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Biomedical subjects

M Thiery

Publications and source records attributed to M Thiery.

At least 73 records · Page 4Linked to original sources

[The impact of a new strict obstetrical strategy on maternal mortality and obstetrical results].

In an attempt to reduce the caesarean section rate without an adverse effect on the obstetrical outcome, new guidelines for the management of dystocia, previous caesarean delivery, fetal distress, and breech presentation were introduced in September 1984 in a provincial hospital in Zimbabwe, Africa. Comparison of the two-year periods before and after September 1984 showed that the caesarean section rate had dropped from 16.8 to 8.0%, the maternal mortality rate from 2.0 to 0.5%, and the perinatal mortality rate from 71.9 to 56.2%. During the latter period use of oxytocin increased from 3.4 to 17.4%. These findings suggest that the adoption of strict guidelines can lead to a decrease of the caesarean section rate and an improvement of the obstetrical outcome in the absence of new technology.

Adult↗

[Historical aspects of pain relief during normal parturition].

Traditional methods used for the relief of pain during normal delivery are few and the medical literature remained silent on this topic up to the middle of the 19th century. Indeed, the first effective method was etherization, and it was introduced by Simpson (Edinburgh) in 1847. Obstetric inhalation analgesia was followed by many other methods the development of which was based on new discoveries in chemistry, pharmacology, physiology, and psychosomatic medicine. This paper reviews the milestones in the historical development of obstetric analgesia.

Analgesia↗

The Copper-Fix (Cu-Fix): a new concept in IUD technology.

The Copper-Fix (Cu-Fix) is a thread-type copper-bearing device designed to overcome the most common IUD-related problems: bleeding and pain. Two distinctive features--virtual absence of a frame and provision of an anchoring system--make this new intrauterine device the first radical departure from current IUD technology. The Cu-Fix 390 was inserted at intervals in 382 women, and 4851 woman-months of experience had been accumulated at 18 months. The device was exceedingly well retained by the uterus (expulsion rate 0.6 at 18 months) and the removal rate for bleeding/pain was low (3.1 at 18 months). Serious complications did not occur; the pregnancy rate amounted to 0.3 at 18 months, with a continuation rate of 87.6%, which includes an 8.1% removal rate for pregnancy wish. Cardinal event rates were not influenced by the age or gravidity status of the recipient.

Adult↗

Ripening procedures.

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Administration, Intravaginal↗

Oligohydramnios, renal insufficiency, and ileal perforation in preterm infants after intrauterine exposure to indomethacin.

Three preterm infants exposed antenatally to indomethacin developed a characteristic syndrome consisting of edema and hydrops with a bleeding disorder at birth, oliguric renal failure during the first 3 postnatal days, and acute pneumoperitoneum resulting from localized ileal perforation(s) at the end of the first week of life. Despite the value of indomethacin for arresting preterm labor, the physician must take into account the potential hazards of drug toxicity.

Amniotic Fluid↗

The validity of Weinberg's rule in the East Flanders Prospective Twin Survey (EFPTS).

Most population studies of twins estimate the number of monozygotic (MZ) and dizygotic (DZ) pairs by Weinberg's differential rule. This rule assumes that within the DZ twins the numbers of unlike-sexed (U) and like-sexed (L) twins are equal. The literature on the validity of Weinberg's rule is still controversial. In this prospective population-based study (EFPTS) of 2,589 twin pairs, of whom 2,577 were of known zygosity and placentation, the estimates of Weinberg's rule agree well with the results of direct zygosity determination.

Belgium↗

The European Multiple Birth Study (EMBS).

The more that twin and other multiple pregnancies are investigated, the more it becomes mandatory that collaborative studies are set up in order to attain the critical number of cases needed to achieve meaningful and reliable results. The European Multiple Birth Study (EMBS) aims to study two aspects of twin and multiple pregnancy: 1) management of pregnancy and labour, with emphasis on the prevention of preterm delivery; 2) accurate determination of zygosity, a prerequisite for the proper use of the twin method in a variety of fields, eg, congenital malformations, genetics, clinical investigations, etc. The rationale, the methods and the organisation of the study are described and discussed.

Data Collection↗

Is the quality of care in twins and in singletons related?

