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Biomedical subjects

R Henrion

Publications and source records attributed to R Henrion.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Administration of diethylstilbestrol during pregnancy, a public health problem].

The analysis of the health risks associated with the administration of diethylstilbestrol (DES) during pregnancy (for the prevention or treatment of threatened abortions) has been largely published. Concerning mothers, a relationship between DES exposure during pregnancy and risk of cancer is unproved. However, existing studies are sufficient cause for serious concern over drug's carcinogenic potential, and further follow-up studies are required. Concerning daughters, a clear association between in utero exposure to DES and clear cell adenocarcinoma of the vagina or cervix is established (incidence between 0.14 and 1.4 per 1000 through age 24). The risk for squamous cell cancer of the vagina and cervix does not seem to be increased. Cervico-vaginal adenosis is frequent (20% to 60% of exposed subjects). This is not a pre-cancerous lesion, its spontaneous evolution is towards regression. No treatment is prescribed. Morphological changes of the genital tract have been described, their consequences on fertility and pregnancy are not clear. Concerning sons, an excess of genital abnormalities (especially of the epididymis and undescended testis) has been reported, but information on the fertility implications of these findings is not available. There is no evidence of an increased risk of testicular cancer. The analysis of all these informations should allow to bring up a policy to take into account these risks in the population.

Adult↗
PubMed1983

[Placental smears in a maternity ward. Importance of early diagnosis of neonatal bacterial infections caused by materno-fetal contamination].

Direct cytobacteriological investigation of the amniochorionic plate of the placenta has been used systematically in the Maternity Hospital as a test to detect amniotic infection. This test was practised on fresh placentae in the laboratory of Histology, preceding the examination of the placenta. The test gave, within 30 minutes of delivery, information about the presence of bacteria of fungi on the amniotic surface, their abundance and their morphology. The results of the placental smears were compared to the results of bacteriological cultures obtained from the placenta, the infant and occasionally the mother. The diagnosis of neonatal infection was established from clinical, biological and bacteriological criteria which were defined in advance. Two series are presented: the first concerns 2,514 cases selected in the delivery room over a period of 4 years for high risks infection, i.e. 1 in 6 of the 15,377 deliveries registered during this period. The rate of positive smears was 9%: 63% Gram positive, 17% Gram negative, and 20% mixed. The most common bacteriologically proven neonatal infections were streptococcus B (40%) and Escherichia coli (33%). The second is a prospective survey of 400 unselected consecutive cases observed during a period of 7 weeks: 1% of the smears were positive - and the test would have been justified in 1 in 5 cases. From these two surveys, it appears that placental smear is a good test to detect maternofetal contamination. The positive predictive value of the test is 80%. The negative predictive value is 98% and approaches 100% if cases where the mother received antibiotics before delivery are excluded.

Bacterial Infections↗
PubMed1983

[Attempt at determining fetal sex by the simultaneous study of the HY antigen and testosterone in the amniotic fluid].

Attempts have been made to determine fetal sex early by a simultaneous study of H-Y antigen and testosterone in amniotic fluid. H-Y (male) antigen was serologically detected in the amniotic cells from both sexes, but the results obtained from 473 amniotic fluids showed no significant sex differences either in fresh cells or after culture. Testosterone assays done from 263 samples of liquor confirm that the results obtained in cases of male fetuses were significantly higher than in females. 55% of all males and 47% of females could thus be detected to a level of 100% certainty. The probability of having a girl decreases as an inverse function of testosterone levels and comes out at 85% for testosterone less than 200 pg/ml. On the other hand the probability of a male fetus is 95% when the values are above 240 pg/ml. The determination of the testosterone/DHA ratio in order to try to eliminate the influence of the variations in volume has not improved the accuracy of this diagnosis.

Adult↗
PubMed1983

[Microsurgical treatment of proximal lesions of the fallopian tubes. Apropos of 51 cases].

Microsurgical anastomosis was carried out on 51 patients who had proximal tubal lesions that were either purely isthmal, interstitial or isthmo-interstitial. 18-24 months later there were, using an actuarial method of calculation, 64% of intra-uterine pregnancies (+/- 2 X 8% skew) (line 8, Table IV). There has not been a single case of extra-uterine pregnancy so far. These results confirm the superiority of microsurgical anastomosis over implantation of the tube into the uterus.

