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Biomedical subjects

G Magnin

Publications and source records attributed to G Magnin.

At least 19 recordsLinked to original sources

[The HELLP syndrome. 13 cases].

The Hellp syndrome is a complication of raised blood pressure in pregnancy, haemolysis, a rise in liver enzymes and thrombopenia. In this retrospective study we report 12 cases of Hellp syndrome which occurred in the University Hospital Centre of Poitiers between 1982 and 1990 and we discuss causes, the progress, the prognosis and the management. Six patients were helped by prophylactic Caesarean operation. Two patients had eclamptic fits. Fortunately there was no maternal death. There were seven cases of intrauterine growth retardation, two of in utero fetal death and one of early neonatal death. When clinical and biological parameters of the Hellp syndrome come right following delivery, the outlook for the mother is quickly favourable, but the syndrome can continue and sometimes become worse after delivery. Stopping the pregnancy is the basic treatment and conservative treatment has only a very limited success. Finally, the prognosis for the future is usually good and it is unlikely to recur.

Anemia, Hemolytic

[The Harlequin Baby syndrome. A new case].

The Harlequin baby syndrome is a rare but lethal ichtyosis. We report a new case of a primiparous woman of 28 years of age who had a pregnancy that progressed normally with the delivery of a child of 2,450 grams whose Apgar was 9 at one minute and 10 at three minutes, but who died after living just 24 hours. The reason for this work is to try to analyse the features that are known about possible treatment and antenatal diagnosis of the Harlequin baby syndrome. It has been suggested that vitamin A supplements should be given for several years because the skin state may be improved. On the other hand morbidity is likely to remain serious particularly from the point of view of growth and psychomotor development. Antenatal diagnosis using skin biopsy can be obtained after 23 weeks of amenorrhoea using a fetoscope; it shows the 25% of cases recur. At present the only treatment if a recurrence does occur is to terminate the pregnancy.

Abortion, Therapeutic

[Q fever and fetal death in utero. Two cases].

Some cases of late abortion occurring after a Coxiella burneti infection, more often with a chronic evolution, have already been mentioned in the literature. We reported here two cases of early abortion, contemporaneous of an acute infection due to C. burneti. Two patients, after a contact, before and at the beginning of the pregnancy, with an animal susceptible to contaminate human beings by C. burneti, presented no clinical symptom characteristic of Q fever. The fetal death for the two cases was found out at the 17th week of amenorrhoea. All the investigations in order to search for an abortion etiology remained negative. Only, the specific serologies showed an acute infection due to C. burneti.

Adult

[Human parvovirus B19 infection during pregnancy. 2 cases].

We report two cases of non immunologic hydrops fetalis associated with intra-uterine human parvovirus B19 (PV B19) infection. The outcome was stillbirth in both cases. Infection by PV B19 was suspected by the presence of intranuclear inclusions in fetal erythroblasts. It was confirmed by the presence of specific immunoglobulins M (IgM) against PV B19 in maternal sera. Intra-uterine infection with human PV B19 is known since 1984; this virus may cause non immunologic hydrops fetalis and stillbirth; teratogenic effects have also been suggested. Epidemiological studies, published in 1988 and 1990 have evaluated the risk of PV B19 fetal related death at 9% and no association was found between infection and congenital anomalies. Subsequent management of infected pregnancies is studied. We emphasize the interest of pathological examination of hydropic stillbirth for this diagnosis.

Adult

[Materno-fetal infection by Chlamydia psittaci transmitted by the goat: a new zoonosis?].

A case report is given of spontaneous abortion at 32 weeks brought about by Chlamydia psittaci following contact with a herd of goats. Severe symptoms were observed post-natally in this woman. Nine cases of materno-foetal infection with this pathogen are known, however, the source of infection is usually ewes suffering abortive chlamydiosis. Goats may also be infected, but caprine origin for the disease in pregnant women has not been reported previously.

Abortion, Spontaneous

[Delivery of large infants. Management and results of 198 cases].

