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Atallah A, Cabet S, Cassart M, James I, Gaucherand P, Guibaud L. Prenatal diagnosis of congenital perineal lipoma: tip of urorectal septum malformation sequence? Ultrasound Obstet Gynecol 2022; 60:139-141. [PMID: 34919755 DOI: 10.1002/uog.24836] [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: 08/30/2021] [Revised: 11/22/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Affiliation(s)
- A Atallah
- University Hospital Centre Sainte Justine, Department of Maternal-Fetal Medicine, University of Montreal, Montreal, Canada
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, University Claude Bernard Lyon 1, Lyon, France
| | - S Cabet
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Department of Radiology, University Claude Bernard Lyon 1, Lyon, France
| | - M Cassart
- Erasme Hospital, Department of Radiology, Brussels, Belgium
| | - I James
- Clinique du Val d'Ouest, Pediatric Plastic Surgery Department, Ecully, France
| | - P Gaucherand
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, University Claude Bernard Lyon 1, Lyon, France
| | - L Guibaud
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, University Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Department of Radiology, University Claude Bernard Lyon 1, Lyon, France
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Senni N, Gerfaud-Valentin M, Hot A, Huissoud C, Gaucherand P, Tebib J, Broussolle C, Jamilloux Y, Sève P. [Spontaneous adrenal hematomas. Retrospective analysis of 20 cases from a tertiary center]. Rev Med Interne 2021; 42:375-383. [PMID: 33775473 DOI: 10.1016/j.revmed.2021.03.009] [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: 04/03/2020] [Revised: 02/23/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Spontaneous adrenal hemorrhages (AH) are a rare condition with no consensus about their management. METHODS Patients were identified using the Medicalization of the Information System Program database, imaging software and a call for observations to internists, intensivists and obsetricians working at our institution. Adult patients whose medical records were complete and whose diagnosis was confirmed by medical imaging were included. RESULTS From 2000 to 2007, 20 patients were identified, including 15 were women. The clinical onset of AH was non-specific. In five cases, AH occurred during pregnancy; four of them were unilateral and right sided. The etiology of the other fifteen (bilateral adrenal hemorrhage in 11) were as follows: antiphospholipid syndrome (n=8), heparin-induced thrombocytopenia (n=4), essential thrombocythemia (n=3), spontaneous AH due to oral anticoagulants (n=1), complication of a surgical act (n=3), and sepsis (n=3). In seven cases, two causes were concomitant. The diagnosis of AH was often confirmed by abdominal CT. An anticoagulant treatment was initiated in 16 cases. Ten of the eleven patients presenting with bilateral adrenal hematomas were treated using a long-term substitute opotherapy. One patient died because of a catastrophic antiphospholipid syndrome. CONCLUSION The clinical onset of HS is heterogeneous and non-specific. The confirmatory diagnosis is often based on abdominal CT. The search for an underlying acquired thrombophilia is essential and we found in this study etiological data comparable to the main series in the literature. Adrenal insufficiency is most of the time definitive in cases of bilateral involvement.
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Affiliation(s)
- N Senni
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - M Gerfaud-Valentin
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - A Hot
- Service de médecine interne, hôpital Edouard-Herriot, Lyon, France
| | - C Huissoud
- Service d'obstétrique, hôpital de la Croix-Rousse, Lyon, France
| | - P Gaucherand
- Service d'obstétrique, hôpital Femme Mère-Enfant, Lyon, France
| | - J Tebib
- Service de rhumatologie, hôpital Lyon Sud, Lyon, France
| | - C Broussolle
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - Y Jamilloux
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - P Sève
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Hospices civils de Lyon, pôle IMER, 69003 Lyon, France; University Lyon, University Claude Bernard Lyon 1, HESPER EA 7425, 69008 Lyon, France.
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Barreto C, Amour S, Kuczewski E, Dupuis O, Huissoud C, Gaucherand P, Gerbier-Colomban S, Girard R, Vanhems P. Maternal infection rates: Surveillance in three obstetric units of a French University Hospital group in 2016. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.407] [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: 11/26/2022] Open
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Atallah A, Lacalm A, Massoud M, Massardier J, Gaucherand P, Guibaud L. Prenatal diagnosis of pericallosal curvilinear lipoma: specific imaging pattern and diagnostic pitfalls. Ultrasound Obstet Gynecol 2018; 51:269-273. [PMID: 28067000 DOI: 10.1002/uog.17400] [Citation(s) in RCA: 11] [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: 12/03/2016] [Revised: 12/16/2016] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
We report the first series of cases of pericallosal curvilinear lipoma (CL) diagnosed prenatally and highlight the limitations in identifying a specific prenatal imaging pattern using ultrasound and magnetic resonance imaging (MRI). In all five of our cases, on ultrasound, the main feature leading to referral was a short corpus callosum. This subtle callosal dysgenesis was associated with a band of hyperechogenicity surrounding the corpus callosum, mimicking the pericallosal sulcus, which increased in size during the third trimester in three of the four cases in which sonographic follow-up was performed. On T2-weighted MRI, this band showed typical hypointensity in all cases; in contrast, on T1-weighted imaging, in only one case was there hyperintensity, suggestive of fat, as seen typically in the postnatal period. For appropriate prenatal counseling regarding outcome, it is important to identify or rule out CL when mild corpus callosal dysgenesis is observed. One should be aware of subtle diagnostic findings, such as a thin band of echogenicity surrounding the corpus callosum that is seen as a band of hypointensity on T2-weighted fetal MRI, and which may increase in size during gestation. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Atallah
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon Bron, France
| | - A Lacalm
- Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon Bron, France
| | - M Massoud
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon Bron, France
| | - J Massardier
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon Bron, France
| | - P Gaucherand
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon Bron, France
| | - L Guibaud
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon Bron, France
- Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon Bron, France
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Abstract
Aspirin is currently the most widely prescribed treatment in the prevention of cardiovascular complications. The indications for the use of aspirin during pregnancy are, however, the subject of much controversy. Since the first evidence of the obstetric efficacy of aspirin in 1985, numerous studies have tried to determine the effect of low-dose aspirin on the incidence of preeclampsia, with very controversial results. Large meta-analyses including individual patient data have demonstrated that aspirin is effective in preventing preeclampsia in high-risk patients, mainly those with a history of preeclampsia. However, guidelines regarding the usage of aspirin to prevent preeclampsia differ considerably from one country to another. Screening modalities, target population, and aspirin dosage are still a matter of debate. In this review, we report the pharmacodynamics of aspirin, its main effects according to dosage and gestational age, and the evidence-based indications for primary and secondary prevention of preeclampsia.
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Affiliation(s)
- A Atallah
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 boulevard Pinel, 69500, Bron, France
- Claude-Bernard University Lyon1, Lyon, France
| | - E Lecarpentier
- Assistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- PremUP Foundation, Paris, France
- DHU Risques et Grossesse, Paris, France
| | - F Goffinet
- Assistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- PremUP Foundation, Paris, France
- DHU Risques et Grossesse, Paris, France
| | - M Doret-Dion
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 boulevard Pinel, 69500, Bron, France
- Claude-Bernard University Lyon1, Lyon, France
| | - P Gaucherand
- Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 boulevard Pinel, 69500, Bron, France
- Claude-Bernard University Lyon1, Lyon, France
| | - V Tsatsaris
- Assistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France.
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
- PremUP Foundation, Paris, France.
- DHU Risques et Grossesse, Paris, France.
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Dargaud Y, Rugeri L, Fleury C, Battie C, Gaucherand P, Huissoud C, Rudigoz RC, Desmurs-Clavel H, Ninet J, Trzeciak MC. Personalized thromboprophylaxis using a risk score for the management of pregnancies with high risk of thrombosis: a prospective clinical study. J Thromb Haemost 2017; 15:897-906. [PMID: 28231636 DOI: 10.1111/jth.13660] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 07/13/2016] [Indexed: 12/30/2022]
Abstract
Essentials Pregnancy is a risk factor for thrombosis. Management of thrombosis risk in pregnancy remains a challenge. Prophylaxis needs to be personalized. Our score may be a helpful tool for the management of pregnancies at high risk of thrombosis. SUMMARY Background Patients with thrombophilia and/or a history of venous thromboembolism (VTE) are at risk of thrombosis during pregnancy. A risk score for pregnancies with an increased risk of VTE was previously described by our group (Lyon VTE score). Objectives The aim of this prospective study was to assess the efficacy and safety of our score-based prophylaxis strategy in 542 pregnancies managed between 2005 and 2015 in Lyon University Hospitals. Patients/Methods Of 445 patients included in the study, 36 had several pregnancies during the study period. Among these 445 patients, 279 had a personal history of VTE (62.7%), 299 patients (67.2%) had a thrombophilia marker, and 131 (29.4%) thrombophilic women had a personal history of VTE. During pregnancy, patients were assigned to one of three prophylaxis strategies according to the risk scoring system. Results In the antepartum period, low molecular weight heparin (LMWH) prophylaxis was prescribed to 64.5% of patients at high risk of VTE. Among them, 34.4% were treated in the third trimester only, and 30.1% were treated throughout pregnancy. During the postpartum period, all patients received LMWH for at least 6 weeks. Two antepartum-related VTEs (0.37%; one with a score of < 3 and the other with a score of > 6) and four postpartum-related VTEs (0.73%; three with scores of 3-5 and one with a score of > 6) occurred. No case of pulmonary embolism was observed during the study period. The rate of bleeding was 0.37%. No serious bleeding requiring transfusions or surgery occurred during the study period. Conclusion The use of a risk score may provide a rational decision process to implement safe and effective antepartum thromboprophylaxis in pregnant women at high risk of VTE.