Fallopian Tube Diseases↗
PubMed1982

[Percutaneous nephrostomy in utero for bilateral foetal hydronephrosis].

Left percutaneous nephrostomy was performed in a 30-week foetus with bilateral hydronephrosis due to abnormal pyelo-ureteral junction. Puncture of the pelvis and insertion of a 5 cm long F8 Malecot catheter were carried out under ultrasonography. The end of the catheter was left free in the amniotic fluid. Drainage was perfect during 3 weeks, until the skin of the foetus grew over the end of the catheter. At 34 weeks, a much longer catheter was introduced, but it was dislodged from the kidney within 48 hours. Vaginal delivery was induced at 37 weeks, giving birth to a normal male child. On the 4th day after birth the catheter was removed and resection-anastomosis of the left pyelo-ureteral junction was performed.

Adult↗
PubMed1982

Prenatal testing for inherited immune deficiencies by fetal blood sampling.

We attempted to develop a prenatal diagnosis in fetuses at risk for immunodeficiency by fetal blood sampling performed under fetoscopy at 18-22 weeks of gestation. In order to obtain normal values, we first investigated thirty-five control fetuses whose blood punctures were undertaken for the diagnosis of haemoglobinopathies. Surface markers and in vitro mitogen-induced proliferation of the fetal lymphocytes were studied using micromethods. We then examined two fetuses at risk for two different types of severe combined immunodeficiency and established their immunological integrity, hence avoiding an unjustified termination of pregnancy. This immunological integrity was confirmed after birth.

Antigens, Surface↗
PubMed1982

[Intra-uterine diagnosis of a central nervous system abnormality (author's transl)].

The authors report a case of intra-uterine fetal convulsions. This is a very rare happening in which the cause is not easy to differentiate between a congenital or a traumatic factor. Some features have already been published. Most of them are connected with the syndrome of lack of pyridoxine, which is a familial condition transmitted by a recessive autosome. This diagnosis should be throught of because such a lack is lethal when not treated, and is curable without any after-effects simply by taking pyridoxin. The authors point out the importance of a qualitative analysis and not only a quantitative measurement of active movements that alone can lead to the detection of such abnormalities in fetal behaviour.

Adult↗
PubMed1982

[Exploratory salpingotomy].

One of the difficulties in tubal surgery concerning the distal portion of the tube is the accurate assessment of the value of the ampullary muscularis and mucosa on which depend the choice of the right operative procedure and the prognosis. The difficulties are most important in case of total terminal occlusion particularly when the site of the former ostium is no longer visible. An exploratory salpingotomy preceding any repair is made under the operating microscope. The simple technique that we describe allows: --an accurate assessment of the inner ampulla; --lysis of the mucosal adhesions inside the ampulla; --detection of the former ostium from the inside and the incision in the right place. The functional consequences of such an incision are difficult to appraise because the number of cases is so far too small and the follow up too short. However, those consequences seem slight when compared to the advantages, which are better precision in the investigation, the indication and the execution of the surgical repair.

Fallopian Tube Diseases↗
PubMed1982

[Echographic detection of chromosomal anomalies apropos of trisomy 13 and 18].

Some multisystemic abnormalities associations which can be found by ultrasound examination are sometimes chromosome anomalies and amniocentesis must be performed for confirmation. By ultrasonography we can now reach a new objective element: the fetus extremities. Limbs anomalies, such as polydactily, club-feet and/or club-hands must lead to perform amniocentesis in order to assess or not a possible 13 or 18 trisomy.

Abnormalities, Multiple↗
PubMed1981

Incidence of idiopathic respiratory distress syndrome during the last ten years.

