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Biomedical subjects

E Papiernik

Publications and source records attributed to E Papiernik.

At least 181 records · Page 10Linked to original sources
PubMed1985

[Phosphatidylglycerol in amniotic fluid. Value of rapid determination using an immunologic technic].

We have studied 55 samples of amniotic fluid taken by amniocentesis from 32 women, most of whom had arterial hypertension, with or without intra-uterine growth retardation; with or without uncertainty as to their dates. Fetal pulmonary maturity was estimated by determining the lecithin/sphingomyelin (L/S) ratio and the levels of phosphatidylglycerol (PG) in 55 samples. The semi-quantitative levels of PG were worked out using a simple and rapid immunological method. Our results show that there is a good correlation between the two tests. The level of PG is, however, more specific than the L/S ratio, for which we found some false negatives. In particular, there were 7 samples looked at 48 hours before delivery which showed an L/S ratio lower than 2 and a PG at or above 2 micrograms/ml. None of these 7 had hyaline membrane disease. Furthermore the simplicity and speed of this test make it possible to use it routinely.

Agglutination Tests↗
PubMed1985

[Analysis of the attraction of an obstetrical service. Analysis of preferences according to geographic distance, sociocultural level and previous medical experiences].

This study analyses selected characteristics of 13,676 women, all single pregnancies, attending the Department of Obstetrics and Gynaeocology of the A. Béclère Maternity Hospital in Clamart (in the greater Paris region of France). The characteristics analysed for each women were: sociocultural level, occupation, place of residence (i.e. distance from the hospital), frequency and time of prenatal visits, and selected aspects of obstetric history (treatment for infertility, previous preterm birth, perinatal mortality). A comparison was made between the patients living near the institution and the patients living far from the hospital; this revealed four separate groups: Women living near by the hospital followed-up early by the department, and whose social class distribution is similar to that of the parisian population as a whole. Women living near the hospital, followed-up late or not at all by the department, most have a low sociocultural level, and are referred to the hospital by local homes for single mothers. Women living far from the hospital, followed-up early and often having a high socio-cultural level. In this group, a higher level of information about pregnancy, obstetrics, and medical services are observed. However this group also shows a high frequency of previous obstetric incidents: previous contact with a medical institution appears to be an important factor in the choice made by these women, independent of their sociocultural level. Women living far from the hospital and followed-up late by the department. These patients have a high sociocultural level, and show a high frequency of previous obstetric incidents: they tend to present as emergencies requiring the department's technical services.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1985

Prevention of preterm births: a perinatal study in Haguenau, France.

A reduction in preterm births has been observed in Haguenau (Eastern France) during a 12-year intervention study with a program for prevention of preterm deliveries. The Perinatal Study of Haguenau was an observation tool used in a stable population, and it allowed measurement of the way women have progressively responded to the new proposals in prenatal care. It also allowed measurement of the results of the interventions: low birth weight (less than 2,500 g) and preterm birth rates (less than 37 weeks of gestation) among single live births. The total duration of the study was divided into three periods of four years (1971 through 1974, 1975 through 1978, and 1979 through 1982), for which the numbers of single live births are 5,763, 4,957, and 5,919, respectively. For the same periods, the low-birth-weight rates, 4.6%, 4.0%, and 3.8%, respectively, showed a significant decrease (P less than .001). Following a similar pattern, the rates of preterm birth were 5.4%, 4.1%, and 3.7% (a significant reduction with P less than .001). These improvements in pregnancy outcome do not disappear after standardization of mother's age, high blood pressure, or social class distribution. These findings, which concur with the results of others, enhance the hypothesis of a direct relationship between a prevention program and a reduction in preterm birth rates.

Birth Weight↗
PubMed1985

[Epiphyseal points of the fetal knee. The impact of growth disorders on bone maturation].

The radiological appearance of bone maturity can be used as a criterion for fetal maturity. This examination with limited irradiation to the fetus is an alternative to amniocentesis. The practice of the latter is not without risk. The authors carried out 194 examinations of the contents of the uterus to look at the epiphyses of the knee between the 34th and 40th week of amenorrhoea. The found three groups: 1) those with normal development; 2) those with delayed development and 3) those with more advanced development. They did not find significant correlation between small-for-dates growth and bony maturity. On the other hand, where there was increased growth of the fetus in cases where maternal diabetes was excluded there was demonstrated that bony maturity accelerated with the presence of Béclard's point from the 34th week onwards. With such great variation in the dates of the appearance of points of ossification the presence of epiphyseal points in the knee cannot be taken as a criterion to establish fetal maturity nor the minimum duration of the pregnancy.

Birth Weight↗
PubMed1984

In vitro fertilization and embryo transfer program in Clamart, France.

Our in vitro fertilization and embryo transfer program really began in September 1980. Yet attempts to collect oocytes had been performed since 1978, and the first in vitro fertilizations were obtained in May 1979. The first pregnancy was obtained in April 1981, but it ended on the 12th week by a spontaneous abortion of a 45,X fetus. We have distinguished two periods in our program. The initial phase was from September 1980 until November 1982: ovulation monitoring of 365 cycles, spontaneous or stimulated, 276 laparoscopies, and 121 embryos transfers were performed, and 12 early pregnancies obtained (4.3% per laparoscopy and 9.9% per embryo transfer). Seven normal healthy infants were born (five boys and two girls); four cases were limited to biochemical pregnancies and one spontaneous abortion (yet described) was observed. The second and actual phase, December 1982-June 1983, is described more precisely: ovulation monitoring of 329 cycles, after stimulation protocols with clomiphene citrate and human menopausal gonadotropin, 230 laparoscopies, and 162 embryos transfers have been performed and have led to 34 pregnancies (14.8% per laparoscopy and 20.9% per embryo transfer). Eighteen of these 34 pregnancies are actually in progress (more than 12 weeks), 9 were limited to an increase in plasma human chorionic gonadotropin, and 7 cases ended in spontaneous abortions between 6 and 12 weeks.

