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Affiliation(s)
- I Nisand
- Pôle de gynécologie-obstétrique-sénologie, hôpitaux universitaires de Strasbourg, CHRU, 1, place de l'Hôpital, 67091 Strasbourg cedex, France; 91, boulevard de Sébastopol, 75002 Paris, France.
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Peyronnet V, Sibiude J, Huissoud C, Lescure FX, Lucet JC, Mandelbrot L, Nisand I, Belaish-Allart J, Vayssière C, Yazpandanah Y, Luton D, Picone O. [Infection with SARS-CoV-2 in pregnancy. Update of Information and proposed care. CNGOF]. Gynecol Obstet Fertil Senol 2020; 48:858-870. [PMID: 33031963 PMCID: PMC7534662 DOI: 10.1016/j.gofs.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The coronavirus SARS-CoV-2 identified late 2019 in China had spread across all continents. In the majority of cases, patients have mild symptoms (fever, cough, myalgia, headache, some digestive disorders) or are asymptomatic, however it can cause serious lung diseases and lead to death. On September 2020, over 28 million people have been infected with over 920,000 deaths. METHODS In view of the evolution of the epidemic the French National College of Obstetricians and Gynecologists has decided to update the recommendations previously issued. To do this, the same group of experts was called upon to carry out a review of the literature and take into account the opinions of the General Directorate of Health (DGS), the "Haute Autorité de Santé" (HAS) and the "Haut Conseil de santé Publique" (HCSP). RESULTS The data on consequences during pregnancy have accumulated. The symptoms in pregnant women appear to be similar to those of the general population, but an increased risk of respiratory distress exists in pregnant women especially in the third trimester. A case of intrauterine maternal-fetal transmission has been clearly identified. Induced prematurity and cases of respiratory distress in newborns of infected mothers have been described. CONCLUSION In light of the new data, we propose updated recommendations. These proposals may continue to evolve in view of the pandemic and of advances in studies in pregnant women.
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Affiliation(s)
- V Peyronnet
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 92700 Colombes, France
| | - J Sibiude
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 92700 Colombes, France; Inserm IAME-U1137, 75000 Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), 75000 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
| | - C Huissoud
- University Lyon, University Claude Bernard, 69000 Lyon, France; Hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Inserm U846, stem cell and brain research institute, 18, avenue Doyen-Lepine, 69500 Bron, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
| | - F-X Lescure
- Inserm IAME-U1137, 75000 Paris, France; Service de maladies infectieuses et tropicales, hôpital Bichat Claude-Bernard, université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - J-C Lucet
- Inserm IAME-U1137, 75000 Paris, France
| | - L Mandelbrot
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 92700 Colombes, France; Inserm IAME-U1137, 75000 Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), 75000 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
| | - I Nisand
- CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
| | | | - C Vayssière
- Hôpital Paule-de-Viguier, CHU de Toulouse, 31000 Toulouse, France; Inserm UMR1027, équipe SPHERE, université Toulouse III, 31000 Toulouse, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
| | - Y Yazpandanah
- Inserm IAME-U1137, 75000 Paris, France; Service de maladies infectieuses et tropicales, hôpital Bichat Claude-Bernard, université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - D Luton
- FHU Prematurity Inserm U1016, service de gynécologie obstétrique, maternité Aline de Crepy, hôpital Bichat, institut IMAGINE, université de Paris, AP-HP, 75018 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
| | - O Picone
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 92700 Colombes, France; Inserm IAME-U1137, 75000 Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), 75000 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France.
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Peyronnet V, Sibiude J, Deruelle P, Huissoud C, Lescure X, Lucet JC, Mandelbrot L, Nisand I, Vayssière C, Yazpandanah Y, Luton D, Picone O. [SARS-CoV-2 infection during pregnancy. Information and proposal of management care. CNGOF]. Gynecol Obstet Fertil Senol 2020; 48:436-443. [PMID: 32199996 PMCID: PMC7186548 DOI: 10.1016/j.gofs.2020.03.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Indexed: 02/07/2023]
Abstract
A new coronavirus (SARS-CoV-2) highlighted at the end of 2019 in China is spreading across all continents. Most often at the origin of a mild infectious syndrome, associating mild symptoms (fever, cough, myalgia, headache and possible digestive disorders) to different degrees, SARS-Covid-2 can cause serious pulmonary pathologies and sometimes death. Data on the consequences during pregnancy are limited. The first Chinese data published seem to show that the symptoms in pregnant women are the same as those of the general population. There are no cases of intrauterine maternal-fetal transmission, but cases of newborns infected early suggest that there could be vertical perpartum or neonatal transmission. Induced prematurity and cases of respiratory distress in newborns of infected mothers have been described. Pregnancy is known as a period at higher risk for the consequences of respiratory infections, as for influenza, so it seems important to screen for Covid-19 in the presence of symptoms and to monitor closely pregnant women. In this context of the SARS-Covid-2 epidemic, the societies of gynecology-obstetrics, infectious diseases and neonatalogy have proposed a French protocol for the management of possible and proven cases of SARS-Covid-2 in pregnant women. These proposals may evolve on a daily basis with the advancement of the epidemic and knowledge in pregnant women. Subsequently, an in-depth analysis of cases in pregnant women will be necessary in order to improve knowledge on the subject.
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Affiliation(s)
- V Peyronnet
- Service de gynécologie-obstétrique Colombes, Assistance publique-Hôpitaux de Paris, hôpital Louis-Mourier, université de Paris, 92700 Colombes, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - J Sibiude
- Service de gynécologie-obstétrique Colombes, Assistance publique-Hôpitaux de Paris, hôpital Louis-Mourier, université de Paris, 92700 Colombes, France; Inserm IAME-U1137, 75000 Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), 75000 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - P Deruelle
- CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Service de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - C Huissoud
- University Lyon, University Claude-Bernard Lyon 1, 69100 Villeurbanne, France; Hospices civils de Lyon, hôpital de la Croix-Rousse, 69004 Lyon, France; Inserm U846, stem cell and brain research institute, 18, avenue Doyen-Lepine, 69500 Bron, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - X Lescure
- Inserm IAME-U1137, 75000 Paris, France; Service de maladies infectieuses et tropicales, hôpital Bichat Claude-Bernard, université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - J-C Lucet
- Inserm IAME-U1137, 75000 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - L Mandelbrot
- Service de gynécologie-obstétrique Colombes, Assistance publique-Hôpitaux de Paris, hôpital Louis-Mourier, université de Paris, 92700 Colombes, France; Inserm IAME-U1137, 75000 Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), 75000 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - I Nisand
- CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - C Vayssière
- Hôpital Paule-de-Viguier, CHU de Toulouse, 31000 Toulouse, France; Équipe SPHERE, Inserm UMR1027, université Toulouse III, 31000 Toulouse, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - Y Yazpandanah
- Inserm IAME-U1137, 75000 Paris, France; Service de maladies infectieuses et tropicales, hôpital Bichat Claude-Bernard, université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - D Luton
- Service de gynécologie obstétrique, maternité Aline-de-Crepy, FHU Prematurity INSERM U1016, hôpital Bichat APHP, université de Paris, Institut Imagine, 75018 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France
| | - O Picone
- Service de gynécologie-obstétrique Colombes, Assistance publique-Hôpitaux de Paris, hôpital Louis-Mourier, université de Paris, 92700 Colombes, France; Inserm IAME-U1137, 75000 Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), 75000 Paris, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France; Infection Control Unit, Bichat University Hospital, Assistance publique-Hôpitaux de Paris, université de Paris, 75018 Paris, France.
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Mathelin C, Nisand I. [Too old for that? Only others believe it]. Gynecol Obstet Fertil Senol 2019; 47:547-548. [PMID: 31003020 DOI: 10.1016/j.gofs.2019.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Indexed: 06/09/2023]
Affiliation(s)
- C Mathelin
- Unité de sénologie, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, CHRU, 1, avenue Molière, 67098 Strasbourg cedex 09, France; IGBMC, institut de génétique et de biologie moléculaire et cellulaire, biologie du cancer, 1, rue Laurent-Fries, 67400 Illkirch-Graffenstaden, France.
| | - I Nisand
- CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
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Auer J, Barbe C, Sutter AL, Dallay D, Vulliez L, Riethmuller D, Gubler V, Verlomme V, Saad-Saint-Gilles S, Miton A, Tessier E, Parant O, Le Foll J, Bourgeois-Moine A, Viaux S, Dommergues M, Apter G, Belaisch-Allart J, Danion A, Nisand I, Graesslin O, Novo A, Eutrope J, Rolland AC. Pregnancy denial and early infant development: a case-control observational prospective study. BMC Psychol 2019; 7:22. [PMID: 30971319 PMCID: PMC6458722 DOI: 10.1186/s40359-019-0290-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 02/20/2019] [Indexed: 11/23/2022] Open
Abstract
Background The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant). Methods The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a “case” group with maternal denials of pregnancy and a “control” group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the “cases” and the “controls” will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development. Discussion This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction. Trial registration Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).
