Publications by authors named "Guerby P"

Fetal death is defined as the spontaneous cessation of cardiac activity after 14 weeks gestational age (GA). Regarding prevention of fetal death in the general population, it is not recommended to counsel or prescribe rest, aspirin, vitamin A, vitamin D, or micronutrient supplementation; systematically look for nuchal cord during prenatal screening ultrasound; or perform systematic antepartum monitoring by cardiotocography for the sole purpose of reducing the risk of fetal death. It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2.

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Objectives: This study aimed to estimate the association between low first-trimester maternal serum PlGF (placental growth factor) and PAPP-A (pregnancy-associated plasma protein A) and the risk of placenta-mediated complications.

Methods: We performed a secondary analysis of the PREDICTION study, including nulliparous participants recruited at 11 to 14 weeks of pregnancy. First-trimester PlGF and PAPP-A levels were reported in multiples of the median (MoM) adjusted for maternal characteristics and gestational age.

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Unlabelled: ST analysis during labour requires the classification of CTG traces in order to help clinical decisions. The usual STAN classification is based on the FIGO 1987 classification, modified in 2007. New STAN guidelines adapted to physiology-based interpretation have been proposed in 2022.

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Article Synopsis
  • The study aimed to determine whether a more restrictive threshold for aspirin prophylaxis (risk >1/70) would effectively identify high-risk nulliparous women for pre-eclampsia compared to the usual threshold (risk >1/100).
  • Conducted at the University Hospital of Toulouse, the study observed two cohorts: one before the screening (2014-2016) and one after implementing the FMF screening and aspirin treatment (2017-2018).
  • Results showed no significant difference in pre-eclampsia rates (1.7% vs. 1.3%) between the two groups, indicating that using the more restrictive threshold did not lead to a decrease in pre-eclampsia with premature delivery
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Fetal death is defined as the spontaneous cessation of cardiac activity after fourteen weeks of amenorrhea. In France, the prevalence of fetal death after 22 weeks is between 3.2 and 4.

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Background: Fetal Medicine Foundation (FMF) studies suggest that preterm preeclampsia can be predicted in the first trimester by combining biophysical, biochemical, and ultrasound markers and prevented using aspirin. We aimed to evaluate the FMF preterm preeclampsia screening test in nulliparous women.

Methods: We conducted a prospective multicenter cohort study of nulliparous women recruited at 11 to 14 weeks.

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To evaluate the predictive value of the sFlt-1/PlGF ratio for the prediction of preeclampsia in women with preexisting diabetes mellitus. This is a monocentric retrospective observational study conducted between January 2018 and December 2020. All singleton pregnancies with preexisting diabetes mellitus, who had a dosage of the sFlt-1/PlGF ratio between 30 and 34 + 6 weeks of gestation were included.

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Objective: Placenta accreta belongs to placenta accreta spectrum and is defined by an adhesion or even invasion of the placental villi in the myometrium. The main risk factor is a history of cesarean section. Its incidence is increasing following an increase in the cesarean section rate in recent years and the cause of severe maternal morbidity (hemorrhage, transfusions, hysterectomy).

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Background And Aims: Pregnancy presents risks, particularly for women with pre-existing health problems. Pre-anaesthetic consultations can help anticipate these risks and establish a medical management strategy on the delivery day. While teleconsultations gained popularity during the coronavirus disease 2019 (COVID-19) pandemic, research on pre-anaesthetic teleconsultations during pregnancy is limited.

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Clinical value of pelvimetry in modern obstetrics practices has never been established and normal values are set since the middle of the twentieth century. The aim of this study was to describe current dimensions of pelvis in a female French Caucasian population. A retrospective, bi-centric observational study was conducted from August 2013 to August 2019 in two French departments of Obstetrics.

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Objectives: Uterine scarring is a risk factor for placenta accreta spectrum (PAS) disorder. We aimed to determine the factors related to PAS in women who had previously undergone a cesarean.

Methods: We performed a case-control study where women who underwent postpartum hysterectomy for placenta accreta/percreta (cases) were matched to all women with a previous cesarean who delivered in the week before each case (controls).

