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Biomedical subjects

C Sureau

Publications and source records attributed to C Sureau.

At least 109 records · Page 6Linked to original sources
PubMed1985

[Safety of term birth and cesarean birth rates].

This was a parallel of the rate of caesarean section and neurological morbidity of the term newborn. This study was performed on all infants born at a gestational age of 37 weeks or greater in 1981 and 1982 at the Baudelocque Maternity Hospital. The results show a stable caesarean section rate during these two years: 21% in 1981, 20% in 1982; as for the safety of term birth there was only one case of perinatal insult during a vaginal birth responsible for cerebral dysfunction of moderate degree. There was a 18% operative maternal morbidity and there were no deaths. We concluded that a caesarean section rate of 20% in a University Hospital is justified by the virtual absence of neonatal morbidity with an acceptable maternal risk. This rate should not increase. The possible ways of decreasing this rate, while maintaining neonatal safety, must be studied. The original aspect of this work concerns the monitoring of the caesarean section rate by the incidence of neurological complications of all term births during a fixed period of time.

Cesarean Section↗
PubMed1984

Oral administration of micronized natural progesterone in late human pregnancy. Effects on progesterone and estrogen concentrations in the plasma, placenta, and myometrium.

A single dose of micronized oral progesterone was administered to 15 pregnant women immediately prior to elective cesarean section. Levels of progesterone, 17 beta-estradiol, and estrone were measured in the plasma, in the placenta, and at different sites in myometrium obtained during the surgical procedure. Results were compared to those observed in a control group of women who did not receive progesterone. Progesterone levels demonstrated a marked increase in plasma and in the whole myometrium 150 minutes after administration. The levels then decreased rapidly to control values in 1 hour. The concentrations of progesterone in the placenta did not show any changes. No difference appeared in 17 beta-estradiol levels in the plasma or the myometrium, whereas an increase was observed in the placenta. Estrone levels did not change in the plasma, but they decreased in the myometrium and in the placenta.

Administration, Oral↗
PubMed1984

HLA-DR locus and maternal-foetal relation.

Antigen HLA-A, B sharing couples have been previously observed in abnormal pregnancies of unknown etiology. We have determined the HLA-A, B, C and DR antigens of 20 couples with recurrent spontaneous abortions (RSAs), 32 control couples and 100 normal controls. The results showed that in couples with more than two idiopathic repeated abortions, there is no significant increase in the HLA antigen sharing couples. But we were able to observe, in the affected couples, a significant increase in HLA-DR antigen sharing as regards the control couples. We also find a significant increase in the DR5 antigen, in both wives and husbands, in couples with repeated abortions of unknown etiology as previously described for the Dw5 antigen.

Abortion, Habitual↗
PubMed1984

Electromyographical study of uterine activity in the human during labour induced by prostaglandin F2 alpha.

In full-term pregnant women, electrical and mechanical activity of the uterus was monitored throughout the course of labour promoted by intravenous infusion of Pg F2 alpha. The recorded potentials were mostly biphasic and characterized by their long duration ranging from 1 to 2s. A wide range of potential amplitudes (100 microV to 1.8 mV) was observed according to the various patients. Early at the beginning of labour induction, the electrical complexes firing at various uterine sites were proved to be in close relationship and also well correlated with the mechanical events. This feature remained unchanged during labour. Potential amplitudes also remained unchanged during the same period of time. Under these conditions, improvement of uterine coordination does not appear to be the mechanism by which the increase of uterine contractile strength, necessary to expel the fetus, is obtained at the end of gestation.

Action Potentials↗
PubMed1983

[Doppler echographic study of placental circulation of the fetus of normal and hypertensive mothers].

