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Biomedical subjects

A Fournié

Publications and source records attributed to A Fournié.

At least 19 recordsLinked to original sources
PubMed2002

[Ultrasound monitoring].

Ultrasound investigation is peculiar when pregnancy is complicated by gestational diabetes. One have to study interventricular septal thickness and to predict macrosomia. Before delivery septal thickness should be under 6 mm. Estimated fetal weight (EFW) and abdominal circumference (AC) are accurate to detect macrosomia. Quite all formulas of EFW are not significantly different. An EFW of 4,000 gm have a sensitivity of 45% and positive predictive value of 81% to predict macrosomia. AC >=35 cm have a negative predictive value of 99% and AC >=37 cm have a positive predictive value of 91% to predict an EFW of 4,000 gm. Soft-tissue measurements are used to evaluate the increase of fetal fat body mass. Cheek to cheek diameter, upper arm subcutaneous tissue, shoulder subcutaneous tissue can be used. Three-dimensional ultrasonography may offer volume assess of the thigh or upper arm.

Delivery, Obstetric↗
PubMed2002

[Induce or not induce labor in gestational diabetes].

The most serious hazard of gestational diabetes is shoulder dystocia, which sometimes is complicated by Erb's palsy and maternal lacerations. This risk is linked to fetal weight, and is more frequent in cases of diabetes. So, a caesarean section performed when macrosomia is present is required and an induction of labor before severe macrosomia is proposed. Unfortunately, estimation of fetal weight is imprecise in spite of formulas from fetal parameters. Abdomen circumference (AC) alone is as effective as complex formulas. So, it is proposed to perform an elective section when AC is equal or above 38 cm, and to induce labor, after 38 weeks of gestation, for limiting the risk of macrosomia when AC is between 35 and 38 cm. Induction is also proposed when pregnancy is complicated by hypertension or when fetal heart septal hypertrophy occurs. The management of gestational diabetes means a strict control of glycemia, which can reduce macrosomia and the need for cesarean section or induction of labor.

Birth Injuries↗
PubMed2000

Gel test assay for IgG subclass detection by GM typing: application to hemolytic disease of the newborn.

The gel test assay was evaluated for IgG subclass detection by GM typing of antibodies and compared to the classical inhibition agglutination method on slides or microtiter plates. We used a panel of 5 murine monoclonal antibodies directed against G1M(1), G1M(3), G1M(17), G2M(23), and G3M(21) and 1 human polyclonal anti-G3M(5) antibody. Eleven polyclonal antisera (of immunized women) directed against red blood cells were tested for the GM allotypes carried by their alloantibodies. We controlled the specificity of the gel test reaction using a panel of anti-RH(D) monoclonal antibodies. All reagents exhibited a good reactivity and specificity. They can be used for routine typing. The gel test assay for IgG subclass detection is a specific, simple, and low-cost technique for the detection and management of severe forms of diseases in alloimmunized pregnancies.

Agglutination Tests↗
PubMed2000

[Metrorrhagia during the second trimester of pregnancy: obstetrical and perinatal outcome. A retrospective study including 85 cases].

OBJECTIVE OF THE STUDY: To examine pregnancy outcome in patients with second-trimester vaginal bleeding and to determine a relationship between presumed etiology and perinatal outcome. MATERIAL: and methods: A retrospective study performed in Toulouse La Grave CHU between January 1993 and December 1997 including 85 cases of vaginal bleeding from 15 to 27 week's amenorrhea (90 fetuses). Results are compared to overall deliveries during the same period (14941 deliveries). RESULTS: Mean age at diagnosis is 29.8 years (SD: 5.3 years). Vaginal bleeding in the midtrimester concern 0.57% of deliveries. Abnormal ultrasonographic findings are observed in 73% of patients (placenta previa, subchorionic hematoma, placental abruption) and 81% were hospitalized (mean hospital duration: 18 days). Perinatal mortality was 17.04% and preterm delivery rate 30.6% (vs 11% in the overall patients). Perinatal complications are significatively increased compared with the overall population especially if ultrasonographic examination was abnormal. Second-trimester placental abruption had the worse prognosis. On the other hand, perinatal outcome was comparable when the origin of bleeding was unknown and ultrasonographic examination normal. 41% patients underwent cesarean section. CONCLUSION: Preterm delivery, perinatal mortality and morbidity are increased in patients with second-trimester vaginal bleeding. The risk is higher when abnormalities are detected at ultrasonography making ultrasonography a useful tool for predicting perinatal outcome.

Adolescent↗
PubMed2000

[Drug use during pregnancy: survey in 250 women consulting at a university hospital center].

