Publications by authors named "Pierre Boulot"
Article Synopsis
- Predicting bleeding risk in carriers of hemophilia A and B is complex, and the study aims to analyze the bleeding phenotype using the standardized Tosetto bleeding score (BS).
- The study found no significant differences in median bleeding scores or abnormal scores between hemophilia A carriers (HAC) and hemophilia B carriers (HBC), but noted a higher risk of factor deficiency in HBC.
- Significant findings include that specific factor activity thresholds were good predictors of bleeding risk in HBC, while no reliable threshold for FVIII:C levels was identified for HAC due to variability.
Which risk score best predicts cardiovascular outcome in pregnant women with congenital heart disease?
Charlene Bredy Fanny Deville Helena Huguet Marie-Christine Picot Gregoire De La Villeon Pierre Boulot
Eur Heart J Qual Care Clin Outcomes
February 2023
Article Synopsis
- Managing pregnancy in women with congenital heart disease (CHD) is complex due to changes in cardiovascular conditions during pregnancy.
- A study evaluated the effectiveness of five existing risk assessment scores in predicting maternal complications for 104 pregnancies involving 65 women with CHD.
- The findings showed that the modified WHO score was more accurate in predicting cardiovascular outcomes compared to the other four scores, indicating a need for improved risk assessment tools for this population.
Article Synopsis
- - The study aimed to compare the effectiveness of remifentanil and sufentanil for performing feticide after 22 weeks of gestation in France, focusing on time to fetal asystole and other safety measures.
- - A randomized trial included 66 women divided into two groups, with results showing no significant differences in time to fetal asystole or procedure success rates between the two drugs.
- - Both remifentanil and sufentanil were safe, with no severe maternal side effects, and tissue examinations showed no significant differences in cellular modifications.
Article Synopsis
- Early gestational diabetes mellitus (eGDM) is diagnosed before 24 weeks of pregnancy, while standard GDM is diagnosed between 24 and 28 weeks using an oral glucose tolerance test; eGDM is associated with worse obstetric outcomes.
- A study compared postpartum glucose metabolism disorders in 500 women with eGDM (Group 1) and standard GDM (Group 2), revealing that eGDM patients required more insulin during pregnancy but had fewer preterm labors and fetal complications.
- Despite differences in treatment and outcomes during pregnancy, the rates of postpartum glucose metabolism disorders were similar between the two groups, indicating a high frequency of these disorders in both categories.
Article Synopsis
- The study aimed to identify the prenatal ultrasound characteristics of cleft palate without cleft lip by using 3D imaging techniques.
- Conducted over seven years, the research involved analyzing fetal secondary palates through 2D and 3D ultrasound views and correlated the findings with postnatal examinations.
- The results showed a high agreement between prenatal diagnoses and postnatal evaluations, successfully categorizing cleft palate types and establishing effective diagnostic methods for prenatal identification.
Article Synopsis
- Pregnancy causes changes in blood flow characteristics, and studies have shown that these changes differ in hypertensive pregnant women compared to non-hypertensive women.
- The research involved analyzing data from 38 hypertensive women and 64 controls to explore the relationship between blood properties, oxygen delivery, and the birth weight of newborns.
- Findings revealed that hypertensive women had a higher blood viscosity and a different optimal blood composition compared to non-hypertensive women, which was linked to lower birth weights of their infants.
Article Synopsis
- The study examined 4580 fetuses over a nine-year period to explore the clinical spectrum of genital defects diagnosed before birth and identify factors predicting severe phenotypes at birth.
- A total of 61 cases were analyzed, with a high prenatal diagnosis accuracy of 90.1%, mostly involving undervirilized boys (68.8%) and some virilized girls (11.5%).
- Key findings indicated that early second trimester detection, intra-uterine growth restriction, and penile curvature were linked to more severe cases, highlighting the importance of prenatal imaging for early intervention.
Article Synopsis
- Prenatal diagnosis of congenital heart disease (CHD) is debated due to unclear benefits on health outcomes and potential healthcare costs.
- A study compared the 1-year morbidity and mortality rates between children diagnosed with severe CHD either before or after birth, finding no significant differences in mortality rates between the two groups.