We investigated if it is possible to use the data collected in twins to identify areas with high rates of operative deliveries, preterm deliveries and low birthweight infants in singletons. Our data correspond to all deliveries registered in Belgium in 1983. A significant correlation was found between the rates of cesarean sections in twins and in singletons. A significant correlation was also found between the rate of deliveries at a gestational age of less than 32 weeks in twins and the rate of deliveries at less than 37 weeks in singletons. However, correlations between other preterm rates, low birthweight rates and vacuum extraction or forceps rates, were nonsignificant. We conclude that the use of twins as tracers of the quality of care in singletons is of limited value.

Belgium↗

Triplet and higher-order births: what is the optimal delivery route?

Data concerning 16 triplet and higher-order deliveries (resulting in a total of 56 infants) are reviewed. The vaginal delivery rate was 81%. Maternal morbidity was more serious after abdominal delivery. Prematurity (less than 36 weeks gestation) rate amounted to 68%. Overall perinatal and neonatal mortalities for infants born after 28 weeks gestation and weighing at least 1000 g were 7% and 3%, respectively. We doubt that neonatal outcome could have been markedly improved by performing more cesareans. The importance of antenatal care is stressed.

Birth Weight↗

Candidiasis in women fitted with an intrauterine contraceptive device.

Vaginal colonization by Candida spp. was compared in 117 women fitted with an intrauterine contraceptive device (IUCD users) and in 100 women not wearing an IUCD (control group). None of the subjects had factors currently assumed to predispose to yeast colonization or infection. Yeasts were present significantly more often in the IUCD users (20%) than in the control group (6%). In two of the 21 women with positive cultures the tail of the IUCD yielded substantially more colonies than the vaginal specimen and in seven, only the tail culture was positive. These findings strongly suggest that the IUCD is a predisposing factor in vaginal colonization by Candida strains. In half the women the presence of yeasts in the vagina was not associated with signs and symptoms of clinical infection. Of the 29 yeast strains isolated 17 were C. albicans, there was no difference in the prevalence of C. albicans between IUCD users and non-users or between symptomatic and asymptomatic women.

Candidiasis, Vulvovaginal↗

Assessment of the indication for intrauterine treatment of urinary tract malformations.

To assess the potential value of intrauterine diversion in cases of fetal urinary tract malformation, we re-evaluated the 19 cases of such lesions which were part of a consecutive series of 94 cases of fetal malformations that were diagnosed in our department between 1980 and 1985. We chose a policy of non-interference for two reasons: Firstly the relative paucity of available data compared with what one would normally expect to obtain when planning a treatment of the newborn, and secondly the expectation that the benefit in terms of recovery of function would be minimal, because a lesion observable on even early echography is more than trivial, and no longer "early" in an ontogenic sense. The empirical criteria which indicate that intrauterine intervention is either futile or superfluous, noted in the literature, were applied in a retrospective study of our cases and evaluated in relation to the data of pregnancy duration, clinical outcome, and pathological findings in the urinary tract and other systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

Endometrial response to the use of a sequential oral contraceptive.

Belgium is 1 of the few countries where sequential oral contraceptives are still commercially available. The authors investigated the endometrial effect of Ortho-Novum SQ (14 tablets of 100 mcg mestranol and 7 tablets of 100 mcg mestranol + 2 mg norethisterone) in 222 biopsy specimens obtained from 184 asymptomatic Caucasian women (mean +or- s.d, age and parity, 34.6 +or- 6.7 and 2.0 +or- 1.0, respectively) who had used this sequential OC during an average of 52.5 months. Notwithstanding predominantly longterm use of Ortho-Novum SQ, 43% of the tissue samples had normal proliferative or luteal endometrium. The data suggest a positive correlation between the endometrial response and the duration of pill use. No premalignant or malignant changes were found. In 15 of 24 subjects for whom multiple biopsy specimens were available, the histological picture was static; 7 showed regression and only in 2 were the changes progressive, although never more severe than minor 'class 2' lesions. These results, which are at variance with those reported for users of other sequential brands (mainly Oracon), suggest that prolonged use of Ortho-Novum SQ does not enhance the risk of endometrial cancer in premenopausal women having no additional risk factors for the development of this type of neoplasia.

Anatomy↗

[Not Available].

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Contraception↗

[Not Available].

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Belgium↗