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Biomedical subjects

G Magnin

Publications and source records attributed to G Magnin.

At least 73 records · Page 4Linked to original sources

[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↗

[Doppler examination of the umbilical arteries. Its role in the surveillance of pregnancy].

Pregnancies with a high risk of fetal growth retardation are at present watched by using clinical observations and biological parameters including ultrasound and estimation of the fetal heart rate. The Doppler waveform in the umbilical arteries provides information about circulatory resistance in the placenta. An index of resistance "R" is evaluated on the Doppler trace. The purpose of this study is to describe the score (with its possibilities and limitations) for this parameter "R" to follow-up pregnancies with fetal growth retardation and to compare it with ultrasound, biological and clinical parameters that are commonly used. Two groups of pregnancies have been explored: pregnancies with hypertension and pregnancies with idiopathic fetal growth retardation. Abnormal values of "R" correlate well with failure of fetal growth. Furthermore pathological values of "R" do not correspond to the same population as abnormal values of the other parameters. In some cases "R" is disturbed before the others are. In conclusion, this study shows that the index increases the accuracy of detection and the follow-up of chronic fetal growth retardation, particularly in cases of pregnancies with vascular placental pathology.

Birth Weight↗

[Doppler examination of the umbilical and cerebral arterial circulation of the fetus].

Umbilical circulation can be explored by Doppler ultrasound methods very easily. The umbilical arteries spectrum provides information on the placental circulation. The diastolic flow is directly related to the vascular resistances of the placenta (Rp). In cases of pathological pregnancies with hypertension the decrease in the diastolic flow and the increase in the resistance index Rp have been correlated with intra-uterine fetal growth retardation. The specificity of this index Rp is of 95% but the sensitivity much more lower (approximately 70%). For that reason Doppler assessment of the fetal circulation in other areas has been recently carried out. Fetal cerebral arteries have been explored during normal pregnancies. The index of cerebral resistances as defined by Pourcelot Rc = S-D divided by S (with S systolic amplitude and D diastolic amplitude) show similar variations to the placental index but later in the pregnancy. During the pregnancy the cerebral index is higher than the placental one and the cerebro placental ratio (CPR) superior to 1. During pathological pregnancy (hypertension) with fetal growth retardation one of the index Rc or Rp may be out of the normal range but the cerebro placental ratio CPR is always lower than 1. The follow up of both the umbilical and cerebral circulation increases notably the accuracy of the Doppler method for the detection of intra-uterine fetal growth retardation.

Cerebrovascular Circulation↗

[Marfan's disease and pregnancy. Apropos of a case].

Marfan's syndrome is a dominant autosome transmitted disease with different degrees of seriousness. When it is associated with pregnancy there is a considerable increase in the rate of cardio-vascular complications which are responsible for a serious rate of maternal mortality due to aortic dissection. It is therefore very important that the patient, before starting a pregnancy, should be examined very carefully clinically and with ultrasound. A woman with dilatation of the aorta less then 40 mm as measured ultrasonically and who has no major clinical signs can start a pregnancy but even then she should be considered as a high risk case. In other cases therapeutic termination of pregnancy or prophylactic surgical treatment of the condition should be considered. Apart from the serious genetic risks (50%) the risks for the fetus are dominated by prematurity and by fetal death resulting from maternal death.

Adult↗

[The female breast as an object of liability complaints. Analysis of relative jurisprudence].

The authors analyse the incidence of medico-legal actions that can follow surgical and irradiation treatment of tumours in the female breast under French jurisprudence, which is now well established. Also involved are cosmetic surgery and all reconstructive procedures on the breast. Attention is drawn to errors that should be avoided in order to minimise the risks of being sued. There has been according to the files that have been inspected, a drop in legal actions for surgery of the breast for growths because radical surgery has become less frequent and less extensive. On the other hand there have been more complications from irradiation or from chemotherapy that has not been well controlled and where the risks had not been properly explained to the patients before treatment started. The article brings to attention how important it is to obtain informed consent about all details including very rare complications, particularly when the indication for the operation is cosmetic or for comfort and not in order to cure disease. Finally, the authors discuss the problem of cancer eventually developing in a tumour of the breast which appears after trauma received by the breast from seat-belt compression injuries. In spite of the unclear pathological causes so far discovered, there may be cause and effect between traumatism and a tumour discovered after an interval. It is suggested that immediately after the injury a careful examination of both breasts should be undertaken using mammography and ultrasound, including the anterior wall of the thorax, so that early diagnosis is made of possible signs suggesting that a tumour would be likely to develop. This should be done in spite of the presence of a haematoma in or around the breast.

Breast↗

[Place of automatic oxytocin perfusion devices in the artificial induction of labor].

Automatic and self-regulated ocytocin perfusion sets, currently available, are able to precisely analyze the uterine activity in 15 minutes and automatically reduce the ocytocin output when a stable and effective uterine activity is obtained. The authors report the results of 41 inducements with the Autosoma pump and compare them with 358 inducements with manually controlled pumps. The duration and the amount of ocytocin perfused with Autosoma are comparable to the results obtained with manually controlled pumps. The frequent release of Autosoma alarms at the beginning of the experiment partially explains the lack of advantages of the automatic perfusion set.

Female↗

[Termination of pregnancy and evacuation of the uterine contents in the second trimester. Use of a prostaglandin E2 analog: sulprostone].

The authors used sulprostone on 165 women whose pregnancies had lasted more than 12 weeks. The principal indications were: intra-uterine fetal deaths in 65 cases and an antenatal diagnosis of fetal malformations in 75 cases. Three routes of administration of the drug were employed: extra-amniotic in 15 women; intravenous in 62 women; intramuscular in 88 women. The doses used (adding together the intramuscular and intravenous routes) were: ampoule of 500 micrograms of sulprostone in 25% of cases; ampoules in 50% of cases; ampoules in 25% of cases. It was found to be very effective: by the intravenous route 88.70% expelled the fetus in 24 hours with a mean induction delivery time of 11 hours; by the intramuscular route 89.77% expelled in 24 hours with a mean induction delivery time of 11 hours 45 minutes. The side effects were not common: nausea in 17.6%; vomiting in 16.4% and diarrhoea in 6%. Ther marked effectiveness of sulprostone on the one hand and the good tolerance on the other indicate the effects of this product, which are a strong action on the uterus and a feeble action on the smooth muscle of other organs.

Abortifacient Agents↗