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Affiliation(s)
- Julie Auer
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Av du Gl Koenig, Centre Hospitalier Universitaire, 51092, Reims Cedex, France
| | - Coralie Barbe
- Unité d'aide méthodologique, Hôpital Robert Debré, Av du Gl Koenig - CHU, Reims, France
| | - Anne-Laure Sutter
- Réseau de psychiatrie périnatale, Pôle Universitaire de Psychiatrie Adulte - Hôpital Charles Perrens, 121, rue de la Béchade, 33076, Bordeaux, France
| | - Dominique Dallay
- Maternité Pellegrin, Place Amélie Raba-Léon, 33076, Bordeaux cedex, France
| | - Laurianne Vulliez
- Psychiatrie infanto-juvénile - Centre Hospitalier Régional Universitaire, Hôpital Saint-Jacques, 2 place Saint-Jacques, 25030, Besançon cedex, France
| | - Didier Riethmuller
- Service de Gynécologie Obstétrique, CHU Besançon -Hôpital Jean Minjoz, 25000, Besançon, France
| | | | - Valérie Verlomme
- C.H.I.T.S. Hôpital Sainte Musse, 54 Henri Sainte Claire Deville, 83056, Toulon, France
| | | | - Alain Miton
- Maternité Régionale, 10 Avenue Dr Heydenreich, 54000, Nancy, France
| | - Emmanuelle Tessier
- Service de Psychiatrie de l'Enfant et de l'Adolescent - Pôle Psychiatrie, Hôpital La Grave, Place Lange, 31059, Toulouse Cedex 9, France
| | - Olivier Parant
- Pôle de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Paule de Viguier - CHU de Toulouse, 330 avenue de Grande-Bretagne, 31059, Toulouse Cedex 9, France
| | - Julie Le Foll
- Polyclinique Ney, Hôpital Bichat, 124 Bd Ney, Paris 18ième, France
| | - Agnès Bourgeois-Moine
- Service de gynécologie obstétrique, Hôpital Bichat, 46 Rue Henri Huchard, 75877, Paris, France
| | - Sylvie Viaux
- UPEP Vivaldi, Hôpitaux Universitaires Pitié Salpêtrière, GHU Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013, Paris, France
| | - Marc Dommergues
- Service de Gynécologie Obstétrique, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Bd de l'Hôpital, 75651, Paris Cedex 13, France
| | - Gisèle Apter
- Unité de Psychiatrie Périnatale d'Urgence Mobile en Maternité Service, EPS Erasme, 14, rue de l'Abbaye, BP 10081, 92161, Antony cedex, France
| | - Joëlle Belaisch-Allart
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier des Quatre Villes, 141, Grande Rue, 92318, Sèvres, France
| | - Anne Danion
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Pôle de Psychiatrie, Santé Mentale et Addictologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091, Strasbourg, France
| | - Israël Nisand
- Pôle de gynécologie-obstétrique, Hôpital de Hautepierre, Avenue Molière, 67200, Strasbourg, France
| | - Olivier Graesslin
- Service de gynécologie-obstétrique - Pôle Femme-Parents-Enfant, Hôpital Maison Blanche, 45 Rue Cognacq Jay, 51092, Reims, France
| | - Alexandre Novo
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Av du Gl Koenig, Centre Hospitalier Universitaire, 51092, Reims Cedex, France
| | - Julien Eutrope
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Av du Gl Koenig, Centre Hospitalier Universitaire, 51092, Reims Cedex, France
| | - Anne-Catherine Rolland
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Av du Gl Koenig, Centre Hospitalier Universitaire, 51092, Reims Cedex, France.
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Nisand I. [I. Nisand in answer to the article by D. Raudrant, P. Madelenat and B. Salle: "Uterus transplant or gestational surrogacy: Is there a possible choice?". Gynecol Obstet Fertil Senol 2018;46:385-7]. Gynecol Obstet Fertil Senol 2018; 46:614-615. [PMID: 29929939 DOI: 10.1016/j.gofs.2018.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Indexed: 06/08/2023]
Affiliation(s)
- I Nisand
- C.M.C.O, centre hospitalier universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
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Mathelin C, Nisand I. [Breast cancer screening: CNGOF gets mobilized]. Gynecol Obstet Fertil Senol 2018; 46:507-508. [PMID: 29776840 DOI: 10.1016/j.gofs.2018.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Indexed: 06/08/2023]
Affiliation(s)
- C Mathelin
- Pôle de gynécologie-obstétrique-sénologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, CHRU, 1, avenue Molière, 67098 Strasbourg cedex 09, France; IGBMC, institut de génétique et de biologie moléculaire et cellulaire, biologie du cancer, 1, rue Laurent-Fries, 67400 Illkirch-Graffenstaden, France.
| | - I Nisand
- Pôle de gynécologie-obstétrique-sénologie, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, CHRU, 1, avenue Molière, 67098 Strasbourg cedex 09, France; CNGOF, 91, boulevard de Sébastopol, 75002 Paris, France
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Abstract
The status of the embryo has kept evolving in our minds since we have been able to see it, examine it in detail, determine its normality and competence and above all since we have been able to care for it in utero. The embryo and the fœtus have become patients. But not entirely like others. If they are too ill, we have the right to end their lives, active euthanasia, which is not possible in other branches of medicine. The legal status of the embryo and the fœtus, which is constantly evolving, cannot be confused with the essence of the embryo and the fœtus which is of a philosophical, even theological, nature, but certainly not legal. Human embryos and foetuses are of course potential human beings who have not yet acquired all the rights of a person. These rights of the embryo and fœtus increase progressively until live birth when they become complete.
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Bardy-Evrard C, Mattuizzi A, Coatleven F, Nithart A, Evrard G, Benachi A, Nisand I, Sentilhes L. [Overview of feelings and practices of gynecologists and obstetricians for the noninvasive prenatal testing in France]. Gynecol Obstet Fertil Senol 2018; 46:34-40. [PMID: 29233528 DOI: 10.1016/j.gofs.2017.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To evaluate the feelings and practices of French obstetrician-gynecologists in prescribing the noninvasive prenatal testing (NIPT) before the release of the French High Authority of Health recommendations. METHODS Descriptive, declarative and transversal study, analyzing the feelings and practices of obstetrician-gynecologists, members of the French College of Gynecologists and Obstetricians (CNGOF) between February and May 2017 using an online questionnaire. Practitioners' feedback was self-assessed for several clinical situations using a numerical scale ranging from 1 to 10. This experience was rated as "good" (grades 6 to 10) or "bad" (grades 1-5). RESULTS Overall, 529 practitioners (29.2%) of 1812 CNGOF members, answered the online questionnaire. A "good" feeling was found for more than 65% of the practitioners audited. Feelings were significantly better for obstetricians, sonographers (P<0.05) and CPDPN members (P=0.003) compared to other practitioners. Situations where the DPNI was proposed "systematically" were risks greater than 1/250 (70.9%), between 1/250 and 1/500 (59.4%), greater than 1/250 associated with history of spontaneous miscarriages and/or fetal death in utero (66%), greater than 1/250 associated with pregnancy resulting from PMA (68.3%), history of fetal aneuploidy (54%) and a parent carrying a Robertsonian translocation (51.6%). CONCLUSION This study highlights a good overall feeling of the practitioners with the NIPT.
