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Biomedical subjects

R Picard

Publications and source records attributed to R Picard.

50 records · Page 3Linked to original sources

Expectant management of post-term patients: observations and outcome.

Post-term pregnancy is associated with increased perinatal mortality. In a retrospective study based on our post-term protocol from 1990 until May 1995 1,798 post-term pregnant women with reliable dating were evaluated for expectant management. A group of 2,633 pregnant women who delivered between 37 and 41 weeks during 1994 served as a control group. The perinatal mortality (0.56 per 1,000 vs. 0.75 per 1,000 in the control group) was similar in both groups. The incidence of induction of labor (7.45% vs. 7% in the control group), meconium of more than +1 (5.2% vs. 4% in the control group), shoulder dystocia (0.33% vs. 0.19%), high birthweight (> 4,500 g) (1% vs. 1%), and cesarean section rates (7.5% vs. 7% in the control group) were similar. However the fetal distress rates (11.6% vs 16%; P = .004), instrumental deliveries (10.1% vs. 13%, P = .002), and the rate of 5-minute Apgar score of less then 7 (1.1% vs. 5%, P = .000001) were found to be significantly lower in the post-date group than in the control group. We conclude that the expectant management and our intensive observation and follow-up in post-term is indicated for both mother and fetus.

Apgar Score↗

[On preclotting of woven Dacron vascular prostheses (author's transl)].

The role and the clinical value of common protocols of preclotting for a woven Dacron vascular prosthesis have been investigated. A comparative study of blood loss was carried out for Standard Woven De Bakey protheses inserted in a specially constructed extracorporeal blood circuit with canine models. The system detected transport of blood across the wall of the prostheses. These measurements were supplemented by gravimetric assessment of blood clot density and scanning electronmicroscopy examination of the internal surfaces of the prostheses. The pre-operative protocols investigated included : absence of pre-treatment, precoagulation with anticoagulant-free blood and various techniques using heparinized blood subsequent to an initial blood contact (modified method of Sauvage). The effect of using heparinized animals was also investigated. Leakages in unclotted prostheses could be reduced almost five fold by any precoagulation technique. Heparinization did not cause a significant increase in leakage and considerably improved the quality of the newly deposited blood product lining on the prostheses which consisted almost entirely of fibrin and eliminated any embolization.

Animals↗