- While prenatal diagnosis influenced decisions about pregnancy termination, it did not improve outcomes for those who were born alive, suggesting a need for further research on its effects on overall management and quality of life.
Conservative versus active management in HELLP syndrome: results from a cohort study.
J Matern Fetal Neonatal Med
June 2019
Article Synopsis
- HELLP syndrome can lead to serious complications for both mothers and babies, especially if not managed properly before 34 weeks of pregnancy; unclear treatment options exist for stable cases.
- A study compared two management approaches: Center A used a conservative method with prolonged pregnancy and monitoring, while Center B opted for active delivery within 48 hours.
- Results showed that active management increased risks of serious complications like postpartum hemorrhage and neonatal issues, suggesting that conservative management may be safer for stable patients.
Article Synopsis
- * Analysis of 28 intrauterine cord punctures and Doppler measurements showed a strong correlation (r = 0.857) between actual hemoglobin levels and the predicted 'ideal' hematocrit, although the actual levels were consistently lower.
- * The results indicate that the difference between ideal and actual hematocrit may serve a purpose, as the body appears to adjust hematocrit levels to reduce vascular resistance, hinting at a regulatory mechanism in fetal blood flow.
Objective: The aim of this study was to evaluate the contribution of prenatal magnetic resonance imaging (MRI) to ultrasound (US) in the prenatal diagnosis of intra-abdominal cystic masses, correlated with the postnatal diagnosis.
Methods: In this retrospective, observational study, prenatal MRI and US diagnoses were compared with postnatal diagnoses. MRI was performed in 56 fetuses with intra-abdominal cyst diagnosed by US between 2004 and 2013.
Article Synopsis
- Current estimates of health outcomes for preterm infants are essential for improving perinatal care and guiding clinical practices and parental decisions.
- The EPIPAGE-2 study analyzed the survival and health issues of infants born between 22 and 34 weeks of gestation in France in 2011, comparing results with a similar study from 1997.
- Survival rates significantly improved with gestational age, with only 0.7% survival for infants under 24 weeks compared to 98.9% for those born at 32-34 weeks, while neonatal morbidity also decreased alongside gestational age.
Objectives: The objective of this article is to describe and assess prenatal imaging findings, fetal and postnatal outcomes of thrombosis of torcular herophili, and to determine diagnostic features, pathophysiology, prognosis, and optimal management.
Methods: Over a decade, we compiled the largest single-center retrospective study of outcomes. Fetal magnetic resonance imaging (MRI) was used to confirm the sonographic suspicion and monitor thrombosis of torcular herophili.
Article Synopsis
- Laminopathies caused by LMNA mutations can lead to early aging and lipodystrophic syndromes, while this study connects lipodystrophy and insulin resistance to Werner syndrome caused by WRN mutations.
- Two normal-weight women aged 32 and 36 displayed partial lipodystrophic syndrome with features like high triglycerides, liver fat, and significant insulin resistance, along with distinct fat distribution patterns.
- Genetic testing revealed biallelic WRN mutations in both patients, affecting their fertility, while insulin-sensitizing treatments helped them conceive, though pregnancies were complicated by severe cervical incompetence.
Article Synopsis
- - The study aimed to compare fetal serum levels of α1-microglobulin, β2-microglobulin, and cystatin C to evaluate their effectiveness in predicting postnatal renal function in infants with kidney and urinary tract abnormalities.
- - Researchers analyzed fetal serum samples from 126 fetuses and categorized them based on their renal function, finding significant differences in the levels of the three markers between those with normal renal function and those with renal failure.
- - Results indicated that while α1-microglobulin levels were notably different in cases of good versus poor renal prognosis, it was found to be a less reliable marker compared to fetal β2-microglobulin for assessing renal outcomes.
Article Synopsis
- The study evaluated the effectiveness of a PCR assay for diagnosing congenital toxoplasmosis in samples from pregnant women, demonstrating high sensitivity and specificity, particularly in amniotic fluid.
- Amniotic fluid had a sensitivity of 86.3% and specificity of 100%, while placenta and cord blood had variable sensitivity (79.5% for placenta, 21.2% for cord blood) and high specificity (92% and 100% respectively).
- The research utilized pretest and posttest probabilities to create risk curves, allowing for better risk assessment based on gestational age at maternal infection, which aids in decision-making for treatment.