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Affiliation(s)
- C Bardy-Evrard
- Service de gynécologie-obstétrique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
| | - A Mattuizzi
- Service de gynécologie-obstétrique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - F Coatleven
- Service de gynécologie-obstétrique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - A Nithart
- Service de gynécologie-obstétrique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - G Evrard
- Service des urgences adultes, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - A Benachi
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Antoine-Béclère, AP-HP, 92140 Clamart, France; Collège national des gynécologues obstétriciens français, 75012 Paris, France
| | - I Nisand
- Collège national des gynécologues obstétriciens français, 75012 Paris, France; Service de gynécologie-obstétrique, CHU de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - L Sentilhes
- Service de gynécologie-obstétrique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; Collège national des gynécologues obstétriciens français, 75012 Paris, France
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Benachi A, Hatem G, Thévenot J, Nisand I. [A challenge for gynecology-obstetrics: promoting “well-treatment” to eradicate abuse in care]. Rev Prat 2017; 67:947-948. [PMID: 30516900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Alexandra Benachi
- Service de gynécologieobstétrique, AP-HP, hôpital Antoine-Béclère, Clamart, France
- Vice-présidente du Collège national des gynécologues et obstétriciens français (CNGOF)
| | | | - Jean Thévenot
- Service d'obstétrique et gynécologie médicale, clinique Ambroise-Paré, Toulouse, France
- Président CDOM 31, vice-président du CNGOF
| | - Israël Nisand
- Service de gynécologieobstétrique, CHU de Strasbourg, France
- Président du CNGOF
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Pinton A, Hanser AC, Metten MA, Nisand I, Bettahar K. [Is there any relation between couple violence and repeated medical abortion?]. ACTA ACUST UNITED AC 2017; 45:416-420. [PMID: 28754340 DOI: 10.1016/j.gofs.2017.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Risk factors of repeated induced abortion remain unclear. One of them could be domestic violence. The aim of this study was to explore the association between repeated induced abortion and domestic violence, including violence during childhood. MATERIALS AND METHODS A cross-sectional questionnaire study was conducted in three hospitals in Alsace. All women between 18 and 50 years old were asked to complete an anonymous questionnaire during their hospitalization for induced abortion between 31th of November 2013 and 1st of December 2014. The questionnaire included questions about the current or past existence of domestic violence. They have also been questioned about the past existence of domestic violence between their parents and the fact that they had themselves been victims of violence and abuse during childhood. RESULTS Four hundred and eighty women answered to the questionnaire: 322 came for their first abortion while 158 were hospitalized for at least the second time for an induced abortion. The proportion of current or past violence was 53% in the "repeated induced abortions" group compared with 33% in the "first induced abortion" group (OR 2.1, CI 95% [1.4-3.1], P<0.01). Statistically significant differences were found between the two groups for all types of domestic violence. CONCLUSION In our sample of women, we found that experiencing domestic violence with current partner appeared to be a risk factor of repeated induced abortions.
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Affiliation(s)
- A Pinton
- C.M.C.O., centre hospitalier universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
| | - A-C Hanser
- C.M.C.O., centre hospitalier universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
| | - M-A Metten
- Service de recherche clinique, Fondation ophtalmologique Adolphe-de-Rothschild, Paris, France.
| | - I Nisand
- C.M.C.O., centre hospitalier universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
| | - K Bettahar
- C.M.C.O., centre hospitalier universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
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Nisand I, Letombe B. ["The way you go with abortion, the way you treat women…"]. ACTA ACUST UNITED AC 2017; 45:63-64. [PMID: 28368795 DOI: 10.1016/j.gofs.2017.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Indexed: 12/01/2022]
Affiliation(s)
- I Nisand
- Unistra, CHU de Strasbourg, 4, rue Kirschlege, 67085 Strasbourg cedex, France.
| | - B Letombe
- Médecine du couple et orthogénie, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59000 Lille, France
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Bettahar K, Pinton A, Boisramé T, Cavillon V, Wylomanski S, Nisand I, Hassoun D. Interruption volontaire de grossesse par voie médicamenteuse. ACTA ACUST UNITED AC 2016; 45:1490-1514. [DOI: 10.1016/j.jgyn.2016.09.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
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Sananès N, Gabriele V, Weingertner AS, Ruano R, Sanz-Cortes M, Gaudineau A, Langer B, Nisand I, Akladios CY, Favre R. Evaluation of long-term neurodevelopment in twin-twin transfusion syndrome after laser therapy. Prenat Diagn 2016; 36:1139-1145. [DOI: 10.1002/pd.4950] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/10/2016] [Accepted: 10/18/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Nicolas Sananès
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
- INSERM, UMR-S 1121, ‘Biomatériaux et Bioingénierie’; Strasbourg France
| | - Victor Gabriele
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | | | - Rodrigo Ruano
- Texas Children's Fetal Center and Baylor College of Medicine; Houston TX USA
| | | | - Adrien Gaudineau
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | - Bruno Langer
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | - Israël Nisand
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | | | - Romain Favre
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
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Guillaume A, Schuller-Dufour E, Faitot V, Pirrello O, Rongières C, Ohl J, Nisand I, Bettahar K. [Patient's experience of topical anesthesia by lidocaine vaginal gel for oocyte retrieval]. ACTA ACUST UNITED AC 2016; 45:942-947. [PMID: 27318637 DOI: 10.1016/j.jgyn.2016.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/08/2016] [Accepted: 05/13/2016] [Indexed: 11/19/2022]
Abstract
A recent adverse effect of a paracervical block (cardiac arrest) occurred during an oocyte retrieval (OR), forcing us to reconsider our pain management during OR. Since then, we decided to use intravaginal lidocaine gel as analgesia during OR. OBJECTIVES To evaluate the pain during OR after intravaginal lidocaine gel analgesia and to evaluate the motivations of women choosing this technique. METHODS A monocentric observational study was performed on 200 patients. Pain was measured using a numeric pain scale during and after oocyte retrieval. The tolerance of the procedure was evaluated through a patient questionnaire. RESULTS Median maximal pain was 5±2.3 (0-10) per-retrieval and 3±2.2 (0-10) post-retrieval. The procedure was considered bearable by 85.5% of the patients and 81.5% of them would choose this method in case of new oocyte retrieval. No adverse effect occurred during the study. CONCLUSION The use of intravaginal lidocaine gel seems an acceptable analgesia alternative during oocyte retrieval.
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Affiliation(s)
- A Guillaume
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
| | - E Schuller-Dufour
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - V Faitot
- Service d'anesthésie, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - O Pirrello
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - C Rongières
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - J Ohl
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - I Nisand
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - K Bettahar
- Service d'aide médicale à la procréation, hôpitaux universitaires de Strasbourg CMCO, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
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Daney de Marcillac F, Lecointre L, Guillaume A, Sananes N, Fritz G, Viville B, Boudier E, Nisand I, Gaudineau A, Langer B, Akladios C. Morbimortalité maternelle associée au traitement conservateur d’un placenta anormalement adhérent (accreta) diagnostiqué en anténatal. À propos d’une série continue de 15 cas. ACTA ACUST UNITED AC 2016; 45:849-858. [DOI: 10.1016/j.jgyn.2016.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/16/2016] [Accepted: 03/22/2016] [Indexed: 10/21/2022]
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Sananes N, Roth GE, Aissi GA, Meyer N, Bigler A, Bouschbacher JM, Helmlinger C, Viville B, Guilpain M, Gaudineau A, Akladios CY, Nisand I, Langer B, Vayssiere C, Favre R. Acupuncture version of breech presentation: a randomized sham-controlled single-blinded trial. Eur J Obstet Gynecol Reprod Biol 2016; 204:24-30. [DOI: 10.1016/j.ejogrb.2016.07.492] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 07/17/2016] [Accepted: 07/26/2016] [Indexed: 11/26/2022]
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Pinton A, Aubry G, Thoma V, Nisand I, Akladios CY. Pyomyoma after abortion: Uterus conserving surgery is possible to maintain fertility. Case report. Int J Surg Case Rep 2016; 24:179-81. [PMID: 27266830 PMCID: PMC4908459 DOI: 10.1016/j.ijscr.2016.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 11/28/2022] Open
Abstract
If initial treatment of endometritis is unsuccessful consider a differential diagnosis of a pyomyoma. We can maintain patient’s fertility with a myomectomy and future pregnancy can be possible. The post abortion period is a risk factor for pyomyoma even in cases of spontaneous miscarriage.
Introduction Pyomyoma is a rare complication associated with high rates of morbidity and mortality. Presentation of case We report the case of a 28-year-old nulligravida patient presenting pyomyoma following a spontaneous abortion at fourteen weeks and four days. Fourteen days following spontaneous miscarriage she was referred to the hospital with abdominal pain and fever. An antibiotic treatment was initiated. However, after ten days, the patient’s condition deteriorated and a decision for an emergency laparotomy made. The pyomyoma was successfully resected and the patient’s postoperative recovery was uneventful. A new pregnancy was confirmed two years later. Discussion The diagnosis of pyomyoma can be difficult but surgical treatment is often indicated. Performing a prompt myomectomy avoids the need for hysterectomy, preserving future fertility. Conclusion Pregnancy is possible following uterine sparing treatment of pyomyoma.
