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Biomedical subjects

C Tchobroutsky

Publications and source records attributed to C Tchobroutsky.

At least 19 recordsLinked to original sources
PubMed1992

Predictive value of uterine artery velocity waveforms in pregnancies complicated by systemic lupus erythematosus and the antiphospholipid syndrome.

The objective of this study was to see if determination of uterine artery velocity waveforms between 20 and 30 weeks in lupus pregnancy and the antiphospholipid syndrome (APS) have a good predictive value for later fetal distress before labor, intrauterine growth retardation, and preeclampsia. Uterine and umbilical artery blood flow velocity waveforms were determined in 21 pregnancies complicated by systemic lupus erythematosus (SLE): 12 with antiphospholipid antibodies (aPL), 9 without aPL. We also studied 7 pregnancies with APS. This retrospective study was running from January 1st 1986 to July 31st 1991, at the Port-Royal Maternity, Paris, France. Abnormal uterine artery blood flow velocity waveforms were found in 10 out of 28 pregnancies at the first examination performed between 20 and 30 weeks gestational age. All the later adverse fetal and neonatal events were predicted by an abnormal uterine artery blood flow velocity waveform. From the 7 cases of fetal distress diagnosed during pregnancy, 6 were predicted by abnormal uterine waveforms and all of these pregnancies resulted in induced delivery before 32 weeks of gestational age. Twelve pregnancies with aPL and normal uterine artery waveforms were uncomplicated. Only 1 out of 7 pregnancies with abnormal uterine artery waveform and aPL ended without complication. Determination of uterine artery flow velocity waveform is a good adjunct to the management of pregnancies complicated by SLE or aPL. This determination has a better predictive value than the presence of aPL.

Adult↗
PubMed1990

[Obstetric management and delivery in diabetics].

A review of the obstetrical management of diabetic pregnancies is presented. The best way to avoid complications is to achieve the best possible diabetic control. Ultrasonics are able to determine gestational age in the first weeks of pregnancy, to detect fetal malformations and to follow fetal growth. At the end of pregnancy, fetal heart rate monitoring is the golden standard to judge fetal well being. Delivery at term is of paramount importance. The presence of fetal macrosomia is an important parameter of the decision of the mode of delivery.

Congenital Abnormalities↗
PubMed1989

[The HELLP syndrome: a special form of hypertension in pregnancy].

The HELLP syndrome--H for haemolysis, EL for elevated liver enzymes and LP for low platelet count, is a serious complication of hypertension of pregnancy. We report five cases of this syndrome. The haemolysis, which is the consequence of a microangiopathic haemolytic anemia, is not always present: we report four such cases. The recognition of the HELLP syndrome even in the absence of hypertension is important and must be thought of when epigastric or dorsal pain occur in the second half of pregnancy. No liver biopsy was done in this small series.

Adult↗
PubMed1987

[Does hypertension have fewer complications in pregnancy in obese patients?].

In order to study the relationships between hypertension, obesity and perinatal morbidity and mortality, we have studied a group of 264 women included in a cooperative prospective study with respect to obesity arbitrarily defined as a body mass index greater than or equal to 27 kg/m2. The obese and normal-weight groups comprised respectively 55 and 209 women of similar age (29.1 +/- 5.5 vs 30.2 +/- 5.3 years, NS). Obese women were less often primiparous than women with a normal weight (29.1 vs 50.2 p. 100, p less than 0.01). Hypertension before pregnancy was similarly frequent in both groups (41.8 vs 31.6 p. 100). Hypertension begun sooner during the pregnancy in the obese than in the normal group (17.1 +/- 11 vs 22 +/- 11 weeks of amenorrhea, p less than 0.01), the first abnormal blood pressure being comparable in both groups (156 +/- 15/96 +/- 14 vs 152 +/- 15/95 +/- 10 mmHg, NS). Indicators of perinatal risk were less often observed in the obese group: hypertension begins less often during the second trimester of the pregnancy (7.4 vs 21.7 p. 100, p less than 0.05), proteinuria greater than or equal to 2+ is more rare (13.0 vs 25.1 p. 100, p = 0.07), plasma urates are lower (maximum recorded value: 272 +/- 63 vs 322 +/- 96 mumol/l, p less than 0.001). No perinatal death occured in the obese group, as compared with 15 in the normal group (p less than 0.05). The weight of surviving babies was higher in the obese than in the normal group (3,294 +/- 596 vs 2,947 +/- 702 g, p less than 0.001), despite a comparable gestational age (38.3 +/- 2.3 vs 38.9 +/- 1.8 weeks, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Factors predictive of perinatal outcome in pregnancies complicated by hypertension.

Perinatal outcome and various indicators of perinatal risk were analyzed in a prospective study of 268 pregnant women with hypertension. Poor perinatal outcome was defined by stillbirth (n = 13), neonatal death (n = 2), and in surviving babies, by birth before 32 weeks or a birthweight below 1500 g (n = 13). In multivariate analysis, proteinuria and onset of hypertension between the 27th and 36th weeks of amenorrhea were the only two independent indicators of poor outcome (relative risks of 4.0 and 3.7, p less than 0.001 and p less than 0.01 respectively). Both these indicators were more frequent in mothers with no history of pre-pregnancy hypertension.

Adult↗
PubMed1986

Spontaneous recurrent fetal wastage and autoimmune abnormalities: a study of fourteen cases.

Case records of 14 women with spontaneous recurrent fetal wastage were analyzed. Venous and/or arterial thrombosis developed in nine patients and vasospastic symptoms in eight. Every patient had some kind of autoantibodies: prothrombin activation inhibitor was present in seven cases, anticardiolipin in five, and, antimitochondrial antibodies in two. Antinuclear antibodies were present in seven cases, and significant titer of antibodies to single-stranded DNA in nine cases. With a mean follow up of 6.5 years no patient developed systemic lupus erythematosus. It is suggested that such women have a peculiar form of vasculitis.

Abortion, Habitual↗
PubMed1985

[Inhibition of angiotensin converting enzyme in human pregnancy. 15 cases].

Angiotensin converting-enzyme inhibitors cross the placenta and modify the maternal, foetal and utero-placental renin-angiotensin system. Eight cases of pregnancy in women taking captopril have been published, 7 other cases being reported in this review paper. There were one spontaneous and 2 therapeutic abortions, one of which disclosed a malformation of uncertain diagnosis and imputation. One intrauterine death at 28 weeks was probably due to the severity of the maternal disease. Two children born to mothers also treated with frusemide died of neonatal anuria. Delivery or caesarean section occurred before term in 8 cases, and there were 3 cases of neonatal respiratory distress with a favourable outcome. Finally, one mother gave birth at term to twins of normal weight. The cases with respiratory distress can be attributed to the mother's hypertension, to prematurity and/or to concomitant treatment with beta-blockers, while the cases with anuria seem to be due to inhibition of the effects of angiotensin on renal haemodynamics, with salt depression as a possible aggravating factor. Treatment with angiotensin converting enzyme inhibitors does not seem to warrant therapeutic abortion. However, these drugs are contra-indicated in pregnancy and should only be given to women wishing to become pregnant if they present with resistant and dangerous arterial hypertension. A programme of pharmacovigilance is being set up to follow up such pregnancies.

Abortion, Spontaneous↗