Search PubMed⌕ Search

Biomedical subjects

C Sureau

Publications and source records attributed to C Sureau.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Fetal telemonitoring].

There is a definite increase in the number of cases in which it is helpful to know about the fetal heart rate. These are: intra-uterine growth retardation whether associated with hypertension or not, or whether the patients have lost a fetus in utero before. In these cases it is necessary to hospitalize the patient for a long time or make them come to the clinic very often. Watching these patients at home (using either midwifery or hospital staff) is often difficult, so it seemed useful to us to develop another system of monitoring these patients at home. We have been testing, for the last year and a half, a simple system of recording the fetal heart rhythm that can be used by the patient herself at home. The recordings are transmitted daily or twice daily by telephone. The midwife in the maternity unit can look at the tracing and ask the patient to come if the tracing is insufficient or suspicious. We present here the results of 816 tracings carried out in 402 patients: --the tracings correspond completely to those taken at the same time by the usual machines as far as the fetal ECG is concerned. Their interpretation does not give rise to any problems as compared with those of usual tracings. --about 80% of the tracings could be interpreted. They vary according to how far on the pregnancy has progressed (73% at 32 weeks of pregnancy and 84% at term). Telephone transmission was carried out in 84% of cases. Isolated monitoring of fetal heart rhythm (without recording tracings of uterine contractions) makes it possible to monitor these patients at risk of having chronic fetal distress.

Electrocardiography↗
PubMed1989

[The role of mefloquine in the prevention of malaria].

The use of Méfloquine in the prophylactic treatment of malaria has, up to now, been hampered by the standpoint adopted by the WHO, the Conseil Supérieur d'Hygiène and some specialists, for whom Méfloquine should be administered only for short stays in areas of strong chloroquine-resistance. This policy, which prevents many travellers and overseas residents from benefitting from one of the most effective prophylactic treatments on the market today, thereby indirectly causing a number of pernicious cases of malaria, is based on the unfounded, unproved premise that wide use of this drug would foster the development of méfloquine-resistance or on side-effects, which are in fact rarely of any consequence and always curable. The efficacity of this drug should ensure that it is used for the basic prophylactic treatment of malaria in chloroquine-resistant areas, whatever the degree of this resistance and the length of stay involved, on condition that care is taken as to the tolerance of this drug in the early stages of treatment.

Africa↗
PubMed1989

[Ovarian seminoma and pregnancy. Apropos of a new case].

The case of a 35-year-old primigravida with a 21-week intrauterine gestation and concurrent dysgerminoma of the ovary (stage Ic) is presented. A total hysterectomy with bilateral salpingo-oophorectomy was performed, followed by postoperative chemotherapy using cisplatin, bleomycin and vinblastine. The patient has done well since treatment, and is without evidence of recurrent disease 19 months later. Both radiation and chemotherapy are highly effective treatment modalities for dysgerminoma. For those patients with disease presenting in stages Ib, Ic, II and III who wish to maintain fertility, unilateral oophorectomy followed by combination chemotherapy may be curative and spare ovarian function.

Adult↗
PubMed1988

Acute fetal distress after fetal blood sampling (case report).

The authors report a case of acute fetal distress after fetal blood sampling, performed for fetal karyotype because of a precocious and symmetrical fetal growth retardation without maternal hypertension or ultrasonographic evidence of fetal malformation. A cesarean section performed because of acute fetal distress showed the newborn to be hypotrophic, with a major acidosis and a refractory hypoxemia. The new born died despite intensive care. Acute fetal anemia was assumed to be the cause of acute fetal distress. The authors emphasize the use of FHR in fetal survey after fetal blood sampling.

Adult↗
PubMed1988

Cerebral handicap in full-term neonates related to the mechanical forces of labour.

