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Biomedical subjects

B Guidicelli

Publications and source records attributed to B Guidicelli.

7 recordsLinked to original sources
PubMed2006

[Evaluation of controlled-release dinoprostone Propess for labor induction].

OBJECTIVE: To evaluate the efficacy of cervix ripening with vaginal controlled-release Propess. PATIENTS AND METHODS: A retrospective study of all women who underwent cervical ripening with Propess during the study period from 1(st) January 2002 to 31(st) December 2004 was carried out. A total of 130 patients who experienced Propess was compared with the next following patient who delivered spontaneously matched on gestational age. Modes of delivery, failure of labor, maternal morbidity were recorded. RESULTS: Indications for induction of labor were: post-term pregnancies in 18.5%, pre-eclampsia in 20.8%, oligohydroamnios in 18.5%, post-term pregnancy and oligohydramnios in 10.8%, intra-uterine fetal growth in 6.9%, premature rupture of membranes in 6.9%, diminution of fetal mobility in 6.1% and miscellaneous in 11.5%. Failure of cervical ripening was 21.2%. Patients in the Propess group had a 3.5 fold higher risk of Cesarean section [95% CI: 1.5-8.3; P < 0.04]. There was no case of maternal or fetal death. There was no difference in incidence of maternal complications, and post-partum haemorrhage. DISCUSSION AND CONCLUSION: Use of vaginal pessary Propess does not induce adverse maternal or fetal morbidity. However, it was associated with a higher incidence of Cesarean delivery.

Delayed-Action Preparations↗
PubMed2006

[Delivery of a macrosomic infant: factors predictive of failed labor].

OBJECTIVE: To determine risk factors of failed labor in case of fetal macrosomia. MATERIALS AND METHODS: Medical charts of two hundred and forty six women who delivered macrosomic infants (>4,000g) between January 2004 and May 2005 were reviewed. Maternal and obstetrical data were analyzed by mode of delivery. Univariate and multivariate (logistic regression analysis) were performed to identify risk factors of failed labor. RESULTS: Rate of cesarean delivery was 18.3%. Indications for cesarean were: failure to progress in 55.6%, arrest in fetal descent in 22.2%, fetal distress in 6.7%, and other in 8.9%. There was a higher risk of failed labor in nulliparous women (p<0.001), in case of a symphysio-fundal measurements>34cm (p=0.004), in nulliparity associated with symphysio-fundal measurements>34cm (p<0.001), in case of previous cesarean delivery (p=0.004), in cases of maternal height<1.65m (p=0.02), and with ocytocin use (p=0.05). In multivariate analysis, nulliparity associated with symphysio-fundal measurements>34cm (OR=5.2; CI 1.5-18.4), previous cesarean section (OR=3.7; CI 1.1-12.4) and maternal height<1.65m (OR=2.6; CI 1.2-5.5) were independent factors of failed labor. CONCLUSION: Failure of labor in case of macrosomia can be predicted in the event of previous cesarean section, shorter maternal height, and association of nulliparity and symphysio-fundal measurements>34cm.

Adult↗
PubMed2005

Diagnosis and management of adenocarcinoma of the ampulla of Vater during pregnancy.

BACKGROUND: Cancer of the biliary tract has a poor prognosis and its association with pregnancy is uncommon. Early diagnosis allowing curative surgical resection offers the only hope of long-term survival. CASE: This report describes the case of a young 26-week-pregnant woman admitted for cholestatis documented by clinical and laboratory examination. Ultrasonography (US) and magnetic resonance cholangiopancreatography (MRCP) were indicative of common bile tract obstruction. Caesarian section was performed at 32 weeks of pregnancy and the tumor was promptly biopsied. Histology demonstrated carcinoma of the ampulla of Vater. The patient underwent a Whipple procedure. Both mother and baby survived. CONCLUSION: Pregnant patients with digestive cancer require careful management. Acute non-invasive assessment and radical surgery improve outcome for both the mother and fetus.

Adenocarcinoma↗
PubMed1994

[Home delivery].

Home delivery, although unconventional, has not totally disappeared. It sometimes results from the desire to "demedicalise" an event deemed natural and is sometimes the consequence of government policy and hence approved by medical authorities. This is the unique situation of Holland, where a highly efficient home delivery system has been created, with the possibility of transfer of the mother at any time to rapidly available emergency medical teams. In fact the large majority of home deliveries are accidental, unprepared and take place in the absence of any medical or paramedical assistance. All available studies show that perinatal and maternal morbidity associated with these accidental deliveries is greater than that of hospital deliveries, and this despite the setting up of emergency services responding as soon as a distress call is received. Home delivery should remain the exception at present since it is unable to guarantee a birth as undangerous as possible.

Emergencies↗
PubMed1993

[Chorionic villus needle sampling by the transabdominal route or by placental centesis. A series of 930 cases].

The authors report on a series of 930 chorion villus sampling diagnoses made with a needle by the transabdominal route, from January 1991 to October 1992 at the Prenatal Diagnosis Center in Marseille. Indications for prenatal diagnosis were: raised maternal age in 75% of cases (N:698); ultrasound findings in 11% (N:106), chromosome abnormalities in the family in 6% cases (N:53), raised human chorionic gonadotrophin in 4% cases (N:38), parental rearrangement in 2% cases (N:20), and sex linked disease in 1% (N:15). The success rate was 97% with 29 failures; the number of needle insertions was one in 97% cases and two in 3% cases. The average gestational age at sampling was related to the indications; 16 weeks of amenorrhoea for raised maternal age, and 22 weeks of amenorrhoea for ultrasound findings. Thirty one abnormalities were observed, four balanced translocations, and seven placental mosaicisms. Forty eight pregnancies terminated in abortion. The rate of fetal loss was 3.5% (7 cases) for the 200 first cases and 1% (8 cases) for the 730 following cases. Choriocentesis through the transabdominal route provides a diagnosis within a few days and the rate of fetal loss is close to that of amniocentesis. These arguments are in favour of an extension of this method of sampling.

Abortion, Therapeutic↗