[The stuck-twin syndrome. Re-establishment of normal hydramnios after quasi-complete drainage of the sac using a polyurethane catheter].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
R Maillet
Publications and source records attributed to R Maillet.
[Hereditary angioneurotic edema in gynecology-obstetrics. Management].
Hereditary angioneurotic edema is a rare disease (250 cases currently identified in France). It is the most frequent among hereditary deficiencies of the complement system. This severe disease is fatal in 15-20% of the patients before 40 years of age. Death can be prevented if correct steps are taken in case of even minor trauma, which often trigger acute, potentially fatal, episodes. Danazol is used as preventive therapy before surgery and C1-esterase inhibitor or fresh frozen plasma is given for acute episodes. In case of obstetrical trauma, C1-esterase inhibitors should be used either as prophylaxy or as treatment. Fresh frozen plasma is used if C1-esterase inhibitors are not available. We report here our experience with three patients with known hereditary angioneurotic edema. Gynecology surgery was required in two.
Adult↗
[Obstetrical epidural analgesia: an epidemiological in Bourgogne and Franche-Comté 1993].
Many publications report the number of epidural analgesias carried out for the last years in English-speaking countries. On the other hand, very little information exists about the incidence of obstetrical epidural analgesia performed in South and Central Europe, particularly in France. A retrospective study within the regions of Bourgogne and Franche-Comté was carried out for the year 1993 firstly, to determine the number of obstetrical epidural analgesias performed and the drugs used; and secondly, to describe the organization and the problems encountered. The result of this study leads to one major question: what is the best type of organization in order to guarantee the highest safety, given the increasing demand for epidural analgesia in obstetrics?
Analgesia, Epidural↗
[Is induced labor justified in cases of scarred uterus, breech presentation and multiple pregnancy?].
Explore the source record for details and available documents.
Breech Presentation↗
[Pregnancy without medical monitoring: obstetrical and neonatal prognosis. A retrospective study of 88 cases].
Unregistered and unmonitored pregnancies account for 0.2 to 0.6 p. cent of all pregnancies. They essentially concern young, single, primiparous mothers from disadvantaged social backgrounds. Labour and delivery are generally without difficulty but the neonatal prognosis is impaired by a high proportion of premature and underdeveloped infants, often requiring a long stay in a pediatric unit.
Adolescent↗
[Toxoplasmosis and pregnancy: is it possible to simplify the diagnostic procedures?].
About 1% of all pregnancies in France are complicated by a primary infection with toxoplasmosis. The risk for the fetus being affected increases during the pregnancy but the seriousness of the effect on the fetus becomes less with more advanced pregnancies. Treatment of the mother using Spiramycin have been proven to be efficient, lessening the risk for the fetus being affected. The diagnosis of the fetus being affected rests on a whole bundle of presumptive evidence culled from non-invasive methods and invasive methods which are not without risk. (Direct or over-enthusiastic diagnostic techniques or none at all). We have studied a series of 101 primary infections with toxoplasmosis for which we have not carried out any invasive diagnostic techniques. The long term results in 77 infants show no difference in fetal morbidity and better results as far as mortality are concerned. We therefore propose simplifying the diagnostic approach in cases of primary infection with toxoplasmosis during pregnancy.
Decision Trees↗
[Artificially induced labor. Experience of the maternity unit of the Besançon teaching hospital].
The authors describe 190 cases in which labor was artificially induced between 29 and 42 weeks. They compare different methods (120 induced by oxytocin-like agents, 70 by prostaglandins) in some cases associated with mechanical methods. Various parameters were investigated, notably the Bishop score at the time labor was induced, the method of delivery and the impact on the offspring of these techniques.
Apgar Score↗
[How to reduce the number of cesareans in teaching hospitals?].
The authors analyze their indications for cesareans for the year 1989, stressing the possibility of doing fewer. They carry out a critical analysis of the various indications by comparing them with literature data. Thus, 157 of the 2,055 deliveries are described, or 7.60 percent.