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Affiliation(s)
- Anne Pinton
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, 1 Avenue Molière Strasbourg, 67098, France.
| | - Gabrielle Aubry
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, 1 Avenue Molière Strasbourg, 67098, France.
| | - Véronique Thoma
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, 1 Avenue Molière Strasbourg, 67098, France.
| | - Israël Nisand
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, 1 Avenue Molière Strasbourg, 67098, France.
| | - Cherif Youssef Akladios
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, 1 Avenue Molière Strasbourg, 67098, France.
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Daney de Marcillac F, Molière S, Pinton A, Weingertner AS, Fritz G, Viville B, Roedlich MN, Gaudineau A, Sananes N, Favre R, Nisand I, Langer B. [Accuracy of placenta accreta prenatal diagnosis by ultrasound and MRI in a high-risk population]. J Gynecol Obstet Biol Reprod (Paris) 2015; 45:198-206. [PMID: 26321608 DOI: 10.1016/j.jgyn.2015.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 06/21/2015] [Accepted: 07/13/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Main objective was to compare accuracy of ultrasonography and MRI for antenatal diagnosis of placenta accreta. Secondary objectives were to specify the most common sonographic and RMI signs associated with diagnosis of placenta accreta. MATERIAL AND METHODS This retrospective study used data collected from all potential cases of placenta accreta (patients with an anterior placenta praevia with history of scarred uterus) admitted from 01/2010 to 12/2014 in a level III maternity unit in Strasbourg, France. High-risk patients beneficiated antenatally from ultrasonography and MRI. Sonographic signs registered were: abnormal placental lacunae, increased vascularity on color Doppler, absence of the retroplacental clear space, interrupted bladder line. MRI signs registered were: abnormal uterine bulging, intraplacental bands of low signal intensity on T2-weighted images, increased vascularity, heterogeneous signal of the placenta on T2-weighed, interrupted bladder line, protrusion of the placenta into the cervix. Diagnosis of placenta accreta was confirmed histologically after hysterectomy or clinically in case of successful conservative treatment. RESULTS Twenty-two potential cases of placenta accreta were referred to our center and underwent both ultrasonography and MRI. All cases of placenta accreta had a placenta praevia associated with history of scarred uterus. Sensibility and specificity for ultrasonography were, respectively, 0.92 and 0.67, for MRI 0.84 and 0.78 without significant difference (p>0.05). The most relevant signs associated with diagnosis of placenta accreta in ultrasonography were increased vascularity on color Doppler (sensibility 0.85/specificity 0.78), abnormal placental lacunae (sensibility 0.92/specificity 0.55) and loss of retroplacental clear space (sensibility 0.76/specificity 1.0). The most relevant signs in MRI were: abnormal uterine bulging (sensitivity 0.92/specificity 0.89), dark intraplacental bands on T2-weighted images (sensitivity 0.83/specificity 0.80) or placental heterogeneity (sensitivity 0.92/specificity 0.89). Association of two sonographic or MRI signs had the best sensitivity/specificity ratio. DISCUSSION AND CONCLUSION Ultrasonography and RMI represent two interesting and complementary diagnostic tools for antenatal diagnosis of placenta accreta. Because of its cost and accessibility, ultrasonography remains the first in line to be used for diagnosis. Use of an analytical grid for diagnosis of placenta accreta could be helpful.
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Affiliation(s)
- F Daney de Marcillac
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - S Molière
- Département de radiologie, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Pinton
- Département de santé publique, hôpital Civil, hôpitaux universitaire de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - A-S Weingertner
- Département de gynécologie-obstétrique, CMCO, hôpitaux universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - G Fritz
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - B Viville
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - M-N Roedlich
- Département de radiologie, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Gaudineau
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - N Sananes
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - R Favre
- Département de gynécologie-obstétrique, CMCO, hôpitaux universitaire de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France
| | - I Nisand
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - B Langer
- Département de gynécologie-obstétrique, hôpital de Hautepierre, hôpitaux universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
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Gassmann AS, Koch A, Boudier E, Averous G, Sananes N, Nisand I, Schneider F, Langer B. Toxic Shock Syndrome detected at 21 weeks’ gestation complicating acute chorioamnionitis with intact sac. ACTA ACUST UNITED AC 2015; 43:400-2. [DOI: 10.1016/j.gyobfe.2015.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 03/27/2015] [Indexed: 02/02/2023]
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21
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Sananès N, Veujoz M, Severac F, Barthoulot M, Meyer N, Weingertner AS, Kohler M, Guerra F, Gaudineau A, Nisand I, Favre R. Evaluation of the Utility of in utero Treatment of Twin Anemia-Polycythemia Sequence. Fetal Diagn Ther 2015; 38:170-8. [PMID: 25790745 DOI: 10.1159/000380822] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/09/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the interest in the in utero treatment of twin anemia-polycythemia sequence (TAPS). METHODS The obstetrical and neonatal data on all cases of TAPS followed up in our institution between 2006 and 2013 were reviewed. Statistical analyses were conducted using Bayesian methods. RESULTS Twenty cases of TAPS were included. Laser therapy or intrauterine transfusion (IUT) was performed on the donor twin in 9 cases. Eleven cases were included in the 'nontreated' group (managed expectantly or diagnosed at birth). The gestational age at diagnosis was lower in the group with treated TAPS [difference (diff) = -22.20 days (-57.13, 14.28), probability (Pr) (diff >0) = 10.6%]. The rate of preterm premature rupture of membranes was higher in the group with treated TAPS [diff = 22.5% (-14, 57), Pr (diff >0) = 89%], but overall mortality was similar. The interval between diagnosis and delivery was longer [diff = 44.37 days (9.41, 77.90), Pr (diff >0) = 99.2%], the TAPS resolution rate was higher [diff = 49.9% (12, 81), Pr (diff >0) = 99.4%], and the neonatal transfusion rate was lower [diff = -30.5% (-60, 0), Pr (diff >0) = 2.6%] in the treated group. CONCLUSION In utero treatment for TAPS is associated with a higher resolution rate of TAPS and a longer time between diagnosis and birth, but overall mortality is the same as with expectant management.
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Affiliation(s)
- Nicolas Sananès
- Department of Obstetrics and Gynecology, Strasbourg University Teaching Hospitals, Strasbourg, France
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de Marcillac F, Akladios CY, Hui-bon-hoa I, Fritz G, Nisand I, Langer B. [Twin pregnancy with complete hydatiform mole and coexistent fetus: Report of 4 cases and review of literature]. ACTA ACUST UNITED AC 2015; 44:840-7. [PMID: 25613826 DOI: 10.1016/j.jgyn.2014.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/16/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Twin pregnancy with complete hydatiform mole and coexistent fetus is a rare clinical condition, occurring in 1 in 22,000 to one in 100,000 pregnancies. Continuation of pregnancy in these cases is controversial because of a high risk of immediate and long-term maternal morbidity. It allows, however, in 33 % of the case the delivery of a healthy child. METHODS This retrospective study included all patients presenting a complete hydatiform mole coexisting with a live twin fetus antenatally diagnosed between 2007 and 2012 in the level III maternity of the Strasbourg University Hospital. Informations concerning diagnostic circumstances, pregnancy follow-up and outcome were studied. RESULTS Four pregnancies were included in the study, all of them were spontaneous. Medical termination of pregnancies was related to maternal reasons in the four cases. One before 17 weeks of gestation, the three other after 2 weeks of gestation, leading to delivery of a healthy child. All patients developed a mild to severe preeclampsia. One patient developed a gestational trophoblastic disease, requiring chemotherapy by methotrexate. There was no fatal evolution. CONCLUSION Twin pregnancy with complete hydatifom mole and coexistent fetus is associated with increased risk of gestational trophoblastic disease. This risk is not increased by continuation of pregnancy. In case of prenatal diagnosis of complete hydatiform mole coexisting with a live twin fetus, patients should be aware of the potential high risk of morbidity and a regular follow-up during and after the pregnancy should be intaured. In absence of maternal complications, continuation of the pregnancy is possible.
