Publications by authors named "DiGuisto C"

Objective: Induction of labor in France concerns one birth out of four with 70% of induction starting by cervical ripening, either with a pharmacological (prostaglandins) or a mechanical (balloon) method. This review aims to compare these two methods within current knowledge, using the PRISMA methodology.

Methods: Trials comparing these two methods, published or unpublished up to July 2023, in French or English were searched for in the PubMed, Cochrane Library and ClinicalTrial.

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  • Pregnant women with fibrinogen levels below 2 g/L are at high risk for severe postpartum hemorrhage and related complications, yet the criteria for identifying those needing fibrinogen therapy are unclear.
  • A UK study identified 124 cases of low fibrinogen in pregnant women, mainly linked to postpartum hemorrhage from events like placental abruption or trauma, with a low incidence of inherited conditions.
  • The study found high maternal and perinatal mortality rates, including 27 stillbirths and two maternal deaths due to massive hemorrhage, indicating the seriousness of low fibrinogen levels in this population.*
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  • The study aimed to compare the cesarean rates and maternal and neonatal complications among obese pregnant women who needed cervical ripening for labor induction at or after 41 weeks gestation.
  • The analysis involved 336 overweight women and examined the effectiveness of various cervical ripening methods: PGE2 pessary, low-dose vaginal PGE1, and double-balloon catheter.
  • Results showed no significant difference in cesarean rates between methods, but the PGE2 pessary was associated with fewer perineal tears compared to PGE1, indicating a need for further research on the best methods for this group.
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Objective: To develop and validate a clinical prediction model for outcomes at 5 years of age for children born extremely preterm and receiving active perinatal management.

Design: The EPIPAGE-2 national prospective cohort.

Setting: France, 2011.

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Aim: To describe the circumstances, causes and timing of death in extremely preterm infants.

Methods: We included from the EPIPAGE-2 study infants born at 24-26 weeks in 2011 admitted to neonatal intensive care units (NICU). Vital status and circumstances of death were used to define three groups of infants: alive at discharge, death with or without withholding or withdrawing life-sustaining treatment (WWLST).

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Objective: To describe the clinical profile, management, and potential preventability of maternal cardiovascular deaths.

Methods: We conducted a retrospective, descriptive study of all maternal deaths resulting from a cardiovascular disease during pregnancy or up to 1 year after the end of pregnancy in France from 2007 to 2015. Deaths were identified through the nationwide permanent enhanced maternal mortality surveillance system (ENCMM [Enquête Nationale Confidentielle sur les Morts Maternelles]).

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  • The study investigates whether using oxytocin for labor induction after an unsuccessful cervical ripening is as safe as repeating the ripening process with prostaglandins in women with unfavorable cervixes.
  • A multicenter, non-inferiority randomized controlled trial will include 1,494 women who meet specific criteria, to compare outcomes like caesarean delivery rates and maternal satisfaction.
  • Ethical approval has been obtained, and informed consent will be acquired from participants to ensure their rights and safety are prioritized.
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Objective: To determine whether birth outside a level-3 centre (outborn) is associated with a difference in the combined outcome of mortality or moderate-to-severe neurological impairment at 5.5 years of age compared with birth in a level-3 centre (inborn) when antenatal steroids and gestational age (GA) are accounted for.

Design: Individual matched study nested within a prospective cohort.

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  • The study aims to analyze maternal mortality rates in eight countries using enhanced surveillance systems to get more accurate data.
  • It includes data from over 2.5 million live births and evaluates maternal mortality ratios based on various factors, including age, origin, and cause.
  • Results show significant variations in maternal mortality rates across countries, with many vital statistics offices underreporting the numbers, particularly for younger and older mothers.
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Background: Induction of labour is one of the most common obstetric interventions globally. Balloon catheters and vaginal prostaglandins are widely used to ripen the cervix in labour induction. We aimed to compare the effectiveness and safety profiles of these two induction methods.

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  • This clinical trial aimed to determine if daily low-dose aspirin could lower the risks of preeclampsia and fetal growth restriction in first-time pregnant women identified as high risk through early ultrasound screenings.
  • Conducted in France, the study involved over 1,100 participants who were randomly assigned to either take low-dose aspirin or a placebo from early pregnancy until the 34th week.
  • Results showed no significant difference in the rates of preeclampsia or low birth weight between the aspirin and placebo groups, leading to the conclusion that low-dose aspirin does not provide benefits for these outcomes in the targeted population.
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Context: Crohn's disease (CD) and sphincter injury during childbirth are two risk factors for anal incontinence (AI). The long-term risk of developing AI in women with CD after childbirth has never been studied.