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Affiliation(s)
- Y Dargaud
- Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon, France
| | - L Rugeri
- Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon, France
| | - C Fleury
- Laboratoire d'Explorations Vasculaires, pavillon M, Hopital Edouard Herriot, CHU de Lyon, France
| | - C Battie
- Service d'Obstetrique, Hopital Femme Mere Enfant, CHU de Lyon, France
| | - P Gaucherand
- Service d'Obstetrique, Hopital Femme Mere Enfant, CHU de Lyon, France
| | - C Huissoud
- Service d'Obstetrique, Hopital de la Croix Rousse, CHU de Lyon, France
| | - R C Rudigoz
- Service d'Obstetrique, Hopital de la Croix Rousse, CHU de Lyon, France
| | - H Desmurs-Clavel
- Service de Medecine Interne, pavillon O, Hopital Edouard Herriot, CHU de Lyon, France
| | - J Ninet
- Service de Medecine Interne, pavillon O, Hopital Edouard Herriot, CHU de Lyon, France
| | - M C Trzeciak
- Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon, France
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Atallah A, Bolze PA, Buenerd A, Marino S, Massardier J, Gaucherand P, Massoud M. Injection des anastomoses vasculaires pour la compréhension des complications propres aux grossesses monochoriales. ACTA ACUST UNITED AC 2017; 45:269-275. [DOI: 10.1016/j.gofs.2017.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/13/2017] [Indexed: 11/16/2022]
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Pons L, Till M, Alix E, Abel C, Boggio D, Bordes A, Caloone J, Raskin FC, Chatron N, Cordier MP, Fichez A, Labalme A, Lajeunesse C, Liaras É, Massoud M, Miribel J, Ollagnon E, Schluth-Bolard C, Vichier-Cerf A, Edery P, Attia J, Huissoud C, Rudigoz RC, Massardier J, Gaucherand P, Sanlaville D. Prenatal microarray comparative genomic hybridization: Experience from the two first years of activity at the Lyon university-hospital. J Gynecol Obstet Hum Reprod 2017; 46:275-283. [PMID: 28403926 DOI: 10.1016/j.jogoh.2016.11.004] [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: 07/18/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aims to describe how microarray comparative genomic hybridization (aCGH) has shifted to become a prenatal diagnosis tool at the Lyon university-hospital. MATERIALS AND METHODS This retrospective study included all patients who were referred in the 3 pluridisciplinary centers for prenatal diagnosis of the Lyon university-hospital and who received a prenatal aCGH between June 2013 and June 2015. aCGH was systematically performed in parallel with a karyotype, using the PréCytoNEM array design. RESULTS A total of 260 microarrays were performed for the following indications: 249 abnormal ultrasounds (95.8%), 7 characterizations of chromosomal rearrangements (2.7%), and 4 twins with no abnormal ultrasounds (1.5%). With a resolution of 1 mega base, we found 235 normal results (90.4%), 23 abnormal results (8.8%) and 2 non-returns (0.8%). For the chromosomal rearrangements visible on the karyotype, aCGH identified all of the 12 unbalanced rearrangements and did not identify the 2 balanced rearrangements. Among the fetuses with normal karyotypes, 11 showed abnormal microarray results, corresponding to unbalanced cryptic chromosomal rearrangements (4.2%). CONCLUSION Transferring aCGH to a prenatal diagnosis at the Lyon university-hospital has increased the detection rate of chromosomal abnormalities by 4.2% compared to the single karyotype.
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Affiliation(s)
- L Pons
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France.
| | - M Till
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - E Alix
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - C Abel
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - D Boggio
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - A Bordes
- Département d'obstétrique et de gynécologie, groupement hospitalier Est, HCL, 69500 Bron, France
| | - J Caloone
- Département d'obstétrique et de gynécologie, centre hospitalier de la Croix-Rousse, HCL, 69004 Lyon, France
| | - F C Raskin
- Département d'obstétrique et de gynécologie, centre hospitalier Lyon Sud, HCL, 69310 Pierre-Bénite, France
| | - N Chatron
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France; Équipe Gendev, CNRS UMR 5292, Inserm U1028, centre de recherche en neuroscience de Lyon, 69500 Bron, France
| | - M-P Cordier
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - A Fichez
- Département d'obstétrique et de gynécologie, centre hospitalier de la Croix-Rousse, HCL, 69004 Lyon, France
| | - A Labalme
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - C Lajeunesse
- Département d'obstétrique et de gynécologie, groupement hospitalier Est, HCL, 69500 Bron, France
| | - É Liaras
- Département d'obstétrique et de gynécologie, centre hospitalier Lyon Sud, HCL, 69310 Pierre-Bénite, France
| | - M Massoud
- Département d'obstétrique et de gynécologie, groupement hospitalier Est, HCL, 69500 Bron, France
| | - J Miribel
- Département d'obstétrique et de gynécologie, groupement hospitalier Est, HCL, 69500 Bron, France
| | - E Ollagnon
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - C Schluth-Bolard
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France; Équipe Gendev, CNRS UMR 5292, Inserm U1028, centre de recherche en neuroscience de Lyon, 69500 Bron, France
| | - A Vichier-Cerf
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France
| | - P Edery
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France; Équipe Gendev, CNRS UMR 5292, Inserm U1028, centre de recherche en neuroscience de Lyon, 69500 Bron, France
| | - J Attia
- Université Claude-Bernard Lyon 1, 69008 Lyon, France; Département d'obstétrique et de gynécologie, centre hospitalier Lyon Sud, HCL, 69310 Pierre-Bénite, France
| | - C Huissoud
- Département d'obstétrique et de gynécologie, centre hospitalier de la Croix-Rousse, HCL, 69004 Lyon, France
| | - R C Rudigoz
- Université Claude-Bernard Lyon 1, 69008 Lyon, France; Département d'obstétrique et de gynécologie, centre hospitalier de la Croix-Rousse, HCL, 69004 Lyon, France
| | - J Massardier
- Département d'obstétrique et de gynécologie, groupement hospitalier Est, HCL, 69500 Bron, France
| | - P Gaucherand
- Université Claude-Bernard Lyon 1, 69008 Lyon, France; Département d'obstétrique et de gynécologie, groupement hospitalier Est, HCL, 69500 Bron, France
| | - D Sanlaville
- Service de génétique, groupement hospitalier Est, HCL, 59, boulevard Pinel, 69677 Bron, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France; Équipe Gendev, CNRS UMR 5292, Inserm U1028, centre de recherche en neuroscience de Lyon, 69500 Bron, France
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Chauleur C, Gris JC, Laporte S, Chapelle C, Equy V, Gaucherand P, Bazan E, Dupuis O, Buchmüller A, Gallot D. OC-7b: Implementation of risk score-guided prophylaxis in over 2000 pregnant women at risk of thrombotic events: impact on morbidity. A quasi-experimental prospective study. Thromb Res 2017. [DOI: 10.1016/s0049-3848(17)30094-4] [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: 10/20/2022]
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Chene G, Lamblin G, Le Bail-Carval K, Beaufils E, Chabert P, Gaucherand P, Mellier G, Coppens Y. [Lucy's cancer(s): A prehistorical origin?]. ACTA ACUST UNITED AC 2016; 44:690-700. [PMID: 27839715 DOI: 10.1016/j.gyobfe.2016.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 09/12/2016] [Accepted: 10/06/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The recent discovery of the earliest hominin cancer, a 1.7-million-year-old osteosarcoma from South Africa has raised the question of the origin of cancer and its determinants. We aimed to determine whether malignant and benign tumors exist in the past societies. METHODS A review of literature using Medline database and Google about benign and malignant tumors in prehistory and antiquity. Only cases with morphological and paraclinical analysis were included. The following keywords were used: cancer; paleopathology; malignant neoplasia; benign tumor; leiomyoma; myoma; breast cancer; mummies; soft tissue tumor; Antiquity. RESULTS Thirty-five articles were found in wich there were 34 malignant tumors, 10 benign tumors and 11 gynecological benign tumors. CONCLUSIONS The fact that there were some malignant tumors, even few tumors and probably underdiagnosed, in the past may be evidence that cancer is not only a disease of the modern world. Cancer may be indeed a moving target: we have likely predisposing genes to cancer inherited from our ancestors. The malignant disease could therefore appear because of our modern lifestyle (carcinogens and risk factors related to the modern industrial society).
