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Biomedical subjects

Y Brossard

Publications and source records attributed to Y Brossard.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Epidemiology of HIV-1 infection in the pregnant woman].

With 6,409 cases of AIDS recorded as at 31st March 1989, 130 of which were due to mother-to-foetus transmission, France is the European country most affected with HIV1 infection. From the results of a recent survey involving 40 p. 100 of all women who gave birth in continental France, the authors estimate that 0.05 p. 100 to 0.1 p. 100 of women delivered in 1988 were seropositive. HIV1 seroprevalence is about twice that figure in women at the beginning of pregnancy, since more than one-half of mothers who know they are seropositive choose to have their pregnancy interrupted. Investigations concerning the geographical origin and mode of contamination of seropositive women followed up in France showed that: (a) HIV1 infection is frequent in women who came from Zaire, Congo and the Ivory Coast and rare in women from Mali and Senegal. There was a similar contrast between women from Haiti and those from the French Antilles; (b) drug abuse plays a major role in the other seropositive women: 70 p. 100 were drug addict and 15 p. 100 had been contaminated by male drug addicts. Heterosexual contamination by multiple partners not classified as being at risk is exceptional, but it seems to be the rule in seropositive women from central Africa and Haiti. The authors emphasize the value, methods and indispensable extension of HIV1 seroepidemiological studies in pregnant women.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Collection of placental blood with a view to hemopoietic reconstitution.

Collection of placental blood in a sterile and closed system is a simple, safe and efficient procedure. One hundred and fifty eight units of fetal blood were collected by applying the same requirements of quality and safety as those defined for blood products in blood banks. No adverse effects were seen in mothers or their newborns.

Blood Banks↗
PubMed1990

Hematopoietic stem cell potential from umbilical cord blood.

We studied the conditions of collection and isolation of hematopoietic cells from cord blood in order to optimise the sampling. A statistically significant correlation was found between the total stem cell content of the samples and the time of delivery suggesting that the quantity of hematopoietic stem cells available is higher when cord blood collection is performed earlier during pregnancy. Attempt to isolate the white cells resulted in a dramatic loss of stem cells. Factors affecting cell recovery and purification must be investigated in order to optimize cord blood cell banking.

Blood Specimen Collection↗
PubMed1990

[Treatment of a positive Rhesus D neonate born of a mother with idiopathic thrombopenic purpura with anti-D immunoglobulins (Rh O)].

A Rhesus D positive infant, born at 37 weeks of gestational age, admitted for neonatal passive immune thrombocytopenia was given 3 intravenous anti-Rhesus D immunoglobulin infusions at 3 weeks of age. This thrombocytopenia which had not responded to conventional therapy improved after the third of anti-Rhesus D immunoglobulin infusion, but the efficacy of this treatment could not be proven in this case report. However, the tolerance was good. No side-effects (jaundice, severe anemia) were observed.

Erythroblastosis, Fetal↗
PubMed1989

Two hundred intrauterine exchange transfusions in severe blood incompatibilities.

Two hundred intrauterine exchange transfusions were performed under local anesthesia in 107 cases of blood incompatibilities (60 fetuses with severe anemia and 47 with hydrops). Under sonographic guidance, depending on fetal and placental position, an optimal puncturing site was selected along the umbilical vein: placental insertion, fetal insertion, or fetal intraabdominal segment. Tests were immediately performed to confirm fetal origin of blood obtained and estimate hemoglobin level. Blood used for exchange transfusion was compatible with maternal blood and had a hematocrit value of 75%. Exchange transfusion was continued until a hemoglobin level of 16 gm/dl was reached. This procedure was first associated with intraperitoneal transfusions and was subsequently used independently once a month to maintain an adequate hemoglobin level. In 4 fetuses with hydrops, antenatal regression of this sign was observed in 33 cases (70.2%). Overall outcome of 107 fetuses after exchanges was 84 living neonates (78.5%), 15 deaths in utero, and eight neonatal deaths. The survival rate was 91.6% for fetuses without hydrops and 61.7% for those with hydrops. The advantage of exchange transfusion appears to be rapid and efficient correction of anemia with elimination of incompatible fetal red blood cells.

Birth Weight↗
PubMed1989

[Preparation of maternal platelets collected by separator for use in fetal transfusion in a case of alloimmunization by anti-PLA1].

In one case of fetal thrombocytopenia due to maternal immunization against PLA1 fetal platelet antigen, maternal platelets were collected by automated plasmapheresis. The platelets were collected 24 hours before fetal transfusion at 28, 29, 31 and 36 weeks of gestation. The maternal platelets were irradiated and concentrated in a small volume (7.10(10) to 1,4.10(11) plts in less than 20 ml maternal plasma) a few hours before transfusion. When prepared as described, maximal and irreversible platelet aggregation is obtained with 20 microM of ADP and the pH is over 6, 5-6 hours after concentration. The amounts of transfused platelets were determined to increase theoretically fetal platelet counts over 200,000 plts/mm3. The fetal platelet counts, determined immediately after transfusion, showed an increase of 100,000 plts/mm3. Prenatal fetal transfusion of maternal platelets is available to avoid fetal bleeding during delivery, and during the early neonatal period.