Foetal blood velocity wave forms, as recorded in chorionic vessels by pulsed Doppler ultrasonography, reflect vascular resistance in foetal placental circulation. The minimal-to-maximal velocity ratio provides an index of vascular conductance; the higher the minimal velocity (positive forward diastolic blood flow), the lower the vascular resistance. In the present study, this index was the same in pregnant women with normal blood pressure (n = 19) and in those with pregnancy-induced hypertension (n = 12); however, it was significantly lowered (p less than 0.001) in pregnant women with essential hypertension (n = 9). In the population of women with normal blood pressure and pregnancy-induced hypertension, a positive correlation (r = 0.71), was found between index value and gestational age, indicating a progressive fall in placental vascular resistance. All placentas from these 31 women were histologically normal except two which showed one single marginal infarct less than 1 cm in diameter. In the group of women with essential hypertension, the 6 placentas examined were pathological, with multiple chronic infarcts, placental growth retardation and maceration. Thus, pulsed Doppler ultrasonography should be used for early detection of placental vascular damage and for improved surveillance of pregnancies complicated by maternal vascular diseases.

Blood Flow Velocity↗
PubMed1983

High-performance liquid chromatography with electrochemical detection for the simultaneous determination of the methoxylated amines, normetanephrine, metanephrine and 3-methoxytyramine, in urine.

A simple method for the simultaneous analysis of normetanephrine, metanephrine and 3-methoxytyramine (both free and conjugated) in human urine by reversed-phase ion-pair high-performance liquid chromatography with electrochemical detection has been developed. Existing methods have been optimized for extraction by study of analytical parameters. The hydrolysed urines are purified and concentrated by successive passages on two ion-exchange resins and ammoniacal elution to eliminate interference from pigments or related chemical compounds. The methoxyamines are separated by high-performance liquid chromatography on a reversed-phase column. Detection and quantitation are achieved with an electrochemical detector using a vitreous carbon electrode. Samples can be injected at 25-min intervals. Reference values of adults and children are given.

Adolescent↗
PubMed1983

Fetal tachycardia and meconium staining: a sign of fetal infection.

A retrospective study was carried out on 72 liveborn babies in whom perinatal infection was suspected. Twenty-nine of the 72 neonates were effectively infected. Analysis of intrapartum FHR recordings showed that tachycardia (base line FHR above 160 beats/min) during labor, occurred more often among infected babies (P less than 0.001). When fetal tachycardia is associated with meconium stained amniotic fluid (MSAF), the relative risk of fetal infection is 51 times as great as in babies without MSAF. Fetal tachycardia is not related to maternal fever nor to prematurity. It is not a sign of limited placental or amniotic fluid infection, but implies infection of the fetus itself. Since most infected babies displayed infectious diarrhea immediately at birth, it is suggested that MSAF may eventually be due to antenatal intestinal infection and intrauterine emission of infected stools. Although great caution is advocated for the management of labor in the presence of fetal tachycardia, MSAF should not be always regarded as a sign of acute fetal distress when antenatal infection of the fetus is suspected.

Bacterial Infections↗
PubMed1983

Fetal growth retardation in gestational hypertension: relationships with blood pressure levels and the time of onset of hypertension.

To evaluate the effects of gestational hypertension on fetal growth, we studied the standardized records of 2996 single live-birth pregnancies. Mothers all had documented diastolic blood pressure of less than 85 mmHg before the 16th wk of amenorrhea and no history of pre-pregnancy hypertension or kidney disease. Diastolic blood pressure readings exceeding 84 mmHg were found later in pregnancy in 38.4% of the mothers, and were associated with an increased number of small-for gestational-age infants: 3.2% in mothers whose diastolic blood pressure had never reached 85 mmHg, 6.3% when peak diastolic blood pressure had been in the 85-94 mmHg range, and 8.5% when it had exceeded 94 mmHg (p less than 0.01). In mothers who had had one or more diastolic readings of more than 84 mmHg, and for all peak diastolic pressures, the rate of small-for-gestational-age infants was higher when hypertension had begun early in third trimester (between the 27th and 36th wk), than in the second trimester or later than the 35th wk (10.2% compared to 5.6 and 6.1% respectively, p = 0.02). This temporal reinforcement of the adverse fetal effects of hypertension when it began in the early third trimester was not explained by differences in the incidence of proteinuria or in maternal age, parity, obstetric history or smoking habits.

Adult↗
PubMed1983

Further studies on production and characterization of HBsAg derived from a human hepatoma cell line (PLC/PRF/5).

