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Biomedical subjects

M Thiery

Publications and source records attributed to M Thiery.

At least 127 records · Page 7Linked to original sources

Assessment of a two dose scheme of PGE2 gel for preinduction cervical softening.

A single dose technique of endocervically administered 0.5 mg PGE2 triacetin gel has been reliably effective for preinduction cervical softening. This study examined the value of a 2 times 0.25 mg dosing scheme over a 12 hour period and compared it with the single dose method. It was concluded that there was no advantage in the two dose scheme and given the potential for contamination or inadvertent rupture of the membranes with more frequent dosing, the single application remains the procedure of choice.

Adult↗

Zygosity determination in newborn twins using DNA variants.

A prerequisite for the optimal use of the twin method in human genetics is an accurate determination of the zygosity at birth. This diagnosis is sometimes hampered by the lack of available specific markers. We report here the use of DNA variants (restriction fragment length polymorphisms) as genetic markers for zygosity determination. We have analysed the placental DNA of 22 twin pairs with known zygosity on Southern blots by hybridisation with polymorphic human DNA probes. We looked at six different polymorphic sites using four restriction enzymes and six DNA probes. Among 10 dizygotic (DZ) pairs, only one was not demonstrably different and seven had at least two discordances. Within each of the 12 monozygotic (MZ) pairs there was complete concordance. Thus, nine of 10 dizygotic and 12 of 12 monozygotic twins were assigned their correct zygosity solely by comparison of six DNA variants. The use of these highly polymorphic DNA probes may have practical importance for antenatal diagnosis and paternity testing.

DNA Restriction Enzymes↗

Plasma oxytocin in human pregnancy and parturition.

Oxytocin concentrations were determined in serial peripheral plasma samples collected from clinically normal women during pregnancy and labor. Measurable concentrations of this hormone were detected in all maternal plasma samples during pregnancy, but there were wide differences in values between patients. Serial samples from individual patients revealed a pattern of gradual rise of oxytocin levels with advancing gestation and the increase in concentration was statistically significant. There were no significant differences in oxytocin levels at any stage of labor, with or without epidural analgesia. Oxytocin levels at the onset of the second stage did not differ statistically from those at crowning. Comparison of cross-sectional data showed no significant difference between the mean oxytocin concentration in early labor and in late pregnancy. Oxytocin surges occurred, but not in a regular pattern. Plasma oxytocin concentration did not increase after pelvic examination, sweeping of the membranes, low amniotomy or after cervical vibration. After spontaneous vaginal delivery, umbilical arterial plasma levels of oxytocin were consistently higher than plasma concentrations from the umbilical vein. The fetal arterio-venous difference was less pronounced at elective cesarean section. At spontaneous vaginal delivery, with and without epidural anesthesia, plasma levels from the umbilical artery were significantly higher than the maternal levels. After vaginal delivery, oxytocin levels in cord plasma were significantly higher than at elective abdominal delivery. Some methodological aspects with regard to blood sampling and to plasma oxytocin radioimmunoassay procedures are discussed. From the results presented it is concluded that the human fetus can be an important source of oxytocin and that neurohumoral birth reflexes described in animals do not occur systematically in man.

Anesthesia, Epidural↗

Outcome of an octuplet pregnancy.

An octuplet pregnancy with survival of all liveborn babies in a woman treated with gonadotropins is described and problems related to ovulation induction and the management of very multiple pregnancy are discussed.

Cesarean Section↗

Endocervical prostaglandin E2 gel for preinduction cervical softening.