Adult↗
PubMed1988

Anti-RH immunoglobulin therapy for human immunodeficiency virus-related immune thrombocytopenic purpura.

The potential hazards of steroids in human immunodeficiency virus (HIV)-infected patients led us to evaluate the effectiveness and safety of anti-D and anti-c Ig in 17 adults with severe HIV-related immune thrombocytopenic purpura (platelet count less than 20 x 10(9)/L). The 14 Rh+ patients received 12 to 25 micrograms/kg of anti-D IgG intravenously on two consecutive days. A significant platelet rise above 50 x 10(9)/L was obtained in nine patients. Repeated boosters were performed in six cases and were effective in all cases. The 3 Rh- patients had a good response after they were given 20 mL x 2 of plasma containing potent anti-c antibodies. Therapy was well tolerated, and only one patient had significant hemolysis. These data suggest that anti-Rh IgG can be effective and safe in HIV-related thrombocytopenic purpura and that a specific interaction between the RBC antigens and the anti-Rh antibodies is required.

Autoimmune Diseases↗
PubMed1988

[Bilirubin-albumin-binding function of 2 human albumin preparations (placental and plasma). Comparison of their efficacy in the icteric premature infant].

Two albumin preparations obtained by Cohn fractionation of either plasma of blood donors (plasmatic albumin) or human placental blood (placental albumin) were studied in vitro and in vivo regarding their bilirubin-binding function. Analysis of this function during the industrial processing of the two preparations indicated that alcoholic fractionation and, to a lesser extent, stabilizers, were responsible for the decrease of (a) the association constants between albumin and bilirubin, (b) bilirubin-binding capacity of albumin. Unexpectedly, improvement of bilirubin-binding parameters was observed after the final heating stage. Stabilizers were reversibly bound as suggested by a further improvement of binding function seen after a brief contact of the preparations with red blood cells. The changes were similar for the two preparations. Fifty-one sick premature hyperbilirubinemic neonates were randomly infused either with placental or plasmatic albumin (1.5 g/kg). Albuminemia, bilirubinemia, erythrocytic bilirubin, unbound bilirubin (peroxidase method) were evaluated before and 3 hours after infusion. Improvement of bilirubin-binding parameters was frequently observed but without clear-cut relation with change in bilirubin/albumin molar ratio. No difference was noted between the two albumin preparations. In spite of a decrease of their association constants with bilirubin, the two albumins retained a high binding potency for bilirubin in vivo.

Bilirubin↗
PubMed1987

[Ante-partum administration of preventive treatment of Rh-D immunization in rhesus-negative women. Parallel evaluation of transplacental passage of fetal blood cells. Results of a multicenter study carried out in the Paris region].

1,969 non immunized rhesus negative primiparous women were followed up in 23 maternity units in the geographical region of Paris. 1,882 could be retained to study antepartum protection and 1,884 to study transplacental passage of fetal blood cells. Two groups were defined according to whether they were born in even or uneven years, so that: 955 were the "control" group who delivered 590 rhesus D positive infants, and 927 were the "treated" group who delivered 599 rhesus D positive infants. The "control" group were used as controls at the 28th and 34th weeks of pregnancy, while the "treated" group received two injections of anti-D immunoglobulin given on the same dates after taking the necessary tests. Immunological testing at the time of the delivery and after the delivery showed that 7 women had become Rh D immunized in the "control" group whereas only one in the "treated" group. This difference, which is statistically significant, confirms the results of other authors about the efficiency of antepartum rhesus disease prevention. The incidence of immunisation during or immediately after the first pregnancy in women who had no previous story of blood transfusions or of terminations of pregnancy is 1.11%, which is a figure relatively low as compared with studies of series carried out in North America, but close to those carried out in other European centres. When primipara of all categories are lumped together the frequency rises to 1.5%. A study of the passage of fetal red blood cells into the maternal circulation shows that at the 29th week of pregnancy out of 1,884 cases there were 5.5% positive kleihauer tests, without a large volume of blood being detected and at the 34th week of pregnancy when 957 tests were carried out, 7% were positive with one of them being of a massive transfusion of blood from the fetus to the mother, which was life-threatening for the fetus. It may be that the incidence had been under-estimated and that the positive results in the two groups, control and treated, show that there is a statistically significant difference that demonstrates that antepartum treatment in the trial has eliminated a worthwhile percentage of positive kleihauer tests which arose from the transfusion of small quantities of blood.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical Trials as Topic↗
PubMed1986

[Detection during pregnancy of massive fetomaternal transfusion. A life saved by adherence to a protocol].

A case of massive feto-maternal haemorrhage which was discovered by chance in the 34th week of pregnancy is described in detail. This case is characterised by: total absence of clinical, electrical and echographic abnormalities, a part from the fetus being very anaemic; the saving of the very anaemic newborn baby because of the performance of caesarean section; although the pregnant woman was Rh negative, giving her large doses of IgG and anti-D prophylactically seems to have protected her from Rh immunisation. The authors conclude with the special value that they have found using the Kleihauer test. This is a simple, reproducible, low-cost laboratory examination. They suggest that it should be used mainly in the last third of pregnancy and may be even routinely.

Adult↗