Socioeconomic Deprivation and Utilization of Anesthetic Care During Pregnancy and Delivery: A Secondary Analysis of a French Prospective, Multicenter, Cohort Study.

Background: Socioeconomic deprivation is associated with reduced use of antenatal resources and poor maternal outcomes with pregnancy. Research examining the association between socioeconomic deprivation and use of obstetric anesthesia care in a country providing universal health coverage is scarce. We hypothesized that in a country providing universal health coverage, France, socioeconomic deprivation is not associated with reduced use of anesthetic care during pregnancy and delivery.

[Preterm labour after adenosine treatment for paroxysmal supraventricular tachycardia during pregnancy, a case report].

Paroxysmal supraventricular tachycardia is the most frequent arrhythmia among young pregnant women. In case of failure of vagal manoeuvres, their management is preferentially intravenous infusion of adenosine. The in vitro contracturant effect of adenosine on myometrial fibres is known, but very few data are available about the in vivo effect during pregnancy.

Fertility and pregnancy outcomes following conservative treatment for placenta accreta.

Background: The aim of this study was to estimate the fertility and pregnancy outcomes after successful conservative treatment for placenta accreta.

Methods: This retrospective national multicenter study included women with a history of conservative management for placenta accreta in French university hospitals from 1993 through 2007. Success of conservative treatment was defined by uterine preservation.

Human foetal hepatocytes: isolation, characterization, and transplantation.

Hepatocyte transplantation has become an alternative to orthotopic liver transplantation for the treatment of liver metabolic diseases. However, there is an increasing lack of donor organs and isolated mature hepatocytes are difficult to manipulate and cannot be expanded in vitro. It is therefore necessary to find alternative sources of hepatocytes, and different approaches to evaluate the therapeutic potential of stem cells of different origins are being developed.

Termination of pregnancy following prenatal diagnosis in France: how severe are the foetal anomalies?

Objective: To determine how severe were the conditions leading to termination of pregnancy for foetal anomaly (TOPFA) in France.

Methods: Detailed indications for TOPFA were extracted from medical charts.

Results: Of 2465 completed records, indications were: chromosomal anomalies n = 963 (39.

[Implementing palliative care for newborns in various care settings. Part 3 of "Palliative care in the neonatal period"].

Palliative care in newborns may take place in the delivery room and then continued either in maternity wards or in the neonatal unit. For babies developing a chronic condition, going home may be advantageous. The population concerned includes babies born with a severe intractable congenital malformation and certain extremely preterm newborn babies at the limits of viability.

Maternal outcome after conservative treatment of placenta accreta.

Objective: To estimate maternal outcome after conservative management of placenta accreta.

Methods: This retrospective multicenter study sought to include all women treated conservatively for placenta accreta in tertiary university hospital centers in France from 1993 to 2007. Conservative management was defined by the obstetrician's decision to leave the placenta in situ, partially or totally, with no attempt to remove it forcibly.

[Endometriosis of the ischio-rectal excavation at the contact of the sciatic nerve: a case report of neurolysis by pararectal incision].

Localisation of endometriosis on the sciatic nerve is exceptional. We report the case of a patient presenting an endometriotic nodule of the left ischio-rectal excavation, with an extension contiguous to the sciatic nerve, responsible of invalidating sciatalgia. Two laparoscopies did not allow to localise the lesion.

[Access to preventative care, screening and treatment of women in vulnerable socio-economic groups presenting with cervical cancer].

Aim: The object of this study was to evaluate access to preventative care, screening and treatment of women in vulnerable socio-economic groups presenting with cervical cancer and the progression of their disease.

Method: This is a retrospective study of 123 patients with cervical cancer treated at the hôpital Bichat (Paris) or the hôpital Verdier (Bondy) between 1st January 1996 and 31 December 2005.

Results: "CMU" or "AME" is the entitlement for fully state funded medical care and was used in this study to indicate social deprivation.

The role of HGF on invasive properties and repopulation potential of human fetal hepatic progenitor cells.

Unlabelled: The success of hepatocyte transplantation has been limited by the low efficiency of transplanted cell integration into liver parenchyma. Human fetal hepatic progenitor cells (hepatoblasts) engraft more effectively than adult hepatocytes in mouse livers. However, the signals required for their integration are not yet fully understood.

[Decision making on breech delivery: information as a way to reconcile maternal autonomy and medical responsibility].

