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Biomedical subjects

M Tournaire

Publications and source records attributed to M Tournaire.

At least 19 recordsLinked to original sources
PubMed2005

[Early prophylactic cervical cerclage for hypoplastic cervix following exposure to DES in utero].

AIM: Presentation of a prophylactic cerclage technique, placed in the beginning of second trimester of the pregnancy, derived from McDonald cerclage and adapted to hypoplastic cervix following exposure to DES in utero. MATERIALS AND METHODS: Prospective study including 20 pregnant patients exposed to DES in utero and presenting a hypoplastic cervix. Study of the location of the cerclage tape in the cervix and of changes in cervical length (before and after cerclage) assessed by physical examination of the cervix and by transvaginal ultrasonography. RESULTS: The cervix was longer after cerclage as shown by physical examination and by ultrasound. The tape was localized near the internal cervical os, its posterior portion nearer the internal cervical os than its anterior portion. CONCLUSION: This easy-to-perform technique of cerclage of hypoplastic cervix allows the tape to be localized near the internal cervical os without colpotomy and without use of the transabdominal approach, while allowing vaginal delivery.

Cerclage, Cervical↗
PubMed2001

Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies.

OBJECTIVE: To assess the maternal, fetal and neonatal safety of enoxaparin in pregnant women who require antithrombotic therapy. DESIGN: Retrospective analysis of case notes of women who received enoxaparin during pregnancy, irrespective of dose, duration and reason for treatment. SETTING: Fifty-five French perinatal centres. SAMPLE: Data from 624 pregnancies in 604 women between 1988 and 1997. The incidence of previous thromboembolism was 29.8%, known thrombophilia 15.2%. METHODS: Indication, regimen of enoxaparin and outcome measures were reported for each pregnancy. Information was obtained from case records, validated by research staff and analysed by an independent scientific committee. MAIN OUTCOME MEASURES: Incidence, seriousness and causality of maternal, fetal and neonatal adverse events, pregnancy outcome, and incidence of venous thromboembolism. RESULTS: Enoxaparin was administered for treatment of an acute episode in 49 cases and for thromboprophylaxis in 574 cases. Serious maternal haemorrhage occurred in 11 cases during pregnancy (1.8%), one being reasonably related to enoxaparin, and in nine cases at delivery (1.4%), all unrelated to enoxaparin. Maternal thrombocytopenia was reported in 10 cases (1.6%). two being serious but unrelated to enoxaparin. Eight pregnancies ended in stillbirth (1.1%). Among the 693 live births, 17 major congenital abnormalities (2.5%) and 10 serious neonatal haemorrhages (1.4%) were reported. None of the fetal or neonatal adverse events was related to enoxaparin. Eight venous thromboembolic events (1.3%) were reported. CONCLUSIONS: The incidence of adverse events reported could be explained by the high risk profile of the study population. Overall, this retrospective study suggests enoxaparin is well tolerated during pregnancy.

Adult↗
PubMed1997

The daughters of diethylstilbestrol. Lessons from an error.

Diethylstilbestrol (DES) has been used extensively to prevent pregnancy disorders in Europe but at different levels depending upon the countries. Lessons from the DES story can be learned for research, information for physicians, communication, administration and industry. However, this paper will focus on the incidence of this story in our practice. We will propose guidelines for different conditions: clear cell adenocarcinoma, adenosis, cervical dysplasia, infertility and pregnancy.

Adenocarcinoma, Clear Cell↗
PubMed1996

Recurring episodes of meningitis (Mollaret's meningitis) with one showing an association with herpes simplex virus type 2.

Benign recurrent aseptic (Mollaret's) meningitis is a rare disease of unknown aetiology. We report the case of a 27-year-old woman who experienced three episodes of lymphocytic meningitis. Human Simplex Virus (HSV) type 2 DNA was detected in the CSF by PCR amplification indicating the diagnosis of recurrent HSV type 2 meningitis. Our observation suggests that search of herpes virus DNA by PCR amplification on CSF may be useful in unexplained recurrent meningitis.

Adult↗
PubMed1994

Identification of genes overexpressed in tumors through preferential expression screening in trophoblasts.

Early trophoblastic cells share several features with neoplastic cells. Based on that observation, we attempted to identify genes overexpressed in tumors by analyzing genes preferentially expressed in trophoblasts. A subtracted library enriched in complementary DNA from early cytotrophoblasts was constructed, and the expression level of selected recombinants was analyzed on a large panel of normal and tumor tissues. The library was prepared using a polymerase chain reaction-based complementary DNA subtraction method with 6-week amenorrhea cytotrophoblast endoplasmic reticulum-bound RNA as target, and a mixture of complementary DNA prepared from terminal placenta and activated T-lymphocytes as driver. Two rounds of screening were performed to isolate clones preferentially expressed in early placenta. From a total number of recombinant clones estimated at 32,000 in the subtracted library, 594 inserts were analyzed by Southern blot and 21 sequences were isolated as corresponding to genes highly expressed in early placenta. Eleven encoded known molecules, such as carcinoembryonic antigen, human chorionic gonadotropin, and mitochondrial rRNAs. Ten sequences represented novel genes. Northern blot analysis confirmed that most of these genes were preferentially expressed in early trophoblast in comparison to terminal placenta. Three clones that gave detectable hybridization signals on total RNA were extensively studied and were found to be overexpressed in various tumors. Two of these clones, designated B9 and E4, were later identified as corresponding to genes coding for the putative ribosomal protein S18 and the bifunctional enzyme ADE2H1 involved in purine biosynthesis, respectively. Expression of the third clone, E9, was increased up to 10-fold in breast cancer tissues in comparison with normal counterparts. Present results confirm that many genes expressed in the trophoblast are overexpressed in malignant cells. This approach could provide a general targeted method for the identification of genes overexpressed in various neoplastic cell types.

