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Biomedical subjects

R Henrion

Publications and source records attributed to R Henrion.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Social acceptability of screening for HIV seropositivity in pregnant women. An inquiry in the Paris region].

Current debate about screening strategies for HIV during pregnancy is not limited to clinical and epidemiologic arguments; ethical and social concerns about the risk of stigmatization against HIV carriers are also taken into account. Therefore, data on public perception of AIDS and attitudes toward preventive measures against the disease can be of interest. In December 1987, a survey was carried out, through personal interview, in a representative sample (900 individuals selected by the quota method) of the 10.5 million inhabitants 18 years of age and over, in the Paris region. 9.8% of the women declared having been tested for HIV, at least once, during 1987, and 20% of these tests were part of prenatal care. Mandatory screening for HIV among pregnant women is supported by 78.6% of the respondents while only 64% support screening during premarital examinations and a minority (37.8%) is in favour of mandatory screening for the whole population. 48.5% of respondents share the misperception that transmission from mother to fetus always happens, and 70% think that women who are HIV carriers should renounce pregnancy: willingness to support mandatory screening for pregnant women is significantly higher among individuals who share these two beliefs.

Adult↗
PubMed1988

Pregnancy and AIDS.

Since the first cases of a new acquired immunodeficiency syndrome (AIDS) described by Oleske et al. and Rubinstein et al. in children in 1983, we have witnessed an ever-increasing number of such observations. As serology is not being performed on all pregnant women in many European countries, obstetricians must try to identify those belonging to risk groups: intravenous drug abusers, natives of affected regions or women having travelled to these areas, women having numerous sexual partners, presenting with other sexually transmitted diseases or living with infected individuals, prostitutes, transfused women. If the woman belongs to risk groups, HIV antibody testing is to be done at the beginning of pregnancy. The risks for the mother remain ill-defined, due in part to the difficulties inherent in keeping track of heroin abusers. Aggravation is certain if the mother is affected with AIDS or an associated syndrome called ARC (AIDS-related complex). It is debatable and at least rarer if the mother presents no clinical symptoms. Infant risks are becoming better known. The existence of materno-fetal contamination by transplacental route is undebatable. However, contamination during delivery or during the passage through the maternal genital tract cannot be excluded. The proportion of contaminated infants is approximately 40%. The disease in the infant is highly dangerous. According to these data, the procedure adopted by most obstetricians is the following: abortion is recommended at the first trimester of the pregnancy, a free choice is left open for the woman at the second trimester and at the third trimester delivery is carried out naturally. Caesarean sections are only done when there are obstetrical indications.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Sexually transmissible diseases and female sterility].

Regarding personal studies and a review of the literature, the authors are discussing the consequences of STD on fertility. Thus, through salpingitis, STD represent the main cause of tubal sterility, distal and proximal, and ectopic pregnancies. It seems desirable to look for them in the latter and treat them with a suitable antibiotherapy. The chlamydia serology seems a good screening examination. The best prevention of STD will certainly permit to decrease the frequency of tubal sterility and ectopic pregnancies, in the years to come, limiting therefore the major public health expenses they involve.

Adolescent↗
PubMed1988

[Pregnancy and AIDS].

The authors discuss the numerous problems currently raised by women and children affected by the HIV virus. After a short reminder of the virus characteristics and the epidemiology, they study the mothers' risk by discussing a possible aggravation of the disease during pregnancy, and the risks for the child, by considering the contamination route, its frequency, its gravity. They present diagnosis methods and propose future management.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Acetylcholinesterase titers in the amniotic fluid. Value of screening dysraphia of the central nervous system].

The authors report the results of 434 titrations of acetylcholinesterase in the amniotic fluid sampled by early amniocentesis, between the 17th and 24th week of amenorrhea. The biochemical technique used was quantitative and the values of the total cholinesterase activity (TchE) and the true acetylcholinesterase (AchE) were studied separately. Their conclusion is similar to that of other authors: the quantitative method, although satisfactory, has less value than the qualitative method using electrophoresis on polyacrylamide gel in order to screen or confirm the existence of a dysraphia of the central nervous system, because any amount of soiled fetal blood elevates the acetylcholinesterase level, titrated by the quantitative method.

Acetylcholinesterase↗
PubMed1987

[Serology of Chlamydia trachomatis infections in tubal pregnancies. Apropos of 95 cases].

This study concerns the results of serology for Chlamydia trachomatis in 95 patients who were operated on for tubal pregnancies consecutively. The serology (Ig GAM) was carried out using a micro-immunofluorescence technique. It was considered positive when the levels were higher than or equal to 1/32, suggesting an old or continuing infection. It was positive in 66 cases out of the 95, which gives a percentage of 69.5. The positive serology was apparently significant (p less than 0.01) more often in tubal pregnancy than in the two control groups (sterile patients with normal tubes and normally delivered patients). Our results coincide with that in the literature. It therefore seems worth while to look systematically for chlamydial infection in the couple in cases of tubal pregnancy and, if found, to treat them.

Adult↗
PubMed1987

[Chronic salpingitis and extra-uterine pregnancy. Results of the histologic study of 215 tubal pregnancies].