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Affiliation(s)
- F de Marcillac
- Département de gynécologie-obstétrique, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - C Y Akladios
- Département de gynécologie-obstétrique, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - I Hui-bon-hoa
- Département de gynécologie-obstétrique, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - G Fritz
- Département de gynécologie-obstétrique, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - I Nisand
- Département de gynécologie-obstétrique, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - B Langer
- Département de gynécologie-obstétrique, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
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Veujoz M, Sananès N, Severac F, Meyer N, Weingertner AS, Kohler M, Guerra F, Gaudineau A, Nisand I, Favre R. Evaluation of prenatal and postnatal diagnostic criteria for twin anemia-polycythemia sequence. Prenat Diagn 2015; 35:281-8. [DOI: 10.1002/pd.4545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/30/2014] [Accepted: 12/01/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Marine Veujoz
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
| | - Nicolas Sananès
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
- INSERM, UMR-S 1121, ‘Biomatériaux et Bioingénierie’; Strasbourg France
| | - François Severac
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
- Department of Public Health; Strasbourg University Teaching Hospital; Strasbourg France
| | - Nicolas Meyer
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
- Department of Public Health; Strasbourg University Teaching Hospital; Strasbourg France
| | - Anne-Sophie Weingertner
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
| | - Monique Kohler
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
| | - Fernando Guerra
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
| | - Adrien Gaudineau
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
| | - Israël Nisand
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
| | - Romain Favre
- Department of Obstetrics and Gynecology; Strasbourg University Teaching Hospital; Strasbourg France
- Federation of Translational Medicine; Strasbourg University Teaching Hospital; Strasbourg France
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Affiliation(s)
- I Nisand
- Unistra, CHU de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France.
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Timbolschi D, Schaefer E, Monga B, Fattori D, Dott B, Favre R, Kohler M, Nisand I, Viville B, Astruc D, Kehrli P, Gasser B, Lindner V, Marcellin L, Flori E, Girard-Lemaire F, Dollfus H, Doray B. Neural Tube Defects: The Experience of the Registry of Congenital Malformations of Alsace, France, 1995-2009. Fetal Diagn Ther 2014; 37:6-17. [DOI: 10.1159/000362663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 03/30/2014] [Indexed: 11/19/2022]
Abstract
Context and Objective: Considering the lack of accurate and up-to-date information available about neural tube defects (NTDs) in France, the purpose of this study was to review clinical and epidemiological data of NTDs and to evaluate the current efficiency of prenatal diagnosis in Alsace (northeastern France). Methods: A population-based retrospective study was performed from data of the Registry of Congenital Malformations of Alsace between 1995 and 2009. Data were analyzed as a whole and according to the anatomical type of the malformation (anencephaly, cephalocele and spina bifida). Statistical analyses were carried out using the Statistical Package for the Social Sciences. Results: 272 NTDs were recorded divided in 113 cases of anencephaly (42%), 35 cases of cephalocele (13%) and 124 cases of spina bifida (45%). The total prevalence at birth of 14/10,000 (95% CI 13-16) was stable throughout the reporting period. A chromosome abnormality was identified in 27 cases (12% of all karyotyped cases). NTDs were prenatally diagnosed by ultrasound in 88% of the cases. The mean age upon prenatal diagnosis slightly declined during the 15-year period, significantly for spina bifida only. The global rate of terminations of pregnancy following prenatal diagnosis was 97% (230/238). Conclusion: This work constitutes a unique population-based study providing accurate and specific up-to-date data from a unique center over a longer period (1995-2009). The most important information concerns the high and stable prevalence, which calls into question the efficiency of the primary prevention by folic acid supplementation and the efficiency of prenatal diagnosis.
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Gapp-Born E, Sananes N, Weingertner AS, Guerra F, Kohler M, Fritz G, Viville B, Gaudineau A, Langer B, Sauleau E, Nisand I, Favre R. Predictive value of cardiovascular parameters in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol 2014; 44:427-433. [PMID: 24585420 DOI: 10.1002/uog.13351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 02/01/2014] [Accepted: 02/18/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the prognostic value of the Children's Hospital Of Philadelphia (CHOP) cardiovascular score and the modified myocardial performance index (MPI), in determining the risk of recipient fetal loss in twin-to-twin transfusion syndrome (TTTS). METHODS This cohort study was based on data collected prospectively from 105 pregnancies complicated by TTTS (Quintero stages I-IV) and treated with laser photocoagulation between May 2008 and February 2013. Fetuses underwent detailed anatomical and Doppler ultrasonography with cardiac assessment as part of routine care. CHOP score and right MPI were calculated and cut-offs selected using receiver-operating characteristics curve analysis. These were compared according to loss of recipient fetus, using univariate and multivariate logistic regression. The correlation between CHOP score, MPI and Quintero stage was determined and we investigated differences in MPI before and after laser coagulation in a cohort of 90 recipient fetuses. RESULTS Rates of recipient fetal loss were significantly higher when the CHOP score was ≥ 3 (39.5% vs 12.9%, P = 0.002) and when MPI z-score was > 1.645 (34.5% vs 10.6%, P = 0.004). After adjustment for Quintero stage, the risk of recipient fetal loss remained significantly higher when the CHOP score was ≥ 3 (odds ratio, 3.09; 95% CI, 1.035-9.21). There was a positive correlation between CHOP score, MPI and Quintero stage. MPI was significantly lower after compared with before laser coagulation. CONCLUSION CHOP score and MPI are predictors of recipient fetal loss in TTTS and may be used to supplement Quintero's classification.
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Affiliation(s)
- E Gapp-Born
- Department of Obstetrics and Gynaecology, Strasbourg University Teaching Hospital, Strasbourg, France
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Lecointre L, Sananes N, Weingertner AS, Kohler M, Guerra F, Fritz G, Viville B, Langer B, Nisand I, Favre R. Fetoscopic laser coagulation for twin-twin transfusion syndrome before 17 weeks' gestation: laser data, complications and neonatal outcome. Ultrasound Obstet Gynecol 2014; 44:299-303. [PMID: 24677292 DOI: 10.1002/uog.13375] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 01/22/2014] [Accepted: 03/14/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To compare laser data, complications and neonatal outcome in pregnancies that undergo 'early' (≤ 17 weeks' gestation) fetoscopic laser ablation of placental vascular anastomoses for twin-twin transfusion syndrome (TTTS) with those from 'conventional' cases treated after 17 weeks. METHODS This was a cohort study of data collected prospectively between January 2004 and December 2012. We included monochorionic diamniotic twin pregnancies complicated by TTTS and treated by fetoscopic laser coagulation. Pregnancies were grouped according to laser treatment ≤ 17 gestational weeks or > 17 weeks and obstetric and neonatal outcomes were compared between groups. RESULTS A total of 178 pregnancies with TTTS underwent laser therapy: 40 at or before 17 weeks and 138 after 17 weeks. There was no statistically significant difference between these two groups with respect to the rate of preterm prelabor rupture of membranes (PPROM), gestational age at PPROM and rate of PPROM occurring in the 7 days following fetoscopic laser coagulation. In the early group, the interval between performing fetoscopic laser coagulation and the time of delivery was significantly longer (104 days vs 74 days, P=0.0002) and the delivery rate within 7 days of laser treatment was significantly lower (2.5% vs 15.9%, P=0.026). There was no significant difference between the two groups with regard to the rates of pregnancy without live birth (15.4% vs 15.4%, P=0.993), with one live birth (84.6% vs 84.6%, P=0.993) and with two live births (64.1% vs 58.1%, P=0.500). CONCLUSION In the event of early TTTS, fetoscopic laser coagulation is technically feasible before 17 gestational weeks and obstetric and neonatal outcomes are comparable with those in cases of laser treatment performed after 17 weeks.
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Affiliation(s)
- L Lecointre
- Fetal Medicine, CMCO-HUS, Schiltigheim/Strasbourg, France
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Sananès N, Rodriguez M, Stora C, Pinton A, Fritz G, Gaudineau A, Aïssi G, Boudier E, Viville B, Favre R, Nisand I, Langer B. Efficacy and safety of labour induction in patients with a single previous caesarean section: a proposal for a clinical protocol. Arch Gynecol Obstet 2014; 290:669-76. [PMID: 24895192 DOI: 10.1007/s00404-014-3287-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 05/19/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of induction in women with a single prior Caesarean section. METHODS This was a cohort study in which we included all singleton pregnancies in patients with a single prior Caesarean who delivered between 2007 and 2012. Methods of induction were ocytocic infusion plus amniotomy (if Bishop score ≥6) or insertion of a Foley catheter (Bishop <6). RESULTS Of the 2,075 patients included, 806 (38.8 %) had an elective repeat Caesarean, 1,045 (50.4 %) went into spontaneous labour, 89 (4.3 %) were induced by artificial rupture of the membranes and infusion of ocytocics and 135 (6.5 %) were induced using a Foley catheter. Rates of vaginal delivery were 79.2, 79.8 and 43.7 %, respectively. Six cases of uterine rupture were reported in the group of patients who went into spontaneous labour. There was no difference between groups with regard to neonatal morbidity. On multivariate analysis, risk factors for Caesarean delivery were macrosomia (OR 2.04, 95 % CI 1.31-3.18) and induction by Foley catheter (OR 3.73, 95 % CI 2.47-5.62); protective factors were previous vaginal delivery (OR 0.41, 95 % CI 0.29-0.57) and cervical dilatation (OR 0.84, 95 % CI 0.78-0.91). CONCLUSIONS Uterine induction after a single Caesarean section with ocytocic infusion and amniotomy where the cervix is favourable does not appear to entail any significant added risk in terms of maternal or foetal morbidity. Foley catheter induction is a reasonable option if the cervix is not ripe.
