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A Fournié

Publications and source records attributed to A Fournié.

At least 19 recordsLinked to original sources

Gel test assay for IgG subclass detection by GM typing: application to hemolytic disease of the newborn.

The gel test assay was evaluated for IgG subclass detection by GM typing of antibodies and compared to the classical inhibition agglutination method on slides or microtiter plates. We used a panel of 5 murine monoclonal antibodies directed against G1M(1), G1M(3), G1M(17), G2M(23), and G3M(21) and 1 human polyclonal anti-G3M(5) antibody. Eleven polyclonal antisera (of immunized women) directed against red blood cells were tested for the GM allotypes carried by their alloantibodies. We controlled the specificity of the gel test reaction using a panel of anti-RH(D) monoclonal antibodies. All reagents exhibited a good reactivity and specificity. They can be used for routine typing. The gel test assay for IgG subclass detection is a specific, simple, and low-cost technique for the detection and management of severe forms of diseases in alloimmunized pregnancies.

Agglutination Tests

[Metrorrhagia during the second trimester of pregnancy: obstetrical and perinatal outcome. A retrospective study including 85 cases].

OBJECTIVE OF THE STUDY: To examine pregnancy outcome in patients with second-trimester vaginal bleeding and to determine a relationship between presumed etiology and perinatal outcome. MATERIAL: and methods: A retrospective study performed in Toulouse La Grave CHU between January 1993 and December 1997 including 85 cases of vaginal bleeding from 15 to 27 week's amenorrhea (90 fetuses). Results are compared to overall deliveries during the same period (14941 deliveries). RESULTS: Mean age at diagnosis is 29.8 years (SD: 5.3 years). Vaginal bleeding in the midtrimester concern 0.57% of deliveries. Abnormal ultrasonographic findings are observed in 73% of patients (placenta previa, subchorionic hematoma, placental abruption) and 81% were hospitalized (mean hospital duration: 18 days). Perinatal mortality was 17.04% and preterm delivery rate 30.6% (vs 11% in the overall patients). Perinatal complications are significatively increased compared with the overall population especially if ultrasonographic examination was abnormal. Second-trimester placental abruption had the worse prognosis. On the other hand, perinatal outcome was comparable when the origin of bleeding was unknown and ultrasonographic examination normal. 41% patients underwent cesarean section. CONCLUSION: Preterm delivery, perinatal mortality and morbidity are increased in patients with second-trimester vaginal bleeding. The risk is higher when abnormalities are detected at ultrasonography making ultrasonography a useful tool for predicting perinatal outcome.

Adolescent

[Drug use during pregnancy: survey in 250 women consulting at a university hospital center].

A prospective study of drug use in pregnancy was performed in the maternity outpatient department of a university hospital in Southwestern France. Two hundred and fifty pregnant women were selected at random and interviewed. Eighty-four percent of the women reported drug consumption, with an average of two medications per week. Some factors were significantly associated with an increase in drug use: European origin, high level of education, medical history, alcohol consumption. The most commonly used drugs were iron (43% of the women), medications for venous disorders (22%) and gynecology (21%) and analgesics (19%). Chronic use (beginning before pregnancy) occurred in 9% of the women. Self medication accounted for around 20% of the women. Adverse effects were described by the women 25 times out of 544 exposures: they concerned 10 drugs and were not "serious". After delivery, 14 cases of malformations of the new-born, three stillbirths, 25 neonatal pathologies and 10 resuscitations were observed. Except one neonatal withdrawal syndrome after "in utero" exposure to benzodiazepines, no relationship between drug exposure and pregnancy outcome could be established.

Adolescent

[Pregnancy and labor of women born in Maghreb and Black Africa followed to delivery at the Maternity Hospital of Toulouse].