Goal: The main objective of the study is to assess the risk of developing severe AI after childbirth in women with CD.

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Aim: To estimate the incidence of diabetic ketoacidosis (DKA) among pregnant women, describe its clinical features, management and outcomes and identify the risk factors for the condition.

Methods: A national population-based case-control study was conducted in the UK using the UK Obstetric Surveillance System between April 2019 and September 2020 including all pregnant women with DKA irrespective of the level of blood glucose. The incidence rate of DKA in pregnancy was estimated.

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Introduction: To evaluate the ability of preinduction ultrasonographic cervical length to predict the interval between induction and delivery in women at term with a Bishop score of 4 to 6 at induction.

Study Design: This multicenter prospective observational cohort recruited 334 women from April 2010 to March 2014. Inclusion criteria were women with singleton pregnancies at a gestational age ≥37 weeks, with no previous caesarean, a medical indication for induction of labor, and a Bishop score of 4, 5, or 6.

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Health consequences of tobacco exposure during pregnancy and childhood.In France, about 15% of fetuses are exposed to maternal smoking during pregnancy and about 30% of children are exposed to second-hand tobacco smoke. Furthermore, 20 to 25% of young adults are active smokers.

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Background: Regionalisation programmes aim to ensure that very preterm infants are born in level III units (inborn) through antenatal referral or transfer. Despite widespread knowledge about better survival without disability for inborn babies, 10%-30% of women deliver outside these units (outborn).

Objective: To investigate risk factors associated with outborn deliveries and to estimate the proportion that were probably or possibly avoidable.

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Background: Prolonged pregnancies are a frequent indication for induction of labour. When the cervix is unfavourable, cervical ripening before oxytocin administration is recommended to increase the likelihood of vaginal delivery, but no particular method is currently recommended for cervical ripening of prolonged pregnancies. This trial evaluates whether the use of mechanical cervical ripening with a silicone double balloon catheter for induction of labour in prolonged pregnancies reduces the cesarean section rate for nonreassuring fetal status compared with pharmacological cervical ripening by a vaginal pessary for the slow release of dinoprostone (prostaglandin E2).

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Objective: To determine the management of patients with term prelabor rupture of membranes.

Methods: Synthesis of the literature from the PubMed and Cochrane databases and the recommendations of French and foreign societies and colleges.

Results: Term prelabor rupture of membranes is considered a physiological process until 12 h have passed since rupture (professional consensus).

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Objectives: To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy and the post-partum period.

Study Design: A systematic review of the international literature was undertaken between January 2003 and April 2019. MEDLINE, EMBASE databases and the Cochrane library were searched for a range of predefined key words.

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Background: To study the cesarean section (c-section) practices in the French Centre-Val de Loire region: incidence of planned c-section and rate variations between maternities, incidence of potentially avoidable cesarean sections.

Methods: The data were extracted from the 2016 regional birth register, which permitted classification of each planned c-section according to the pre-existing risk of c-section (high or low) as defined by the Robson classification. To enhance the data, especially the indications for c-section, which are not included in the register, a survey was conducted from September 2016 to February 2017 in all of the 20 maternities in the region.

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Objective: To synthesize knowledge on the consequences of active smoking in pregnancy.

Methods: The MedLine database, the Cochrane Library and French and foreign guidelines from 1999 to 2019 have been consulted.

Results: Active maternal smoking is associated with an increased risk of first trimester complications such as early miscarriage and ectopic pregnancy with a dose-effect relationship between smoking and those risks.

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Objectives: The aim was to review the clinical impact of lymph node ratio (LNR) of groin metastatic nodal disease in women with vulvar squamous cell carcinoma.

Material And Methods: Cohort study of women with vulvar squamous cell carcinoma, managed between January 2005 and December 2015, in five institutions in France with prospectively maintained databases (French multicenter tertiary care centers).

Population: In total, 636 women managed for VSCC of whom 508 (79.

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Objectives: To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy.

Methods: Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords.

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