Publications by authors named "Verspyck E"

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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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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  • The study aimed to analyze the neonatal and maternal outcomes of routine maneuvers during breech vaginal deliveries at term through a secondary analysis of a multicenter study in France and Belgium.
  • A total of 1,163 women were compared between those who had routine maneuvers and those who did not, with similar adverse perinatal outcomes in both groups (4.5% vs 5.0%).
  • The findings suggested that routine maneuvers did not lead to increased neonatal morbidity, with factors like being a first-time mother and low birth weight being linked to adverse outcomes.
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  • Obstetric hemorrhage is a significant cause of maternal mortality that can be largely prevented, yet surgical injury during cesarean sections has become more common in France as a contributing factor to this issue.
  • A nationwide study analyzed maternal deaths from surgical injuries during cesareans in France from 2007 to 2018, revealing a concerning trend of increasing mortality ratios despite overall improvements in maternal health outcomes.
  • Key findings indicate that factors such as obesity, prior cesareans, and inadequate facilities played a significant role in these deaths, highlighting the need for improved care processes and risk factor management to enhance maternal safety.
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Objectives: To evaluate whether the quality scores validated for second-trimester ultrasound scan can be used for third-trimester ultrasound scan.

Methods: Prospective multicenter ancillary study using data from the RECRET study. Nulliparous women, with no reported history, with second- and third-trimester ultrasound examinations performed by the same ultrasonographer and using the same ultrasound machine were recruited.

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Introduction: The use of different growth charts can lead to confusion in discussions between professionals. There are obstetric charts (of fetal growth) and neonatal charts (of measurements at birth and of postnatal growth). These charts can be descriptive (derived from an unselected population) or prescriptive (derived from of a population at low risk and with optimal conditions for growth).

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In France, 272 maternal deaths occurred during the period 2016-2018, of which 131 were initially treated by healthcare professionals not specialized in obstetric. Fifty-six files were excluded because they did not concern emergency services or because there was insufficient data to allow analysis. Seventy-five cases of maternal deaths initially treated by emergency services (in-hospital emergency department [ED] or emergency medical ambulance [SAMU]) were analyzed.

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  • Between 2016 and 2018, there were 20 maternal deaths due to obstetric haemorrhage, resulting in a mortality ratio of 0.87 per 100,000 live births and accounting for 7.4% of all maternal deaths within a year.
  • The rate of maternal mortality from obstetric haemorrhage has decreased significantly since the early 2000s, but it remains a leading direct cause of maternal deaths, with many cases considered preventable due to shortcomings in care.
  • Most deaths from haemorrhage during this period occurred during caesarean deliveries, often linked to complications like uterine rupture and surgical injuries, highlighting the need for hospitals to be prepared for such emergencies.
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  • Between 2016 and 2018, cardiovascular diseases were the leading cause of maternal deaths in France, with a mortality ratio of 1.8 per 100,000 live births, showing a slight increase from the previous period.
  • Most deaths were due to cardiac issues, predominantly aggravated by pregnancy, while 13 deaths were linked to vascular causes.
  • The study indicates that there is potential to prevent 56% of these deaths, highlighting the need for better multidisciplinary care, regular risk assessments, and active participation from the women themselves in managing their health.
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Objective: To assess which fetal growth charts best describe intrauterine growth in France defined as the ability to classify 10% of fetuses below the 10th percentile (small for gestational age [SGA]) and above the 90th percentile (large for gestational age [LGA]) in the second and third trimesters.

Methods: We analyzed five studies on fetal ultrasound measurements using three French data sources. Two studies used second and third trimester ultrasound data from a nationwide birth cohort in 2011 (the ELFE study, N = 13 197 and N = 7747); one study used third trimester ultrasound data from on a nationwide cross-sectional study (the 2016 French National Perinatal Survey, N = 9940); and the last two studies were from the "Flash study" 2014 which prospectively collected ultrasound data from routine visits in the second and third trimesters (N = 4858 and N = 3522).

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Objectives: There is a progressive reduction in the rate of episiotomies since the recommendations of the French college of gynaecologists. Our objective was to study the evolution of the rate of episiotomies and Obstetric Anus Sphincter Injury (OASI) since the restriction of episiotomies in our department.

Methods: Observational monocentric retrospective study performed at the Rouen University Hospital.

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  • 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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Background: Recent studies have demonstrated that a routine third-trimester ultrasound scan may improve the detection of small for gestational age infants when compared with clinically indicated ultrasound scans but with no reported reduction in severe perinatal morbidity. Establishing the optimal gestational age for the third-trimester examination necessitates evaluation of the ability to detect small for gestational age infants and to predict maternal and perinatal outcomes. Intrauterine growth restriction most often corresponds with small for gestational age infants associated with pathologic growth patterns.

