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R Maillet

Publications and source records attributed to R Maillet.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Maternal and fetal prognosis of occipito-posterior presentation].

Occipito-posterior persistent presentation is a relatively rare obstetrical condition, occurring in 2 to 4.5% of deliveries. Failure of the occiput to spontaneously rotate has been associated with increased maternal and neonatal morbidity. We performed a retrospective study of 210 vaginal occiput posterior deliveries to investigate the influence of this position on maternal and fetal morbidity. Our results demonstrate that overall prognosis of occipito-posterior persistent presentation is good but less auspicious than occipito-anterior presentation on account of importance of perineal injuries and maternal and fetal infections. Forceps extraction in posterior presentation is criticized today. In our opinion, the vacuum extractor is the better instrument because it is less aggressive to maternal tissues and also because, in most cases, the fetal head rotates anteriorly after provoked flexion.

Adolescent↗
PubMed1999

[Prenatal ultrasonic measurements of the eye and the interorbital distance].

OBJECTIVES: The two-fold objective of this study was to ascertain whether the antero-posterior diameter of the fetal eye is comparable to the transversal diameter and to establish nomograms based on the measurements obtained for ocular diameter (OD), mean interorbital distance (MIOD) and the MIOD/biparietal diameter (BPD) ratio related to gestational age. TYPE: A prospective monocentric study based on 398 sonographic fetal eye measurements. RESULTS: The antero-posterior and transverse ocular diameters of the fetal eye remain comparable throughout pregnancy (R = 0.997, p < 0.0001). They were related to gestational age and BPD. The MIOD/BDP ratio decreased with gestational age. The OD/BPD ratio remained nearly constant. Nomograms were established for OD, MIOD and the MIOD/BPD ratio related to gestational age. DISCUSSION AND CONCLUSION: The fetal eye can be measured on any diameter provided the sonographic scan for the measurement is flawless. Nomograms and values are given. Hyper- and hypotelorism and microphthalmia can be found in numerous malformative syndromes. Previously published tables are not well-suited to the French population.

Cephalometry↗
PubMed1999

[Value of histologic examination of the interamniotic membrane in the twin placenta for confirmation of chorionicity diagnosis].

The interest of twin chorionocity and zygosity diagnosis is unquestioned. Indeed, in many medical situations, the knowledge of zygosity is an important fact for management of twins. Prenatal echographia is not a perfect tool to characterize chorionicity, and so postnatal examination of the placenta is always necessary. But macroscopic examination is also not relevant, and competent midwives can make many mistakes. Considering that biological postnatal diagnosis of twin zygosity is difficult and costly, we believe that microscopic chorionicity confirmation is required for identical twins.

Amnion↗
PubMed1998

Use of energy color Doppler in visualizing fetal pulmonary vascularization to predict the absence of severe pulmonary hypoplasia.

OBJECTIVE: The aim of our study was to determine if the assessment of pulmonary vascularization by energy color Doppler during ultrasound examination can predict the absence of pulmonary hypoplasia before birth in situations where it is a high risk. METHODS: In a prospective study of 12 pregnancies presenting a risk of pulmonary hypoplasia (5 early and prolonged premature ruptures of the membranes, 1 diaphragmatic hernia, 1 chylothorax, 1 pulmonary sequestration, 1 omphalocele, 1 anamnios and 2 Potter's syndromes) energy color Doppler was used to visualize pulmonary vascularization. RESULTS: In 10 cases where pulmonary vascularization could be visualized, none of the infants had pulmonary hypoplasia. In the 2 cases of Potter's syndrome where pulmonary vascularization was not visualized there was a pulmonary hypoplasia. CONCLUSION: The visualization of fetal pulmonary vascularization with energy color Doppler in situations with a high risk of pulmonary hypoplasia can predict the absence of severe pulmonary hypoplasia.

Adult↗
PubMed1997

[A rare cause of postpartum hemorrhage: a genital thrombus].

Puerperal hematoma is a grave but fortunately rare hemorrhagic post-partum complication (occurring in less than 1:1000 deliveries). The hematoma arises due to detachment of para-vaginal conjunctive tissue. In this type of tissue, no natural hemostasis take place and the hematoma may spread into the retroperitoneal cavity. The different risk factors include primiparity, instrumental extraction of the foetus, pre-eclampsia, twin pregnancy and the presence of vulvo-vaginal varicose veins. External bleeding may not always be evident and other clinical symptoms may be delayed. Despite this, rapid course may still occur with drastic consequences. When a case is referred, an examination of the vulvo-vaginal region is mandatory, resuscitation and surgery performed immediately. If this fails angiographic embolization should be carried out. The prognostic outcome of this rare case of post-partum hemorrhagia is highly dependent on early diagnosis and rapid treatment involving close cooperation between obstetricians and anesthetists, and also of rapid embolization to prevent possible intractable hematomas.

