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Biomedical subjects

F Daffos

Publications and source records attributed to F Daffos.

At least 37 records · Page 2Linked to original sources
PubMed1994

Tumour-associated antigens in maternal and fetal blood.

Normal levels of cancer-associated antigen (CA) 19-9, neurone-specific enolase (NSE), cancer-associated antigen (CA) 125, and mucin-like carcinoma-associated antigen (MCA) during pregnancy were determined in 87 mothers and fetuses, using a solid-phase sandwich enzyme immunoassay. CA 19-9 concentrations were higher in the fetuses, whereas the other three tumour-associated antigen levels were higher in the mothers. Only fetal NSE and MCA levels were positively correlated with those in maternal serum. Contrary to adult samples, no difference was demonstrated between male and female fetal levels of CA 125. MCA was the only maternal marker that increased significantly with gestational age between 20 and 34 weeks' pregnancy.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1994

Prenatal diagnosis of tuberous sclerosis. Use of magnetic resonance imaging and its implications for prognosis.

Tuberous sclerosis (TS) is an autosomal dominant disorder with a high rate of de novo mutation. The real difficulty is to ascertain the diagnosis and to give the neurological prognosis in each case. Prenatal diagnosis of TS is generally based on ultrasonographic signs of multiple cardiac tumours, i.e. rhabdomyomas. Recent progress in magnetic resonance imaging (MRI) enables the diagnosis in a large proportion of cases based on typical brain lesions. It may have a role in the prenatal management of TS, although MRI images seem to underestimate the anatomical findings. Two cases in which TS was diagnosed prenatally are presented with reference to the value of MRI in the prenatal management and comparison with anatomical findings.

Female↗
PubMed1994

[Fetal-neonatal thrombocytopenia of immunologic origin: current aspects].

Fetal/neonatal immune thrombocytopenias result from increased platelet destruction by maternal antiplatelet antibodies. There is a risk of intracerebral haemorrhage and therefore of neurological impairment or death during the thrombocytopenic period, especially if a defective platelet function co-exists. As no maternal parameter is predictive of the fetal platelet count, the only reliable assessment of the fetal status depends on the fetal blood sampling. Only in case of materno-fetal alloimmunisation the therapy initiated to reverse fetal thrombocytopenia was shown to be effective, but the optimal mode of antenatal treatment is currently under study. As the neonatal therapy and the management of subsequent pregnancies are somehow different it is mandatory to make the distinction between the auto or allo-origin of the fetal thrombocytopenia. The definition of high risk pregnancies will be of help for the development of a routine screening program.

Antigens, Human Platelet↗
PubMed1994

[RU 486 and sulprostone in pregnancy termination in the 2nd and 3rd trimesters].

OBJECTIVE: Describe our experience with the RU 486 (mifepristone) in case of pregnancy termination induced by sulprostone. METHOD: Prospective non controlled study in the department of Fetal Medicine of the "Institut de Puériculture de Paris". 158 women undergoing termination of pregnancy during the second and third trimester received a single dose of 600 mg of RU 486, 36 hours prior to infusion of 100 micrograms/hour of sulprostone. MAIN OUTCOME MEASURES: Delay between sulprostone therapy and diagnosis of labour duration of delivery. Prostaglandin doses used and frequency of secondary effects. RESULTS: The mean time between sulprostone administration and diagnosis of labour (146.5 +/- 106 minutes) as well delay of delivery (592.2 +/- 504 minutes) corresponded to the results reported in the literature. The primigravid women needed higher doses of prostaglandin and consequently experienced more secondary effects. No severe secondary effects were observed in this study. CONCLUSION: RU 486 is a satisfactory treatment for pregnancy termination during the second or third trimester.

Abortifacient Agents, Nonsteroidal↗
PubMed1994

Ocular toxoplasmosis in the fetus. Immunohistochemistry analysis and DNA amplification.