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Article Synopsis
  • Oxytocin can shorten labor but may cause complications, leading researchers to investigate if stopping the drug during labor affects neonatal outcomes.
  • The STOPOXY trial, conducted in 21 French maternity units, randomly assigned participants to either stop or continue oxytocin infusion after reaching 6 cm dilation, measuring neonatal morbidity based on specific health indicators at birth.
  • The study included 2,170 eligible participants, finding no significant difference in neonatal morbidity between the two groups, suggesting that discontinuing oxytocin may not increase risks for newborns.
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Article Synopsis
  • The study aimed to find ways to lower maternal and neonatal health issues linked to preeclampsia by reviewing literature and assessing the quality of evidence using the GRADE® method and PICO format.* -
  • The findings indicated that while encouraging physical activity during pregnancy is strongly recommended to decrease preeclampsia risk, broader definitions for preeclampsia and early screening with aspirin are not recommended due to low levels of evidence.* -
  • A consensus was reached among reviewers on all evaluated questions, but for women with preexisting health conditions, the evidence was insufficient to determine the effectiveness of aspirin in reducing risks associated with preeclampsia.*
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Objective: To describe maternal and fetal outcomes of pregnancies after 42 years and to compare maternal and fetal morbidities according to the conception mode; comparing pregnancies obtained spontaneously and those resulting from assisted reproductive technology (ART).

Methods: This retrospective cohort study was conducted in a level 3 maternity hospital. This study covered all women, aged 42 years or older, who gave birth between January 1, 2014 and December 31, 2019.

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Background: Recent observational studies reported a high rate of suboptimal use of antenatal corticosteroids (too anticipated or retrospectively not indicated) for women at risk of preterm delivery despite a recommended use within 7 days before delivery.

Objective: This study aimed to elaborate a nomogram aiming at optimizing the timing of administration of antenatal corticosteroids in case of threatened preterm labor, asymptomatic short cervix, or uterine contractions.

Study Design: This was an observational retrospective study conducted in a tertiary hospital.

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Objective: This study aimed to compare 2 aspirin dosage regimens for the prevention of preterm preeclampsia (PE): 75 to 81 mg vs 150 to 162 mg taken daily starting in the first trimester of pregnancy.

Data Sources: A systematic search was performed using PubMed, Embase, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials from January 1985 to April 2023.

Study Eligibility Criteria: The inclusion criteria were randomized controlled trials that compared the effect of 2 aspirin dosage regimens during pregnancy for the prevention of PE initiated in the first trimester of pregnancy.

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Objectives: To assess factors associated with spontaneous rotation in the occiput anterior position for fetuses in persistent occiput posterior (OP) during the second stage of labor. To evaluate maternal and fetal outcomes after spontaneous rotation of persistent OP.

Methods: This is a prospective cohort of 495 women with fetuses in persistent OP position, confirmed with ultrasonography during the second stage of labor.

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Article Synopsis
  • The study evaluates the effectiveness of combining placental growth factor (PlGF) with other markers (PAPP-A, free β-hCG, and AFP) for screening Down syndrome in the first trimester of pregnancy.
  • Out of 13,386 pregnancies, only 26 cases of Down syndrome were detected, with the biomarker combination identifying 88% of these cases at a 13% false-positive rate.
  • Incorporating nuchal translucency measurements would significantly improve detection rates, allowing for identification of over 95% of Down syndrome cases while lowering false positives to around 5%.
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Objective: To describe and analyze a series of uterine ruptures (UR) that occurred in the context of medical termination of pregnancy (MTP) or intrauterine death (IUD) from a risk management perspective.

Methods: French retrospective descriptive observational study of all cases of UR occurring during induction for IUD or MTP, reported between 2011 and 2021 by Gynerisq. Cases were recorded on a basis of voluntary reports using targeted questionnaires.

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Objectives: Lower uterine segment (LUS) thickness measurement using transabdominal ultrasound (TA-US), transvaginal ultrasound (TV-US), or the combination of both methods can detect scar defect in women with prior cesarean. We aimed to compare the sensitivity of three approaches.

Methods: Women with prior cesarean underwent LUS thickness measurement at 34-38 weeks' gestation.

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Unlike other Flaviviruses, Zika virus (ZIKV) infection during the first trimester of pregnancy causes severe pregnancy outcomes including the devastating microcephaly and diseases associated with placental dysfunctions. We have previously reported that the maternal decidua basalis, the major maternal-fetal interface, serves as a replication platform enabling virus amplification before dissemination to the fetal compartment. However, the rate of congenital infection is quite low, suggesting the presence of a natural barrier against viral infection.

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The idea of using an instrument to assist natural childbirth is not new and it was in the 18th and 19th centuries that the forceps was developed. It is only after the Second World War that the suction cup provides an alternative to instrumental childbirth, but still based on prehension and traction. In 1950, Emile Thierry, in France, presented his spatulas based on the then original principle of propulsion.

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