OBJECTIVE: To identify risk factors related to maternal ethnic origin. METHODS: Retrospective review of 5808 cases of French, Maghrebian and Black African women who delivered between 1988 and 1994 at the Maternity of La Grave Hospital in Toulouse. RESULTS: Pathological pregnancies were more frequent (60% vs 45%), specifically anemia OR = 10.2[6.3-16.7] and OR = 5.7[4.0-8.3]) and genital infections (OR = 1.7[1.2-2.6] and OR = 1.7[1.4-2.1]) in African and Maghrebian respectively. than in French women. These differences cannot be referred to any classical risk factors but only to the mother's ethnic origin. Moreover, cesarean delivery occurred almost twice as much in African women 34% vs 19%) and no specific medical indication was found to explain this increase. CONCLUSION: Our data concluded that important risk factors were related to the mother's ethnic origin. This finding demonstrates that management of perinatal care and epidemiologic studies should take maternal ethnic origin into account.

Adult

Proposed classification criteria of psoriatic arthritis. A preliminary study in 260 patients.

UNLABELLED: Psoriatic arthritis probably owes to its radioclinical presentation its position as the most controversial and poorly understood of all major chronic inflammatory joint diseases. Differentiating psoriatic arthritis from ankylosing spondylitis and rheumatoid arthritis remains difficult. OBJECTIVE: To conduct a statistical analysis aimed at identifying clinical, radiological, and laboratory criteria for classifying psoriatic arthritis. PATIENTS AND METHODS: 260 patients were studied retrospectively, including 100 cases with psoriatic arthritis and 160 controls with ankylosing spondylitis meeting Amor's criteria (n = 80) or with rheumatoid arthritis meeting American College of Rheumatology criteria (n = 80). Mean disease duration was five years. Thirty-nine variables were recorded for each patient. Multiple logistic regression and discriminant analysis were used to select the classification criteria. RESULTS: Each of the two statistical methods selected the same nine criteria. After assigning a weighting coefficient to each of these criteria, sensitivity and specificity were better with the multiple logistic regression model (95% and 98%, respectively) than with the discriminant analysis model. CONCLUSION: Our classification criteria require further evaluation in multicenter prospective studies.

Adult

[Pelvic actinomycosis abscess and intrauterine device].

A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

Abscess

[Short-term outcome of infants from triplet pregnancies. A series of 45 pregnancies].

OBJECTIVE: To evaluate outcome of triplets pregnancies. METHODS: A retrospective study about children of 45 triplet pregnancies which occurred spontaneously or after assisted reproductive technologies. All were managed by the same obstetrical and pediatric team. RESULTS: Mean birth weight was 1800 g and 26% of children were very low birth weights (< 1500 g). There was no difference in the mean Apgar score of pH between first, second and third infant. Neonatal and perinatal mortality rate were respectively 60 and 75%. Incidence of respiratory distress syndrome was 29%, hyaline membrane disease 11%, intraventricular hemorrhage (grade 4) 1.3%, necrotizing enterocolitis 10.5% and bronchopulmonary dysplasia 4%. Only 10% of the infants were not hospitalized and were kept by their mother. 38% of the newborns had to be hospitalized in a Neonatal Intensive Care Unit, with a mean stay of 6 days. At birth, 34% of the babies required intubation for artificial ventilation. CONCLUSIONS: The main problem of triplet pregnancies is high prematurity.

Apgar Score

[Prenatal diagnosis of holoprosencephaly. A series of twelve cases].

OBJECTIVE OF THE STUDY: To determine the prenatal ultrasound criteria of holoprosencephaly and their correlation with embryogenesis. MATERIAL AND METHODS: We report 12 cases of holoprosencephaly that have been discovered between January 1990 and June 1996 (eleven alobar holoprosencephalies and one semilobar holoprosencephaly) at La Grave Hospital, Toulouse. RESULTS: In all cases, severe facial anomalies have been (cyclopia, cebocephaly or ethmocephaly). Prenatal ultrasound diagnosis was based on the association of brain anomalies (wide monoventricular cavity, thalami fusion, lacking of median structures) and facial dysmorphia (hypotelorism, orbital anomalies, median cleft lip ...). Finding microcephaly was a frequent sign of holoprosencephaly (64% of all cases). Chromosomal abnormalities have been found in 36% of the fetuses (Trisomy 13 is the most common). All patients underwent therapeutic abortions. CONCLUSION: Transvaginal sonography diagnosis can be made around the 14th to 16th week amenorrhea. An early diagnosis allows an easier pregnancy termination, when such severe anomalies are found. In order to provide genetic counseling, a cytogenetic study of the fetus is necessary.