PURPOSE: Ocular toxoplasmosis is often the result of a congenital infection. However, the earlier stages of the ocular lesions in the fetus have not been well studied. The purpose of the present study is to analyze the ocular findings in four aborted fetuses that were infected congenitally with Toxoplasma gondii. METHODS: Eight eyes from four fetuses of 22 to 27.5 weeks with T. gondii infection were studied by routine and immunohistochemical techniques. Two of the four were also examined by polymerase chain reaction (PCR). RESULTS: In two cases, the results of gross and histopathologic of the eyes were normal; marked retinal necrosis was present in the other two cases. Although no toxoplasmic cysts were identified by routine histopathologic examination, antigens of the tachyzoite were detected by immunohistochemistry analysis in the areas of retinal necrosis. In one of the cases with ocular lesions, the presence of T. gondii was confirmed by PCR. The presence of ocular lesions correlated with the severity of pathologic changes in the central nervous system. Large numbers of T cells were observed in the retinal lesions and in the choroid. CONCLUSION: Retinal necrosis, neovascularization, and marked chorioretinal inflammations despite the absence of bradyzoites are characteristic findings in the fetal eyes infected with T. gondii, and infiltrating T lymphocytes play a role in early recognition of the toxoplasma organism.

Adult↗
PubMed1993

[Toxoplasmosis in pregnancy. Diagnosis and new therapeutic possibilities].

Congenital toxoplasmosis results from contamination of the foetus by Toxoplasma gondii during pregnancy. It is a frequent and severe condition calling for close surveillance of mothers at risk. During the last few years, numerous advances have been made in the diagnosis and treatment of toxoplasmosis. Its diagnosis in the mother is now more reliable due to improvements in serological techniques, while in the foetus the use of foetal vascular techniques has made it possible to detect those who are infected. Owing to a new and effective therapeutic method certain foetuses can now be treated successfully in utero, so that induced abortion is reserved to cases with severe and early toxoplasmosis. The contribution of new molecular biology techniques to advances in this ever moving field is explained.

Adult↗
PubMed1993

Antenatal thrombocytopenia in three patients with TAR (thrombocytopenia with absent radii) syndrome.

Three fetuses with TAR (thrombocytopenia with absent radii) or TAR variant syndrome were found to be thrombocytopenic during the third trimester of the pregnancy. These findings indicate that fetal blood sampling, besides ultrasonography, skeletal radiographs, or even fetoscopy, may indeed contribute to the prenatal diagnosis of TAR syndrome, and thus may help in differentiating TAR syndrome from other syndromes with malformations of the upper limbs.

Abnormalities, Multiple↗
PubMed1993

Diagnosis and management of foetal thrombocytopenia.

Platelet counts remain stable during intrauterine life (245 +/- 65 x 10(9)/litre, mean +/- SD). Before diagnosing thrombocytopenia (< 150 x 10(9)/litre), a foetal blood sample must be checked for contamination with amniotic fluid, since even slight contamination can activate coagulation and lead to a false positive result. In this paper, we review the major causes of thrombocytopenia and discuss their pathogenesis and management. Foetal thrombocytopenia can be caused by maternal complications (immune thrombocytopenic purpura, neonatal alloimmune thrombocytopenia, gestational thrombocytopenia, preeclampsia, alloimmune haemolytic disease) or infectious diseases (toxoplasmosis, cytomegalovirus, rubella) or be of true foetal origin (chromosomal abnormalities, malformations, congenital thrombocytopenia, intrauterine growth retardation.

Female↗
PubMed1992

First-trimester diagnosis of nuchal anomalies: significance and fetal outcome.

High-resolution real-time ultrasonography now permits the differentiation between nuchal translucencies and cystic hygromata of the neck in the first trimester. A series of 85 nuchal anomalies are presented that were diagnosed by ultrasonography at 9-14 weeks' gestation; their association with chromosomal defects and fetal outcome are also presented. Chromosomal anomalies were found in 8/29 nuchal translucencies and in 16/56 cystic hygromata of the neck. However, in fetuses with normal karyotype, additional defects were diagnosed in l0/40 fetuses with cystic hygromata and in none with nuchal translucency. These data may be important for the management of these conditions and for counselling the patients toward further pregnancy.

Journal Article↗
PubMed1992

Electrophoretic and functional characteristics of the von Willebrand factor in human fetal plasma.