As far as breech vaginal delivery remains an acceptable option, each case has to be evaluated in order to determine whether in that particular situation it is medically relevant. When vaginal delivery is to be envisaged, maternal consent is needed. This implies seeking medical information that allows women to express their autonomy and to be part of the decision regarding their delivery.

[Multifetal pregnancy reduction: indications, technical aspects and psychological impact].

High-order multiple pregnancies (triplets and above) are associated with high pediatric mortality and morbidity, mainly due to their premature delivery. Maternal morbidity is also substantially higher than for singleton gestations. The main goal of multifetal pregnancy reduction (MFPR) is to decrease the rate of severe prematurity and its consequences, including neurodevelopmental handicaps.

[Fetal toxicity of angiotensin-II-receptor inhibitors. Case report].

The fetal toxicity of angiotensin-converting enzyme inhibitors (ACEI) is now well known. Sartans which are angiotensin II inhibitors, are supposed to have the same side effects on the fetus as ACEI because of their similar mechanism of action. This is supported by experimental and clinical data.

The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage.

Background: Postpartum hemorrhage (PPH) is a major source of maternal morbidity.

Objectives: This study's objective was to determine whether changes in hemostasis markers during the course of PPH are predictive of its severity.

Patients And Methods: We enrolled 128 women with PPH requiring uterotonic prostaglandin E2 (sulprostone) infusion.

Hepatocyte transplantation: studies in preclinical models.

Transplantation of allogeneic or genetically modified autologous hepatocytes may be an alternative to whole-liver transplantation for the treatment of hereditary metabolic liver diseases. Human hepatocytes have already been transplanted in patients, demonstrating the safety and feasibility of both approaches. Although a few cases of allogeneic transplantation have resulted in long-term engraftment and function, only a partial and transient correction of the disease was achieved.

Paradoxic activation of the renin-angiotensin system in twin-twin transfusion syndrome: an explanation for cardiovascular disturbances in the recipient.

Despite advances in treatment, twin-to-twin transfusion syndrome (TTTS) still carries a high risk for perinatal mortality and morbidity. Simple blood transfer from the donor to the recipient twin cannot explain all of the features of this disease, in particular the recipient's hypertensive cardiomyopathy. We report a case in which TTTS resulted in preterm delivery with early neonatal death of both twins, allowing assessment of the renin angiotensin system (RAS) status of each fetus, both by cord blood renin and aldosterone assay and by renal immunohistochemistry.

Leptin and Ob-Rb receptor isoform in the human digestive tract during fetal development.

Context: Leptin, partially produced by the stomach, is a hormone involved in energy balance and regulation of food intake. It also regulates some digestive functions through its functional receptor Ob-Rb expressed by gastrointestinal epithelial cells.

Objective: The objective of the study was to investigate the temporal and spatial appearance of Ob-Rb in the human digestive tract and leptin in the stomach.

[Neurological outcome of children from twin pregnancies].

The neurological outcome is an important issue regarding twin pregnancies. In fact, twin pregnancy is clearly associated with an important neurological morbidity, roughly 4 times higher than singleton pregnancy. It is possible to distinguish some high-risk situations, making it possible to calculate more accurately the individual risk.

Repopulation of athymic mouse liver by cryopreserved early human fetal hepatoblasts.

Transplantation of hepatocytes is a promising alternative to liver transplantation for the treatment of severe liver diseases. However, this approach is hampered by the shortage of donor organs and intrinsic limitations of adult hepatocytes. To investigate whether most of the hurdles faced with adult hepatocytes could be surmounted by the use of human fetal hepatoblasts, we have developed a method to isolate, transduce, and cryopreserve hepatoblasts from human livers at an early stage of development (11-13 weeks of gestation).

Fetal home monitoring for the prenatal management of gastroschisis.

Background: Fetal distress is a frequent complication of gastroschisis, and could be screened for by home monitoring, as many pregnant women expecting an affected child live far away from a specialized perinatal center. This study was undertaken to audit a policy of fetal home monitoring (FHM) to achieve early detection of fetal heart rate (FHR) abnormalities in gastroschisis.

Methods: Daily FHM was started at a median age of 30 weeks in 31 pregnant women referred following prenatal diagnosis of isolated gastroschisis.

Evaluation of fetal pulmonary vasculature by power Doppler imaging in congenital diaphragmatic hernia.

Objective: To evaluate the feasibility of prenatal power Doppler imaging of pulmonary arteries in congenital diaphragmatic hernia and to study its potential to predict outcome.

Methods: A prospective observational study was conducted. Forty-two cases of congenital diaphragmatic hernia (32 left and 10 right) without associated anomalies were analyzed.