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Affiliation(s)
- N Sananès
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Avenue Molière, 67200, Strasbourg, France
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Gapp-Born E, Sananes N, Guerra F, Kohler M, Weingertner AS, Fritz G, Viville B, Langer B, Sauleau E, Nisand I, Favre R. Predictive value of cardiovascular parameters in stages 1 and 2 of twin-to-twin transfusion syndrome. Prenat Diagn 2014; 34:908-14. [DOI: 10.1002/pd.4393] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 03/31/2014] [Accepted: 04/20/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Elodie Gapp-Born
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Nicolas Sananes
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
- Biomatériaux et Bioingénierie; INSERM, UMR-S 1121; Strasbourg France
| | - Fernando Guerra
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Monique Kohler
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Anne Sophie Weingertner
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Gabrielle Fritz
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Brigitte Viville
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Bruno Langer
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Erik Sauleau
- Department of Biostatistics; Strasbourg University Teaching Hospital; Strasbourg France
| | - Israël Nisand
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
| | - Romain Favre
- Department of Obstetrics and Gynaecology; Strasbourg University Teaching Hospital; Strasbourg France
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Sananès N, Langer B, Gaudineau A, Kutnahorsky R, Aissi G, Fritz G, Boudier E, Viville B, Nisand I, Favre R. Prediction of spontaneous preterm delivery in singleton pregnancies: where are we and where are we going? A review of literature. J OBSTET GYNAECOL 2014; 34:457-61. [PMID: 24661250 DOI: 10.3109/01443615.2014.896325] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prematurity is the chief cause of neonatal morbidity and mortality. The objective of this study is to review the different methods for predicting preterm delivery in asymptomatic pregnant women and in situations of threatened preterm delivery. A search of the PubMed/Medline database was carried out for the years 1980-2012. We included studies for predicting preterm birth in asymptomatic and symptomatic patients. Models for predicting preterm delivery based on maternal factors, cervical length and obstetric history in first trimester of pregnancy is a valuable avenue of research. Nevertheless, prediction accuracy still needs to be improved. In the second and third trimesters, routine digital vaginal examination is of no value in asymptomatic women. Echography of the cervix is not useful except in patients with a history of late miscarriage or preterm delivery in order to offer them a preventive treatment. In symptomatic women, the combination of digital vaginal examination, cervical echography and fibronectin gives the best predictive results. Electromyography of the uterus and elastography of the cervix are interesting avenues for future research. Identifying patients at risk of preterm delivery should be considered differently at each stage of pregnancy.
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Affiliation(s)
- N Sananès
- Department of Obstetrics and Gynecology, CMCO Hospital , Schiltigheim
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Koch A, Aïssi G, Gaudineau A, Sananes N, Murtada R, Favre R, Nisand I. [Klippel-Trenaunay syndrome and pregnancy: difficult choice of delivery from a case and a review of the literature]. ACTA ACUST UNITED AC 2014; 43:483-7. [PMID: 24461340 DOI: 10.1016/j.jgyn.2013.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/11/2013] [Accepted: 11/19/2013] [Indexed: 01/19/2023]
Abstract
Klippel-Trenaunay syndrome (SKT) is a rare disease characterized by cutaneous haemangiomas, capillary malformations venous (venous varicosities), bone and soft tissue hypertrophy affecting one or more limbs. It is often associated with hemorrhagic and thrombotic complications, especially during pregnancy. Vulvovaginal anomalies at risk of bleeding may occur in late trimester of pregnancy, affecting delivery. The terms of delivery depends on the severity of vascular malformations and the experience of the obstetrician. We report the case of a woman in labor at 38 weeks gestation with a SKT with involvement of the left leg up to the corresponding large lip. She presented after vaginal delivery a severe post-partum hemorrhage (2000mL) secondary to vaginal lacerations requiring sutures and supplemented by arterial embolization. A multidisciplinary approach is required at delivery.
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Affiliation(s)
- A Koch
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France
| | - G Aïssi
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France.
| | - A Gaudineau
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France
| | - N Sananes
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France
| | - R Murtada
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France
| | - R Favre
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France
| | - I Nisand
- Département de gynécologie-obstétrique, hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim cedex, France
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Aissi G, Gaudineau A, Trieu NT, Sananes N, Boisramé T, Stoll F, Koch A, Favre R, Nisand I. [Exceptional hemoperitoneal third trimester of pregnancy]. ACTA ACUST UNITED AC 2014; 42:441-3. [PMID: 24411297 DOI: 10.1016/j.gyobfe.2013.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 08/26/2013] [Indexed: 11/18/2022]
Abstract
We report a case of spontaneous break of the wide ligament revealed by an abdominal pelvic painful syndrome of rough appearance in 36 weeks+2 days with an acute foetal suffering and an important hemoperitoneal to a primigeste of 32 years. The laparotomy explorer allowed to make the diagnosis but the foetal forecast was dramatic. The foetal extraction has to be made as a matter of urgency and at the same time that the vascular haemostasis.
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Affiliation(s)
- G Aissi
- HUS-CMCO (centre médico-chirurgical et obstétrical), 19, rue Louis-Pasteur, BP 120, 67303 Schiltigheim cedex, Strasbourg, France.
| | - A Gaudineau
- HUS, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg cedex, France
| | - N-T Trieu
- HUS-CMCO (centre médico-chirurgical et obstétrical), 19, rue Louis-Pasteur, BP 120, 67303 Schiltigheim cedex, Strasbourg, France
| | - N Sananes
- HUS, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg cedex, France
| | - T Boisramé
- HUS, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg cedex, France
| | - F Stoll
- HUS-CMCO (centre médico-chirurgical et obstétrical), 19, rue Louis-Pasteur, BP 120, 67303 Schiltigheim cedex, Strasbourg, France
| | - A Koch
- HUS-CMCO (centre médico-chirurgical et obstétrical), 19, rue Louis-Pasteur, BP 120, 67303 Schiltigheim cedex, Strasbourg, France
| | - R Favre
- HUS-CMCO (centre médico-chirurgical et obstétrical), 19, rue Louis-Pasteur, BP 120, 67303 Schiltigheim cedex, Strasbourg, France
| | - I Nisand
- HUS, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg cedex, France
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Viossat P, Ville Y, Bessis R, Jeny R, Nisand I, Teurnier F, Coquel P, Lansac J. Rapport du Comité national technique de l’échographie de dépistage prénatal (CNTEDP) : recommandations pour l’échographie de diagnostic. ACTA ACUST UNITED AC 2014; 42:51-60. [DOI: 10.1016/j.gyobfe.2013.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Indexed: 10/25/2022]
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Sananes N, Meyer N, Gaudineau A, Aissi G, Boudier E, Fritz G, Viville B, Nisand I, Langer B, Favre R. Prediction of spontaneous preterm delivery in the first trimester of pregnancy. Eur J Obstet Gynecol Reprod Biol 2013; 171:18-22. [DOI: 10.1016/j.ejogrb.2013.07.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 07/08/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
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Sananès N, Schuller E, Gaudineau A, Kohler M, Guerra F, Weingertner AS, Fritz G, Viville B, Langer B, Nisand I, Favre R. What is predictive of preterm delivery in the first trimester: isthmus or cervical length? Prenat Diagn 2013; 33:894-8. [PMID: 23733613 DOI: 10.1002/pd.4158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aims to evaluate the utility of first trimester cervical ultrasonography in predicting preterm delivery by separate analysis of measurements of cervical and isthmus length. METHODS This is a cohort study based on data collected prospectively on singletons between 1 July 2011 and 1 February 2013. Mean cervical, isthmus and cervico-isthmic complex length were measured for deliveries before and after 37 weeks. RESULTS A total of 1494 pregnancies were analysed, including 51 cases of spontaneous preterm delivery (3.4%). The cervico-isthmic complex in the first trimester was significantly shorter in patients who delivered before term (43.8 mm vs 47.5 mm, p = 0.04). This difference is related to differences in length at the isthmus (10.7 mm vs 14.1 mm, p = 0.005) rather than at the cervix proper (34.5 mm vs 35.0 mm, p = 0.56). CONCLUSIONS Measurement of the cervico-isthmic complex enables detection of a number of patients who will go on to deliver before term. Further studies are necessary to confirm that isthmic length and not cervical length is predictive of preterm delivery.