Second- and third-trimester management of medical termination of pregnancy and fetal death in utero after prior caesarean section.
Eur J Obstet Gynecol Reprod Biol
August 2011
Article Synopsis
- The study aimed to assess the outcomes and risks of terminating pregnancies in women with a history of caesarean sections during the second and third trimesters.
- Conducted from January 2001 to September 2008, 67 women underwent a specific protocol involving medications like mifepristone and misoprostol, with most deliveries being vaginal and occurring within a few hours.
- The findings showed a high vaginal delivery rate (95.5%) and a low incidence of severe complications, including a 4.8% rate of uterine rupture and only 3% experiencing significant bleeding.
Prevalence and timing of pregnancy termination for brain malformations.
Arch Dis Child Fetal Neonatal Ed
September 2011
Article Synopsis
- The study aims to assess how often and when pregnancies are terminated due to specific types of central nervous system (CNS) malformations in a cohort of 481 cases from France between 2005 and 2009.
- About one-third of the terminations were linked to severe CNS issues, with earlier terminations predominantly for problems arising in the initial stages of CNS development, while later terminations were associated with specific anomalies like corpus callosum agenesis.
- The findings suggest that the prevalence and timing of terminations reflect both the developmental understanding of brain malformations and the influence of French prenatal screening policies.
Article Synopsis
- The study involved 37 women who received uterine compression sutures to treat postpartum hemorrhage, with 13 of them undergoing follow-up assessments using hysteroscopy.* -
- Out of the participants, seven developed synechia, which refers to scar tissue formation in the uterus.* -
- Among those with synechia, three women were diagnosed with Asherman syndrome, affecting 23% of those who wished to conceive and were evaluated via hysteroscopy.*
Article Synopsis
- Inherited fibrinogen disorders are rare conditions that affect either the amount or quality of fibrinogen, leading to various forms like hypofibrinogenaemia and dysfibrinogenaemia, often due to different genetic mutations.
- A novel mutation named Fibrinogen Montpellier II was discovered in three siblings with hypodysfibrinogenaemia, causing an important part of the fibrinogen protein to be skipped during production.
- This mutation results in abnormal fibrinogen that lacks a critical component, leading to poor clot formation characterized by thinner fibers and larger pores during clotting tests.
Article Synopsis
- The study aimed to assess if early postpartum discharge (ED) from the hospital affects breastfeeding practices compared to conventional discharge (CD) in mothers.
- Conducted with 135 breastfeeding mothers, the results showed similar rates of exclusive breastfeeding between ED (77.8%) and CD (71.1%) groups, with no significant differences in satisfaction or reasons for switching feeding methods.
- The research concluded that early discharge, when managed by professionals, does not negatively impact breastfeeding rates, suggesting formal support programs could further encourage breastfeeding continuity.
Article Synopsis
- Maternal obesity is increasingly recognized as a high-risk factor in pregnancies, resulting in more complications and adverse fetal outcomes, including gestational diabetes and perinatal mortality.
- The risks associated with maternal obesity, such as higher cesarean rates and long-term health issues for both the mother and child, are proportional to the degree of obesity.
- It is crucial for obese women to receive personalized weight-loss guidance before conception and to monitor their diet during pregnancy to ensure healthier outcomes for both mother and baby.
Article Synopsis
- The study evaluates the effectiveness of arterial embolization for treating postpartum hemorrhage (PPH) by comparing patient management before and after clinical practice recommendations were published.
- A total of 48 patients were analyzed, showing a significant increase in embolization procedures and a 30% reduction in decision-making time post-recommendations.
- Results indicated a high success rate of 96%, improved patient hemodynamic status, and minimal complications, demonstrating that embolization is both effective and safe.
Article Synopsis
- - The report aims to assess a new three-dimensional ultrasound method for identifying issues with the fetal palate, specifically in cases of incomplete cleft palate.
- - Using this technique, the fetal palate of a patient with a known cleft palate condition was analyzed at 34 weeks of pregnancy, and the results were compared with postnatal observations.
- - The findings suggest that this ultrasound approach effectively reveals the complete hard palate, highlighting its potential for improving prenatal diagnoses and leading to better surgical planning for cleft palate conditions.