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Biomedical subjects

M Tournaire

Publications and source records attributed to M Tournaire.

33 records · Page 2Linked to original sources
PubMed1983

[Request for reversal of tubal sterilization. Survey conducted by the National College of French Gynecologists and Obstetricians].

A retrospective enquiry was carried out by the National College of French Gynaecologists and Obstetricians to try to specify more clearly indications and contra-indications for tubal sterilization in sixty centres. 377 requests were analysed over the years 1979-1980-1981. The average age of these women was 33 and the interval following sterilization was of a mean of 5 years. Remarriage is the main reason for asking. Those women most likely to ask for reversal of sterilization were patients who were sterilized when young or who had had only one or two children, or who had been sterilized during Caesarean operation. Half the requests for reversal could not be granted, usually because the techniques used for sterilization were too mutilating (40% of the patients could not be operated on); even if the sterilization is to be considered as final these techniques should not be used.

Adult↗
PubMed1981

[The bacteriostatic and bactericidal effect of amniotic fluid (author's transl)].

The bacteriostatic and bactericidal effect of 100 samples of amniotic fluid (LA) was studied against 5 bacterial species that are responsible for neonatal infections. These results show that there is a bacteriostatic activity in liquor. 52 specimens of liquor amnii (52%) were shown to be active against at least one of the 5 bacterial specimens studied. 32 samples of liquor (32%) were active against Listeria monocytogenes, 21 (21%) against Flavobacterium meningosepticum, 18 (18%) against Escherichia coli, 17 (17%) against group B streptococci and 7 (7%) against Bacteroides fragilis. A simultaneous study of the 6 types of germs show a separate characteristics of this activity. In this way the number of samples of liquor that were active against one or at the same time against 2, 3, 4 or 5 bacteria were respectively 24, 19, 5, 2 and 2. The bacteriostatic effect was more frequently active in those samples of liquor which were studied near term (57.5%) than in the samples studied nearer the beginning of pregnancy (31.5%). All the same, this difference is not statistically significant. There was no difference in the antibacterial activity of samples of liquor from normal and from abnormal pregnancies. The bacterial effect was found only in 12% of samples of liquor, particularly against streptococcus B (8%) and against Listeria monocytogenes (4%). This bactericidal effect was only found after the 31st week of amenorrhoea.

Amniotic Fluid↗
PubMed1981

[Antenatal microcephaly. A contribution of ultrasound. Twelve cases (author's transl)].

It is necessary to think about the frequency of mistakes made at term as well as about the rare case of antenatal microcephaly when confronted with an abnormally small biparietal diameter. The authors, when confronted on twelve occasions with the problem of antenatal microcephaly, classified two situations: the discovery from systematic screening of a break in the growth of the cranial diameters. In the case of overall growth retardation of the fetus it becomes necessary to carryout amniocentesis to look for associated chromosome abnormality (two out of twelve cases); ultrasound monitoring of a pregnancy in the woman who has previously delivered a microcephalic infant in order to diagnose a possible recurrence of the condition (three out of the twelve cases). Furthermore the authors point out tha there are limits to the method. Ultrasound is only a complementary examination and the results obtained should be studied critically, confirmed by repeated examinations and integrate into the whole clinical picture. Finally, it is not always possible to differentiate between the normal and the abnormal by ultrasound. In borderline cases ultrasound has the advantage that it can point out the need for extra careful post-natal examination of the infant.

Adult↗
PubMed1980

[The influence of pethidine on uterine activity and dilatation of the cervix in spontaneous labour (author's transl)].

Two series of patients, randomly selected, 29 of whom had pethidine and 29 of whom had a placebo, were compared in order to study the influence of intra-muscular pethidine on uterine activity and on the speed with which the cervix dilated. The experiment was a double blind one. A significant increase in the basal tone of the uterine muscle was found 40 minutes after the injection in the group that received pethidine, although there was no other significant difference in the other parameters which were intensity, frequency, length, surface of the contractions [half the height multiplied by (X times) the base on the monitor recording], uterine activity in Montevideo and in Toulouse units and the speed of dilatation. These results do not bear out the classical hypotheses of the muscle relaxing effect of pethidine, and in particular that the uterus relaxes better between contractions, nor that there is relaxation of the cervix in labour. The indication for the use of pethidine is perhaps justified because of its analgesic effect, but as far as favouring dilatation of the cervix in labour is concerned is at best worthy of discussion.

Cervix Uteri↗
PubMed1980

[Perinatal pathology after normal pregnancies (author's transl)].

