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Biomedical subjects

F Puech

Publications and source records attributed to F Puech.

At least 145 records · Page 8Linked to original sources

[The prognostic value of raised uric acid in the blood in arterial hypertension in pregnancy. 58 cases (author's transl)].

The authors have carried out research in 58 cases to see whether the findings of high uric acid levels in the blood are of prognostic value in all cases of arterial hypertension in pregnancy whatever the aetiology. The material studied consisted of 30 true cases of toxaemia of pregnancy, 13 cases of recurrent toxaemia and 15 cases of the vasculo-renal syndrome on top of the pre-existing pathological condition. In 37 cases where the blood uric acid level was lower than 300 micromoles there were only 4 minor complications. Serious complications were found in 6 cases in which the patients had a blood uric acid level highthan 480 micromoles. This study confirms the prognostic value of blood uric acid levels. The estimation of these levels, however, seems to be of less value in making a differential diagnosis between the various kinds of toxaemia and hypertension found in pregnant women due to different aetiologies.

Adult↗

[Meadows syndrome. A case history (author's transl)].

The authors, having studied a case of Meadows syndrome, confirm that this cardiomyopathy is a specific entity in pregnancy and the puerperium. They point out the difficulties in diagnosis, as Meadows syndrome seems to be diagnosis of elimination. They point out that a paraclinical balance has to be drawn up very fully on the biological and haemodynamic planes to confirm this condition. Finally, after a short discussion about the therapy, they tackle the problem of the prognosis for life and for future childbearing in these patients, which is determined by the persistence or absence of cardiac enlargement.

Adult↗

[Exact determination of the lecithin/sphingomyelin ratio in amniotic fluid. Suggestion of a reference methods (author's transl)].

Pulmonary maturity of the fetus can be evaluated by the lecithin/sphingomyelin (L/S) ratio in amniotic fluid. To existing methods of lipid extraction, precipitation with acetone and chromatography, we add a simple and accurate estimation of sphingomyelins (S) and precipitated lecithins (Lp) without acid digestion. The method is reproducible (C.V. less than 9%) for the measurement of Lp/S ratio and gives with accuracy the concentrations of Lp, avoiding possible errors in interpretation of Lp/S. Our results show that at 35 weeks of normal gestation, Lp/S ratio is about 2 and Lp concentration, 10 mg/1.

Amniotic Fluid↗

Some physical and biochemical parameters during normal labour.

A statistical study of parameters of uterine contraction, fetal heart rate, acid-base balance and glycaemia has been made in 30 patients during spontaneous and clinically normal labour for each 2 cm of cervical dilatation. The study of uterine contractility gives the mean values and 95% limits of parameters of uterine contraction as labour progresses. The fetal heart rate is stable during dilation, on the other hand, during the expulsive phase, alterations of fetal heart rate appear, modifications which give evidence of trial that expulsive phase is for the fetus. The study of fetal and maternal acid-base balance shows little change during cervical dilatation, changes towards acidosis during expulsive phase, as importance of feto-maternal relationships. These relationships meet again on the study of glycaemia.

Acid-Base Equilibrium↗

[Study of fetal heart rate in deliveries complicated by fetal acidosis].

A study has been carried out on the parameters of the graph of the fetal heart rate (the basal rate and dips) in 44 cases of acute fetal distress with a pH lower than 7.2 in the blood and in 30 normal deliveries. The statistical analysis confirms that there is a significant rise in the number of heart rate abnormalities such as persistent bradycardia or persistent tachycardia and with dips during deliveries with fetal acidosis. The frequency of these abnormalities increases with the degree of acidosis. Sometimes the abnormalities in the fetal heart rate precede the appearance of the acidosis. All the same the discovery of these abnormalities does not by itself make a precise diagnosis of fetal distress because we do find these abnormalities in a certain number of cases even in normal deliveries. Only measuring fetal pH at a definite time can establish the diagnosis of fetal distress and the severity of the condition.

Acidosis↗

Evolution of the prematurity before the 32nd week from 1980 to 1985 in a tertiary perinatal center in Lille, France.

127 infants were born alive before the 32nd week of gestation in the H. Salengro obstetrical unit from the University Hospital of Lille from January 1980 to December 1985. During this period the annual number of deliveries was constant, 2700. Two periods were considered, 1980-1982 and 1983-1985. The number of such premature infants increased slightly: from 56 to 71. The most striking feature was the dramatic increase in infants born after induction of delivery for fetal reasons. Another finding is the statistically significant lowering of gestational age and birthweight of the spontaneously born infants. These trends counterweight the efficacy of the policy of prevention. When considering the morbidity and the mortality, hyaline membrane disease still plays a preeminent role in this population.

Female↗

[Peridural anesthesia for all women in labor: utopia or reality?].

Peridural anesthesia in obstetrics is more and more widely used, improving comfort and security for delivery. In 1989, 74% of the deliveries occurred under peridural anesthesia in our unit. In order to assess if this percentage can be increased, we analysed during one month the reasons why some women did not get a peridural anesthesia.

Anesthesia, Epidural↗

[Obstetric outcome of the malformed uterus. Study of 155 pregnancies].

Gynecological and obstetrical pathologies are considered in 155 pregnancies involving uterine deformity. Evaluation of their relative importance shows that maintenance of pregnancy is more important than pregnancy per se. Certain rules are proposed for treatment and obstetrical management of such pregnancies.

Abortion, Spontaneous↗