Search PubMed⌕ Search

Biomedical subjects

J C Pons

Publications and source records attributed to J C Pons.

At least 73 records · Page 4Linked to original sources

Fetal karyotype from cystic hygroma fluid.

In cystic hygroma (CH) fetuses, hydrops fetalis and anamnios make it difficult or impossible to obtain amniotic fluid or cord blood for cytogenetic analysis. We report six cases of CH in which cytogenetic analysis was simply and successfully performed using nuchal fluid cells. The karyotypes were 47,XY, + 18,46,XY,46,XX, and 45,X (n = 3).

Cytodiagnosis↗

[Medical and ethical problems posed by the prenatal diagnosis of distal absence of a limb].

Eight cases of distal amputation of limb are reported. The diagnosis were made by ultrasound scans at 18-25 weeks of amenorrhea. In all cases, according to the French law, our team of fetal medicine refused the therapeutic terminations of pregnancy requested by the parents. The therapeutic terminations of pregnancy were achieved by another unit of fetal medicine in France, or in another country. These reported cases address many questions about the aim of fetal medicine (therapeutic terminations of pregnancy or treatment of infants), the place of the parents request in the decision, the different decision arguments, and the variations in the decision between different fetal medicine crew facing to similar prenatal diagnosis.

Abortion, Legal↗

[Quadruplet pregnancies: management and obstetric and pediatric outcome].

Multi-fetal gestations are associated with increased frequency of maternal, fetal and neonatal complications. Data on the prognosis of multi-fetal pregnancies are of particular importance when the option of selective termination is considered. The present study details the obstetric management, neonatal outcome, and follow-up of seven quadruplet pregnancies in a french university center. The perinatal mortality was 250/1000. The neonatal mortality was 214/1000. The incidence of respiratory distress syndrome was 38%, bronchopulmonary dysplasia 19% and intraventricular hemorrhage 9.5%. Follow-up from one to 16 years shows that no child is handicapped. Our specific management for higher order multi-fetal pregnancies include early diagnosis, meticulous follow-up, early decrease of maternal activity, midwives at home, psychological care, delivery by cesarean section and a neonatalogist for each baby at the time of delivery.

Abortion, Therapeutic↗

[RU 486 (mifepristone) and therapeutic abortions in the second and third trimesters].

RU 486 activity for therapeutic pregnancy termination through prostaglandin was studied in a controlled survey including 50 patients, in the second and third trimester of pregnancy (in conformity with the French law). Patients were randomly divided into two groups. The first one was administered orally 200 mg of RU 486, 48 hours before the first Sulprostone injection. The control group did not receive any RU 486. The mean duration between prostaglandin administration and miscarriage was significantly shorter in the RU 486 group (13.16 hours), than in the control group (23.16 hours). Women with RU 486 treatment needed less prostaglandin doses and, above all, had less prostaglandin secondary effects than the patients in the control group.

Abortifacient Agents, Nonsteroidal↗

Placental passage of azathiothymidine (AZT) during the second trimester of pregnancy: study by direct fetal blood sampling under ultrasound.

AZT-therapy during pregnancy is actually contraindicated. Two HIV-positive pregnant women who were due to have an induced abortion in the second trimester of pregnancy, were treated with AZT. Blood samples from mothers and fetuses and amniotic fluid samples were taken simultaneously. AZT crossed the placental barrier in the two patients. AZT and GAZT concentrations from the two fetuses were close to those obtained in the two women and in six non-pregnant volunteers.

Acquired Immunodeficiency Syndrome↗

Vaginal infections, cervical ripening and preterm delivery.

A prospective study is presented which addresses the relative effect of cervicovaginal infection and precocious maturation of the uterine cervix on preterm delivery. From April 1981 through December 1983, a total of 5758 pregnant women were checked by means of a vaginal examination at every prenatal visit and a research for bacterial cervicovaginal infection whenever abnormal signs were observed. The study reveals that vaginal infection has no measurable effect when observed during the second trimester of pregnancy, and a small effect during the third trimester. This means that infection of the vagina or/and the cervix may be demonstrated as a risk factor only when the cervix is short before 28 weeks or open before 37 weeks.

Bacterial Infections↗

HIV proteins absent from placentas of 75 HIV-1-positive women studied by immunohistochemistry.

Recent epidemiological and virological data suggest that the incidence of maternofetal transmission of HIV-1 infection is between 20 and 30%. The available evidence points to a possible role of peri- and postnatal contamination, but the isolation of HIV from fetuses shows that transplacental transmission also occurs. We attempted to detect, by means of an immunohistochemical method, HIV proteins in frozen placentas from 75 HIV-1-positive women (30 at term, 45 induced abortions). In addition, in situ hybridization using HIV-specific probes was performed in three cases. Neither HIV proteins nor nucleic acid sequences were detected, but CD4+ mononuclear cells were present in the chorion and villi, regardless of the clinical and biological status of the mother (particularly in the nine cases in which the infants were infected). There are several possible mechanisms involving the placenta in the maternofetal transmission of HIV, including active transport of the HIV-immunoglobulin G complex via Fc receptors on trophoblastic cells, passive transplacental passage of HIV during a viraemic episode, the passage of infected maternal cells, and infection of the placenta itself. The methods we used could not rule out the presence of HIV DNA provirus within the genome of placental cells. In any event, immunohistochemical detection of HIV proteins in the placenta is not a technique suitable for the prenatal diagnosis of HIV infection or for identifying newborns likely to develop HIV infection.