Sometimes the relationship between peripartum events and neonatal CNS injury is obvious: for example, following complete abruptio placentae or umbilical cord prolapse and occlusion with a delay of many minutes before delivery of the baby. These circumstances are, of course, rare in modern obstetrics. Usually, when a neonate develops neurological injury, a host of various potentially adverse peripartum factors are assumed to be the aetiology, but without definitive evidence. Among these latter factors are those we have focused on in this paper: the mechanical forces exerted on the fetal head during labour when the full-term fetus is in cephalic presentation. The mechanical events during the first stage of labour are reviewed, showing how uterine contractions result in cervical dilatation and descent and rotation of the fetal head. The consequences of these forces on the fetal intracranial pressure and blood flow are discussed: FHR remains normal up to a certain pressure threshold, above which decelerations occur. In other words, excessive pressures applied to the fetal head, either spontaneously (e.g. uterine tetany) or iatrogenically (e.g. traumatic forceps delivery or excessive fundal pressure) can increase fetal intracranial pressure to such a degree as to result in significant decreases in cerebral blood flow that are associated with fetal heart rate decelerations. Even when decelerations are simultaneous to contractions, decelerations cannot be considered as reflex and innocuous, as they are indeed associated with a decreasing cerebral blood flow. They must therefore be considered and evaluated in the management of labour. Cord compression and functional modifications of intervillous space by mechanical forces may further compromise the biological status of the fetus, leading to severe asphyxia. Neurological evaluation of the neonate within the first few days after delivery is currently the only way to provide the obstetricians with information on the possible consequences of an abnormal labour. The assessment of normality of the CNS in the neonate born at term, and its value in predicting late outcome are discussed. When abnormalities are detected after one or repeated assessments, abnormal neurological signs and symptoms are classified into three grades at the end of the first week. According to our data, a good correlation exists between this neonatal grading of cerebral dysfunction and late outcome. A careful evaluation of fetal head deformation, extensive caput succedaneum, and extensive retinal haemorrhages can help to interpret an abnormal labour retrospectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Asphyxia Neonatorum↗
PubMed1988

A molecularly cloned hepatitis B virus produced in vitro is infectious in a chimpanzee.

The infectivity of hepatitis B virus (HBV) produced in vitro by HepG2 cells transfected with HBV DNA (HepG2T14) has been assayed in a chimpanzee. Following inoculation, the chimpanzee underwent a typical course of type B hepatitis infection, characterized by elevation of serum aminotransferases and by histological identification of hepatic damage. Hepatitis B surface antigen and core-related antigen appeared in the serum at weeks 5 and 7, respectively, after infection. HBV DNA was detected in serum samples, and replicative forms of the HBV genome were identified in liver biopsies. Subtype identification of hepatitis B surface antigen and restriction enzyme analysis of HBV DNA in both the inoculum and the serum of the infected chimpanzee confirmed that the hepatitis B infection observed in this animal was caused by viral particles produced by HepG2T14 cells. These findings indicate that, although HepG2 cells do not seem to be susceptible to infection by HBV in vitro, they can produce biologically active infectious virions after transfection with cloned HBV DNA.

Animals↗
PubMed1988

[Measurement of maternal plasma volume during pregnancy].

An increased maternal plasma volume (PV) is a characteristic phenomenon of normal pregnancy, which may be related to a physiological decrease of peripheral resistances. The authors have studied the plasma volume of 1,105 patients distributed as follows: normal (387), permanently hypertensive patients (84), hypertensive patients during pregnancy (390), patients with apparently isolated RCIU (154) or with a pathological past-history during previous pregnancies (90). It appears that the PV is a sign of a severe HBP, and presents a rather early and good predictive value regarding the weight of the fetus and some complications such as severe UCIU and fetal death in utero. In case of pathological past events or pre-existing hypertension, the PV enables to differentiate rather well patients who will be prone to a complicated pregnancy. In view of these results, utilization and interpretation criteria of this parameter during pregnancies with hypertension or pregnancies in which there is a suspicion or a risk of intra-uterine growth delay, are defined.

Adult↗
PubMed1988

[Cerebral Doppler technic during labor using signal monitoring at the level of the fetal scalp].

The purpose of modern obstetrics is to obtain tracers of the fetal cerebral risk during labor, enabling to deliver the child before cerebral ischemia occurs. Recording of the fetal heart and measurement of acid-base balance are remarkable tracers; however, a much better precision is desired to avoid unnecessary or too late caesarean sections. Blood velocity measurement by Döppler at the level of the vessels at the base of the fetal skull is technically possible during labor; this has been demonstrated in 8 fetuses. The major cerebral index D/S during labor is 0.40 +/- 0.04, i.e. slightly lower than the mean index measured at the cord (0.50 +/- 0.07). In case of decelerations, it decreases to a mean value of 0.22 +/- 0.02. These preliminary results permit to hope that long-term measurements with continuous Döppler, of the arterial fetal cerebral flow, provide a direct and accurate tracer of the risk of cerebral ischemia during labor.

Blood Flow Velocity↗
PubMed1987

[Autoimmune abortive disease. A new entity of gynaeco-obstetrical expression].