Base Sequence↗
PubMed1991

[Limb-girdle dystrophy and pregnancy: a case report].

A case of pregnancy with Limb-girdle dystrophy is presented. The course of pregnancy remained uncomplicated, the patient has been delivered at 42 week's gestation by cesarean section, performed for dystocia and fetal distress. Histological and immunohistochemical examinations of the myometrium were unable to show its involvement in the muscular disease. The influence of the muscular disease and the route of delivery for such patients are discussed.

Adult↗
PubMed1990

The use of the antiprogestin RU486 (mifepristone) as an abortifacient in early pregnancy--clinical and pathological findings; predictive factors for efficacy.

RU486, a potent antiprogesterone steroid was administered to 124 women requesting therapeutic abortion. All were less than 49 days from their last menstrual period. Ten of these subjects (Group I) received high doses of RU486 in a decremental dose regimen (400, 300, 200 and 100 mg/day) over 4 successive days and 14 received 50 mg/day for 7 days (Group II). A further 50 subjects (Group III) received 100 mg/day for seven days and the remaining 50 subjects (Group IV) received 450 mg in a single dose. In the first three groups, half the daily dose was given in the morning and the remainder in the evening. Blood was collected before, and on Days 4 and 7 and then once a week after commencing therapy until disappearance of circulating beta HCG. In addition to beta HCG, estradiol-17 beta (E2), progesterone (P), cortisol, and various metabolic and hematological parameters were measured. Plasma RU486 concentrations were also assayed in Group II, III and IV subjects on Day 7 of therapy and in some cases on Days 14 and 21. Ultrasonography was performed in all cases on Day 1 and on Day 14. All the patients bled within five days following RU486 administration, for 1 to 21 days. A complete abortion occurred in 60% in Group I, 50% in Group II, 86% in Group III, and 80% in Group IV. The difference between the last two groups and the first two was significant at p less than 0.01. The non-responders were submitted to a uterine vacuum aspiration. A stepwise discriminant analysis was performed and indicated that the best predictors of the outcome of therapy were beta HCG values and the gestational sac diameter. With these criteria, the prediction was accurate in 86.4% of the cases. The best results were obtained in the cases where the ultrasonic measurement of gestational sac was under 10 mm in diameter and the initial beta HCG values under 15,000 mIU/ml. Among the observed side effects were moderate pelvic cramps (20.9%), nausea (27%), fainting (4.8%); 61.3% of the women complained of fatigue. Heavy bleeding occurred in 15.3% of the women but only one of them required blood transfusion. In the patients with complete abortion, beta HCG values decreased to below 500 mIU/ml by Day 14 (but in 11 cases values fell below 2,000 mIU/ml only by Day 21). Plasma estradiol and progesterone also fell. Cortisol levels increased during therapy especially in subjects of Group I, but returned to basal values after termination of treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Abortifacient Agents↗
PubMed1990

[Evaluation of uterine activity by ambulatory tocography].

The mother's sensations of uterine contractions were compared to the graphs made by the ambulatory tocograph linked to a telephone system (system Tokos), 95 women were assessed. They felt only 20% of their contractions. When the pregnancies were single pregnancies the sensation was found in more women (26%). In a group of women who had a threat of premature labor only 12% of contractions were felt.

Adult↗
PubMed1988

[Outcome of pregnancy in patients exposed in utero to diethylstilbestrol. Survey by the National College of French Gynecologists and Obstetricians].

This study analyses the outcome of 110 pregnancies that occurred in 57 patients who were exposed to DES (DiEthylStilboestrol) during their fetal life. The quantities of Distilbene that were received in the first trimester of the pregnancy were the same in France and in the United States. The obstetrical complications of exposure in utero to DES were identically the same in France and in the United States. Of particular note is the high level of extra-uterine pregnancies (15%) and of 1st and 2nd trimester miscarriages (42%). Only 41% of the population exposed to DES delivered a live baby. It is estimated that 80,000 women were exposed to it in France. Exposure in utero to DES has given rise to a public health problem.

Abortion, Spontaneous↗
PubMed1986

[Cerebrovascular complications in obstetrics and beta mimetic drugs].

The authors report a new case of a cerebro-vascular accident following the stopping of an infusion of a beta-mimetic drug to inhibit uterine contractions. The clinical symptomatology and the spontaneous recovery (over more than 6 months) makes it correct to call this pathological condition "an acute cerebral vascular disorder of a benign nature". It is not known how the cerebral vessels were affected by the beta-mimetic drugs.

Adrenergic beta-Agonists↗
PubMed1986

[Detection during pregnancy of massive fetomaternal transfusion. A life saved by adherence to a protocol].

A case of massive feto-maternal haemorrhage which was discovered by chance in the 34th week of pregnancy is described in detail. This case is characterised by: total absence of clinical, electrical and echographic abnormalities, a part from the fetus being very anaemic; the saving of the very anaemic newborn baby because of the performance of caesarean section; although the pregnant woman was Rh negative, giving her large doses of IgG and anti-D prophylactically seems to have protected her from Rh immunisation. The authors conclude with the special value that they have found using the Kleihauer test. This is a simple, reproducible, low-cost laboratory examination. They suggest that it should be used mainly in the last third of pregnancy and may be even routinely.

Adult↗