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Affiliation(s)
- G Chene
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France; EMR 3738, université Claude-Bernard Lyon 1, 69000 Lyon, France.
| | - G Lamblin
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - K Le Bail-Carval
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - E Beaufils
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - P Chabert
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - P Gaucherand
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - G Mellier
- Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, CHU de Lyon, 59, boulevard Pinel, 69000 Lyon, France
| | - Y Coppens
- Chaire de paléoanthropologie, collège de France, 75005 Paris, France
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Pichon M, Gaymard A, Bolze P, Verneau V, Buenerd A, Gaucherand P, Lina B, Mekki Y. Severe fetopathy caused by cytomegalovirus recurrence with isolated intra-abdominal complication in an immune woman. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.006] [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: 10/21/2022]
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Sciard C, Lacalme A, Combourieu D, Gaucherand P, Lajeunesse C, Massardier J, Guibaud L, Massoud M. [Fetal transcerebellar diameter measured in screening ultrasound: Feasibility and reproducibility]. J Gynecol Obstet Hum Reprod 2016; 45:516-520. [PMID: 26321618 DOI: 10.1016/j.jgyn.2015.07.003] [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: 04/07/2015] [Revised: 06/25/2015] [Accepted: 07/13/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate feasibility and reproducibility of fetal transcerebellar diameter measurement during second and third trimester ultrasound mass screening by junior and senior physicians. MATERIALS AND METHODS A monocentric prospective study was conducted at the tertiary care teaching hospital in Lyon, including patients undergoing their second or third trimester planned ultrasound exam. For each patient, a resident and a senior practitioner measured each fetal transcerebellar diameter, during a blinded experiment, according to the transcerebellar plane described by the International Society of Ultrasound in Obstetrics and Gynecology. Images have been scored on 4 criteria. The inter-observer variability for transcerebellar diameter and image quality was assessed using an intra-class correlation coefficient. Image quality has been analyzed according to pregnancy term and to fetal presentation. RESULTS Sixty-six patients were included, 44 patients before and 22 patients after 30 weeks. Inter-observer variability of transcerebellar diameter measurement was 0.4%. Inter-observer variability of image quality was 13.5%. Image quality was not significantly different between seniors and residents (P=0.06). Gestational age and fetal presentation did not affect significantly image quality (P=0.42) and (P=0.64) respectively. CONCLUSION Transcerebellar diameter measurement during mass screening is simple and reliable. Posterior fossa abnormalities can be explored through its measurement.
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Affiliation(s)
- C Sciard
- Centre pluridisciplinaire diagnostic prénatal, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - A Lacalme
- Département d'imagerie pédiatrique et fœtale, hôpital Femme-Mère-Enfants, Lyon, France
| | - D Combourieu
- Centre pluridisciplinaire diagnostic prénatal, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - P Gaucherand
- Centre pluridisciplinaire diagnostic prénatal, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - C Lajeunesse
- Centre pluridisciplinaire diagnostic prénatal, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - J Massardier
- Centre pluridisciplinaire diagnostic prénatal, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - L Guibaud
- Département d'imagerie pédiatrique et fœtale, hôpital Femme-Mère-Enfants, Lyon, France
| | - M Massoud
- Centre pluridisciplinaire diagnostic prénatal, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69677 Lyon-Bron, France.
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Lacalm A, Nadaud B, Massoud M, Putoux A, Gaucherand P, Guibaud L. Prenatal diagnosis of cobblestone lissencephaly associated with Walker-Warburg syndrome based on a specific sonographic pattern. Ultrasound Obstet Gynecol 2016; 47:117-122. [PMID: 26315758 DOI: 10.1002/uog.15735] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 05/30/2015] [Revised: 08/18/2015] [Accepted: 08/21/2015] [Indexed: 06/04/2023]
Abstract
We report a specific sonographic cerebral pattern of cobblestone lissencephaly (CL) that has not been described previously. This pattern was encountered in four index cases and allowed prenatal diagnosis of CL associated with Walker-Warburg syndrome. The pattern included both an outer echogenic band with reduced pericerebral space, corresponding to an infra- and supratentorial extracortical layer of neuroglial overmigration on pathological examination, and a 'Z'-shaped appearance of the brainstem. This pattern was found as early as 14 weeks' gestation in one of our cases.
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Affiliation(s)
- A Lacalm
- Département d'Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - B Nadaud
- Laboratoire de Pathologie, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - M Massoud
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - A Putoux
- Département de Génétique, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - P Gaucherand
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - L Guibaud
- Département d'Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Lyon-Bron, France
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Lyon-Bron, France
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14
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Bolze PA, Massardier J, Buénerd A, Thivolet Béjui F, Perrin C, Rouvet I, Sanlaville D, Mazé MC, Dufay N, Gaucherand P, Chêne G, Hajri T, Golfier F. [Elaboration of a national biobank for the study of gestational trophoblastic diseases]. ACTA ACUST UNITED AC 2015; 45:559-62. [PMID: 26323857 DOI: 10.1016/j.jgyn.2015.07.006] [Citation(s) in RCA: 3] [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: 02/09/2015] [Revised: 07/02/2015] [Accepted: 07/13/2015] [Indexed: 11/26/2022]
Abstract
AIM To generate a national biobank made up of samples of the highest quality for the purpose of inciting basic research on gestational trophoblastic diseases (GTD). MATERIAL AND METHODS Three priority axes of research were defined to optimize the nature, method of collection, and storage of the samples. These are: to enhance our understanding of GTD, develop new diagnostic tests, and identify new therapeutic targets. The protocol for patient inclusion and sample processing was determined after extensive literature review and collaboration with international experts in the field of GTD. RESULTS For each patient with a GTD and for control patients (legally induced abortions), chorionic villi, decidua and tumor samples (fresh, immersed in RNA-protective solution and fixed in formaldehyde), blood (serum, plasma, RNA, and peripheral blood mononuclear cells), urine (supernatant), and cell cultures of villous cytotrophoblasts are prospectively collected. Associations are then made between the collected samples and numerous clinical and biological data, such as human chorionic gonadotropic plasma levels following curettage in the case of a hydatidiform mole. CONCLUSION Such a collection of high quality samples and their associated data open up new perspectives for both national and international collaborative research projects.
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Affiliation(s)
- P-A Bolze
- Service de chirurgie gynécologique et oncologique, obstétrique, université Lyon 1, CHU Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, bâtiment 3B, 69495 Pierre-Bénite, France; Centre français de référence des maladies trophoblastiques, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, bâtiment 3B, 69495 Pierre-Bénite, France.
| | - J Massardier
- Centre français de référence des maladies trophoblastiques, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, bâtiment 3B, 69495 Pierre-Bénite, France; Centre pluridisciplinaire de diagnostic anténatal, groupement hospitalier Est, hôpital Femme-Mère-Enfant, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - A Buénerd
- Service d'anatomie et cytologie pathologiques, centre de biologie et de pathologie Est, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - F Thivolet Béjui
- Service d'anatomie et cytologie pathologiques, centre de biologie et de pathologie Est, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France; CardioBioTec, centre de biologie et de pathologie Est, centre de ressources biologiques des hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - C Perrin
- Service d'anatomie et cytologie pathologiques, centre de biologie et de pathologie Est, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France; CardioBioTec, centre de biologie et de pathologie Est, centre de ressources biologiques des hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - I Rouvet
- Laboratoire de cytogénétique constitutionnelle, centre de biologie et de pathologie Est, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France; CBCBioTec, centre de biologie et de pathologie Est, centre de ressources biologiques des hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - D Sanlaville
- Laboratoire de cytogénétique constitutionnelle, centre de biologie et de pathologie Est, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France; Centre de ressources biologiques des hospices civils de Lyon, 3, quai des Céléstins, 69002 Lyon, France
| | - M-C Mazé
- Centre de ressources biologiques des hospices civils de Lyon, 3, quai des Céléstins, 69002 Lyon, France; Direction de la recherche clinique et de l'innovation, hospices civils de Lyon, 3, quai des Céléstins, 69002 Lyon, France
| | - N Dufay
- Centre de ressources biologiques des hospices civils de Lyon, NeuroBioTec, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69500 Bron, France
| | - P Gaucherand
- Centre pluridisciplinaire de diagnostic anténatal, groupement hospitalier Est, hôpital Femme-Mère-Enfant, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France; Service d'obstétrique, groupement hospitalier Est, hôpital Femme-Mère-Enfant, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - G Chêne
- Service de gynécologie, groupement hospitalier Est, hôpital Femme-Mère-Enfant, université Lyon 1, hospices civils de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - T Hajri
- Centre français de référence des maladies trophoblastiques, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, bâtiment 3B, 69495 Pierre-Bénite, France
| | - F Golfier
- Service de chirurgie gynécologique et oncologique, obstétrique, université Lyon 1, CHU Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, bâtiment 3B, 69495 Pierre-Bénite, France; Centre français de référence des maladies trophoblastiques, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, bâtiment 3B, 69495 Pierre-Bénite, France
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15
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Bricca P, Guinchard E, Meyer F, Garin L, Doret M, Chassard D, Gaucherand P. Cas d’une grossesse à risque hémorragique de groupe sanguin rare GE : –2 et immunisée : risque d’impasse transfusionnelle et stratégie de la prise en charge à l’Hôpital Femme–Mère-Enfant (HCL). Transfus Clin Biol 2014. [DOI: 10.1016/j.tracli.2014.08.117] [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: 10/24/2022]
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16
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Massoud M, Cagneaux M, Garel C, Varene N, Moutard ML, Billette T, Benezit A, Rougeot C, Jouannic JM, Massardier J, Gaucherand P, Desportes V, Guibaud L. Prenatal unilateral cerebellar hypoplasia in a series of 26 cases: significance and implications for prenatal diagnosis. Ultrasound Obstet Gynecol 2014; 44:447-454. [PMID: 24185815 DOI: 10.1002/uog.13217] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 05/26/2013] [Revised: 09/13/2013] [Accepted: 09/16/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To define imaging patterns of unilateral cerebellar hypoplasia (UCH), discuss possible pathophysiological mechanisms and underline the etiology and prognosis associated with these lesions. METHODS In this retrospective study we reviewed the charts of 26 fetuses diagnosed between 2003 and 2011 with UCH, defined by asymmetrical cerebellar hemispheres with or without decreased transverse cerebellar diameter. The review included analysis of the anatomy of the cerebellar hemispheres, including foliation, borders and parenchymal echogenicity, and of the severity of the hypoplasia. Data from clinical and biological work-up and follow-up were obtained. RESULTS Our series could be divided into two groups according to whether imaging features changed progressively or remained constant during follow-up. In Group 1 (n = 8), the progression of imaging features, echogenic cerebellar changes and/or hyposignal in T2*-weighted MR images were highly suggestive of ischemic/hemorrhagic insult. In Group 2 (n = 18), imaging features remained constant during follow-up; UCH was associated with abnormal foliation in three proven cases of clastic lesions, a cystic lesion was noted in three cases of PHACE (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac abnormalities/aortic coarctation, eye abnormalities) syndrome and, in the remaining cases, UCH remained unchanged, with no imaging pattern typical of hemorrhage. In 24 cases the infant was liveborn and follow-up was continued in 23, for a mean period of 3 years. Among these, neurological complications were identified in seven (in one of seven (at a mean of 46 months) in Group 1 and in six of 16 (at a mean of 35 months) in Group 2). The surface loss of cerebellar hemisphere was > 50% in 19/24 fetuses and the vermis was clearly normal in appearance in 19/24. Predisposing factors for fetal vascular insult were identified in eight cases: these included maternal alcohol addiction, diabetes mellitus, congenital cytomegalovirus infection and pathological placenta with thrombotic vasculopathy and infarctions. CONCLUSION UCH is defined as a focal lesion of the cerebellum that may be secondary to hemorrhage and/or ischemic insult, suggesting a clastic origin, particularly when imaging follow-up reveals changes over time. UCH may also be a clue for the prenatal diagnosis of PHACE syndrome. The amount of surface loss of cerebellar hemisphere does not correlate with poor prognosis. UCH with normal vermis is often associated with normal outcome.