Four aspects for the use of PLC/PRF/5 cell line as an alternative source of HBsAg for hepatitis B vaccine production were assayed in this study: improvement in HBsAg production with chemical inducers, tests for the presence of hepatitis B virions, antigenic topology of HBsAg polypeptides and immunogenicity of HBsAg in guinea pigs. 10(-6) M dexamethasone and/or 10(-4) M sodium butyrate treatments enhanced HBsAg production by a factor of approximately two when compared with untreated cells. Particles of 35 nm diameter produced by PLC/PRF/5 cells were observed at a CsCl density of 1.22-1.24, associated with typical HBsAg 22 nm spheres. These particles did not contain HBV DNA as proved by negative results of hybridization using cloned HBV/DNA as a probe. Western blot analysis revealed that only polypeptides P 22000 (P1) and P 26000 (P2) were specifically recognized by a human anti-HBs serum, irrespective of the origin of HBsAg, i.e. human serum or PLC/PRF/5 hepatoma cell line. HBsAg purified from PLC/PRF/5 cell line was immunogenic in guinea pigs. However, the humoral response was delayed and lower in terms of anti-HBs titers when compared to the response obtained after immunization with a licensed hepatitis B vaccine (HEVAC B, Institut Pasteur Production).

Animals↗
PubMed1983

[Placental smears in a maternity ward. Importance of early diagnosis of neonatal bacterial infections caused by materno-fetal contamination].

Direct cytobacteriological investigation of the amniochorionic plate of the placenta has been used systematically in the Maternity Hospital as a test to detect amniotic infection. This test was practised on fresh placentae in the laboratory of Histology, preceding the examination of the placenta. The test gave, within 30 minutes of delivery, information about the presence of bacteria of fungi on the amniotic surface, their abundance and their morphology. The results of the placental smears were compared to the results of bacteriological cultures obtained from the placenta, the infant and occasionally the mother. The diagnosis of neonatal infection was established from clinical, biological and bacteriological criteria which were defined in advance. Two series are presented: the first concerns 2,514 cases selected in the delivery room over a period of 4 years for high risks infection, i.e. 1 in 6 of the 15,377 deliveries registered during this period. The rate of positive smears was 9%: 63% Gram positive, 17% Gram negative, and 20% mixed. The most common bacteriologically proven neonatal infections were streptococcus B (40%) and Escherichia coli (33%). The second is a prospective survey of 400 unselected consecutive cases observed during a period of 7 weeks: 1% of the smears were positive - and the test would have been justified in 1 in 5 cases. From these two surveys, it appears that placental smear is a good test to detect maternofetal contamination. The positive predictive value of the test is 80%. The negative predictive value is 98% and approaches 100% if cases where the mother received antibiotics before delivery are excluded.

Bacterial Infections↗
PubMed1983

[Early discharge of women after delivery. Results of an opinion survey among patients and unit personnel].

Women's and maternity staff's opinion about early discharge and home care after hospital delivery was studied in 1981 in an university clinic; 100 pregnant women and 100 newly delivered mothers filled in a questionnaire, the former during an antenatal visit, the latter during their stay in hospital after delivery; and so did all the staff of the maternity unit. We found that 28% of pregnant women, 22% of newly delivered mothers and 25% of maternity staff were in favour of a short stay in hospital after delivery followed by home care. The main reasons for disapproving a short postnatal stay were medical safety, need for rest and fear of being alone with the baby. For the women approving of early discharge the best duration of hospital stay was 2 or 3 days. Rather more doctors, head nurses and midwives than nurses, auxillary nurses and ancillary staff approved a short stay in hospital after delivery. It seems that the opinion of the maternity staff was not linked to changes in working conditions that this new organization would introduce. We consider that the women's preference should be given priority in deciding early discharge after delivery, when there is no medical contra-indication. Home care could be a useful transition between hospitalization and being alone at home; for instance health visitors could give advice about breastfeeding, infant care and birth control. But before generalizing this type of care it would be important to evaluate the medical, economic and psycho-social consequences.