Abortion, Therapeutic

[Obstetrical management of triplets. A series of forty five cases].

OBJECTIVE: To evaluate management of triplet pregnancies. METHODS: A retrospective study of 45 triplet pregnancies which occurred spontaneously or after assisted reproductive technologies. All were managed by the same obstetrical and pediatric team. Obstetrical data were collected. RESULTS: Major etiologies were fertility drugs and in vitro methods (66%). Mean maternal age as 30 years, higher with assisted reproductive technologies (p < 0.05). Risks of chorioamniotitis, preeclampsia and anemia were respectively 4.4%, 13.3% and 70%. Triplets had a 100% prematurity rate and mean gestational age was 33.6 weeks; 22.2%, 51.1% and 64.4% delivered before respectively 32, 34 and 35 weeks of gestation. Triplet had a 91% cesarean section rate. CONCLUSION: Triplet pregnancies present a high risk of prematurity and infertility specialists have to be vigilant in the use of fertility drugs. Their management requires early reduced maternal physical activity.

Adult

Behçet syndrome with ankylosing spondylitis.

Two HLA B27-positive patients with concomitant Behçet syndrome and ankylosing spondylitis are reported. The relevant literature is reviewed and the meaning of this combination discussed.

Adult

Termination of pregnancy for maternal toxoplasmosis.

Termination of pregnancy is usually recommended to pregnant women who have infection with Toxoplasma gondii before 26 weeks of pregnancy if the fetus is infected. No prospective studies are available on the outcome if such pregnancies are allowed to continue with anti-parasitic treatment. We prospectively studied 163 mothers with acute toxoplasma infection before 28 weeks of amenorrhoea. All received anti-parasitic treatment with 9 million IU spiramycin orally. 23 also received pyrimethamine and sulphadiazine. All had cordocentesis and regular obstetric ultrasound examinations. The 162 liveborn infants were followed up for 15 to 71 months. 3 fetuses died in utero. 27 of 162 liveborn infants had proven congenital toxoplasmosis: 10 had one or more clinical signs of congenital toxoplasmosis; 5 had isolated or multiple intracranial calcifications; 7 had peripheral chorioretinitis; and 2 had moderate ventricular dilations. All 27 are free from symptoms and have normal neurological development at 15 to 71 months of age. We conclude that in first and second trimester pregnancies with acute fetal toxoplasma infection, the pregnancy need not be interrupted if repeated fetal ultrasound is normal, and antiparasitic treatment is given.

Abortion, Eugenic

[Hemorrhage during the 3d trimester of pregnancy].

Bleeding during the final three months is a serious event. Mortality is very slight in developed countries but morbidity remains considerable. Fetal mortality and morbidity are notable, linked to resultant pathology or prematurity. Their existence requires hospitalisation in a department of gynecology/obstetrics, with a team including an obstetrician, anesthetist/intensive care specialist, and pediatrician. Bleeding is due to placental separation involving the inter-villous chamber (basal decidual hematoma) or the marginal region (marginal decidual hematoma). Precise diagnosis of refractory bleeding is essential and must be obtained simultaneously with treatment. Maternal and fetal prognosis can only be improved by early and appropriate management. The treatment of serious cases is based upon intensive therapy including the replacement of losses, the correction of possible hemostasis problems and fetal extraction. Delivery is a critical phase, with the risk of extremely heavy bleeding and decompensation. This stage of labour requires careful monitoring and intensive therapy without delay.

Adult