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Affiliation(s)
- M Massoud
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon I, Lyon, France
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17
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Vinurel N, Van Nieuwenhuyse A, Cagneaux M, Garel C, Quarello E, Brasseur M, Picone O, Ferry M, Gaucherand P, des Portes V, Guibaud L. Distortion of the anterior part of the interhemispheric fissure: significance and implications for prenatal diagnosis. Ultrasound Obstet Gynecol 2014; 43:346-352. [PMID: 23640781 DOI: 10.1002/uog.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 01/06/2013] [Revised: 04/07/2013] [Accepted: 04/25/2013] [Indexed: 06/02/2023]
Abstract
In order to illustrate the significance of a new anatomical finding, distortion of the interhemispheric fissure (DIHF) associated with impacted medial borders of the frontal lobes, we report a retrospective observational study of 13 fetuses in which DIHF was identified on prenatal imaging. In 10 cases there were associated anatomical anomalies, including mainly midline anomalies (syntelencephaly (n=2), lobar holoprosencephaly (n=1), Aicardi syndrome (n=2)), but also schizencephaly (n=1), cortical dysplasia (n=1) and more complex cerebral malformations (n=3), including neural tube defect in two cases. Chromosomal anomaly was identified in two cases, including 6p deletion in a case without associated central nervous system anomalies and a complex mosaicism in one of the cases with syntelencephaly. In two cases, the finding was apparently isolated on both pre- and postnatal imaging, and the children were doing well at follow-up, aged 4 and 5 years. The presence of DIHF on prenatal imaging may help in the diagnosis of cerebral anomalies, especially those involving the midline. If DIHF is apparently isolated on prenatal ultrasound, magnetic resonance imaging is recommended for careful analysis of gyration and midline, especially optic and olfactory structures. Karyotyping is also recommended.
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Affiliation(s)
- N Vinurel
- Département d'Imagerie Pédiatrique et Foetale, Hôpital Femme Mère Enfant, Lyon Bron, France
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18
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Maillet L, Rudigoz RC, Buffin R, Massardier J, Gaucherand P, Huissoud C. [Neonatal outcome of fetal hyperechogenic bowel]. ACTA ACUST UNITED AC 2014; 42:383-6. [PMID: 24533992 DOI: 10.1016/j.gyobfe.2014.01.006] [Citation(s) in RCA: 3] [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: 01/07/2013] [Accepted: 11/25/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Echogenic bowel (EB) represents 1 % of pregnancy and is a risk factor of fetal pathology (infection, cystic fibrosis, aneuploidy). The aim of our study was to determine the fetuses' outcomes with isolated EB. PATIENTS AND METHODS This is a retrospective study of all patients who presented singleton gestations with a fetal isolated echogenic bowel between 2004 and 2011 in two prenatal diagnosis centers. Search of aneuploidy, infection and cystic fibrosis was systematically proposed as well as an ultrasound monitoring. RESULTS On 109 fetus addressed for isolate echogenic bowel five had other signs associated and 74 had a real isolated echogenic bowel (without dilatation, calcification, intrauterine growth restriction). In 30 cases, the EB was not found. Eighty-five percent of the patients had in the first trimester a screening for trisomy 21. None fetus with isolated EB had trisomy, infection or cystic fibrosis. One fetus died in utero and one newborn died of a metabolic disease without digestive repercussions. DISCUSSION AND CONCLUSION The risk of trisomy 21 and the risk to have a serious disease appear low for the fetus with EB. It does not seem necessary to propose a systematic amniocentesis in case of isolated echogenic bowel.
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Affiliation(s)
- L Maillet
- Service de gynécologie-obstétrique, hospices civils de Lyon, hôpital de la Croix-Rousse, 104, grande rue de la Croix-Rousse, 69004 Lyon cedex 04, France.
| | - R C Rudigoz
- Service de gynécologie-obstétrique, hospices civils de Lyon, hôpital de la Croix-Rousse, 104, grande rue de la Croix-Rousse, 69004 Lyon cedex 04, France; Université Claude-Bernard - Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 08, France
| | - R Buffin
- Service de gynécologie-obstétrique, hospices civils de Lyon, hôpital de la Croix-Rousse, 104, grande rue de la Croix-Rousse, 69004 Lyon cedex 04, France
| | - J Massardier
- Service de gynécologie-obstétrique, hospices civils de Lyon, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69500 Bron, France
| | - P Gaucherand
- Service de gynécologie-obstétrique, hospices civils de Lyon, hôpital Femme-Mère-Enfants, 59, boulevard Pinel, 69500 Bron, France
| | - C Huissoud
- Service de gynécologie-obstétrique, hospices civils de Lyon, hôpital de la Croix-Rousse, 104, grande rue de la Croix-Rousse, 69004 Lyon cedex 04, France; Inserm U846, Stem Cell and Brain Research Institute, 18, avenue Doyen-Lepine, 69500 Bron, France; UMR-S 846, université Lyon 1, 69003 Lyon, France
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19
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Cagneaux M, Vasiljevic A, Massoud M, Allias F, Massardier J, Gaucherand P, Guibaud L. Severe second-trimester obstructive ventriculomegaly related to disorders of diencephalic, mesencephalic and rhombencephalic differentiation. Ultrasound Obstet Gynecol 2013; 42:596-602. [PMID: 23371522 DOI: 10.1002/uog.12427] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [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: 12/01/2012] [Revised: 01/16/2013] [Accepted: 01/17/2013] [Indexed: 06/01/2023]
Abstract
By review of a series of cases, we set out to identify sonographic features suggestive of an obstructive mechanism in second-trimester fetuses with ventriculomegaly and describe developmental disorders related to pathological differentiation of the diencephalon, mesencephalon and rhombencephalon that lead to obstruction of cerebrospinal fluid flow. We studied retrospectively 11 fetuses referred for severe second-trimester ventriculomegaly of undetermined origin. Neurosonography was performed with detailed analysis of the third ventricle, thalami, cerebral aqueduct and cerebellum. The cerebral imaging data were compared with neuropathological data in eight patients, with a focus on the level and etiology of the obstruction. Parenchymal thinning and reduction of the pericerebral spaces were highly suggestive of ventriculomegaly due to an obstructive mechanism. The ventriculomegaly was related to diencephalosynapsis (thalamic fusion and third ventricle atresia) in five cases and partial/complete aqueduct stenosis in six; it was associated with cerebellar hypoplasia in six cases, including rhombencephalosynapsis in two cases. In nine patients, disorders of the diencephalon, mesencephalon and rhombencephalon were present. In cases of severe isolated ventriculomegaly in which sonographic features are suggestive of an obstructive mechanism, close examination of the third ventricle, thalami, aqueduct of Sylvius and cerebellum may reveal pathological differentiation of the diencephalon, mesencephalon or rhombencephalon, often in combination.