Female↗
PubMed1983

[Experimental prevention of a hemolytic disease of the fetus with F (ab)'2 immunoglobulin fragments].

An experimental study was designed to tentatively protect fetal red blood cells (RBC) against hemolysis by covering fetal RBC antigenic sites with F (ab)'2 fragments of hemolysing antibodies. Sheep antibodies were raised against rabbit RBC. IgG were separated and part of the IgG pool subjected to pepsin digestion, in order to isolate F (ab)'2 fragments. Near term rabbit fetuses were injected through the uterine wall with either IgG, F (ab)'2 or successively F (ab)'2 then IgG. Fetuses were extracted by hysterotomy, one hour after the last injection. Neonatal blood was collected by cardiac puncture for hematocrit determination and detection of hemolysis. Among fetuses injected with IgG alone, nine were deal at hysterotomy and evidenced diffuse hemorrhagic syndrome. Six were born alive with hemolysis, including three with severe anemia. (Ht = 26%). Nine fetuses successively injected with F (ab)'2 and then IgG, were all born alive with normal hematocrits (Ht = 43%). The protective role of F (ab)'2 fragments and their potential therapeutic use are discussed.

Animals↗
PubMed1982

[Necrotizing enterocolitis. A study of forty-six cases seen in a maternity hospital].

Forty-six cases of necrotizing enterocolitis were seen at the Baudelocque maternity hospital from august 1978 to october 1980. In eighteen cases, clinical signs associated with roentgenograms showing pneumatosis led to unequivocal diagnosis. A surgical procedure was done in nine of these patients, during the acute stage in four and later on in five. Diagnosis was strongly suspected in twenty-eight cases. Clinical features were less serious and included abdominal distension, bloody stools, and emesis. There were no roentgenological signs. None of these infants underwent surgery. Overall mortality rate was 7% (3/46). In comparison to previously published studies, our series shows lower perinatal risk factors, higher mean birthweight, and lower prematurity rate (14%). No evidence was found to support the responsibility of a specific bacterial agent. Corona virus was found in the stools of five out of eleven cases studied during the second epidemic wave in october 1979, suggesting a possible viral etiology. Several preventive steps have been taken. Breast-feeding has been encouraged. Each mother-infant pair has been isolated instead of grouping infants in night nurseries. Staff members have been given specific information on the means of preventing contamination.

Coronaviridae↗
PubMed1982

Electrical activity of the pregnant uterus in the cynomolgus monkey.

Electromyographic activity in six pregnant cynomolgus monkeys was recorded in vivo by means of bipolar electrodes individually attached to the surface of the uterine corpus. These data were compared with recordings of intra-amniotic pressure obtained simultaneously by means of an open-ended, fluid-filled catheter placed in the amniotic cavity. During the last third of pregnancy, the electromyograms showed recurrent electrical complexes (trains of potentials, TOP) which lasted for about 2 minutes and whose rate of occurrence varied during the nyctohemeral period. The initiation of electrical activity in various uterine areas was always synchronous with and was related to mechanical contraction. The complex, polyphasic contractions that were observed can be explained, largely, by the variations of potentials within a train of potentials. However, a simple quantitative relationship between the mean frequency of the potentials within the TOP and the mean amplitude of the change in pressure could not be demonstrated. In contrast to data available on the woman, the increase in contractile strength at the onset of labor in the macaque appears to be due to a higher frequency of excitation of individual cells rather than the result of an improved functional coordination between the active muscular elements.

Action Potentials↗
PubMed1982

Sinusoidal fetal heart rate pattern in severe fetal anemia from feto-maternal transfusion.

A case is reported where a sinusoidal fetal heart rate pattern was found in a fetus at 34 weeks. This pattern, at first isolated and later persistent for several hours, during a normal pregnancy became progressively transformed into a silent pattern. Cesarean delivery then performed resulted in the birth of an infant affected by a severe anemia due to a major feto-maternal transfusion and it died aged 36 h. The authors enquire into the significance of this pattern when found in apparently normal pregnancies, not involving rhesus iso-immunization, and they suggest a possible management when confronted with a sinusoidal fetal heart pattern.

Adolescent↗