Cesarean Section↗
[Update on delayed births].
Sixteen (16) cases of delayed births have been reported in the literature. All of these patients obtained at least one live child. This method can, therefore, be suggested in cases of premature birth after less than 28 weeks of amenorrhea for patients who present with a multiple, pluriamniotic pregnancy.
Adult↗
[Clinostatic variations of the lumbosacral spine and obstetrical mechanics].
An X-ray study of the lumbar spine after childbirth in 2 groups of patients (one control group and one group with engagement dystocia) picked up one difference between the groups. The patients who gave birth spontaneously, presented with hyperlordosis which was relieved when lying down. In contrast, the patients who had presented engagement dystocia, presented with hyperlordosis which was aggravated when lying down.
Adult↗
[Influence of Chlamydiae serology and the presence of a pelvic inflammatory state on the results of in-vitro fertilization].
The authors investigated the influence of Chlamydiae serology and the presence of a pelvic inflammatory state on the outcome of in-vitro fertilization on the basis of an analysis of 116 stimulation cycles. The study included 71 female patients suffering from infectious sterility of tubular origin with distal lesions. Chlamydiae trachomatis serology was considered to be positive at IgG titers in excess of 1/64. When the serum test was positive, there was a significant reduction in the number of clinical pregnancies and the cleavage rate. The percentage of ectopic pregnancies (6 ectopic pregnancies out of 29 clinical pregnancies) was very high, particularly if the serum test was positive and a pelvic inflammatory state persisting after antibiotic treatment contraindicated microsurgery. Surgery was performed only in favorable cases and did not appear to have any negative impact on the outcome. The presence of a non-stabilized pelvic infectious state was correlated with a significant increase in the drop-out rate and the number of post-menopausal gonadotropin required to achieve stimulation. The fact that unexpected spontaneous pregnancies may occur after an unsuccessful attempt must be taken into account when sterilization or salpingectomy are envisaged in an attempt to improve the outcome.
Chlamydia Infections↗
[Breast cancer following breast prosthesis and irradiation in childhood].
The authors report a case of breast cancer developing 7 years after insertion of a breast prosthesis. This patient was 45 years old at the time of this discovery and had received low dose radiation during childhood for a haemolymphangioma of the homolateral axillary region. The possible factors predisposing development of cancer are discussed: haemolymphangioma, low dose axillary irradiation during childhood, peri-prosthetic fibrous capsule. These various points are examined in the light of data from the literature. The conclusions recall the necessity for clinical and radiological follow-up of breast prostheses, preferably performed by a plastic surgeon.
Axilla↗
[Comparative study of 2 protocols for antibiotic therapy. Maternal-fetal non-specific bacterial infections during labor].
Two protocols for prophylaxis by antibiotics in labour were compared to see how effective they were in preventing materno-fetal infection in patients who had signs of chorio-amnionitis. There was in increase in E. coli infections in 40% of liquor which were resistant to amoxycillin which had been used right up to now. 135 cases of patients who had received antibiotic treatment in labour were studied. 61 of these were treated with amoxycillin and 74 with piperacillin. The results show that there was a drop of 11.05% in the number of newborns who were infected in the group of patients who were treated with piperacillin. It was not possible using piperacillin to avoid all infections of the mother and fetus. The severity of the infection in the fetus, as judged by the Apgar score and the opinion of the paediatricians, was less serious in the group that was treated with piperacillin. The death rate for both groups was identical: one in each group. Both were caused by E. coli infections. A drop of 11% in post partum maternal infections was noted. Its was shown that piperacillin was more efficacious, but this way of preventing of infections in the mother and fetus lay in finding as early as possible the situation that could increase the risk of infection.
Amoxicillin↗
[Birth delayed by 23 days after premature delivery in a triplet pregnancy obtained by in vitro fertilization].