215 women who had tubal pregnancy were treated by total salpingectomy at the University Hospital Port-Royal between the 1st January 1977 and the 30th January 1986. All of these had histological examination of the tube in which the pregnancy occurred. Our series of histological examinations confirms that tubal pregnancy occurs in the great majority of cases in a tube that is already pathological. The responsibility for tubal abnormalities in the occurrence of tubal pregnancy has been suggested by a comparative study of a control series where chronic lesions of the tube were statistically far less frequent (p less than 0.001). Ampullary pregnancy, of which there were 200 cases, was associated in 89.5% of the cases with a pathological condition of the ampulla. Isthmic pregnancy, of which there were 15 cases, would seem to be secondary to a pathology in the isthmus in all cases except one, and is nearly always associated with lesions in the ampulla. Chronic salpingitis was the main histological lesion that was observed. It represented 95.5% of the abnormalities of the ampulla in ampullary pregnancies. In isthmic pregnancies it was found in two-thirds of cases attacking the isthmus, the ampulla or the whole tube. Isthmic salpingitis nodosa was the second lesion that was observed in 40% of isthmic pregnancies. As far as endometriosis is concerned, it is very rare and occurred in only one case. Prevention of tubal pregnancy, therefore, necessarily must lie in preventing tubal infections and sexually transmitted diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗
PubMed1987

[Termination of pregnancy and evacuation of the uterine contents in the second trimester. Use of a prostaglandin E2 analog: sulprostone].

The authors used sulprostone on 165 women whose pregnancies had lasted more than 12 weeks. The principal indications were: intra-uterine fetal deaths in 65 cases and an antenatal diagnosis of fetal malformations in 75 cases. Three routes of administration of the drug were employed: extra-amniotic in 15 women; intravenous in 62 women; intramuscular in 88 women. The doses used (adding together the intramuscular and intravenous routes) were: ampoule of 500 micrograms of sulprostone in 25% of cases; ampoules in 50% of cases; ampoules in 25% of cases. It was found to be very effective: by the intravenous route 88.70% expelled the fetus in 24 hours with a mean induction delivery time of 11 hours; by the intramuscular route 89.77% expelled in 24 hours with a mean induction delivery time of 11 hours 45 minutes. The side effects were not common: nausea in 17.6%; vomiting in 16.4% and diarrhoea in 6%. Ther marked effectiveness of sulprostone on the one hand and the good tolerance on the other indicate the effects of this product, which are a strong action on the uterus and a feeble action on the smooth muscle of other organs.

Abortifacient Agents↗
PubMed1986

[Microsurgical desterilizations. Reflections on 65 cases].

Sixty-five patients were operated on for reversal of sterilization between the 1st January 1978 and the 1st January 1984, with a follow-up of longer than 20 months. All had at least one tube which had a healthy distal and ampullary portion. Sterilization had been carried out in 54 cases by laparotomy (31 at caesarean operation) and they represented 83% of the cases, and laparoscopically in 11 cases. Laparotomy is still the most frequently used method to sterilise women in France; but it is to be hoped that in the future it will be superseded by laparoscopy which is less traumatising and allows the use of more conservative methods. The pathological study that was carried out on the segments of tube that were removed during the reversal operation showed that they were usually normal or had only very limited abnormalities (44.7%). When there were lesions these were usually in the proximal isthmic portion, where in 23% of cases there were diverticula or in 10.7% of cases epithelial atrophy. Fifty one out of the 65 patients had an intra-uterine pregnancy that carried to term and this was a success rate of 78.5%. There were four ectopic pregnancies (6.1%). The success rate did not seem to depend at all on the way the sterilization had been carried out except that it seemed that we had greater success in cases where the resection had been cornual. There seemed also to be no difference no matter how long a time interval had occurred from the sterilization to the reversal operation, the site of the anastomosis and the histological appearance of the fragments of the tube that were sent for section. This similarity in results seems to us to depend on using micro-surgical techniques which allow precise resection of pathological portions of the tube and a perfect anastomosis in a healthy zone of the tube.

Adult↗
PubMed1986

[Epidemiology of tubal lesions. Apropos of 588 microsurgical plastic procedures and 69 in vitro fertilisations].

Genital infections and in particular sexually transmitted diseases are mainly responsible for tubal sterility. We have studied five factors each of which could carry responsibility for this sterility. All were in some degree associated with infection in the 588 patients who were operated on for tuboplasty and 69 patients who had in vitro fertilisation. There results have been compared with 50 sterile women who had healthy tubes and with 8,356 women who were delivered during the same period of time. The previous histories of women who had extra-uterine pregnancies were significantly more frequent for these infections in the tubes leading to chronic salpingitis. Acute salpingitis was given in the history in about 35% of women who had to have tubal surgery or in vitro fertilisation. This was significantly higher than those sterile women who had healthy tubes and those who were delivered of babies. There was a significantly raised number of those where the serology was positive for chlamydia trachomatis in sterile women with tubal lesions. We have also been able to note that there was correlation between the frequency with which positive serology was found and the degree of severity of the tubal lesions. So, the serology was often positive in cases of hydrosalpinx (77.3%) and in double lesions (91.5%). These figures were significantly higher than those who had proximal blocks (61%) and who had adhesions (54.8%). The frequency of therapeutic terminations of pregnancy in patients with tubal lesions was significantly higher than those in the control groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Chlamydia Infections↗
PubMed1986

[Tubal histology in extra-uterine pregnancies].

141 patients affected by tubal pregnancy have been treated by total salpingectomy at the Port-Royal university clinic between the 1st January 1977 and the 31st January 1984. Tubal pregnancy occurred in the majority of cases in a pathological Fallopian tube, of which the histological state was unrelated to the clinical observations made at laparotomy. Ampullary pregnancy (88% of cases) is secondary to a pathological ampulla in 94 p. cent of cases. The latter was chronic salpingitis in 92 p. cent of cases. Isthmic pregnancy (12% of cases) appears to us to be secondary to isthmic pathology in all cases, and is generally associated with ampullary lesions. There also chronic salpingitis preponderates, whilst endometriosis is very rare. The great frequency of pre-existing lesions which we have noted explains perfectly the high level of recurrences in situ observed after conservative surgery of the gravid tube.

Fallopian Tubes↗