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Affiliation(s)
- M Cagneaux
- Département d'Imagerie Pédiatrique et Foetale, Université Claude Bernard Lyon I, Hôpital Femme Mère Enfant, Lyon-Bron, France; Centre Pluridisciplinaire de Diagnostic Prénatal, Université Claude Bernard Lyon I, Hôpital Femme Mère Enfant, Lyon-Bron, France
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20
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Chicaud B, Massoud M, Vasiljevic A, Van Nieuwenhuyse A, Massardier J, Guibaud L, Gaucherand P, Bouvier R. Dysplasie rénale plurikystique de forme hydronéphrotique avec atrésie fibro-inflammatoire de la jonction pyélo-urétérale : une forme atypique d’obstruction haute des voies excrétrices urinaires. Ann Pathol 2012. [DOI: 10.1016/j.annpat.2012.09.097] [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: 10/27/2022]
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21
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Huoi C, Casalegno JS, Bénet T, Neuraz A, Billaud G, Eibach D, Mekki Y, Rudigoz R, Massardier J, Huissoud C, Massoud M, Gaucherand P, Claris O, Gillet Y, Floret D, Lina B, Vanhems P. A report on the large measles outbreak in Lyon, France, 2010 to 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.36.20264-en] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- C Huoi
- Infection Control Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - J S Casalegno
- Virology Department, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - T Bénet
- Epidemiology and Public Health Group, CNRS UMR 5558, University of Lyon 1, Lyon, France
- Infection Control Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - A Neuraz
- Infection Control Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - G Billaud
- Virology Department, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - D Eibach
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Y Mekki
- Virology Department, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - R Rudigoz
- Gynecology Obstetrics Department, Hospices Civils de Lyon, Lyon, France
| | - J Massardier
- Gynecology Obstetrics Department, Hospices Civils de Lyon, Lyon, France
| | - C Huissoud
- Gynecology Obstetrics Department, Hospices Civils de Lyon, Lyon, France
| | - M Massoud
- Gynecology Obstetrics Department, Hospices Civils de Lyon, Lyon, France
| | - P Gaucherand
- Gynecology Obstetrics Department, Hospices Civils de Lyon, Lyon, France
| | - O Claris
- Pediatrics Department, Hospices Civils de Lyon, Lyon, France
| | - Y Gillet
- Pediatrics Department, Hospices Civils de Lyon, Lyon, France
| | - D Floret
- Pediatrics Department, Hospices Civils de Lyon, Lyon, France
| | - B Lina
- Virology Department, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - P Vanhems
- Epidemiology and Public Health Group, CNRS UMR 5558, University of Lyon 1, Lyon, France
- Infection Control Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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22
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Huoi C, Casalegno JS, Bénet T, Neuraz A, Billaud G, Eibach D, Mekki Y, Rudigoz R, Massardier J, Huissoud C, Massoud M, Gaucherand P, Claris O, Gillet Y, Floret D, Lina B, Vanhems P. A report on the large measles outbreak in Lyon, France, 2010 to 2011. Euro Surveill 2012; 17:20264. [PMID: 22971330] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
In 2010 and 2011, the city of Lyon, located in the Rhône-Alpes region (France), has experienced one of the highest incidences of measles in Europe. We describe a measles outbreak in the Lyon area, where cases were diagnosed at Lyon University hospitals (LUH) between 2010 and mid-2011. Data were collected from the mandatory notification system of the regional public health agency, and from the virology department of the LUH. All patients and healthcare workers who had contracted measles were included. Overall, 407 cases were diagnosed, with children of less than one year of age accounting for the highest proportion (n=129, 32%), followed by individuals between 17 and 29 years-old (n=126, 31%). Of the total cases, 72 (18%) had complications. The proportions of patients and healthcare workers who were not immune to measles were higher among those aged up to 30 years. Consequently, women of childbearing age constituted a specific population at high risk to contract measles and during this outbreak, 13 cases of measles, seven under 30 years-old, were identified among pregnant women. This study highlights the importance of being vaccinated with two doses of measles vaccine, the only measure which could prevent and allow elimination of the disease.
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Affiliation(s)
- C Huoi
- Infection Control Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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Massoud M, Clerc J, Cagneux M, Vasiljevic A, Massardier J, Doret M, Gaucherand P, Des Portes V, Guibaud L. Prenatal diagnosis of cerebellar cortical dysplasia associated with abnormalities of foliation. Ultrasound Obstet Gynecol 2012; 40:243-244. [PMID: 22689128 DOI: 10.1002/uog.11210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- M Massoud
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon I, Lyon, France
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Journet D, Gaucherand P, Doret M. [Adding parity to the Bishop score for term labor induction: a retrospective study]. J Gynecol Obstet Hum Reprod 2012; 41:339-345. [PMID: 22560659 DOI: 10.1016/j.jgyn.2012.03.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 03/14/2012] [Accepted: 03/28/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the interest to add parity to the Bishop score before induction of labor by intravenous oxytocin. PATIENTS AND METHODS This retrospective cohort study compared cesarean section rate for induction failure by intravenous oxytocin in nulliparous and multiparous with modified Bishop score from 7 to 9. The modified Bishop score is calculated by adding 2 points to the Bishop score if the patient had a previous vaginal delivery and 0 point in nulliparous. RESULTS Over 2 years, 468 patients were included (201 nulliparous and 267 multiparous). Cesarean section rate for induction failure was higher for nulliparous with a modified Bishop score equal to 7 or varying between 7 and 9. These results confirm that parity is an important predicting factor of successful labor induction. In multiparous, cesarean section rates for induction failure were not significantly different with Bishop score or modified Bishop score equal to 7. CONCLUSION Adding 2 points for multiparity at the Bishop score did not increase cesarean for failure of labor induction with intravenous oxytocin with a modified Bishop score from 7 to 9.
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Affiliation(s)
- D Journet
- Service d'obstétrique, université Lyon-1, hôpital Femme-mère-enfant, hospices civils de Lyon, 59 boulevard Pinel, Lyon, France
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Roux-Chevalier M, Gaucherand P, Cluze C. La version par manœuvre externe : audit sur un an dans une maternité de niveau 3. ACTA ACUST UNITED AC 2011; 39:346-50. [DOI: 10.1016/j.gyobfe.2011.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Accepted: 01/24/2011] [Indexed: 11/28/2022]
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Abstract
Per partum fetal asphyxia is a major cause of neonatal morbidity and mortality. Fetal heart rate monitoring plays an important role in early detection of acidosis, an indicator for asphyxia. This problem is addressed in this paper by introducing a novel complexity analysis of fetal heart rate data, based on producing a collection of piecewise linear approximations of varying dimensions from which a measure of complexity is extracted. This procedure specifically accounts for the highly non-stationary context of labor by being adaptive and multiscale. Using a reference dataset, made of real per partum fetal heart rate data, collected in situ and carefully constituted by obstetricians, the behavior of the proposed approach is analyzed and illustrated. Its performance is evaluated in terms of the rate of correct acidosis detection versus the rate of false detection, as well as how early the detection is made. Computational cost is also discussed. The results are shown to be extremely promising and further potential uses of the tool are discussed. MATLAB routines implementing the procedure will be made available at the time of publication.
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Roux M, Fichez A, Roth P, Gaucherand P. [Ogilvie's syndrome after cesarean section: A case report]. Gynecol Obstet Fertil 2011; 39:e15-e19. [PMID: 21183385 DOI: 10.1016/j.gyobfe.2010.08.006] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Accepted: 10/21/2009] [Indexed: 05/30/2023]
Abstract
Ogilvie's syndrome is a rare postsurgical complication. The high mortality rate (normally 15 to 31% and up to 45% after caecal perforation) explains the seriousness of this clinical situation. The early diagnosis is made by plain abdominal X-ray. Conservative treatment is usually effective and surgery should be reserved for complicated cases or refractory to conservative treatment. We report a case of Ogilvie's syndrome after cesarean section, which has been treated by conservative methods.
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Affiliation(s)
- M Roux
- Maternité de l'hôpital Édouard-Herriot, Lyon, France.
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Peyrière MP, Roth P, Combourieu D, Vavasseur C, Bouvier R, Guibaud L, Gaucherand P. [Aetiology and prognosis of prenatally diagnosed megacystis regarding gestational age at discovery. A six-year retrospective study]. Gynecol Obstet Fertil 2010; 38:663-667. [PMID: 21035372 DOI: 10.1016/j.gyobfe.2010.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The purpose of this study is to describe the diagnosis, the care and the prognosis of the fetuses with an antenataly diagnosed megacystis. PATIENTS AND METHODS Six year retrospective study about 46 cases of megacystis (26 diagnosed during 1st trimester; 14 during 2nd trimester; 9 during 3rd trimester) referred in the prenatal fetal medicine unit of the Femme-Mère-Enfant hospital in Lyon (France). RESULTS The main aetiology is urethral occlusion, particularly for megacystis discovered during the 1st and the 2nd trimesters. Twenty-two terminations of pregnancy were performed (47.8%) and 6 pregnancies arrested spontaneously (13%). Eighteen children were born alive, but 2 died in neonatal period. Finally, 16 children survived (34.8%). Chromosomal abnormalities are frequent (22%). DISCUSSION AND CONCLUSION Antenatal discovery of a megacystis is a complex situation, and often of poor fetal prognosis. It requires a multidisciplinary approach to allow the concerned couple to be determined on the best care of this pregnancy.