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Background And Objective: The conventional technique of general anesthesia induction during a Cesarean section involves the use of opioids only after cord clamping. We hypothesized that the use of remifentanil before cord clamping might reduce the use of maternal supplemental anesthetic agents and improve the maternal hemodynamics status and neonatal adaptation of the preterm neonate.

Methods: A phase III, double-blind, randomized, placebo-controlled, hospital-based trial enrolled parturients undergoing a Cesarean section under general anesthesia before 37 weeks of gestation.

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Objective: To assess the long-term risk of repeated surgery in women undergoing complete excision of endometriosis by an experienced surgeon and to identify circumstances leading up to repeat surgery.

Design: Retrospective study based on data recorded in a large prospective database.

Setting: University Hospital.

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  • The study investigates the effects of intrauterine balloon tamponade when used along with second-line uterotonics versus after the failure of second-line treatment in managing severe postpartum hemorrhage for women who had vaginal deliveries.
  • Conducted across 18 hospitals with 403 participants, it focuses on women with postpartum hemorrhage that did not respond to first-line treatment (oxytocin) and required additional intervention.
  • The primary outcome measured was the need for blood transfusions or excessive blood loss, with secondary outcomes including the frequency of significant blood loss, transfusions, invasive procedures, and ICU transfers.
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Objective: To learn lessons for maternity care by scrutinizing postpartum hemorrhage management (PPH) in cases of PPH-related maternal deaths in France and the Netherlands.

Methods: In this binational Confidential Enquiry into Maternal Deaths (CEMD), 14 PPH-related maternal deaths were reviewed by six experts from the French and Dutch national maternal death review committees regarding cause and preventability of death, clinical care and healthcare organization. Improvable care factors and lessons learned were identified.

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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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Nociplastic pain syndromes include particular fibromyalgia, irritable bowel syndrome, headache, complex regional pain syndrome, and idiopathic orofacial pain. Several mechanisms have been proposed to account for nociplastic pain including central sensitisation, alterations of pain modulatory controls, epigenetic changes, and peripheral mechanisms. Importantly, nociplastic pain might also be present in patients with cancer pain, particularly those with pain related to complications of cancer treatment.

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Objective: To assess whether standardised longitudinal reporting of growth monitoring information improves antenatal detection of infants who are small for gestational age (SGA), compared with usual care.

Design: Cluster-randomised controlled trial.

Setting: Sixteen French level-3 units in 2018-2019.

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Article Synopsis
  • The study aimed to assess the prevalence of maternal sudden death (MSD) in France and compare characteristics between women whose deaths were explained versus unexplained.
  • A total of 83 cases of MSD were identified from 2007-2012, making up 16% of all maternal deaths; 61% of these deaths had an explained cause, while 39% were unexplained.
  • The results indicated significant differences in factors such as hospital treatments and postmortem investigations, suggesting a need for enhanced training for healthcare providers and systematic autopsies to improve understanding and prevention of MSD.
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Objective: To recommend the most appropriate biometric charts for the detection of antenatal growth abnormalities and postnatal growth surveillance.

Methods: Elaboration of specific questions and selection of experts by the organizing committee to answer these questions; analysis of the literature by experts and drafting conclusions by assigning a recommendation (strong or weak) and a quality of evidence (high, moderate, low, very low) and for each question; all these recommendations have been subject to multidisciplinary external review (obstetrician gynecologists, pediatricians). The objective for the reviewers was to verify the completeness of the literature review, to verify the levels of evidence established and the consistency and applicability of the resulting recommendations.

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  • Tranexamic acid (TXA) after cesarean delivery may reduce blood loss and transfusions, but it doesn’t significantly help with other hemorrhage-related issues, making its routine use uncertain.
  • The study aimed to see if TXA is effective in preventing blood loss specifically for women with multiple pregnancies undergoing cesarean deliveries.
  • Results showed no significant difference in blood loss between women receiving TXA and those on placebo, indicating that TXA may not be beneficial in this high-risk group.
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Importance: Endometriosis is an inflammatory disease with a heterogeneous presentation that affects women of childbearing age. Given the limitations of previous retrospective studies, it is still unclear whether endometriosis has adverse implications for pregnancy outcomes.

Objective: To evaluate the association between the presence of endometriosis and preterm birth and whether the risk varied according to the disease phenotype.

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