The relationship between abortive disease and systemic lupus erythematosus is complex as shown by data from the literature and by our 9 patients selected for presenting with abortive disease, circulating anticoagulant and biological signs of autoimmunity. The risk of transformation into a systemic disease is real, although difficult to evaluate in the absence of prospective studies, but the major problem with these patients is the severity of the obstetrical pathology. The sombre foetal prognosis, already reported in the literature, requires close supervision and sustained treatment during pregnancy. For these reasons we suggest calling autoimmune abortive disease the disease which affects women with signs of autoimmunity who have had several, often late foetal deaths associated with the presence of circulatory anticoagulant thought to interfere with placental blood flow.

Abortion, Habitual↗
PubMed1987

Prostaglandin E2-induced changes in the distribution of glycosaminoglycans in the isolated rat uterine cervix.

In order to study the hormonal control mechanisms of cervical ripening, we investigated the prostaglandin E2 (PGE2)-induced changes in the distribution of glycosaminoglycans (GAG) using hysterectomized and ovariectomized rats, leaving the vascularized uterine cervix in situ, as an animal model. In the first series of experiments, the GAG were measured in a control (n = 22 Wistar rats) and in a PGE2-treated group (n = 20 Wistar rats) without steroid supplementation. In the second series of experiments, the GAG were measured in a control (n = 19) and in a PGE2-treated group (n = 18) receiving estradiol and progesterone supplements. After PGE2 treatment in the two series of experiments, and despite being surgically isolated from the uterine corpus, the cervix was still able to undergo some of the structural changes associated with normal ripening (increased hydration and hyaluronic acid concentration). This suggests that PGE2, acting directly on the cervix, could be, at least in part, a modulator of biochemical events which underlie normal cervical maturation. The animal model described here seems to be suitable for studying the hormonal mechanisms of cervical ripening and the regulatory relationship between cervical maturation and myometrial contractility, which are probably subject to concordant endocrine regulation.

Animals↗
PubMed1987

Treatment of polyhydramnios with prostaglandin synthetase inhibitor (indomethacin).

Polyhydramnios, which is caused by an excess of amniotic fluid, was diagnosed uniformly in eight patients by ultrasound examination and clinical symptoms, namely, premature uterine contraction, abdominal pain, and respiratory discomfort that resulted from excessive pressure on the diaphragm. Fetal anomalies incompatible with extrauterine existence were excluded by serum alpha-fetoprotein levels, repeated sonography, amniocentesis, and chromosomal analyses. Patients were treated with 2.2 to 3.0 mg of indomethacin/kg body weight/day. The treatment was started at an average gestational age of 24 +/- 0.5 weeks and continued for 2 to 11 weeks. All patients had significant improvement with a simultaneous reduction in amniotic fluid volume, fundal height, and umbilical perimeter. All patients were delivered satisfactorily at an average of 39 weeks' gestation. The fetuses were within the normal body weight range of 2750 to 3600 gm and showed normal development during the neonatal period of 2 to 6 months. Before delivery without indomethacin, the polyhydramnios reformed. Adverse effects or intolerance to the drug was avoided by either a reduction in the dose or cessation of indomethacin therapy. Our studies suggest that indomethacin therapy is an effective way to manage pregnancy complicated by polyhydramnios.

Adult↗
PubMed1987

[The Doppler in obstetrics: experience of the Baudelocque Clinic].

The authors report three years of experience with the use of the Doppler in Obstetrics. Certain notions may be integrated to the principles of clinical decision. The diastolic index D at the umbilical artery increases regularly during a normal pregnancy. It is significantly decreased in case of intra-uterine growth delay (IUGD). When this index reaches zero, it may be considered as a reliable criteria for fetal extraction. Certain notions must be verified: the index seems frequently altered in case of chromosomal abnormality. Some results still depend on research. The index measured at the uterine arteries could predict IUGD and at the level of the fetus' internal carotids, its elevation could be one of the first signs of fetal hypoxia. Finally, the index was measured during normal labor. In case of deceleration it is markedly altered. Thus, this could be an additional element of fetal monitoring.

Blood Volume↗
PubMed1987

[Improvement in the prenatal etiologic diagnosis of severe 2d trimester oligo-amnios by intra-amniotic injection of physiologic solution].

In reference to 4 severe cases of oligo-amnios of the second trimester of pregnancy, the authors advocate a method in order to improve the pre-natal diagnosis by intra-amniotic injection of a normal saline solution. This method facilitates the morphological exploration of the fetus by sonogram and enables to obtain a fetal karyotype by umbilical or amniotic tap. The potential risk of this technique are described.

Amniocentesis↗