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Affiliation(s)
- M-P Peyrière
- Service d'obstétrique, centre pluridisciplinaire de diagnostic prénatal, hôpital Femme-Mère-Enfant, 69500 Bron, France
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Doret M, Constans A, Gaucherand P. Bases physiologiques de l’analyse du rythme cardiaque fœtal au cours du travail. ACTA ACUST UNITED AC 2010; 39:276-83. [DOI: 10.1016/j.jgyn.2010.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 01/04/2010] [Accepted: 01/12/2010] [Indexed: 11/15/2022]
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Bloc F, Dupuis O, Massardier J, Gaucherand P, Doret M. Abuse-t-on des césariennes en extrême urgence ? ACTA ACUST UNITED AC 2010; 39:133-8. [DOI: 10.1016/j.jgyn.2009.12.006] [Citation(s) in RCA: 6] [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: 09/07/2009] [Revised: 12/06/2009] [Accepted: 12/15/2009] [Indexed: 10/20/2022]
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Abry P, Wendt H, Jaffard S, Helgason H, Goncalves P, Pereira E, Gharib C, Gaucherand P, Doret M. Methodology for multifractal analysis of heart rate variability: from LF/HF ratio to wavelet leaders. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2010:106-109. [PMID: 21095647 DOI: 10.1109/iembs.2010.5626124] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The present contribution aims at proposing a comprehensive and tutorial introduction to the practical use of wavelet Leader based multifractal analysis to study heart rate variability. First, the theoretical background is recalled. Second, practical issues and pitfalls related to the selection of the scaling range or statistical orders, minimal regularity, parabolic approximation of spectrum and parameter estimation, are discussed. Third, multifractal analysis is connected explicitly to other standard characterizations of heart rate variability: (mono)fractal analysis, Hurst exponent, spectral analysis and the HF/LF ratio. This review is illustrated on real per partum fetal ECG data, collected at an academic French public hospital, for both healthy fetuses and fetuses suffering from acidosis.
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Massoud M, Giannesi A, Amabile N, Manevy M, Geron G, Gaucherand P. Fetal electrocardiotocography in labor and neonatal outcome: An observational study in 1889 patients in the French center of Edouard Herriot, Lyon. J Matern Fetal Neonatal Med 2009; 20:819-24. [DOI: 10.1080/14767050701580564] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mekki Y, Faure AC, Casalegno JS, Billaud G, Lina B, Gaucherand P, Rudiguoz RC. V-07 Infections materno-fœtale à Parvovirus B19 : expérience de 2005 à 2009 aux hospices civils de Lyon. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74323-9] [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: 11/15/2022]
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Clerc J, Gaucherand P, Berland M, Dupuis O. [Perinatal transfers: survey to evaluate the satisfaction degree of obstetricians and pediatricians with the Rhône-Alpes regional hotline center]. ACTA ACUST UNITED AC 2009; 37:222-8. [PMID: 19261505 DOI: 10.1016/j.gyobfe.2009.01.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 01/08/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In 2006, the Ministry of Health issued a legal text relating to organization of maternal transports: "By the end of the year 2008, transfers of women and new-born babies will have to be treated in a centralized way", have to provide a 24 hours service and can take several forms such as a regional transfer center, working for several perinatal network or a simple hotline within the level 3 maternity hospital of the perinatal network and would be managed by efficiently trained professionals. In order to help professionals to choose between various types of organizations, we considered to evaluate their degree of satisfaction with the Rhône-Alpes regional hotline center. PATIENTS AND METHODS A postal survey was carried out 15 months after the creation of the regional hotline center to the 146 obstetricians and neonatologists of the perinatal network. Eight questions dealt with the following points: organization of in utero transfers and retransfers for obstetricians on the one hand, and the organization of neonatal transfers and retransfers for pediatricians on the other hand.Moreover, several questions relating to the communication quality and the global transport organization were asked to all of these professionals. Finally, practitioners were asked whether the regional hotline center should carry on its activity or not. RESULTS The response rate was 51%. Seventy-two percent of practitioners considered the regional hotline center improved the communication between professionals. 66,7% thought that it improved the organization of transport. Obstetricians get benefits in 91,7% of in utero transfers and in 63,8% of retransfers. Neonatologists get benefits in 92,3% of new born babies' transfers and in 53,8% of retransfers. Finally, 85,3% of the doctors felt that the regional hotline center was time saving and 96% of them felt that this structure should carry on its activity. DISCUSSION AND CONCLUSION In the French Rhône-Alpes region, most obstetricians and pediatricians are satisfied by a regional hotline center dedicated to in utero as well as neonate transfer.
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Affiliation(s)
- J Clerc
- Service de gynécologie-obstétrique, centre hospitalier Lyon-Sud, Pierre-Bénite, France.
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Raboisson M, Samson C, Ducreux C, Rudigoz R, Gaucherand P, Bouvagnet P, Bozio A. Impact of prenatal diagnosis of transposition of the great arteries on obstetric and early postnatal management. Eur J Obstet Gynecol Reprod Biol 2009; 142:18-22. [DOI: 10.1016/j.ejogrb.2008.09.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 07/03/2008] [Accepted: 09/04/2008] [Indexed: 11/27/2022]
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Rolin M, Pérard L, Hot A, Simon M, Desmurs H, Gaucherand P, Girard-Madoux M, Durieu I, Seve P, Coppere B, Ninet J. Étude de 131grossesses chez 36patientes présentant un syndrome des anticorps antiphospholipides : évolution, traitement et facteurs prédictifs de gravité obstétricale. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.052] [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: 10/21/2022]
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Massardier J, Roth P, Michel-Calemard L, Rudigoz RC, Bouvier R, Dijoud F, Arnould P, Combourieu D, Gaucherand P. Campomelic dysplasia: echographic suspicion in the first trimester of pregnancy and final diagnosis of two cases. Fetal Diagn Ther 2008; 24:452-7. [PMID: 19033726 DOI: 10.1159/000176299] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 12/18/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Campomelic dysplasia (CD) is a rare skeletal dysplasia characterized by marked femoral and tibial angulations, hypoplasic scapulae, normal upper limbs and sex reversal in 3/4 of 46,XY fetuses. Most cases are lethal in the neonatal period. Heterozygous mutations in the SOX9 gene are responsible for CD. The diagnosis is not usually made until the mid-second trimester or later. METHODS We describe 2 cases of CD suspected by ultrasonography in the first trimester. RESULTS The 2 cases presented with hygroma colli along with anomalies in the lower but not the upper limbs. Terminations of pregnancy were obtained at 14+3 and 20+6 gestational weeks. Fetopathological examinations confirmed sonographic findings. CONCLUSION When first trimester hygroma colli is accompanied by specific findings of the lower limbs, the diagnosis of CD can be investigated through SOX9 mutation analysis.
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Affiliation(s)
- J Massardier
- Université de Lyon, Lyon, Hospices Civils de Lyon, Unités de Diagnostic Anténatal, Lyon, France.
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Doret M, Gaucherand P. Suture péritonéale ou non au cours de la césarienne en 2008 ? ACTA ACUST UNITED AC 2008; 37:463-8. [DOI: 10.1016/j.jgyn.2008.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 12/14/2007] [Accepted: 03/11/2008] [Indexed: 01/19/2023]
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Guibaud L, Selleret L, Larroche JC, Buenerd A, Alias F, Gaucherand P, Des Portes V, Pracros JP. Abnormal Sylvian fissure on prenatal cerebral imaging: significance and correlation with neuropathological and postnatal data. Ultrasound Obstet Gynecol 2008; 32:50-60. [PMID: 18570201 DOI: 10.1002/uog.5357] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To illustrate and determine the significance of abnormal Sylvian fissure development (or abnormal operculization) in cases in which prenatal cerebral imaging is suggestive of underlying cortical dysplasia. METHODS This was a retrospective study of 15 fetuses at 24-34 weeks in which abnormal operculization was identified on prenatal cerebral imaging and for which follow-up data were available. The imaging findings were correlated to macro- and microscopic neuropathological data (n = 11) or to postnatal clinical and imaging findings (n = 4). RESULTS On microscopic examination of fetuses from 11 terminated pregnancies, abnormal operculization was associated with cortical dysplasia in four cases and the cortex was normal in seven. Abnormal operculization was associated with cortical dysplasia in only one of the four liveborn infants. Cases of abnormal Sylvian fissure development with normal cortical architecture were classified, according to associated anomalies of the central nervous system, into one of five groups: those with neural tube defects, microcephaly or frontal hypoplasia, glutaric aciduria, other cerebral abnormalities, and extracerebral anomalies. CONCLUSION Abnormal operculization on prenatal imaging does not systematically reflect underlying cortical dysplasia. It may be related to extracortical factors such as abnormal cerebral volume or other developmental anomalies of the central nervous system. An understanding of the significance of abnormal Sylvian fissure development could be useful in integrating its analysis into a more general one of the whole central nervous system.
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Affiliation(s)
- L Guibaud
- Imagerie Pédiatrique et Foetale, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon I, Lyon-Bron, France.
