[Prognostic and therapeutic value of biologic signs of infection in the management of preterm labor (amniocentesis excepted)].

During threatened preterm delivery, both general and local signs of infection increase the risks of amniotic infection, premature rupture of membranes, preterm delivery, and neonatal and/or maternal morbidity of infectious origin. Nonetheless, as antibiotics have not been sufficiently studied to be proved of benefit in chorioamnionitis with intact membranes, search for these general (C Reactive Protein, hyperleucocytosis) or cervical/vaginal (Group B Streptococcus, Escherichia Coli, bacterial vaginosis) signs of infection have not been proved to be really necessary. We have to except Group B Streptococcus, which have to be searched during weeks that precede delivery: in those cases where it is shown to be present in the cervix or the vagina, antibiotics must be prescribed during delivery (ANAES recommendation).

Successful treatment of extremely severe fetal anemia due to Kell alloimmunization.

Background: Repeated plasmapheresis was used to prevent fetal death from severe anti-Kell alloimmunization until intrauterine transfusions were feasible.

Case: Repeated maternal plasma exchanges (N = 40) beginning at 7 weeks' gestation were used to treat severe anti-Kell alloimmunization. Ultrasound examination at 19 weeks' gestation revealed diffuse hydrops in this fetus (umbilical venous hemoglobin, 1.

[Placental chorioangiomas diagnosed during the second trimester of pregnancy: four cases].

Placental chorioangioma is a benign vascular tumor found in about 1% of pregnancies at routine histological examination of the placenta. The large placental tumor may cause serious fetal complications. We report 4 cases of placental chorioangioma diagnosed during the second trimester.

[Hyperemesis in the first trimester of pregnancy: role of biological hyperthyroidism and fetal sex].

Objectives: Our objectives were to link hyperemesis gravidarum with biochemical hyperthyroidism and hormonal modification (HCG and estradiol) and to test the hypothesis that biological abnormalities (ionogram and liver enzyme) are more often reported in hyperemesis gravidarum with biochemical hyperthyroidism.

Study Design: Thirty three patients admitted in "Hôpital Jeanne de Flandre" with hyperemesis gravidarum were studied prospectively.

Results: Twenty-two patients (66.

[Fertility after ectopic pregnancy: the population-based register of the urban area around Lille, Northern France].

The aims of this work were the evaluation of the reproductive outcome after ectopic pregnancy, and the assessment of the role of infertility risk factors and treatment's strategy. All patients in the population-based register of the urban area around Lille, Northern France, were followed-up. 345 women treated between April 1994 and March 1997, who were trying to become pregnant were interviewed by telephone every 6 months and then every year.

The role of bacterial vaginosis in preterm labor and preterm birth: a case-control study.

Objective: To study the association between preterm labor and bacterial vaginosis; in women with preterm labor, to determine whether vaginosis modifies the risk of preterm delivery.

Study Design: Case-control study. We used Amsel's clinical criteria to test 102 patients hospitalized for preterm labor and 102 control patients for bacterial vaginosis.

[Value of fetal fibronectin research for predicting premature delivery].

Objective: To estimate the performance of the foetal fibronectin test as a predictor of preterm delivery.

Patients And Methods: This prospective study concern 61 patients who had a singleton pregnancy between 24 and 36 weeks of gestation and were hospitalized because of a threatened preterm labor without premature rupture of the membranes. For each patient the presence of foetal fibronectin in cervicovaginal secretions was determined with a rapid swab-test.

Preclinical phase of polycythemia vera in pregnancy.

Background: In some cases, complications of pregnancy are related to thrombophilia. We describe a preclinical phase of polycythemia vera.

Case: A woman, who experienced perinatal deaths in her first two pregnancies, was diagnosed with polycythemia vera during antenatal counseling for a third pregnancy.

[An ischemic pulmonary malformation of the surviving fetus occurring after selective embryo reduction in bichorionic pregnancy. Report of one case and literature review].