Adult↗

Fetal platelet counts in thrombocytopenic pregnancy.

Fetal platelet counts were assessed by percutaneous umbilical blood sampling in 64 pregnancies (62 women) with maternal thrombocytopenia. In 33 pregnancies associated with chronic immune thrombocytopenia, 11 of the fetuses had platelet counts below 150 x 10(9)/l and 4 were severely thrombocytopenic (less than 50 x 10(9)/l). In 31 pregnancies with symptomless maternal thrombocytopenia as an incidental finding, 4 fetuses were thrombocytopenic, 1 of them severely. Maternal indices, including antiplatelet antibodies, did not correlate with risk of fetal thrombocytopenia; and in those with repeat measurements there was no evidence of benefit from treatment with either corticosteroids (4 cases) or intravenous immunoglobulin (3 cases). Percutaneous umbilical blood sampling, a safe procedure in experienced hands, provides accurate platelet counts in thrombocytopenic pregnancy, as an aid to decisions on mode of delivery and to assessment of treatments.

Blood Specimen Collection↗

Transfusion syndrome in a triplet pregnancy.

A case is reported of a transfusion syndrome in a triplet pregnancy with intrauterine death of two of the fetuses. This is an exceptional occurrence in a triplet pregnancy and raises the problem of the management of multiple pregnancies associated with the death of one or more of the fetuses. The problem of the method of delivery and the complications arising in triplet dizygotic pregnancies is discussed.

Adult↗

[A study of fetal pulmonary maturity using amniotic fluid obtained from the vagina after premature rupture of membranes].

Amniotic fluid was obtained from the vagina not more than 24 hours before delivery in 100 patients who had premature rupture of the membranes. Thirty per cent of these cases had contamination with blood or with meconium. Phosphatidylglycerol (PG) estimate the degree of lung maturity using an immunological method (AMNIOSTAT-FLM test). In the 22 cases where the gestational age was 35 weeks or less there were two cases of hyaline membrane disease. In 68% of the 22 cases, the PG was negative, intermediate in 14% and positive in 18%. One of the cases of hyaline membrane disease was accompanied by fluid that was not infected and that was negative for PG; the other case had infection with S. faecalis and the PG was intermediate. On the other hand in the 78 cases when the pregnancies had lasted longer than 35 weeks there were no children who had hyaline membrane disease. The PG reaction was positive in only 57% of these cases. Search for bacteria showed infection in 10 cases (three with alpha-haemolytic streptococci, four with group B beta-haemolytic streptococci and three with E. coli). Determination of PG on the supernatant of reference strain cultures showed positive results for S. faecalis and E. coli. In conclusion, the poor specificity of the test (48%) and the possibility that when there was bacterial contamination false positive results were obtained shows that looking for fetal maturity by testing amniotic fluid from the vagina is unreliable and is contra-indicated.

Amniotic Fluid↗

[Utero-ovarian mucoid carcinoma, of presumed wolffian duct origin (pure mesonephrotic carcinoma). Apropos of a case and review of the literature].

This is a case report of a rare tumour of the ovary originally developing from the embryonal vestiges of the Wolffian duct and becoming a pure mesonephrotic carcinoma. Although initially considered to be benign, the course of the tumour is one of a potential low grade long term malignancy. Histological changes are of a pure mesonephrotic carcinoma or of a female adnexal tumour probably of wolffian origin (FATWO). It showed few specific traits. Each site of the development is constantly linked to the anatomy of the Wolffian duct. Metastases and recurrencies can develop late (after 5 to 10 years) following radical surgery. A survey of the literature confirmed the salient features of these tumours, which can differ from those of Müllerian origin.

Adenocarcinoma, Mucinous↗

[Sports and pregnancy. A review of the literature].

A review of the literature concerning sport during pregnancy is presented. The mother's heart rate, arterial blood pressure, systolic ejection fraction and cardiac output undergo the same changes during exercise in the pregnant and non-pregnant patient. The increase in the fetal heart rate during maternal physical exercise does not adversely affect the fetal outcome. The uterine blood flow is diminished during exercise. The respiratory rate increases equally in pregnant and non-pregnant women. The maternal response to effort is also modified by weight gain during pregnancy, by changes in the musculo-skeletal system, and by maternal temperature control during exercise. Weight gain, uterine contractility, duration of pregnancy, labour and neo-natal conditions are not altered by sport during pregnancy. Contra-indications to sport during pregnancy include threatened premature labour, and conditions associated with an increased risk of prematurity. A previous history of fetal growth retardation, acute fetal distress, or the presence of diabetes or arterial hypertension is a contra-indication to sport during pregnancy. The advice which should be given to a pregnant woman wishing to continue her sporting activities during pregnancy is outlined.

Female↗