At 26 weeks' gestation, the patient gave birth to 2 premature infants who did not survive. Following this delivery, under general anaesthesia and infusions of tocolytic drugs and antibiotics the uterus was washed with Ringer's lactate solution and cerclage of the cervix was performed after ligation and section of the two umbilical cord flush with the cervix. The "second delivery" was delayed by 3 weeks; the child weighed 1,150 grams at birth and survived. Six similar cases (including ours) have been published, and in each of them one living child was obtained. The above technique can therefore be recommended, in case of premature delivery before 28 weeks of gestation, for women with multiple pluriamniotic pregnancy.
Adult↗
[Accelerations of the fetal cardiac rhythm and fetal movements. Significance of their association recorded on the cardiotocogram by the Tococinon].
Recording all fetal movements on the cardiotocogram using tococinon showing forty minutes observations adds a new dimension to the old and new methods of monitoring the fetus. A group of 53 pregnancies without any risk was compared to a group of 37 pregnancies of high risk in which were also found sub-groups as designated by the aetiology and the severity of the fetal risk. Furthermore we have carried out a longterm study of 5 cases over six days. We propose a choice of the best parameters to be used according to their reliability, accuracy, sensitivity and predictability. The number of accelerations that coincided with the movements that were recorded was not very reliable or sensitive but it was accurate enough and predictive. The number of movements that accompanied the accelerations when added to the overall activity did become precise and predictive. Adding the two together make it more accurate and sensitive. New methods of monitoring are suggested, and these appear to be more simple and more efficient.
Female↗
[Hellp syndrome may precede the appearance of arterial hypertension in pregnancy toxemia].
The "Hellp syndrome" describes the association of three biological abnormalities (hemolysis, liver abnormalities and thrombocytopenia) establishing the severity of arterial hypertension during pregnancy and requiring the interruption of pregnancy as much for the child as for the mother. This article reports a case of "Hellp syndrome" which was special in that the biological abnormalities preceded the occurrence of pre-eclampsia. The signs, diagnosis, prognosis and treatment of the "Hellp syndrome" are studied in this article.
Adult↗
[Recording of fetal movements during pregnancy. Aid to the diagnosis and prognosis ascertained by Tococinon].
Objective recording of fetal movements has become operational since the use of the tococinon. At the beginning of pregnancy, from the twelfth week of amenorrhoea onwards, aberrant values seem to be linked to several factors such as mother's anxiety, urinary infection and anesthesia. If they are repeated that suggests there are abnormalities, such as trisomies or malformations in the central nervous system, and implies that other diagnostic methods must be used to make the diagnosis such as ultrasound or amniocentesis. A new definition for lowered activity by the fetus is proposed for the end of pregnancy. If these recordings are repeated before or at the same time as other signs of fetal distress have been found we must think of pathological features such as intrauterine growth retardation, post-maturity, infections, rhesus incompatibility and diabetes. Pharmacological influences, too, have to be thought of and they are usually correlated with rises in the fetal pulse rate and with using the apparatus when the patient is walking about.
Amniocentesis↗
[Current aspects of engagement dystocia].
It seems likely, in view of the large number of caesarean operations that are now being carried out and that too have complications, that the mechanism of obstetric procedures will sooner or later become of interest again to obstetricians. This study looks at a consecutive series of cases where dystocia in the upper part of the pelvis occurred and tries by analysing different obstetrical parameters to work out the best time for carrying out different obstetrical manoeuvres. It is possible to come to two conclusions, so long as both the mother and the fetus are watched carefully during the labour: the trial of delivery of the fetal head using the obstetric ventouse will bring about a significant reduction in the numbers of caesarean operations. it is always rewarding to be patient and it does not seem sensible to intervene too quickly. Two important results come from this approach: mechanical dystocia has practically disappeared, as it now only occurs in about 1% of labours. on the other hand, particularly in primiparous women, dystocia in the upper straight of the pelvis is quite common.
Adolescent↗