We have studied the deliveries of 198 large fetuses over a period of 3 years between 1st January 1987 and 31st December 1989 in the University Hospital of Poitiers. By large fetus we mean the delivery of a child of 4,000 grammes or more. This occurs in 4.5% of deliveries. The following risk factors are present either singularly or together with others: previous delivery of a large child (12.6%), a previous history of pregnancy diabetes or its absence (2.5%), an increase of weight during pregnancy of more than 15 kgs (46.8%), obesity before the onset pregnancy (19.7%), the height of the uterus equal to or above 35 cms (75.8%). These factors were found in nearly 90% of the patients. Their presence should make one look for a large fetus. The obstetrical results were as follows: 18 ceasareans were carried out (9.09%); instrumental delivery was necessary in 43 cases (23.8%); there were 17 cases of shoulder dystocia treated by obstetrical manoeuvres (9.5%). There were therefore 122 vaginal deliveries without any interference (61%). Neonatal complications were: one lost because of malformation (0.5%), serious morbidity in 30 deliveries (15.15%); 16 fractures of the clavicle and two cases of brachial plexus paralysis of which one persisted, two facial palsies which recovered, six infections, three cases of hypoglycaemia and one serious fetal distress which recovered without any sequelae. Maternal complications were: no mortality, serious morbidity in 26 women (14.1%), 9 haemorrhages at delivery, 9 cases of trauma of the perineum, 6 infections, and 2 haematomata in the episiotomy wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Invasive cervix cancer stage I and II in women less than 35 years old].

The results of a retrospective study of 74 women under the age of 35, treated invasive cervical cancer, stage I and stage II, between 1973 and 1985, were compared with those obtained in 547 women over 35, treated during the same period of time for a similar cervical cancer. The treatment consisted of: association radium therapy-surgery for stages IB less than 25 mm and II A moderately extended and an association radiotherapy-radium therapy for stages IB greater than 25 mm and II A extended, II B and II C. A better distribution per stage is found in women under 35, identical regarding the histological type with 5-year survival identical in both groups at the same stage. Relapses or recurrences occur much earlier in younger women. In the literature, the age as a prognosis factor is very much controverted. On the contrary, other factors should be taken into consideration: clinical stage, node invasion, size and volume of the tumor, depth of infiltration of the cervix.

Adult

[The Hellp syndrome: is this a clinical form of thrombotic microangiopathy?].

There are similarities between the clinical, biological and histological features of thrombotic micro-angiopathy (TMA) when it is a complication of pregnancy and the "Help Syndrome" (HS). HS can be associated in pregnancy with pre-eclampsia, thrombocytopenia, micro-angiopathic haemolysis and hepatic cytolysis. We have analysed on the one hand biological features of six cases that occurred in the literature and two personal cases of thrombotic micro-angiopathy that had been proven histologically; and on the other hand the histological findings of the liver in two cases of the literature and in a personal case of HS. Demonstration that in HS deposits exist under the endothelium in the region of the hepatic biopsy suggest that the latter can only be a special clinical form of TMA.

Anemia, Hemolytic

[The value of antibiotic prophylaxis during intrauterine procedures during vaginal delivery. A comparative study of 500 patients].

This comparative study carried out on 550 patients has made it possible for us to show how valuable prophylactic antibiotic therapy is when certain intra-uterine manipulations (such as forceps delivery, manual removal of the placenta or exploration of the cavity of the uterus) are carried out during vaginal delivery. Furthermore, we have been able to show that there are certain risk factors of which the most important are premature rupture of the membranes, infected liquor, birth weight of the infant less than 2,500 g and epidural analgesia. The financial study has shown that it is cheaper to use prophylactic antibiotics when the comparison is made with the cost of treating complications of infection associated with these intra-uterine procedures.

Amoxicillin

[Pre-eclampsia and the nephrotic syndrome. Prognosis and management; apropos of a series of 23 cases].

In pregnancy pre-eclampsia can be complicated by the nephrotic syndrome. We report on the clinical findings in 23 patients who had the nephrotic syndrome in pregnancy with hypertension. None of these patients had any previous sign of nephropathy. In most patients clinical signs first showed up in the 3rd trimester. The prognosis for the fetus was poor. This was because of the degree of proteinuria and of uraemia (5 fetuses died). After delivery all signs cleared up, as they would have done in moderately severe pre-eclampsia. All patients were considered to be cured by six months. In spite of this the longterm prognosis is difficult to assess. It is necessary to find out whether the nephrotic syndrome was evidence of an underlying nephropathy or just was due to the pre-eclampsia. Treatment consists mainly of rest, control of hypertension, correction of low blood volume and delivery of the fetus with regard to the degree of maturity and the viability of the fetus.

Adolescent