In the Port Royal Maternity Hospital, with about 2000 deliveries per year, the incidence of idiopathic respiratory distress syndrome (IRDS) has been studied during the last ten years. Because of the potential hazards of drugs, the attitude of restricting the use of steroids to a few particular cases was adopted. In period I (1968-1969), the incidence of IRDS was 1 per 100 live births. In period II (1972-73), the incidence dropped to 0.54% of the live births. In period III (1975-77), the incidence remained at 0.47% of the live births. The difference in frequency between period I and period II and III is statistically significant (P less than 0.01). This diminution appears to be the result of an overall improvement in the pre- and postnatal care of premature infants. The newborns who could have benefited from prenatal glucocorticoid treatment are studied in period III. From 28 to 34 wk of gestational age, 148 infants were born. Seventy-eight (not equal to 50%) did not have any respiratory problems, 54 had mild and transitory distress and 16 (not equal to 10%) had IRDS. In only 7 cases was the time interval between the first signs of premature labor and delivery longer than 24 h. In conclusion, at least 148 neonates would have had prenatal glucocorticoid treatment, in order possibly to avoid 7 cases of IRDS, which would mean hazard for 20 and benefit for 1. A hazardous effect on brain development seems to be the main concern and has to be more fully documented.

Female↗
PubMed1981

New techniques for the prenatal diagnosis of hemoglobinopathies.

Two new techniques have been devised for the prenatal diagnosis of hemoglobinopathies performed on fetal blood samples. Isoelectric focusing (IEF) of hemoglobins was compared to the classical chromatography of labelled globin chains for 51 fetal blood samples, 40 being obtained for prenatal diagnosis of hemoglobinopathies, in Paris. In all cases the two methods provided identical results. Adult hemoglobin was quantitatively evaluated. In addition blood samples obtained in other centers after abortion of 22 fetuses homozygous for beta thalassemia did not exhibited measureable amounts of Hb A by IEF. The fetal blood must be free of maternal contamination. If present maternal red blood cells can be completely eliminated by selective lysis using the 0RSKOV reaction. A chromatography of hemoglobins on Biorex 70 has been devised very recently to overcome the two limitations of IEF: First the contamination of fetal blood samples by maternal cells, and second the impossibility to evaluate Hb A when present in proportion below 1%. The chromatography of hemoglobins on Biorex 70 is performed in 75 minutes with 0.1 mg of hemoglobin present in membrane free hemolysate. The optical density recording allows to evaluate .5% of Hb A and to detect .1% of Hb A. In addition, the radioactivity profile of the chromatography can be determined. It has to be used in case of maternal contamination.

Anemia, Sickle Cell↗
PubMed1981

[The antenatal diagnosis of Bonnevie-Ullrich's syndrome. The role of ultrasound (author's transl)].

The authors report four cases of Bonnevie-Ullrich's syndrome where the diagnosis was made by ultrasound. The typical picture is of a cystic retrocervical hygroma with generalised lymphoedema which is more marked in the lower limbs and on the backs of the hands and feet, together with ascites. This syndrome adds up to Turner's syndrome. The diagnosis was definite in one case because it was confirmed by amniocentesis with monosomy X caryotype. It is very likely that the three other cases were the same because the anatomo-pathological features of the external and internal genital organs showed that the baby was feminine. In two cases raised alpha-foetoprotein was found. The levels were 1000 micrograms/ml and 2100 micrograms/ml and the authors discuss the origin of the alpha-foetoprotein. It is advisable to terminate the pregnancies in these major forms of Turner's syndrome because they usually die in utero (in two cases) at different stages of the pregnancy.

Abortion, Therapeutic↗
PubMed1981

[Neonatal mortality and morbidity. Priorities in perinatal care (author's transl)].

Perinatal mortality rates have been decreasing from 25 to 15 0/00 at the Port-Royal maternity hospital from 1969 to 1978. The incidence of materno-foetal infection has been stable within the last 10 years, around 1.2% live-births; mortality linked with these infections represents 28% of early neonatal deaths and remains nearly as high as mortality from malformations. The incidence of Idiopathic Respiratory Distress Syndrome has been decreasing as low as 0.3% live births (14% between 28 and 34 weeks of gestation). The risk appears not high enough to justify the systematic use of prenatal glucocorticoids. Birth injury in the full term newborn occurs at a rate of 1 0/00 births in the most severe cases. In cases of moderate severity, the incidence has been decreasing from 1% to 1 0/00 births within the last 5 years, probably due to improved obstetrical care.

Female↗