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Biomedical subjects

A Treisser

Publications and source records attributed to A Treisser.

At least 37 records · Page 2Linked to original sources
PubMed1991

Prenatal diagnosis of congenital myasthenia with arthrogryposis in a myasthenic mother.

We studied two children born to a myasthenic mother. The first child, a female, had multiple flexion contractures. She died 1 h after birth. In the second pregnancy, 3 years later, ultrasonographic examination at 20 weeks showed decreased fetal movements and multiple flexion contractures. The pregnancy was interrupted. Eight other cases of congenital myasthenia with arthrogryposis are known; four of them are siblings. The recurrence risk may be as high as 100 per cent. Our second case demonstrates that prenatal diagnosis is possible early enough to allow termination of pregnancy.

Adult↗
PubMed1991

[A fetal extraction device used in under-equipped countries: the obstetrical vacuum extractor. Results of 393 vacuum extractions in the Maternity Hospital in Sélestat. (Reflections on the use of this device in African practice)].

The level of mortality and feto-maternal morbidity in under-equipped countries is frightening. It is important to find answers. Among these: the obstetrical Ventouse is an instrument that can be used for extracting the fetus without too much difficulty. It is relatively easy to learn and to apply as compared with forceps (so long as the mechanism by which it is used is understood). The conditions under which it can be used are well defined at present: term pregnancy, the woman must be in labour, fetal membranes must be ruptured, the cervix must be completely dilated, presentation must be cephalic and the head must be engaged. 393 Ventouse extractions were carried out between 1982 and 1988 at the Maternity Hospital of Selastat and this resulted in delivery of 393 infants in good health. No maternal or fetal mortality occurred in the series. The maternal morbidity was low at 0.76% and the fetal morbidity was only 4.7%. In view of our experience, we believe that the tendency for black women to have android pelves makes it preferable to use the Ventouse as against the forceps because it has several advantages. In view of the literature and of their practice, the authors advise that the obstetric Ventouse should be used in under-equipped countries where conditions of practice are often precarious and the team poorly qualified. This will reduce the mortality and morbidity due to delivery. Pregnant women are insufficiently educated. The quality of health personnel is inadequate. The health services are inadequate for the needs of the population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Functional and urodynamic results of Burch's colpopexy. A series of 173 cases].

The authors describe their experience with modified Burch retropubic urethropexy with a mean follow-up of 4 1/2 years; they clinically assessed 173 women. 114 of these had urodynamic studies. The long term objective success of this operative procedure, with a success rate of 95% in genuine stress incontinence and of 96% in correction of the cystocele, justify its use to cure urine loss in women with primary stress incontinence or after failure of a previous operation. The results do not get worse with a long term follow-up. The mechanism of action consists in improving the abdominal pressure transmission ration (+29%) with only a little decrease of the post-operative mean maximal urethral closure pressure (-8,8 cm H2O). The most challenging complication encountered was bladder instability (22.5%); post-operative retrocele or enterocele occurred in 15% of cases. The other side effects were dysuria, pubic pain and trachelocele. The rate of failure is nearly 5% mainly due to insufficient correction of the abdominal pressure transmission ration, or post-operative bladder instability or low urethral closure pressure.

Adult↗
PubMed1990

Induction of labor with mifepristone (RU 486) in intrauterine fetal death.

In a double-blind controlled multicentric study involving 94 patients with an intrauterine fetal death, we investigated the efficacy and tolerance of mifepristone (RU 486), a steroid compound that antagonizes progesterone action at the receptor level. Success of treatment was defined as the occurrence of fetal expulsion within 72 hours after the first drug intake. Mifepristone treatment (600 mg per day for 2 days) was considered to be effective in 29 of 46 patients (63%). There were only eight successes in 48 patients (17.4%) in the placebo group (p = 0.001, chi 2 test). Tolerance was good in the mifepristone group. In the placebo group, disseminated intravascular coagulation occurred in one woman for whom the investigator waited several weeks for spontaneous expulsion. This large double-blind controlled study provides evidence that mifepristone is of interest in the management of intrauterine fetal death. It could provide a pharmacologic alternative to the use of prostaglandins in this indication.

Adult↗
PubMed1989

[Glanzmann's thrombasthenia and pregnancy. Contribution of plasma exchange before scheduled cesarean section].

Glanzmann's thrombasthenia is a thrombopathy which affects primary hemostasis due to a qualitative or quantitative abnormality of membrane glycoproteins IIb-IIIa. The treatment of hemorrhages is usually associated with the transfusion of packed red blood cells and platelet concentrates. If massive allo-immunisation occurs, the transfusion will prove to be inefficient. A case of a cesarean section was scheduled after therapeutic plasmapheresis and platelet transfusions in a massively allo-immunised patient with Glanzmann's thrombasthenia. The plasma exchange made it possible to reduce to trace levels the concentrations of anti-PLA1 and anti-PLA2 antibodies, thus making platelet transfusions hemostatically efficient. The cesarean section was therefore safely performed when the bleeding time was normalized.

