We assessed the effectiveness of the home-visiting system in reducing the care provided in maternity units, especially hospitalization, and attempted to establish whether this system increases women's satisfaction with medical care. The trial involved 158 women and was conducted in four maternity units in Paris. A policy of one or two weekly visits by domiciliary midwives was compared with the usual policy of the hospitals. The study was restricted to women with moderate threatened preterm labor between 26 and 36 weeks of gestation. No decrease in the number of women hospitalized or the number of days spent in hospital was observed in the intervention group, but the number of prenatal visits to outpatient clinics was significantly smaller in the intervention than control group. Satisfaction with medical care during the episode of threatened preterm labor was much greater in the intervention group. Home visits by a midwife were considered by the women to be a better care system than numerous outpatient visits or hospitalization. Our results for medical care suggest that the introduction of the home-visiting system did not greatly alter medical practice in the maternity units, although this system had been designed to avoid or reduce hospitalization.

Adult↗

PubMedDate not supplied

[Treatments of sterility and multiple pregnancies in France: analysis and recommendations].

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Embryo Transfer↗

PubMedDate not supplied

Antigenic variation of poliovirus studied by means of monoclonal antibodies.

The natural distribution of poliovirus neutralization epitopes was studied on several field isolates of each of the three serotypes by a neutralization index test for which a panel of homotypic monoclonal antibodies was used. Two categories of neutralization epitopes were detected: strain-specific or variable epitopes, and cross-reacting or common epitopes. The latter tended to be conserved among homotypic viruses. Some of the Sabin-specific neutralization epitopes were found to be mutually exclusive of wild-type epitopes, but coexistence of Sabin-specific and wild-type epitopes was found in other cases. During virus excretion by infants fed type 1 Sabin vaccine, the Sabin-specific neutralization epitope was lost, and sometimes the original epitope motif of the parental wild (Mahoney) virus was recovered. Epitope variation was also expressed by loss of epitope function in virus neutralization without modification of antigenic conformation.

Antibodies, Monoclonal↗

PubMedDate not supplied

Consequences of misdiagnosis of intrauterine growth retardation for preterm elective cesarean section.

We studied the consequences of misdiagnosis of intrauterine growth retardation (IUGR) for preterm elective cesarean section among live singleton newborns in two teaching hospitals in Paris between 1978 and 1983. The population studied comprised the 16,540 babies who were normal for date, according to the 10th percentile of the reference curve established in this population. For 118 of these infants, IUGR had been diagnosed during pregnancy. The preterm elective cesarean section rate was 12.7% among newborns for whom IUGR was erroneously diagnosed, compared to 1.2% among those for whom IUGR was not diagnosed. The relationship between preterm cesarean section and misdiagnosis of IUGR still existed (odds ratio: 5.2, 95% CI: 2.1-12.9) after taking into account obstetric history and hypertension during pregnancy. Our results show that after diagnosis of IUGR, supplementary tests are essential to confirm fetal distress and consequently avoid unnecessary interventions.

Cesarean Section↗

PubMedDate not supplied

[Mortality of children aged 1 to 4 years in the countries of the European Community].

Mortality rates of children aged 1 to 4 years in each country of the European Community were reviewed. Data was drawn from statistics published by the individual countries. Overall, mortality rates were 61 per 100,000 in boys and 51 per 100,000 in girls and are highest in the Republic of Ireland, the FRG and Belgium. Between 1960 and 1980, mortality decreased in all countries and for both sexes; improvement was greatest in the countries where mortality rates were the highest in 1960. Accidents of different types were the main causes of death in each country. Some were related to age group specific behaviour, such as drownings and falls in young children and suffocations in infants. However, most deaths were due to traffic accidents.

Accidents↗

PubMedDate not supplied

[Contraception before pregnancy. Evolution between 1972 and 1975 in the Rhone-Alpes region (author's transl)].

The studies was made from two enquiries carried out on women who delivered in June 1972 and 1975 in the Rhone-Alpes region. Contraception therefore dealt exclusively with birth control before a pregnancy. It is clear that contraception has developed significantly: it is practised by 48% of women who were questioned in 1975 as compared with 41% in 1972. There is also a change in the last method used between the two dates: the pill featured in only 17% of all the method used in 1972 and 45% in 1975: on the other hand coitus interruptus went down from 41% to 21%. The spread of the use of the pill is a generalised phenomenon whereas there are several categories of women who do not seem to have used, coitus interruptus less frequently. As far as the social classes are concerned, it is to be pointed out that only non-skilled working-class people have not changed their habits as far as these two methods are concerned. Contraception is practised with more and more success as a method of birth control: on the one hand the number of conceptions which occurred when the women was using a birth control method has gone down from 27% in 1972 to 15% in 1975: on the other hand 51% of those who used a birth control method stopped using it in order to have a baby, whereas in 1972 only 32% did so. Parallel with this evolution, one can point out that the number of women who have 2 or more children has gone down. On the other hand the number of conceptions before marriage and the rhythm of the way the families are constituted has not changed between the two dates.

Adolescent↗