Adult↗
PubMed1984

The prevention of preterm delivery through prenatal care: an intervention study in Martinique.

During 1976-1978, improvements were made in the free prenatal care provided by the maternal and child health authority (PMI) of Martinique. Central to these changes was implementation of a program of preventive prenatal care developed in France by one of the authors (EP). Data on all births during 1980-1982 show no significant difference in pregnancy outcomes between women receiving free prenatal care from the government and women receiving private care from obstetricians.

Adolescent↗
PubMed1984

[Transcutaneous cerebral electric stimulation by Limoge current during labor].

In order to test the analgesic efficacy of Anesthelec (transcutaneous cranial electrical stimulation with Limoge currents) during labour and delivery, a double blind study was performed in 20 cases for whom analgesia was necessary. In 10 cases Anesthelec was used with the Limoge currents on and in 10 cases as a sham. Labour and delivery were carried out by a medical team different from that which set up the Anesthelec. The results showed that this method, with or without nitrous oxide inhalation, decreased by 80% the number of epidural and general anaesthesias that would otherwise have been unavoidable. To define the effects of this new method, maternal and foetal parameters of 50 deliveries carried out under Anesthelec were compared with 50 deliveries carried out under epidural analgesia. Anesthelec was used only if analgesia was required. This study was a retrospective comparison between two similar non paired series. Despite the fact that analgesia obtained with Anesthelec was less powerful than with epidural analgesia, this method showed many advantages: total safety for the child and the mother, easy utilization, shorter labour time, decreased number of instrumental extractions and potentially reduced costs. Good acceptance and satisfaction for the mother should allow a rapid evolution of this new method.

Adult↗
PubMed1984

Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery.

A total of 506 women at moderate risk of preterm delivery were randomly allocated to either cervical cerclage or a control group. Significantly more women in the group allocated to cerclage were admitted to hospital for reasons other than the operation and more received oral tocolytic drugs. There were also more caesarean sections and more preterm deliveries in the women allocated to cerclage although the differences between the two groups were small and not statistically significant.

Adult↗
PubMed1984

[True primary prevention of premature birth].

The authors are interested in the social differences observed in rates of preterm births. Most of the published studies show a social gradient. Their hypothesis is that these differences are accessible to a simple preventive policy. The propositions are first a better information given to the pregnant women on the risks, and on the relationship of the way of living with uterine contractions and preterm labour and second a reduction in physical efforts, common triggers to uterine pains. The study deals with 11,017 singles pregnancies. It is shown that the social gradient disappears for the women following the program (80% of the pregnancies). The social gradients are those expected for the women followed by other means and referred during pregnancy.

Female↗
PubMed1984

[Primary-purpose peridural analgesia in labor induction].

21 parturients, showing in most of cases either high blood pressure badly controlled or a "real" out of date term, have undergone a peridural analgesia of first intention in labour induction. All these patients were considered to be uninducable according to Bishop score. After an injection of adrenalinized bupivacaïne, either 0.25% or 0.375% rupture depending on state of cervix of membranes occurred in most cases 6 hours after peridural analgesia. The mean between onset of analgesia and delivery was 17 h and the mean time between induction with ocytocin to birth 5 h 37 min. 16 parturients gave birth per vaginam, 9 of which spontaneously 5 have undergone caesarian section because of a non lack of dilatation or foetal distress. Children at birth, at the 2nd and the 24th hour were all healthy.

Anesthesia, Epidural↗
PubMed1983

[Maternal iron and folate deficiencies. Effects on the newborn infant].

Three studies of materno-fetal iron and folate status are analyzed. Repercussions of maternal iron and folate deficiencies on neonates are investigated. The incidence of iron deficiency is high during pregnancy and increases in multiparous and alien women. Although no correlation was found between mothers' and neonates' ferritinemia, maternal iron deficiency was shown to influence fetal hemoglobin synthesis and iron stores. Folate deficiency in mothers had no obvious incidence on hematological parameters in neonates. However it does influence gestation duration and therefore birthweight.

Female↗
PubMed1983

Social cost of twin births.

This study analyzes costs for neonatal care and costs for care of handicapped children related to twin pregnancies and births. These costs are highly related to the unfavorable birthweight distribution for twins. Each twin pregnancy may cost 10 times more than a single pregnancy. This economic analysis favors all kinds of preventive policies and a calculation is proposed for measuring the probable effect in costs of even a slight decrease in the proportion of very low and low birthweight for twins.

Birth Weight↗
PubMed1983

Iron supplements versus placebo during pregnancy: its effects on iron and folate status on mothers and newborns.

Iron and folate status of 203 pregnant women have been evaluated at 6 months gestation and on the same women and their newborn infants at delivery. The women who had, at 6 months gestation, a Hb level below 11 g/dl were systematically given iron supplements. Iron or placebo were randomly allocated to the other women. At 6 months of pregnancy, one quarter of the women had a Hb level under 11 g/dl but one third had a serum ferritin level below 12 micrograms/l and more than half had low levels of serum and red cell folate. Iron supplements induced an increase both in Hb levels and in serum ferritin values; however, no significant differences were observed in serum ferritin of the newborn infants, whether their mothers had received iron supplements or not. These results have led us to reconsider the value of ferritin levels at birth as an index of iron stores in the infant. Iron supplements had no effect on the folate status in mothers or infants or on the frequency of obstetrical complications. A significant relationship was found between maternal folate levels and length of gestation. Folate supplementation may reduce the incidence of premature delivery.

Adolescent↗