A single, endocervical application of a new commercial preparation of prostaglandin E2 (PGE2) gel, 0.5 mg of PGE2 in 2.5 ml (3 g), was evaluated for preinduction cervical softening. Safety and efficacy were assessed in a comparison with a 2.0 mg PGE2 vaginal tablet and placebo in normal nulliparous women at term, with low Bishop scores. Treatment was administered in randomized, double blind fashion. Overall success, defined as a progression in Bishop score of at least 3 points within 12 hours, was achieved in 22/40 (55%) of the gel group, 15/41 (37%) in the tablet treated women, and 8/40 (20%) in those receiving placebo. Of interest was the observation that of women with very unfavorable induction features (Bishop score 0-2), the cervical gel treatment resulted in a 6/8 (75%) success rate compared with 2/13 (15%) success for the vaginal tablet and 0/17 (0%) for placebo. In as much as a very low incidence of side effects accompanied this treatment scheme, expanded multi-center testing is recommended.

Adult↗

Screening for multiple pregnancy. Determination of human chorionic gonadotropin (hCG), alpha-fetoprotein (alpha-FP) and human placental lactogen (hPL) in blood during the second trimester of pregnancy.

The value of single determinations of serum hCG, hPL, and alpha FP for the detection of multiple pregnancy was investigated in a consecutive series of 992 women between the 14th and 24th week of pregnancy. With the 90th percentile as referent value, all twin pregnancies (n = 10) were detected by the combined results of the three determinations. Considered separately, hPL proved to be the most useful indicator of multiple gestation; the sensitivity of hPL alone was 70% and the predictive value of hPL concentrations above the 90th percentile was 8.1.

Chorionic Gonadotropin↗

Cranial ultrasound after forceful midpelvis vacuum extraction at term.

The heads of 28 non-hypoxic, full-term infants of normal gravidas delivered by forceful vacuum extraction were examined with ultrasound during the early neonatal period. All echographic findings were normal and all neonates had an uneventful evolution during the first week of life. Addendum: Since this article was completed, a massive intracranial haemorrhage occurred in a non-hypoxic full-term newborn after elective midpelvic vacuum extraction. The intervention was performed by a resident who, despite the guidelines did not call the senior obstetrician after three unsuccessful attempts to extract the fetus. The head was stationed, 2 cm above the level of the ischial spines, not completely flexed with the occiput in the right-anterior position. The newborn died at the age of 3 hours. Autopsy showed a tear of the tentorium cerebelli and the vena cerebri magna.

Brain Injuries↗

Hair copper in intrauterine copper device users.

The antifertility effect of copper-bearing IUDs is based on continuous release of copper, which is a result of the reaction between the metal and the uterine secretions. Released cupric ions collect in the endometrium and in the uterine fluid but significant accumulation has not been found in the bloodstream or elsewhere. Following Laker's suggestion that hair be used for monitoring essential trace elements, e.g., copper, we checked the copper content of the hair of women wearing copper-bearing IUDs. Samples of untreated pubic hair removed by clipping before diagnostic curettage were obtained from 10 young (24-34 years old), white caucasian females who until then had been wearing an MLCu250 IUD for more than 1 year. Pubes from 10 comparable (sex, age, race) subjects who had never used a Cu-containing device served as controls. The unwashed material was submitted to the toxicology laboratory, where the copper content was assessed by flameless atomic absorption, a technique whose lower limit of measurement lies at a concentration of 0.05 mcg Cu/ml fluid (50 ppb). Hair samples were washed to remove extraneous traces of metal according to the prescriptions of the International Atomic Energy Agency, weighed, and mineralized, after which a small volume (10 mcl) of the diluted fluid was fed into the graphite furnace. Each sample (75-150 mg) was analyzed 4 times, both before and after washing. Since the cleaning procedure reduces the weight of the sample (mainly by the removal of fat, dust, etc.) this explains why the percentage copper content of washed hair is higher than that of unwashed hair belonging to the same subject. The results indicate that there was no significant difference (Mann-Whitney U test) between the mean copper levels of both unwashed and washed pubes from women who were using or had never used an MLCu250 IUD. We therefore conclude that the use of this copper-containing device is not associated with significant accumulation of copper in (pubic) hair.

Chemical Phenomena↗