We describe, to our knowledge, the first case of a pulmonary malformation called acinar dysplasia occurring at a surviving fetus after selective embryo reduction in a bichorionic pregnancy. The chronological and histological observations suggest that this anomaly may be linked with a feticide achieved at 13 week's gestation. Literature review concerning selective embryo reduction shows rare cases of vascular connections in bichorionic pregnancies especially during the first half of gestation, that can explain in part the apparition of survivor's anomalies.

Patient satisfaction with management of ectopic pregnancy.

Objectives: This study was designed (1) to identify characteristics of patients and their treatment and aspects of care that may be associated with satisfaction, and (2) to investigate the way these factors contribute to the degree of satisfaction expressed after treatment of ectopic pregnancy. Our ultimate goal in so doing was to determine how to improve ectopic pregnancy management.

Study Design: We used data from a register of ectopic pregnancy established in an urban area (Communauté Urbaine de Lille) in northern France.

[Fetal arrhythmias: diagnosis, prognosis, treatment; apropos of 33 cases].

From October 1993 to February 1998, 33 cases of fetal cardiac arrhythmia were investigated by doppler-echocardiography at the Lille infantile and congenital cardiology department. Extrasystolic arrhythmias were the most frequently encountered disorder (25 fetuses, i.e.

Survival analysis of fertility after ectopic pregnancy.

Objective: To evaluate the reproductive outcome after ectopic pregnancy and to assess the contribution of risk factors to future fertility.

Design: Prospective follow-up in a population-based sample.

Setting: Register of ectopic pregnancies established in an urban area around Lille, France.

[Trisomy 18: ultrasound aspects. Report of 40 cases].

Objective: We describe the different ultrasound findings suggestive of trisomy 18.

Patients And Methods: We conducted a retrospective study in 40 cases of trisomy 18 diagnosed in the department of obstetrics at the Lille University Hospital between 1988 and 1998.

Results: Eighty percent of the women in this series were multiparous.

[Medical indications of labor induction: a comparison between intravaginal misoprostol and intravenous prostaglandin E2].

Objectives: To assess the effectiveness and safety of misoprostol compared to dinoprostone at term, in cervical priming and labor induction for medical indications.

Material: and methods. Retrospective analysis of 87 patients.

[Echographic signs of trisomy 21 in the second trimester of pregnancy: actual value after analysis of the literature].

Objective: To evaluate the interest and to compare the major echographic signs of Down syndrome in the second trimester of pregnancy.

Methods: A bibliographic research has been performed for most of the echographic signs known and studied until now. For each study and in average for each sign, we have computed its sensitivity, its specificity, its positive and negative predictive values using the results of the different authors.

Prenatal alcohol exposure and signs of minor neurological dysfunction at preschool age.

High levels of alcohol consumption during pregnancy affect the development of the baby's central nervous system. Pregnant women were interviewed about their alcohol consumption during pregnancy, when they first visited the maternity hospital in Roubaix, France. Of the 698 women interviewed, 156 of their children were investigated at the age of 4 1/2 years with a standardised examination to assess the effects of prenatal alcohol exposure on neurological status.

[Antenatal diagnosis of limb body wall complex].

The "limb body wall complex" or LBWC is a rare polymalformative syndrome. Two distinct phenotypes of which were recently described: one form with "placento-cranial" adhesion and the other with "placento-abdominal" adhesion. Coelosomia is found in all cases, it variably coexists with encephalic, vertebral, visceral or limb anomalies.

[Nuchal translucency: screening for chromosomal abnormalities and congenital malformations. Multicenter study].

Objective: To value the rate of chromosomal abnormalities and evolution of children who had a prenatal diagnosis of fetal nuchal translucency in the first trimester.

Material And Methods: Multicenter prospective study conducted in 4,582 patients who had a first ultrasonography between 10 and 14 weeks' gestation (abdominal and/or transvaginal sonography). The measurement of fetal nuchal translucency was performed by mid-sagittal section and when it was higher than 2.