. Low hCG levels on days 0, 4 and 7 as well as the absence of pain, metrorrhagia and hemoperitoneum were predictive of success. MTX was also efficient in the treatment of persisting pregnancies of unknown location (PUL). CONCLUSION: Our results are consistent with previous studies and emphasize the fact that MTX is less effective above a certain level of hCG. We obtained a cut-off value of 2439 IU/L with a sensitivity of 66.7% and a specificity of 93.9%. MTX should not be used when hCG is higher than 5,000 IU/L and laparoscopic surgery should be performed. Our results bring additional data about the efficacy of MTX in the management of persisting pregnancies of unknown location. [less ▲]

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