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M Uzan

Publications and source records attributed to M Uzan.

153 records · Page 9Linked to original sources

First-trimester diagnosis of sirenomelia. A case report.

We report a case of sirenomelia diagnosed at 13 gestational weeks. This rare malformation sequence is characterized by fusion and rotation of the lower limbs to various degrees and anorectal atresia, usually associated with absence of bladder and agenesis or dysgenesis of the kidneys. Diagnosis is commonly made later in the second trimester of pregnancy with oligohydramnios as the alerting sign. Survival is extremely rare, and only possible in the absence of bilateral renal agenesis. In view of the dismal prognosis, early diagnosis allows for earlier and less traumatic therapeutic abortion.

Adult↗

Doppler ultrasonography and implantation: a critical review.

Active perifollicular angiogenesis in ovaries and endometrium is linked with the quality of oocytes and endometrial receptivity, and consequently with the outcome of implantation. Studies evaluating ovarian velocimetry in relation to implantation and pregnancy rates bring essentially into play velocity values or non-quantitative parameters, whose reproducibility is low and which are hardly usable in daily practice. Conversely, the assessment of uterine artery flow by Doppler examination is easy and reproducible, and high impedance at the end of the follicular phase is a good predictive indicator of poor endometrial receptivity. In early pregnancy, Doppler investigation must not be used routinely because its safety is still under discussion; however, the available data show that impedance in the uterine and spiral arteries does not show any significant difference between normal and abnormal pregnancies (missed abortions or anembryonic pregnancies), and the significance of easily detectable intervillous flow is hotly debated, raising fundamental points.

Arteries↗

Prospective evaluation of uterine artery flow velocity waveforms at 12-14 and 22-24 weeks of gestation in relation to pregnancy outcome and birth weight.

OBJECTIVE: Uterine artery flow velocity was prospectively assessed using Doppler ultrasound at 12-14 and 22-24 weeks of gestation in the prediction of subsequent complications related to uteroplacental insufficiency: preeclampsia, pregnancy-induced hypertension, fetal growth restriction, fetal death and placental abruption, and to elucidate its relationship with birth weight. METHODS: Uterine artery Doppler assessment was obtained during routine ultrasound screening in 263 unselected women. Flow velocity waveforms were coded according to the number of notches present at each scanning, respectively: none (0, 0), uni-/bilateral notches that disappeared (1, 0) or (2, 0), uni-/bilateral notches that persisted unilaterally (1, 1) or (2, 1), and persistent bilateral notches (2, 2). RESULTS: Complete outcome data was obtained for 243 (92.4%) women. Of these women, 55 (22.6%) and 84 (34.6%) women had uni- and bilateral notches, respectively, at 12-14 weeks' gestation; 14 (5.8%) and 21 (8.6%) patients had uni- and bilateral notches, respectively, at 22-24 weeks' gestation. Analysis of complication rates for the four groups showed that they increased with notch persistence (5.7, 13.5, 57.1 and 76.2%), while the corresponding mean birth weight declined (3,273, 3,180, 2,698 and 2,418 g). CONCLUSION: The absence or early disappearance of uterine artery notches is associated with fewer complications related to uteroplacental insufficiency and normal birth weight, whereas their late and partial disappearance or bilateral persistence tends to compromise the prognosis.

Adult↗

Predictive value of uterine Doppler waveform during pregnancies complicated by diabetes.

Diabetes, whether or not it is insulin deficient, is frequently associated with vascular complications during pregnancies. It is accepted nowadays that the uterine artery velocity waveform is predictive concerning pregnancy-induced hypertension (PIH) and its complications. It thus seemed interesting to analyse the predictivity of vascular complications of diabetes by using uterine artery velocity waveforms. We have thus explored 37 diabetic patients [group 1: insulin-deficient diabetes (IDD), n = 10; group 2: gestational IDD, n = 6; and gestational non-IDD, n = 21). We have found vascular complications for 10 patients, divided between all 2 groups: 2 pre-eclampsia, 2 fetal suffering before any labour, 2 cases of intra-uterine growth retardation (including a trisomy 18) and 5 PIH. The uterine artery velocimetry measurement has been found to be pathological 5 times, and always in patients who later developed vascular complications. Among this selected population and excluding the trisomy 18, the sensitivity is of 44.5%, the specificity of 100%, the positive predictive value of 100%, and the negative predictive value of 84.3%. If these results are confirmed, this examination could be an excellent marker of the vascular risk and thus would have its place during systematic survey of pregnancies complicated by diabetes.

Adult↗

[Heartburn and regurgitation in pregnancy. Efficacy and innocuousness of treatment with Gaviscon suspension].

This open trial was conducted in 50 pregnant women, presenting during the 2nd and 3rd trimesters of their pregnancy typical symptoms of gastro-esophageal reflux (pyrosis, regurgitations, retro-sternal burning sensations, dyspepsia, epigastric burning). The treatment with Gaviscon, suspension to drink, lasted 1 month at a dose of 2 tablespoons, 4 times/day after meals and in the evening at bedtime. After one month, all symptoms were improved, in a statistically significant fashion, regarding their frequency, intensity and duration. The efficacy is considered positive in 98 p. cent of the cases; the patient's impression is favorable in 70 p. cent of the cases. Tolerance is excellent and the medication is satisfactorily accepted.

Adult↗