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Mellerio C, Marignier S, Roth P, Gaucherand P, des Portes V, Pracros JP, Guibaud L. Prenatal cerebral ultrasound and MRI findings in glutaric aciduria Type 1: a de novo case. Ultrasound Obstet Gynecol 2008; 31:712-714. [PMID: 18470866 DOI: 10.1002/uog.5336] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Tissot Guerraz F, Jaisson-Hot I, Beaumont G, Audra P, Gaucherand P. Le dossier informatisé en obstétrique et les infections nosocomiales (IN). Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.02.107] [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: 10/22/2022] Open
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Abstract
UNLABELLED Laparoscopic adjustable gastric banding and pregnancy. OBJECTIVES We intend to understand the interactions between pregnancy and laparoscopic adjustable gastric banding in order to ensure better care for patients. MATERIALS AND METHOD We undertake an observation retrospective study, from January 2004 to December 2005, at Edouard Herriot hospital, of births from women with laparoscopic adjustable gastric banding with a study of gastric banding interaction with pregnancy, neonatal outcomes and postpartum; we read through literature. RESULTS We studied 35 pregnancies from women with a gastric banding out of 5773 pregnancies (0.6%); we noted lower obstetrical complications with loss of weight that we attributed to the gastric banding comparing with the pregnancies before the gastric banding: three hypertensive diseases and one gestational diabetes had been avoided; we observed a complication due to the gastric banding: occlusive syndrome, which implied gastric banding calibration during immediate postpartum. CONCLUSION Our record folders are in accordance with literature and confirm improvement in obstetrical prognostic. Waiting for stabilization of weight is recommended before starting a pregnancy after gastric banding surgery; the adjustment of the gastric banding during pregnancy must be undertaken individually according to symptoms (vomiting, gain of weight...).
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Affiliation(s)
- J Bienstman-Pailleux
- Service d'obstétrique pavillon K, hôpital Edouard Herriot, 5, place d'Arsonval, 69003 Lyon, France
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Doret M, Pasquier JC, Gharib C, Gaucherand P. [Uterine electromyogram: principle and interest in the diagnosis of preterm labour]. ACTA ACUST UNITED AC 2007; 37:24-32. [PMID: 18036747 DOI: 10.1016/j.jgyn.2007.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 07/10/2007] [Accepted: 08/27/2007] [Indexed: 10/22/2022]
Abstract
Preterm labour diagnosis rely on clinical arguments exhibiting low positive predictive values. Discrimination between uterine contractions leading to preterm delivery and physiologic uterine activity increase throughout pregnancy and remains difficult. Uterine electrical activity can be recorded non-invasively from the abdominal wall and could help in the diagnosis of preterm labour. Electrical signal characteristics are reflecting myometrial cells electrical properties which are varying throughout pregnancy and labour. During pregnancy, uterine electrical activity is very low. During term and preterm labour, uterine electrical activity increases as well as mechanical activity. Bursts become regular with high amplitude. Spectral analysis demonstrates an increase in the frequency content, as represented by the shift of the burst power density spectrum peak frequency from low to high frequencies. Consequently, the electromyogram signal reflects myometrial excitability and allows differentiating powerful uterine contractions leading to delivery from uterine physiologic activity. Moreover, electromyogram signal modifications occur before any increase in mechanical activity in the pregnant rats, allowing identification of preterm labour earlier than uterine mechanical activity measured by intrauterine pressure. Two studies performed in women present with preterm contractions are supporting the potential interest of the uterine electromyogram recording to help in the diagnosis of preterm labour; but further investigations are necessary.
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Affiliation(s)
- M Doret
- Département de gynécologie-obstétrique, hospices civils de Lyon, hôpital Edouard-Herriot, place d'Arsonval, Lyon cedex 03, France.
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Verkauskiene R, Beltrand J, Claris O, Chevenne D, Deghmoun S, Dorgeret S, Alison M, Gaucherand P, Sibony O, Lévy-Marchal C. Impact of fetal growth restriction on body composition and hormonal status at birth in infants of small and appropriate weight for gestational age. Eur J Endocrinol 2007; 157:605-12. [PMID: 17984240 DOI: 10.1530/eje-07-0286] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Fetal growth restriction (FGR) has been related to several health risks, which have been generally identified in small-for-gestational age (SGA) individuals. OBJECTIVE To evaluate the impact of FGR on body composition and hormonal status in infants born either small- or appropriate-for-gestational age (AGA). METHODS Fetal growth was assessed by ultrasound every 4 weeks from mid-gestation to birth in 248 high-risk pregnancies for SGA. Fetal growth velocity was calculated as change in the estimated fetal weight percentiles and FGR defined as its reduction by more than 20 percentiles from 22 gestational weeks to birth. Impact of FGR on body composition, cord insulin, IGF-I, IGF binding protein-3 (IGFBP-3), and cortisol concentrations was assessed in SGA and AGA newborns. RESULTS Growth-retarded AGA infants showed significantly reduced birth weight, ponderal index, percentage of fat mass, and bone mineral density when compared with AGA newborns with stable intrauterine growth. Cord IGF-I and IGFBP-3 concentrations were significantly decreased in growth-retarded infants in both SGA and AGA groups. Cord insulin concentration was significantly lower and cord cortisol significantly higher in AGA infants with FGR versus AGA newborns with stable intrauterine growth. After adjustment for gestational age and gender, birth weight was directly related to fetal growth velocity and cord IGF-I concentration. The variation in infant's adiposity was best explained by fetal growth velocity and cord insulin concentration. CONCLUSIONS FGR affects body composition and hormonal parameters in newborns with birth weight within the normal range, suggesting these individuals could be at similar metabolic risks as SGA. .
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Affiliation(s)
- R Verkauskiene
- INSERM, Unité de recherche U690, Hôpital Robert Debré, 48, bd Serurier, 75019 Paris, France.
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Carrabin N, Cordier MP, Gaucherand P. Traitement par immunoglobulines pendant la grossesse chez deux patientes à risque de récurrence d'hémochromatose néonatale. ACTA ACUST UNITED AC 2007; 36:409-12. [PMID: 17446006 DOI: 10.1016/j.jgyn.2007.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 01/02/2007] [Revised: 02/15/2007] [Accepted: 03/15/2007] [Indexed: 10/28/2022]
Abstract
Two patients, with prior affected children with Neonatal Haemochromatosis [NH], benefited from intravenous immunoglobulin treatment during their following pregnancy in order to prevent recurrent NH. Whereas NH is a severe disease with high risk of recurrence and high mortality rate (about 80%), a recent treatment was suggested in the USA, which seems to completely modify the prognosis of this pathology. We proposed this treatment for two patients with indeed apparent benefit, giving birth to two healthy babies.
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Affiliation(s)
- N Carrabin
- Pavillon K, hôpital Edouard-Herriot, 8, place d'Arsonval, 69008 Lyon, France.
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Pasquier JC, Morelle M, Bagouet S, Moret S, Luo ZC, Rabilloud M, Gaucherand P, Robert-Gnansia E. Effects of residential distance to hospitals with neonatal surgery care on prenatal management and outcome of pregnancies with severe fetal malformations. Ultrasound Obstet Gynecol 2007; 29:271-5. [PMID: 17318944 DOI: 10.1002/uog.3942] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVES To examine the effect of maternal origin and distance between maternal residence and the nearest maternity ward with a neonatal surgical center in the same hospital, on prenatal diagnosis, elective termination of pregnancy, delivery in an adequate place and neonatal mortality for pregnancies with severe malformations requiring neonatal surgery, and to examine the effect of the place of delivery on neonatal mortality. METHODS This was a retrospective study, through the France Central-East malformation registry, of 706 fetuses with omphalocele (n = 123), gastroschisis (n = 99), diaphragmatic hernia (n = 222), or spina bifida (n = 262), but without chromosomal anomalies. Maternal origin was classified as Western European and non-Western European. Adequate place for delivery was defined as birth in a Level-III maternity ward with a neonatal surgical center in the same hospital. RESULTS The prenatal diagnosis rate was 67.7% in 1990-1995 and 80.2% in 1996-2001 (odds ratio (OR), 2.07 (95% CI, 1.24-3.45)). On multivariate analysis, the rate was significantly lower for women living 11-50 km (adjusted OR, 0.49 (95% CI, 0.25-0.94)), or > 50 km (adjusted OR, 0.39 (0.20-0.74)) from the closest adequate place of delivery, compared with those living < 11 km from it, but there was no difference for maternal origin. Non-Western European women had fewer elective terminations of pregnancy (adjusted OR, 0.34 (95% CI, 0.14-0.81)) and fewer deliveries in an adequate place (adjusted OR, 0.40 (95% CI, 0.18-0.89)). Neonatal mortality was lower in the case of delivery in an adequate place (adjusted OR, 0.22 (95% CI, 0.07-0.72)) and was not associated with maternal origin and distance from nearest maternity ward with a neonatal surgical center. CONCLUSION Rate of prenatal diagnosis decreases with increasing distance between parental residence and referral center. Non-Western European women are diagnosed prenatally as often as are Western Europeans, but terminate their pregnancy less often, perhaps for cultural reasons. Non-Western European women with malformed fetuses deliver in adequate centers less often, probably because of the way the perinatal care system is run.
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Affiliation(s)
- J-C Pasquier
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Quebec, Canada.
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Abstract
The Marfan's syndrome is an autosomal dominant genetic disorder resulting in a diminished strength of connective tissue. The ocular, skeletal and cardiovascular systems are mostly at risk. Principal complications of the disease are aortic dilatation and the risk of acute dissection. Pregnancy increases this risk. Based on the experience of our obstetrics department and after reviewing medical literature, we have tried to establish guidelines for obstetric care adapted to pregnant patients affected by Marfan's syndrome. Women with aortic root > 40 mm should avoid pregnancy. In all cases B-adrenergic receptor blockers must be used as soon as possible. Because there is a 50% risk that offspring will inherit the syndrome, prenatal diagnosis should be suggested. In addition to usual pregnancy monitoring, echocardiography should be performed every 3 months as well as 2 months after delivery. No increase of obstetrical complications has been shown in these patients. Route of delivery also depends on the diameter of the aortic root: vaginal delivery is warranted if the aortic root is<40; cesarean section should be performed in the other cases. Thus, with appropriate supervision, women with Marfan's syndrome will tolerate pregnancy without any adverse effect.