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Affiliation(s)
- Nicolas Sananès
- Department of Obstetrics and Gynecology, Strasbourg University Teaching Hospital, Strasbourg, France.
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Aissi G, Sananes N, Veujoz M, Felder A, Kasbaoui SM, Trieu NT, Favre R, Nisand I. [Vasa previa: Of the diagnosis to neonatal prognosis]. ACTA ACUST UNITED AC 2013; 42:591-5. [PMID: 23287072 DOI: 10.1016/j.jgyn.2012.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 11/19/2012] [Accepted: 11/26/2012] [Indexed: 11/17/2022]
Abstract
Vasa previa is a rare complication of pregnancy (1/2000 to 1/6000) with a high fetal mortality rate (75 to 100%). We will discuss two case reports of vasa previa: the first was diagnosed before labor, while the second was during delivery. In the first case, the diagnosis of vasa previa was confirmed by a transvaginal ultrasound and color doppler, while the second case involved late diagnosis during delivery and after gross examination of the placenta. Risk factors for vasa previa are: low-lying placenta, bilobed or succenturiate lobed placenta, velamentous and in vitro fertilization (IVF). Antenatal diagnosis of vasa previa is crucial because it allows for prophylactic caesarean section and prevents severe Benckiser's hemorrhage responsible for a very high neonatal mortality.
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Affiliation(s)
- G Aissi
- Service de gynécologie et d'obstétrique, HUS-CMCO, Strasbourg, 19, rue Louis-Pasteur, BP 120, 67300 Schiltigheim, France.
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Faller E, Garbin O, Hummel M, Nisand I. Retrograde Tubal Catheterization: About a Retrospective Study of 103 Cases. J Minim Invasive Gynecol 2012. [DOI: 10.1016/j.jmig.2012.08.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Doray B, Badila-Timbolschi D, Schaefer E, Fattori D, Monga B, Dott B, Favre R, Kohler M, Nisand I, Viville B, Kauffmann I, Bruant-Rodier C, Grollemund B, Rinkenbach R, Astruc D, Gasser B, Lindner V, Marcellin L, Flori E, Girard-Lemaire F, Dollfus H. Épidémiologie des fentes labio-palatines : expérience du Registre de malformations congénitales d’Alsace entre 1995 et 2006. Arch Pediatr 2012; 19:1021-9. [DOI: 10.1016/j.arcped.2012.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 05/25/2012] [Accepted: 07/04/2012] [Indexed: 11/15/2022]
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Gaudineau A, Sauleau EA, Nisand I, Langer B. Obstetric and neonatal outcomes in a home-like birth centre: a case–control study. Arch Gynecol Obstet 2012; 287:211-6. [DOI: 10.1007/s00404-012-2553-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
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Kuhn-Beck F, Moutel G, Weingertner AS, Kohler M, Hornecker F, Hunsinger MC, Kohler A, Mager C, Neumann M, Nisand I, Favre R. Fetal reduction of triplet pregnancy: one or two? Prenat Diagn 2012; 32:122-6. [PMID: 22418954 DOI: 10.1002/pd.2906] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To review outcomes following reductions in trichorionic triplet pregnancies at our institution. METHOD Retrospective analysis of the outcome of trichorionic triamniotic triplets reduced to singletons (group I, n = 44) or twins (group II, n = 136) at 10 and 12 weeks of gestation. RESULTS Reduction to one or two was based on parent's preference, hence unrelated to any specific obstetrical or maternal issue. Early fetal loss rate (e.g. <24 weeks) was 9.1% in group I versus 5.1% in group II (p = 0.83). In group I, the take-home baby rate was 86.4% versus 91.9% in group II (p = 0.8). In group I, 17.5% of the women gave birth between 33 and 36(+6) weeks of gestation versus 40.6% in group II (p = 0.026). Delivery beyond 37 weeks was 72.5% in group I and 46.9% in group II (p = 0.01). Intrauterine growth restriction rate was 27.0% in group I versus 45.0% in group II (p = 0.049). CONCLUSION Reduction to one rather than two fetuses led to significantly higher term delivery rate without significant differences in fetal loss rate or take-home baby rate.
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Affiliation(s)
- F Kuhn-Beck
- Département d'Echographie et de Médecine Fœtale, Hôpitaux Universitaire de Strasbourg-Centre Médico-Chirurgical et Obstétrical (HUS-CMCO), Schiltigheim, France.
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Gaudineau A, Sauleau EA, Nisand I, Langer B. [Obstetric and neonatal outcomes in a home-like birth centre: a case-control study]. ACTA ACUST UNITED AC 2012; 40:524-8. [PMID: 22902711 DOI: 10.1016/j.gyobfe.2012.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 05/07/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare intervention rates associated with labor in low-risk women who began their labor in the "home-like birth centre" and the traditional delivery room. PATIENTS AND METHODS This retrospective study used data that were collected from January 2005 through June 2008, from women admitted to the "home-like birth centre" (n=316) and compared to a group of randomly selected low-risk women admitted to the traditional labor ward (n=890) using the Baysian Information Criterion to select the best predictive model. RESULTS Women in the "home-like birth centre" had spontaneous vaginal deliveries more often (88.6% versus 82.8%, P value 0.034) and perineal lesions less often (60.1% versus 62.5%, P value 0.013). The frequency of adverse neonatal outcomes did not differ statistically between the two groups, although mean clamped at birth umbilical arterial pH level was higher in the "home-like birth centre" group. The transfer rate from "home-like birth centre" to traditional labor ward was 31.3%. DISCUSSION AND CONCLUSIONS It appears that women could benefit from "home-like birth centre" care in settings such as the one studied. Larger observational studies are warranted to validate these results.
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Affiliation(s)
- A Gaudineau
- Département de gynécologie-obstétrique, centre hospitalo-universitaire de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
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Kremer V, Girard F, Gasser B, Marcellin L, Christmann D, Nisand I, Schmitt E, Florent S, Flori E. Prenatal diagnosis of a 12q22q23.2 interstitial deletion by array CGH in a malformed fetus. Eur J Med Genet 2012; 55:269-73. [PMID: 22425634 DOI: 10.1016/j.ejmg.2012.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 02/06/2012] [Indexed: 11/13/2022]
Abstract
We report the prenatal diagnosis of a 12q22q23.2 de novo interstitial deletion performed by array based comparative genomic hybridization (array CGH) in a fetus with cystic hygroma colli, intrauterine growth retardation, microcephaly and micrognathism. Haploinsufficiency for insuline-like growth factor 1 gene (IGF1), which is mapped in the deleted region, is suggested because of its implication in prenatal and postnatal growth and in neuronal maturation. This case demonstrates the contribution of array CGH in prenatal diagnosis for detecting small unbalanced chromosomal abnormalities in malformed fetuses and, subsequently, for genetic counselling.