We have analysed, using the score of Hobel, 326 case notes of pregnancies that were considered normal out of 500 consecutive deliveries in order to try to find out whether there was any way in which women could be selected for delivery at home without risk. We have studied among these cases complications or accidents that happened in the neonatal period and the time when the first abnormal signs appeared. These signs were discovered at the consultation which took place at the beginning of the 9th month (for example, breech presentation) in 4.6 per cent of cases of normal pregnancy, at the examination carried out on admission to the unit (for example, post-term) in 16 per cent of cases and during labour in 9.8 per cent of cases. These showed up in half the cases by clinical signs (for example, the appearance of meconium), and in the other half of the cases they were totally unpredictable (for example, compression of the cord) which was diagnosed early thanks to continual monitoring of the fetal heart rate. The figure for complications or accidents in the perinatal period (fetal death, an Apgar score less than 7 at 5 minutes, intensive resuscitation of the baby, a birth weight of less than 2000 g) was found tobe in 5.4 per cent of normal pregnancies and 15 per cent of pathological pregnancies. The presence of these complications after normal pregnancy made us look more carefully for diagnostic features which could be singled out during the pregnancy (for example, mild urinary tract infection, a little bleeding at the beginning of the pregnancy). These "small signs" could not help to make a prognosis. These findings suggest, without definite proof because a controlled study has not been possible, that the prevention of serious complications in labour is only possible when all labours are supervised intensively routinely: and delivery at home means that a real risk is run by the infant even after the pregnancy has been normal.

Adult↗
PubMed1976

Evaluation of the fetal state by automatic analysis of the heart rate. 2. Deceleration areas and umbilical artery blood pH.

Fetal heart rate (FHR) deceleration areas were studied to obtain by objective measurement of the FHR, their prognostic value of the new-born state. 1. There is a reasonably good correlation between FHR deceleration areas and UApH (Tab. II). Such a correlation was found by SHELLEY and TIPTON [6] for the whole deceleration area, and by TOURNAIRE et al. [10] for areas divided in a slightly different way. The correlation coefficients between FHR deceleration areas and Apgar score at 1 minute are within a close range of those of the FHR deceleration area and UApH (Tab. I and II). 2. According to the time relationship between deceleration areas and uterine contractions the best correlation coefficient was obtained surprisingly for total, followed by residual and then simultaneous areas. These results agree with those of SHELLEY and TIPTON [6] suggesting that in practice a simple measurement of the whole deceleration area, regardless of the uterine contractions is a sufficient method in evaluating FHR patterns. 3. The special purpose computer built by the BAUDELOCQUE research group can be used on-line, thus in clinical practice. It was not the case for the manual method [4] or the method using a large programmed computer [10]. 4 The evaluation of deceleration areas appears to have several advantages: 1. It provides objective measurements. 2. The unit used is independant of factors such as display speed or scale of the strip-chart. 3. The data is reduced: A few numbers replace the long descriptions of the usual clinical classifications.

Apgar Score↗
PubMed1976

[Electronic surveillance during delivery. A method of reading the tracings].

A method for reading the foetal heart rate tracings and a guide of management advise in each case have been established from a review of the literature and the study of 500 records. The tracings are schematically divided into three categories according to the presumed risk of foetal distress: normal or "tolerable" tracings, alarm symptoms and danger symptoms. For each categorie, and according to the duration of the variations, a type of management is proposed. Other diagnostic means, such as capillary blood pH measurement are desirable to improve the foetal state diagnostic and make the treatment more precise.

Adult↗
PubMed1975

[Use of the Doppler signal in the determination of fetal cardiac rhythm].

The authors, after going over in brief the technical details of the physical characteristics of ultra-sounds and in particular the Doppler effect, describe a new cardiotachymeter using ultra-sounds which they have developed at the Baudelocque Maternity Hospital in Paris. In the first month in which they used this apparatus they kept 37 records on women who had not yet started labour and 36 records on women who were in labour. In 9 of the latter group they recored the fetal cardiac rhythm by the external route using ultra-sound pick-up and a recording by internal route using the fetal electrocardiogram. Tracings were comparable. It is interesting to note that even when uterine contractions are very strong indeed or the mother moves a lot the ultra-sound pick-up very rarely loses the fetal signal.

Adult↗
PubMedDate not supplied

[Automatic analyses of rapid fluctuations of basal fetal heart rate during delivery. Verification of parameters].

The authors using an electronic calculator have measured 3 parameters, which allowed them to carry out quantitative evaluations of rapid variations in basal fetal cardiac rhythms (fluctuation) of 29 samples of fetal heart rate obtained during labour. The three parameters are: 1. Mean variation by intervals. 2. Values for differences in intervals approaching zero. 3. Zero changes in the derived curve. Each of these parameters was compared with the values of fluctuations which were obtained by visual analysis quantified on the same samples of tracings. The results of these coefficients of correlation show that the chosen parameters enable quantitative values for these fluctuations to be obtained.

Adult↗