Performance of HIV-1 DNA or HIV-1 RNA tests for early diagnosis of perinatal HIV-1 infection during anti-retroviral prophylaxis.

Objective: To compare performance of testing for human immunodeficiency virus (HIV)-1 DNA and HIV-1 RNA for diagnosis of HIV-1 infection in infants receiving preventive antiretroviral therapy.

Study Design: This substudy of the French multicenter prospective cohort of neonates born to HIV-infected mothers, included 1567 infants tested for HIV with polymerase chain reaction (PCR) in a single laboratory, receiving post-natal prophylaxis, not breastfed, and having simultaneous HIV-1 DNA and RNA results before 45 days. The performance of PCR was assessed in reference to the 6-month HIV-1 RNA result.

Twin pregnancy as a risk factor for mother-to-child transmission of HIV-1: trends over 20 years.

Objective: We investigated whether twin pregnancies were at increased risk of mother-to-child HIV-1 transmission (MTCT), in comparison with singletons.

Methods: Among HIV-1 infected women enrolled in the French Perinatal HIV Cohort (n = 9262), we studied the association between twin deliveries and MTCT rate according to three time periods (pre-1994, 1994-1996, 1997-2004) and the effect of birth order. The mother was considered to have transmitted if at least one of the twins was infected.

[Uterine fibroids embolization: results about 454 cases].

Objective: To determine the effectiveness of uterine arterial embolization (UAE) as primary treatment in the management of symptomatic leiomyomas.

Patients And Method: UAE was performed on 454 patients (age range: 21-68) with menorrhagia, bulk-related symptoms or both, due to leiomyomas. The effectiveness of this therapy in the control of symptoms and reduction of uterine and leiomyoma volume was measured by clinical and imaging controls at 3, 6 and 9 months after the procedure.

Lamivudine-zidovudine combination for prevention of maternal-infant transmission of HIV-1.

Context: Zidovudine reduces maternal-infant transmission of human immunodeficiency virus 1 (HIV-1) infection by two thirds. Combination antiretroviral therapies are potentially more effective prevention.

Objectives: To assess the safety of perinatal lamivudine-zidovudine therapy, especially in children, and its effects on viral load, acquisition of drug resistance, and maternal-infant transmission of HIV-1 in a nonbreastfeeding population.

[Arterial embolization of uterine myoma: results apropos of 286 cases].

Objective: Report outcome in non-surgical treatment of symptomatic uterine myomata by particulate arterial embolization.

Patients: and method: Two hundred eighty-six women aged 21 to 53 years with symptomatic uterine fibroids initially programmed for surgery were studied. The size and number of myomata were determined by pelvic ultrasound.

Persistent mitochondrial dysfunction and perinatal exposure to antiretroviral nucleoside analogues.

Background: Zidovudine is commonly administered during pregnancy to prevent mother-to-child HIV-1 transmission. We investigated mitochondrial toxic effects in children exposed to zidovudine in utero and after birth.

Methods: We analysed observations of a trial of tolerance of combined zidovudine and lamivudine and preliminary results of a continuing retrospective analysis of clinical and biological symptoms of mitochondrial dysfunction in children born to HIV-1-infected women in France.

Acceptability and impact of zidovudine for prevention of mother-to-child human immunodeficiency virus-1 transmission in France.

We studied the propagation and the impact of zidovudine prevention on the human immunodeficiency virus-1 transmission rate from infected mothers to their infants in the French nationwide prospective cohort. Infection was diagnosed in the children on the basis of at least two positive human immunodeficiency virus-1 polymerase chain reaction tests, culture, or both. The transmission rate among treated women was compared with that among untreated women during the same period and with that among women enrolled in the cohort since 1986.

[Recourse to particular arterial embolization in the treatment of some uterine leiomyoma].

Unlabelled: In 88 women between the ages of 34 and 51 years with one or several symptomatic uterine leiomyomata (menometrorrhagia, mass syndrome) after failure of medical treatment, particulate arterial embolization was proposed as an alternative to the scheduled surgical operation. Free-flow embolization with Ivalon particles (150 to 600 microns) was performed under local anaesthesia after femoral artery puncture and catheterization of the hypogastric then uterine arteries (5 F catheter) including occlusion Pelvic pain was frequently observed immediately after embolization, lasting 12 to 18 hours, and required analgesia. Necrobiosis syndromes can be observed in the case of very large leiomyomata.

Evidence of fetal cerebral vasodilatation induced by submaximal maternal dynamic exercise in human pregnancy.

To investigate the relationship between maternal exercise and fetal circulatory responses in humans during the third trimester of pregnancy, changes in uterine, umbilical and fetal cerebral circulations were measured by pulsed-Doppler ultrasound method in 14 healthy volunteer pregnant women before and just after a moderate non-exhaustive exercise. Maternal heart rate increased significantly reaching 80% of the theoretical maximal heart rate (TMHR) while uterine resistance indices did not change. The fetal heart rate and umbilical mean velocity were unchanged while umbilical resistance index decreased slightly (0.

Maternal virus load during pregnancy and mother-to-child transmission of human immunodeficiency virus type 1: the French perinatal cohort studies. SEROGEST Cohort Group.