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Affiliation(s)
- Valérie Kremer
- Service de Cytogénétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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Trieu NT, Weingertner AS, Guerra F, Dautun D, Kohler M, Vayssière C, Nisand I, Favre R. Evaluation of the measurement of the middle cerebral artery peak systolic velocity before and after placental laser coagulation in twin-to-twin transfusion syndrome. Prenat Diagn 2012; 32:127-30. [DOI: 10.1002/pd.2907] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ngoc-Tu Trieu
- Fetal Diagnosis and Medicine; CMCO; Schiltigheim; France
| | | | - F. Guerra
- Fetal Diagnosis and Medicine; CMCO; Schiltigheim; France
| | - D. Dautun
- Fetal Diagnosis and Medicine; CMCO; Schiltigheim; France
| | - M. Kohler
- Fetal Diagnosis and Medicine; CMCO; Schiltigheim; France
| | - C. Vayssière
- Fetal Diagnosis and Medicine; CMCO; Schiltigheim; France
| | - I. Nisand
- Service de Gynécologie Obstétrique; Hôpitaux Universitaires de Strasbourg; Strasbourg; France
| | - R. Favre
- Fetal Diagnosis and Medicine; CMCO; Schiltigheim; France
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Sunkara SK, Seshadri S, El-Toukhy T, Khalaf Y, Schuh-Huerta SM, Johnson NA, Rosen MP, Sternfeld B, Cedars MI, Reijo Pera RA, Groendahl M, Vikesa J, Borup R, Yding Andersen C, Ernst E, Lykke-Hartmann K, Liu W, Zhong Y, Zou X, Xi WY, Gong F, Fan LQ, Lu GX, Lehert P, Rongieres C, Pirrello O, Ohl J, Bettahar K, Nisand I, Smit JG, Kasius JC, Eijkemans MJC, Campo R, Broekmans FJM. SESSION 03: FEMALE INFERTILITY 1. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Jamin C, André G, Audebert A, Christin-Maître S, Elia D, Harvey T, Letombe B, Lopes P, Moreau C, Nisand I, Pélissier C. Oublis de la contraception hormonale : réflexions sur leur prise en charge en pratique quotidienne. ACTA ACUST UNITED AC 2011; 39:644-55. [DOI: 10.1016/j.gyobfe.2011.08.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Accepted: 07/31/2011] [Indexed: 10/16/2022]
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46
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Weingertner AS, Trieu NT, Kohler M, Viville B, Levy G, Montaya Y, Kutnahorsky R, Tissier I, Kohler A, Tanghe M, Mager C, Benassi E, Cancelier M, Neuman M, Bouffet N, Hunsinger MC, Hornecker F, Langer B, Nisand I, Favre R. [First trimester screening for Down syndrome: five years prospective experience]. J Gynecol Obstet Biol Reprod (Paris) 2010; 39:353-61. [PMID: 20541874 DOI: 10.1016/j.jgyn.2010.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 04/06/2010] [Accepted: 04/28/2010] [Indexed: 10/19/2022]
Abstract
First trimester screening for Down syndrome is yet to become the first intention strategy in France. This screening program at 11-14 weeks of gestation using maternal age, fetal nuchal translucency, maternal serum free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A has already been validated for a long time by many international studies. It seems to improve detection rate and decrease false positive rates. We report here five years prospective experience.
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Affiliation(s)
- A-S Weingertner
- Pôle de gynécologie obstétrique, département d'échographie et de diagnostic anténatal, centre médicochirurgical et obstétrical SIHCUS, 19, rue Louis-Pasteur, 67303 Schiltigheim cedex, France.
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Ohl J, Partisani M, Demangeat C, Binder-Foucard F, Nisand I, Lang JM. [Alterations of ovarian reserve tests in Human Immunodeficiency Virus (HIV)-infected women]. ACTA ACUST UNITED AC 2010; 38:313-7. [PMID: 20430670 DOI: 10.1016/j.gyobfe.2009.07.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 07/15/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Little is known about the impact of highly active antiretroviral therapy or HIV infection itself on the ovarian function. The aim of this study was to evaluate ovarian function in HIV-infected women in comparison with normal values from non-HIV infected women. PATIENTS AND METHODS This is a prospective pilot study using markers of ovarian function: the antral follicular count (AFC) defined between cycle days 7 and 10 and follicle-stimulating hormone (FSH), inhibin B and antimüllerian hormone (AMH) for early follicular phase hormonal assessments. A descriptive analysis according to age was performed. RESULTS Results from 78 HIV positive women are presented. AFC shows a high rate of abnormal values (63 %) occurring surprisingly early. The hormonal markers are concordant with a 36, 57 and 23 % abnormal rate for FSH, inhibin B and AMH respectively. DISCUSSION AND CONCLUSION In our series, HIV seropositivity was associated with stigmas of premature ovarian insufficiency. This may explain impaired fertility but also suggests premature menopause in this population that should therefore be monitored early for such changes.
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Affiliation(s)
- J Ohl
- Centre d'AMP de Strasbourg, CMCO-SIHCUS, 1, rue Louis-Pasteur, 67303 Schiltigheim, France.
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Sananes N, Guigue V, Kohler M, Bouffet N, Cancellier M, Hornecker F, Hunsinger MC, Kohler A, Mager C, Neumann M, Schmerber E, Tanghe M, Nisand I, Favre R. Nuchal translucency and cystic hygroma colli in screening for fetal major congenital heart defects in a series of 12,910 euploid pregnancies. Ultrasound Obstet Gynecol 2010; 35:273-279. [PMID: 20069678 DOI: 10.1002/uog.7534] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Many studies have shown that an increased nuchal translucency (NT) may be a good marker of fetal heart malformation, but the extent to which NT is suitable for identifying the population at risk remains unclear. We aimed to determine the value of NT measurement and of the presence of cystic hygroma colli in the screening of euploid fetuses for congenital heart defects (CHD). METHODS We carried out a retrospective analysis of 12 910 euploid pregnancies examined between January 1995 and August 2007 at our institution. The screening performance of NT measurements in identifying fetuses with CHD was assessed, with comparison between the use of cut-offs defined as absolute values, multiples of the median (MoM) and percentiles. The presence of cystic hygroma colli was also assessed in the prediction of CHD. RESULTS The incidence of major CHD was 3.4 per thousand (44/12 910). The sensitivity of NT measurement in screening for major CHD was 54.5% if the threshold was set at the 95(th) percentile, 45.4% if it was set at 3 mm, 27.3% for 3.5 mm, 50.0% for 1.5 MoM and 45.5% for 1.75 MoM. The false-positive rates for these thresholds were 8.4, 6.6, 1.7, 8.9 and 6.3%, respectively. The incidence of major CHD was 1.2% (10/813) in cases of thick NT (> 95(th) centile) and 4.3% (13/304) in cases of hygroma colli. CONCLUSIONS NT measurement during the first trimester is potentially useful for screening for fetal major CHD. Screening performance is consistent whether NT values are expressed as MoMs, percentiles or absolute values. The incidence of major CHD seems to be higher in cases of cystic hygroma colli.
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Affiliation(s)
- N Sananes
- Department of Ultrasound and Fetal Medicine, CMCO-SIHCUS, Strasbourg, France
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Affiliation(s)
- I Nisand
- Département de gynécologie-obstétrique, CHRU de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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Thoma V, Bridoux V, Lefebure B, Wattiez A, Nisand I, Tuech JJ. Methodological and ethical quality in phase III--breast cancer trials. Med Law 2009; 28:637-648. [PMID: 20157975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The gold standard of Evidence Based Medicine remains the randomised controlled trial (RCT), which is the only tool that allows an approach to the "therapeutic truth". To reach credible conclusions, these trials need to be perfect in methodological and ethical quality. The purpose of this study is to evaluate methodological quality (MQ), ethical quality (EQ) and compliance with ethical requirements in phase III randomized clinical trials of breast cancer treatment. STUDY DESIGN MQ was evaluated by the Jadad-scale and EQ by the Berdeu-score for all the randomised controlled clinical trials (RCT) (n = 137), published between January 2001 and December 2005 in 11 international journals. RESULTS Mean MQ was 9.88 +/- 1.43. MQ was insufficient (Jadad score pound 9) for 49 RCT (35,8%). Mean EQ was 0.45 +/- 0.12. Mean EQ for RCT with insufficient MQ (n = 49) was 0.43 +/- 0.12; Mean EQ for RCT with good MQ (Jadad score > 9)(n = 88) was 0.46 +/- 0.11. There was significant improvement in MQ depending on the year in which the study was started (p = 0.002). EQ was independent of the year of study's start (p = 0.134).There was no relationship between MQ or EQ and the number of patients included in the study (p = 0.53 and p = 0.1). There was a tendency towards correlation between MQ and EQ (p = 0.052), but the correlation between these two variables could not be considered as significant (r = 0.67). Informed consent from patients (ICP) was not obtained in 5.8% (n = 8) of the RCTs and the approval of a research ethics committee (REC) was not mentioned in 26.3% (n = 36) of the RCTs. CONCLUSIONS Good MQ and reporting of ethical requirements (EQ) reflects the respect shown to the patients during the whole research process. There are still deficiencies in EQ and MQ. Quality improvement requires education and appropriation by the scientific community, in particular, medical staff, of methodological and ethical basic rules concerning trials involving human beings.
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Affiliation(s)
- Véronique Thoma
- IRCAD/EITS, 1 Place de l'Hôpital- BP 426 -67091 Strasbourg Cedex, France
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