A prospective study of drug use in pregnancy was performed in the maternity outpatient department of a university hospital in Southwestern France. Two hundred and fifty pregnant women were selected at random and interviewed. Eighty-four percent of the women reported drug consumption, with an average of two medications per week. Some factors were significantly associated with an increase in drug use: European origin, high level of education, medical history, alcohol consumption. The most commonly used drugs were iron (43% of the women), medications for venous disorders (22%) and gynecology (21%) and analgesics (19%). Chronic use (beginning before pregnancy) occurred in 9% of the women. Self medication accounted for around 20% of the women. Adverse effects were described by the women 25 times out of 544 exposures: they concerned 10 drugs and were not "serious". After delivery, 14 cases of malformations of the new-born, three stillbirths, 25 neonatal pathologies and 10 resuscitations were observed. Except one neonatal withdrawal syndrome after "in utero" exposure to benzodiazepines, no relationship between drug exposure and pregnancy outcome could be established.

Adolescent↗
PubMed1999

[Pregnancy and labor of women born in Maghreb and Black Africa followed to delivery at the Maternity Hospital of Toulouse].

OBJECTIVE: To identify risk factors related to maternal ethnic origin. METHODS: Retrospective review of 5808 cases of French, Maghrebian and Black African women who delivered between 1988 and 1994 at the Maternity of La Grave Hospital in Toulouse. RESULTS: Pathological pregnancies were more frequent (60% vs 45%), specifically anemia OR = 10.2[6.3-16.7] and OR = 5.7[4.0-8.3]) and genital infections (OR = 1.7[1.2-2.6] and OR = 1.7[1.4-2.1]) in African and Maghrebian respectively. than in French women. These differences cannot be referred to any classical risk factors but only to the mother's ethnic origin. Moreover, cesarean delivery occurred almost twice as much in African women 34% vs 19%) and no specific medical indication was found to explain this increase. CONCLUSION: Our data concluded that important risk factors were related to the mother's ethnic origin. This finding demonstrates that management of perinatal care and epidemiologic studies should take maternal ethnic origin into account.

Adult↗
PubMed1999

Proposed classification criteria of psoriatic arthritis. A preliminary study in 260 patients.

UNLABELLED: Psoriatic arthritis probably owes to its radioclinical presentation its position as the most controversial and poorly understood of all major chronic inflammatory joint diseases. Differentiating psoriatic arthritis from ankylosing spondylitis and rheumatoid arthritis remains difficult. OBJECTIVE: To conduct a statistical analysis aimed at identifying clinical, radiological, and laboratory criteria for classifying psoriatic arthritis. PATIENTS AND METHODS: 260 patients were studied retrospectively, including 100 cases with psoriatic arthritis and 160 controls with ankylosing spondylitis meeting Amor's criteria (n = 80) or with rheumatoid arthritis meeting American College of Rheumatology criteria (n = 80). Mean disease duration was five years. Thirty-nine variables were recorded for each patient. Multiple logistic regression and discriminant analysis were used to select the classification criteria. RESULTS: Each of the two statistical methods selected the same nine criteria. After assigning a weighting coefficient to each of these criteria, sensitivity and specificity were better with the multiple logistic regression model (95% and 98%, respectively) than with the discriminant analysis model. CONCLUSION: Our classification criteria require further evaluation in multicenter prospective studies.

Adult↗
PubMed1997

[Pelvic actinomycosis abscess and intrauterine device].

A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

Abscess↗
PubMed1997

[Short-term outcome of infants from triplet pregnancies. A series of 45 pregnancies].

OBJECTIVE: To evaluate outcome of triplets pregnancies. METHODS: A retrospective study about children of 45 triplet pregnancies which occurred spontaneously or after assisted reproductive technologies. All were managed by the same obstetrical and pediatric team. RESULTS: Mean birth weight was 1800 g and 26% of children were very low birth weights (< 1500 g). There was no difference in the mean Apgar score of pH between first, second and third infant. Neonatal and perinatal mortality rate were respectively 60 and 75%. Incidence of respiratory distress syndrome was 29%, hyaline membrane disease 11%, intraventricular hemorrhage (grade 4) 1.3%, necrotizing enterocolitis 10.5% and bronchopulmonary dysplasia 4%. Only 10% of the infants were not hospitalized and were kept by their mother. 38% of the newborns had to be hospitalized in a Neonatal Intensive Care Unit, with a mean stay of 6 days. At birth, 34% of the babies required intubation for artificial ventilation. CONCLUSIONS: The main problem of triplet pregnancies is high prematurity.

Apgar Score↗