Adult↗
PubMed1997

[Is the Mauriceau maneuver deleterious? Study of 103 cases].

The Mauriceau manoeuvre has a poor reputation in France where some obstetricians believe it leads to an increase in the number of neonatal traumal injuries. To evaluate this hypothesis we examined the results of a personal series of 103 cases of breech extraction where foetal head extraction was performed using the Mauriceau manoeuvre. Our study showed that the level of traumal complications was not worse than that of the general neonatal population. We therefore conclude that this active and organized method of breech delivery is safe and provides a young obstetrician with valuable experience of practical obstetrical manipulation.

Adolescent↗
PubMed1997

[Estimation of the treatment cost of cervical cancer].

BACKGROUND: The goal of this study was to estimate direct costs induced by the first year of treatment of cervix cancers according to the stage at diagnosis. METHODS: Fifteen patients of the Gynaecology Department of the Besançon hospital (Doubs, France) were involved in a prospective study to estimate the real cost of treatment of carcinomas in situ (CIS) by conization and of microinvasive carcinomas (MIC) by simple hysterectomy. Costs of invasive cancers were obtained from a retrospective analysis of 24 hospital records in the Radiotherapy Department. RESULTS: The average real cost of treatment for the CIS was 5023 FF (1995 French Francs). Real treatment cost of the MIC was 15,867 FF. The average cost of treatment for the IB and IIA cancers stage (FIGO classification) was 61,540 FF and 145,314 FF for the IIB to IV stage cancers. CONCLUSIONS: Cost-estimation of cervix cancer treatment according to the stage of diagnosis has to be done before starting a cost-effectiveness analysis of mass screening for cervix cancers. This study will allow us to take into account changes in the stages distribution following on a screening campaign.

Carcinoma in Situ↗
PubMed1996

[Ultrasonic diagnosis and laparoscopic treatment of an ovarian pregnancy. A case report and review of the literature].

Ovarian pregnancy is an uncommon type of ectopic pregnancy. Incidence has been estimated at 1 per 7 000 pregnancies and 1 to 6% of ectopic pregnancies. Pathogenesis is different from tubal pregnancy. Generally it occurs as a single event in an otherwise healthy woman. Early diagnosis of ectopic pregnancy is essential and is now possible with the advent of endovaginal sonography associated with serum beta-hCG assay. There are various forms of ectopic pregnancies. Macroscopically, 4 forms can be distinguished: hematoma, clar ovum, embryonnized ovum, and placenta with fetus. Histology alone can confirm the diagnosis and distinguish between the 4 forms: intrafollicular, justafollicular, justacortical and interstitial pregnancy. For many authors, laparotomy is required in all cases, but in any case, the ovary can generally be preserved as implantation is usually superficial. We describe here a case of ovarian pregnancy after stimulated ovulation. Early diagnosis with correct localization was achieved with endovaginal sonography. Conservative treatment with laparoscopy was successful.

Adult↗
PubMed1996

[Breech extraction of the second twin. 56 cases and review of the literature].

The best indication for breech extraction, and undoubtedly the last, is for delivery of the second twin with a non-cephalic presentation. At the Besançon University Hospital, we have used this technique routinely and without delay in case of non-cephalic presentation of the second twin. In order to evaluate the results of this approach, we studied 56 patients files retrospectively in a continuous series of case over a 7-year period. The following data were noted: birthweights, APGAR score at 5 minutes, requirement for paediatric intensive care, hospitalization in paediatric ward, and death. Gestational age and rate of prematurity were calculated. We also recorded the rate and type of antalgisia used, as well as the frequency of episiotomy. Both the obstetrical and neonatal results indicated that breech extraction of the second twin is a reliable effective technique in terms of mortality and morbidity for the second twin. Using this technique should not raise any legal problems since the other techniques for delivering the second twin have not been shown to give better results. When planned and performed under precise conditions by an experimented physician, this route does not give any poorer results than cesarean. Breech extraction should be an exceptional technique all obstetricians can use, together with cesarean, for delivering the second twin.

Adult↗