Although the haemostatic role of von Willebrand factor (vWF) in adults is well known, there is little information currently available about its possible contribution to in utero haemostasis. We have investigated the distribution of vWF multimers in 27 pure fetal platelet-poor plasma (FP) samples aged from 20 to greater than 36 weeks, by using electrophoresis in both low- and high-resolution agarose gels in the presence of sodium dodecyl sulphate. Our data confirm that most FP samples contain higher molecular weight (HMW) vWF multimers than those present in normal adult plasma, the proportion of these HMW forms being lower in FP samples aged greater than 36 weeks. However, we found that the multimeric unit and the protomeric form of vWF were similar in normal fetal and adult plasma. Functional assays of vWF were performed on three pooled FP samples. In all cases, fetal vWF was able to interact with factor VIII and to bind to GP Ib platelet receptor in the presence of ristocetin and to types I and III collagen. These results indicate that plasma vWF has already acquired in fetal life the functional activities required for its role in both coagulation and primary haemostasis.

Adult↗
PubMed1992

Fetal and neonatal alloimmune thrombocytopenia: current trends in diagnosis and therapy.

Neonatal thrombocytopenia affects 20-40% of the infants in intensive care units. The frequency of neonatal alloimmune thrombocytopenia (NAIT) is estimated at 1/1500 to 1/5000 live births. The risk of morbidity is significant with 20% neurological sequelae and the death rate is estimated at 10% of affected infants. During recent years considerable efforts have been made to prevent fetal bleeding and to avoid birth trauma, which have significantly changed the natural history of NAIT.

Antigens, Human Platelet↗
PubMed1992

Diagnosis of Toxoplasma infection in the pregnant woman and the unborn child: current problems.

Prevention of congenital toxoplasmosis requires identification of non immune women at the beginning of pregnancy, instruction on how to avoid contamination and a serological follow-up of the women until the delivery. The latter is easily achieved by a repeated testing for specific IgG and IgM. Most of the interpretation difficulties arise from results suggestive of recent infection obtained on a first specimen. If no rise in IgG titer is demonstrated on a second serum sample, the use of additional tests studying other Ig-isotypes or acute-phase IgG antibodies can be helpful, mainly as a way to exclude the possibility of infection acquired during pregnancy. Congenital infection can be investigated by biological measurements on fetal blood and by ultrasound examination. Detection of specific IgM and IgA in fetal serum must be interpreted with care because of the existing risk of contamination with maternal blood. Demonstration of Toxoplasma gondii in fetal blood or amniotic fluid by mouse inoculation definitely proves the diagnosis; though less sensitive, tissue culture offers the advantage of a more rapid result. The very promising results obtained by the PCR-method applied to amniotic fluid samples give the hope that it can replace som of the existing confirmatory methods.

Animals↗
PubMed1991

Changes in alpha 1-acid glycoprotein serum concentrations and glycoforms in the developing human fetus.

alpha 1-Acid glycoprotein concentrations and reactivity to concanavalin A were measured in maternal and fetal serum and amniotic fluid obtained from 24 women undergoing diagnostic cordocentesis at 20 to 33 wk gestation and in 30 additional fetal sera (19 to 34 weeks gestation). Maternal alpha 1-acid glycoprotein serum levels were five to ten times higher than fetal and amniotic levels. Fetal alpha 1-acid glycoprotein levels were found to increase with advancing gestational age. Using crossed immunoaffino electrophoresis with concanavalin A, alpha 1-acid glycoprotein patterns were identical in maternal serum and amniotic fluid but totally different in fetal serum. The fetal concanavalin A pattern changed progressively during fetal life towards that of the newborn. These data confirm earlier assumptions of fetal synthesis of alpha 1-acid glycoprotein and provide normal reference values for alpha 1-acid glycoprotein in fetal serum. In addition, the specific fetal concanavalin A pattern indicates that the alpha 1-acid glycoprotein glycosylation process during fetal life differs from that in post-natal life.

Amniotic Fluid↗
PubMed1991

[Infectious fetal diseases. Prevention, prenatal diagnosis, practical measures].

Many congenital infections can produce foetal diseases and are sometimes responsible for major disablements. The most frequent infectious foetal diseases are toxoplasmosis, rubella and chickenpox. Diseases caused by parvovirus or cytomegalovirus are exceptional. Foetal blood sampling has considerably simplified the prenatal diagnosis and made it accessible to more medical centres; it has also widened the therapeutic possibilities and above all, it has considerably reduced the number of therapeutic abortions. It may well be that the development of molecular biology, which has the great advantage of permitting an earlier diagnosis, will in the near future make it possible not only to detect numerous monogenic diseases before birth, but also to diagnose some foetal infections. We might then hope that a much earlier treatment in utero will also be more effective.

Chickenpox↗