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Affiliation(s)
- A Lunel
- Service de Gynécologie Obstétrique, Pavillon K, Hôpital Edouard-Herriot, place d'Arsonval, 69437 Lyon Cedex 03
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Dupuis O, Gaucherand P, Mellier G. Organisation de la cellule des transferts périnatals et taux de transfert périnatal en 2003 et 2004 dans la région Rhône-Alpes. ACTA ACUST UNITED AC 2006; 35:702-10. [PMID: 17088772 DOI: 10.1016/s0368-2315(06)76467-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study aims to describe the organization that was implemented at the Rhône-Alpes perinatal hotline, as well as to describe in utero transfer and neonate transport from an epidemiological point of view. MATERIAL AND METHOD A cohort study was performed between January 2003 and December 2004. Every in utero transfer and neonate transport was included. Transfers performed in 2003 were compared to transfers performed in 2004. Three endpoints were defined: the rate of in utero transfer (number of in utero transfers/number of in utero transfers + number of neonatal transfers), the rate of transfer toward level II units (number of transfers from level I to level II/number of transfers from level I to level II + number of transfers from level I to level III) as well as the rate of intra network transfer (number of intra network transfers/number of intra network transfers + number of extra network transfers). RESULTS In 2003, 865 in utero transfers (IUT) and 1297 neonate transports (NT) were performed, in 2004 848 IUT and 1069 NT were performed. The rate of in utero transfer significantly increased from 40 to 44.2% in 2004 (865/2162 versus 848/1917, p = 0.007). The rate of transfer toward level II units increased for the mothers from 31.8% to 36.9% (177/557 versus 174/471, p = 0.09) and significantly increased for the neonates from 43.2 to 51.6% in 2004 (335/775 versus 327/633, p = 0.002). Finally the rate of intra network transfer has not significantly changed: for the IUT it decreased from 87 to 86% (755/865 versus 732/848, p = 0.59) and for the NT from 91% to 90% (1179/1297 versus 963/1069, p = 0.45). CONCLUSION The organization that was implemented allows not only a safe 24 hour on call management of maternal transfers as well as neonate transport, but also a precise knowledge of epidemiologic indications relative to perinatal transfer.
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Affiliation(s)
- O Dupuis
- Cellule Régionale des transferts périnatals, Hôpital Edouard-Herriot, place d'Arsonval, Lyon Cedex 03.
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Dupuis O, Dupont C, Gaucherand P, Rudigoz RC, Fernandez MP, Peigne E, Labaune JM. Is neonatal neurological damage in the delivery room avoidable? Experience of 33 levels I and II maternity units of a French perinatal network. Eur J Obstet Gynecol Reprod Biol 2006; 134:29-36. [PMID: 17049711 DOI: 10.1016/j.ejogrb.2006.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 12/20/2005] [Revised: 08/10/2006] [Accepted: 09/15/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the frequency of avoidable neonatal neurological damage. STUDY DESIGN We carried out a retrospective study from January 1st to December 31st 2003, including all children transferred from a level I or II maternity unit for suspected neurological damage (SND). Only cases confirmed by a persistent abnormality on clinical examination, EEG, transfontanelle ultrasound scan, CT scan or cerebral MRI were retained. Each case was studied in detail by an expert committee and classified as "avoidable", "unavoidable" or "of indeterminate avoidability." The management of "avoidable" cases was analysed to identify potentially avoidable factors (PAFs): not taking into account a major risk factor (PAF1), diagnostic errors (PAF2), suboptimal decision to delivery interval (PAF3) and mechanical complications (PAF4). RESULTS In total, 77 children were transferred for SND; two cases were excluded (inaccessible medical files). Forty of the 75 cases of SND included were confirmed: 29 were "avoidable", 8 were "unavoidable" and 3 were "of indeterminate avoidability". Analysis of the 29 avoidable cases identified 39 PAFs: 18 PAF1, 5 PAF2, 10 PAF3 and 6 PAF4. Five had no classifiable PAF (0 death), 11 children had one type of PAF (one death), 11 children had two types of PAF (3 deaths), 2 had three types of PAF (2 deaths). CONCLUSION Three quarters of the confirmed cases of neurological damage occurring in levels I and II maternity units of the Aurore network in 2003 were avoidable. Five out of six cases resulting in early death involved several potentially avoidable factors.
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Affiliation(s)
- O Dupuis
- Cellule des Transferts Périnataux de la Région Rhône-Alpes, Hôpital Edouard Herriot, Hospices Civils de Lyon, Place d'Arsonval, 69008 Lyon, France.
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Ducray F, Colin P, Cartalat-Carel S, Pelissou-Guyotat I, Mahla K, Audra P, Gaucherand P, Honnorat J, Trouillas P. Prise en charge des gliomes malins découverts au cours d’une grossesse. Rev Neurol (Paris) 2006; 162:322-9. [PMID: 16585887 DOI: 10.1016/s0035-3787(06)75018-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Glioma is seldom diagnosed during pregnancy. In this situation management presents difficult problems for both neuro-oncologists and obstetricians. We report four cases and discuss the management of this unusual situation. CASE REPORT The first patient was admitted to hospital at 29 weeks' gestation because of a generalized seizure and a right hemiparesis. MRI showed a left fronto-insular lesion. A stereotactic biopsy was obtained and revealed an anaplastic oligodendroglioma. With corticosteroids the patient remained stable until cesarean delivery at 36 weeks. In post-partum additional treatment with chemotherapy was started. The second patient was hospitalized at 26 weeks' gestation because of cranial hypertension, right hemiparesis and aphasia. MRI showed an important left fronto-parietal lesion. Partial resection was performed at 28 weeks. Histology revealed a glioblastoma multiforme. With corticosteroids the patient remained stable until cesarean delivery at 33 weeks. In post-partum additional treatment with radiotherapy and chemotherapy was started. The third patient was admitted to the hospital at 12 weeks' gestation because of cranial hypertension. MRI showed a left frontal lesion. A subtotal resection was done at 13 weeks. Histology revealed a glioblastoma multiforme. Two weeks after surgery the patient's neurological condition worsened and in agreement with the patient a therapeutic abortion was decided. Afterwards additional treatment with radiotherapy and chemotherapy was started. The last patient received combined treatment with radiotherapy and chemotherapy for local recurrence of a mesencephalic high-grade glioma. A posteriori it was discovered that the patient was at 4 months' gestation during this treatment. Cesarean delivery was done at 36 weeks. The child was normal at birth and is still in good health 5 years later. CONCLUSION The management of gliomas diagnosed during pregnancy should not be different from the standard management of gliomas in young non-pregnant adults. Pregnant women because of their young age can have a long survival. Their pregnancy should not prevent them from receiving the best treatment for their glioma. Treatment will depend upon clinico-radiological presentation, histology, gestational age and the patient's desires. Generally speaking, surgical resection of high-grade gliomas should not be delayed during pregnancy. Progress in anesthesia and neurosurgery have greatly reduced the risks for the foetus. After delivery, if the delay between surgery and delivery is too long it is possible to begin cerebral radiotherapy during pregnancy. After the first trimester of gestation this treatment can be given without any important risks for the child.
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MESH Headings
- Abortion, Therapeutic
- Adrenal Cortex Hormones/therapeutic use
- Adult
- Algorithms
- Anesthesia, General
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carbamazepine/therapeutic use
- Carmustine/administration & dosage
- Case Management
- Cesarean Section
- Chemotherapy, Adjuvant
- Cranial Irradiation
- Craniotomy
- Dacarbazine/analogs & derivatives
- Dacarbazine/therapeutic use
- Female
- Frontal Lobe
- Glioblastoma/drug therapy
- Glioblastoma/radiotherapy
- Glioblastoma/surgery
- Glioblastoma/therapy
- Humans
- Infant, Newborn
- Intracranial Hypertension/etiology
- Magnetic Resonance Imaging
- Male
- Neoplasm Recurrence, Local
- Nitrosourea Compounds/administration & dosage
- Nitrosourea Compounds/therapeutic use
- Organophosphorus Compounds/administration & dosage
- Organophosphorus Compounds/therapeutic use
- Paresis/drug therapy
- Paresis/etiology
- Prednisolone/therapeutic use
- Pregnancy
- Pregnancy Complications, Neoplastic/drug therapy
- Pregnancy Complications, Neoplastic/radiotherapy
- Pregnancy Complications, Neoplastic/surgery
- Pregnancy Complications, Neoplastic/therapy
- Prenatal Exposure Delayed Effects
- Radiotherapy, Adjuvant
- Remission Induction
- Supratentorial Neoplasms/drug therapy
- Supratentorial Neoplasms/radiotherapy
- Supratentorial Neoplasms/surgery
- Supratentorial Neoplasms/therapy
- Temozolomide
- Temporal Lobe
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Affiliation(s)
- F Ducray
- Service de Neurologie B, Hôpital Neurologique Pierre-Wertheimer, Lyon
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