Virus load in pregnancy and its relation to mother-to-child human immunodeficiency virus (HIV) transmission were studied prospectively. From 1989 to 1994, 320 HIV-infected women from 18 centers had plasma samples stored. Among women not receiving antiretroviral therapy, the polymerase chain reaction RNA level was 3.

Obstetric factors and mother-to-child transmission of human immunodeficiency virus type 1: the French perinatal cohorts. SEROGEST French Pediatric HIV Infection Study Group.

Objective: We attempted to determine whether the risk of mother-to-child transmission of human immunodeficiency virus type 1 is related to events in pregnancy, labor, and delivery.

Study Design: In a prospective multicenter cohort study of human immunodeficiency virus type 1-infected mothers and their children, we studied pregnancy histories, labor (including gestational age, induction, membrane rupture, length of labor, intrapartum procedures, bleeding, infection, antiseptic technique, and antiretroviral therapy), and conditions of delivery.

Results: Among 1632 singleton infants, 310 were confirmed infected with human immunodeficiency virus type 1 at age 18 months (19.

[Pregnant women with HIV infection: medical decision].

The aim of this study was to review current knowledge of mother-to-fetus transmission of human immunodeficiency virus (HIV) and attempt to determine a rationale for decision making in infected women. The risk of transmission to the fetus varies from 20% for women with stage II infection to 50% in stage IV patients. The risk can be reduced to 8% with zidovudine (in stage II patients).

Separation between HIV-positive women and their children: the French prospective study, 1986 through 1993.

Objectives: We studied the risk and circumstances of separation (due to either maternal death or drug use) between women infected by human immunodeficiency virus (HIV) type 1 and their children.

Methods: This analysis was based on the French Prospective Study of Infants Born to HIV-seropositive Women (1986 through 1993). Data recorded at each follow-up visit included the mother's effective presence with the child and the child's care after separation.

Arterial embolisation to treat uterine myomata.

Haemorrhage, probably related to hypervascularisation, is the commonest complication of uterine myomata and is difficult to treat. 16 patients, aged 34-48 years, with symptomatic uterine myomata, for which a major surgical procedure was planned after failure of medical treatment, were treated by selective free-flow arterial embolisation of the myomata with Ivalon particles. With a mean follow-up of 20 months (range 11-48) in the responders, symptoms resolved in 11 patients; menstrual cycles returned to normal in ten of these.

[Pneumoperitoneum related to celioscopy. Prevention of vascular wounds].

The insertion of the inflation needle during laparoscopic procedures carries the risk of severe vascular damage to the aorto-cava bifurcation. Interindividual anatomic variation is great as shown by magnetic resonance imaging, increasing the risk of vascular damage. Four simple technical precautions are recommended to prevent accidents: insertion at the lower umbilical margin, widen distance between the umbilicus and the greater vessels, a 45 degree insertion angle and strictly medial position.

Thrombocytopenia in pregnant women infected with human immunodeficiency virus: maternal and neonatal outcome.

Objectives: Our purpose was to evaluate the prevalence of thrombocytopenia related to human immunodeficiency virus among seropositive pregnant women and its impact on maternal and neonatal outcome.

Study Design: A retrospective survey of all deliveries of women infected with human immunodeficiency virus in 14 maternity units in France over a 6-year period collected data on mothers who had thrombocytopenia < 100.10(9)/ and their infants.

Relation of the course of HIV infection in children to the severity of the disease in their mothers at delivery.

Background: Among infants with maternally transmitted human immunodeficiency virus (HIV) infection, there are two patterns of disease progression. In about a fifth of these infants there is a rapid progression to profound immunodeficiency, whereas in the majority the disease progresses much more slowly.

Methods: We studied the clinical and biologic characteristics of the mothers of infants infected with HIV type 1 (HIV-1) in the French Prospective Multicenter Cohort.

Relationship between birth weight and umbilical Doppler blood flow velocity waveforms during the third trimester of pregnancy.

Objectives: The Doppler ultrasound method for recording blood flow velocity waveforms in the fetal umbilical arteries is now widely used as an indicator of fetal well-being. This study was conducted to investigate the impact of umbilical placental resistance level on fetal growth development.

Methods: Maximal flow velocity waveforms were recorded from the umbilical artery in 108 pregnant women including 50 with normal pregnancies, 3 with previous death in utero, and 55 with moderate arterial hypertension corrected by resting only.

The use of viral culture and p24 antigen testing to diagnose human immunodeficiency virus infection in neonates. The HIV Infection in Newborns French Collaborative Study Group.

Background: Early diagnosis of human immunodeficiency virus (HIV) infection in infants born to infected mothers is important for the infants' medical care, but the presence of maternal antibodies makes serologic tests uninformative.

Methods: In a cohort study of 181 infants born to HIV-infected mothers, we assessed the diagnostic value of HIV viral culture and testing for the presence of p24 antigen. The infants were tested at birth, again during the first 3 months, then followed and tested at the age of at least 18 months.

[Intraperitoneal chemotherapy for ovarian adenocarcinoma: pharmacokinetics of cisplatin].

Chemotherapy using cis dichlorodiamine platinum (CDDP) in doses of 30 and 60 mg/m2 was carried out in 6 patients who had adenocarcinoma of the ovary, that had not been treated before, 15 to 120 minutes before surgery was carried out. The results of doses of platin given on the blood levels are demonstrated. A slight and progressive increase in the plasma levels of CDDP with peaks between 0.