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Biomedical subjects

H Bossart

Publications and source records attributed to H Bossart.

At least 19 recordsLinked to original sources
PubMed1991

[Invasive fetal medicine: pros and cons].

Many methods of ovular sampling now exist. They give us access to our second patient, the foetus, for the purpose of carrying out diagnoses and prognoses and of beginning treatment. These methods carry a risk for the foetus, and it is therefore to weigh up the indications carefully. In addition, some methods (embryoscopy, foetoscopy, skin and liver biopsies, foetal blood samples) have to be performed by experienced specialists in reference centers. These methods also raise numerous ethical problems, notably in view of the multiple diagnostic possibilities and the relatively limited therapeutic possibilities.

Academic Medical Centers↗
PubMed1990

[Hematological parameters and prognosis in established or imminent HELLP syndrome. Apropos of 12 case reports].

We describe the clinical and biological characteristics of 12 pregnant women with the HELLP syndrome as defined by Weinstein in 1982 (H for hemolysis, EL for elevated liver enzymes and LP for low platelet count). The data demonstrate that this syndrome is an obstetric emergency threatening the lives of both mother and child. However, if delivery is prompt the prognosis is good. The suspicion of gestosis requires a hematological assessment (complete blood count and close examination of blood film, evaluation of hemostasis) as an essential component in therapeutic decisions.

Adult↗
PubMed1990

[Fertilization in vitro and embryo transfer].

After a brief historical survey and review of the main Swiss centres engaged in medically assisted procreation, the indications for in vitro fertilization and embryo transfer (IVF-ET) are discussed. This technique offers the sterility specialist a new approach in allowing separate investigation of the two gametes and study of their interactions. This therapeutic approach to infertility is thus supplemented by biological data which may modify or highlight some of the etiologic aspects and promote new treatments. The techniques employed at our centre and the results obtained over the past four years are presented. Analysis of IVF pregnancies shows that the obstetric risks can be associated with the characteristics of the groups treated rather than with the IVF technique.

Corpus Luteum Maintenance↗
PubMed1989

[Active management of labor. Preliminary results].

Concerned by the raise in cesarean section rate we introduced a more active management of labor derived from the Dublin experience. This involved a more accurate diagnosis of labor, associated with early diagnosis and augmentation of nonprogressive labor by oxytocin. Two groups of patients who delivered before and after the method was applied were compared. Cesarean section rate fell from 29.6% to 21% (p less than 0.01) and the mean duration of labor was reduced by two hours in nulliparas (from 7 h to 5 h: p less than 0.0005) and by one hour 15 minutes in multiparas (from 4 h 15 min to 3 h: p less than 0.0005), without change in the number of forceps deliveries and the perinatal outcome. Our cesarean section rate remains high. This is largely due to the number of high-risk pregnancies (10% preterm deliveries), the percentage of nulliparas (49%) and the systematic abdominal delivery of breech in nulliparas.

Adult↗
PubMed1987

[Lupus erythematosus, circulating anticoagulant and obstetric complications. Apropos of 2 cases].

Systemic lupus erythematosus (SLE) is a disease occurring mostly in women in the childbearing age. We present two cases of pregnancy complicated one by SLE, the other by a "lupus-like" syndrome. In the first case, the fetus suffered from a complete heart block; in the second one, a lupus anticoagulant was discovered in the mother. These two cases are discussed by the light of the literature.

Adult↗
PubMed1983

Systematic pH-measurements in the umbilical artery: causes and predictive value of neonatal acidosis.

Subpartal and neonatal blood gas analyses have attracted increasing interest during the past 20 years. Different studies have been carried out to investigate the causes and immediate consequences of perinatal acidosis. It was the aim of this study to examine the long term outcome of acidotic-born babies. During 16 consecutive months all deliveries in the Obstetric Department of the Centre Hospitalier Universitaire Vaudois (CHUV) were investigated with regard to incidence and causes of a perinatal acidosis (pHa.umb. less than 7.15). The psycho-motor development of all acidotic newborns was followed up for an average of 15 months. Out of 1922 deliveries a blood sample was available in all but 11 cases (0.57%). Seven newborns were excluded from the study on the assumption that their acidosis and outcome might be related to the underlying condition (congenital malformation and infection, extreme prematurity) rather than perinatal events. From the remaining 1904 deliveries 6.4% (N = 121) had a pHa.umb. less than 7.15 (Tab. I). The incidence of certain perinatal factors was compared in the acidotic and the non acidotic groups (Tab. II). The percentage of acidotic newborns is significantly higher in primipareae, in deliveries done on peridural analgesia in cord complications and premature rupture of the membranes, and in forceps deliveries. No difference could be found with regard to multiple pregnancies, meconiumstained amniotic fluid, cesarean sections, prematurity of 28-37 weeks, and sex. The relationship between CTG score and pHa.umb. is summarized in Tab. III.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗
PubMed1979

[Place of routine amnioscopy in the screening of fetal distress (author's transl)].

In order to assess the benefits of routine amnioscopy in the screening of fetal distress, the CTG score, the pH of umbilical artery and the Apgar score were determined and compared in two groups of patients: one group had meconium stained amniotic fluid (MSAF), the other (control) had clear amniotic fluid. Although the prepathological and pathological CTG scores were more frequent in the MSAF group, the values of the umbilical artery pH had the same distribution in the two groups. The percentage of acidotic fetuses in the MSAF group is very low (2.9 p. 100) and practically the same as in the control group (2.5 p. 100). The Apgar score distribution at one and five minutes is also the same in the two groups. The distribution of CTG scores in acidotic fetuses is the same in the two groups, but the pre-acidotic fetuses born with meconial fluid have more often a pre-pathological or pathological CTG score. Fetuses with normal or suspect CTG-score and nevertheless acidotic or pre-acidotic pH values at birth are equally present whether the liquid is stained or not. Amnioscopy is therefore of no help even in this situation. In conclusion, the discovery of a MSAF is the manifestation of fetal hypoxia in only 2.9 p. 100 of cases: the detection of this condition is better achieved by CTG recordings than by routine amnioscopy.

Amniotic Fluid↗
PubMed1978

Clinical aspects of continuous tissular pH measurements of the newborn and the fetus.

The first results of continuous tissular pH readings in 58 neonates are presented. These results are compared with blood pH values and technical problems are discussed. The positive results made us proceed to sub-partu measurements. We finally give our opinion on the new ROCHE equipment and insist that it is not yet ready for routine use, but a promising tool for clinical research.

Adult↗
PubMed1978

[A new instrument for measurement of actual instantaneous pH in obstetric (author's transl)].

The authors present a new instrument for measurement of actual instantaneous pH in obstetrics. It has been developped to avoid most errors of the usual scalp-blood sampling. Its advantages are:--Aspiration is manual and controlled.--Results are obtained within 10--15 seconds. A comparative study with two other pH-meters has demonstrated an excellent correlation and reliability of this new instrument. The authors consider the method as simple, functional and reliable, all favourable factors for routine use.

Blood Specimen Collection↗