Adult↗
PubMed1988

[Ripening of the cervix uteri at term by a single intracervical application of prostaglandin E2 gel].

The efficacy and the side effects of an intracervical PGE2 gel application, as compared to placebo, for priming of the cervix have been studied in 208 patients at term (104 PGE2 and 104 placebo) with an unripe cervix (Bishop score less than 5) and with a medical indication for induction of labour. The cervical ripening success rate (as defined in methodology) is significantly higher in the treated group (58.6%) than in the control group (27.8%; p = 0.0001): 38.5% out of the PGE2 treated patients delivered within 12 hours after the gel application; 12 hours after PGE2 or placebo gel application labour was induced in the remaining patients with intravenous oxytocin infusion. Under these conditions there were 13.5% failures in the PGE2 treated group and 16.3% in the placebo group. We observed a statistically significant decrease in the length of labour of the PGE2 treated patients as compared to the control group. Since signs of myometrial hypercontractility were observed in the PGE2 treated group as compared to the control group (p = 0.01), the authors advocate careful cardiotocographic monitoring for at least three hours after the gel application. It is concluded that intracervical application of Prostaglandin E2 followed by intravenous infusion of oxytocin in an effective and safe method for induction of labour with an unfavorable cervix at term.

Adult↗
PubMed1987

[Oligohydramnios. Diagnosis. Etiology. Prognosis].

We have studied 68 cases of severe oligohydramnios and compared them with the published literature on the aetiology, pathology, diagnosis, complications and prognosis. The principal aetiological features have been malformations of the fetal urinary tracts, intra-uterine growth retardation, high maternal blood pressure, nicotine poisoning and prolonged pregnancy. The perinatal mortality and morbidity, as well as the caesarean section rate, are raised because of the complications, such as the tetrad of oligohydramnios, prematurity, fetal distress in labour and post-maturity. When oligohydramnios is the sole presenting feature the prognosis for the fetus is better.

Adult↗
PubMed1985

[Early biopsy of chorionic villi. Personal experience and review of the literature].

Chorionic villus biopsies made during the first trimester of pregnancy offer the advantage of earlier antenatal diagnoses than usual methods. This technic was introduced about 15 years ago but recently improved thanks to innovations in equipment and the contribution of echography. 75 biopsies were made using aspiration technic by echographic-guided catheter. These biopsies were carried out before elective abortion, 18 in an ambulatory setting one to three weeks before the abortion in order to test the social acceptability and tolerance of this method, as well as the inherent risks involved. The biopsy technic is described as well as preliminary results of chromosomic analyses of biopsied chorionic tissues. Drawing from a perspicacious review of the literature, the respective advantages of various biopsy technics and their uses (i.e. sex determination and chromosome analyses by culture and especially direct methods, study of fetal DNA, and enzyme assay) are examined. Finally, the risks of biopsy technic in the immediate and near future are discussed, and the indications today for this new technic are described.

Abortion, Therapeutic↗
PubMed1985

[Correlations between pregnancy pathology, study of the placenta, antenatal echography and examination of the product of conception in a series of 175 congenital malformations].

In order to verify the hypothesis that during pregnancy in a woman without peculiar history, signs could be discovered when the fetus is malformed we have reviewed the files of 175 women who had a malformed child and of 300 controls. All of these women had at least one clinical examination and one ultrasonographic examination during pregnancy. Two clinical symptoms were more often discovered in the mother of the malformed fetus (p less than 0.001): decrease of fetal movements and small for date fetus. The placenta is never abnormal in the mother with normal fetus. Placenta is abnormal in 31% of the mother with malformed fetus but the abnormalities are not specific. Ultrasonographic examinations allowed more often the discovery of a malformation when hydramnios (p less than 0.001) or fetal hypotrophy (p less than 0.01) or an anomaly of the morphology of the fetus is discovered. Accuracy of prenatal diagnostic is considered for the different categories of congenital malformations.

Congenital Abnormalities↗
PubMed1985

[Epidemiologic factors in ovarian cancer].

Ovarian carcinoma is the most severe gynecological cancer with an overall incidence of 12 per 1000 Americans or Europeans developing it over 40 years of age. Only 3 of the 12 cases will receive efficient care because the diagnosis will be made too late. This study reveals the principal risk factors i.e. upper socioeconomic echelon, ovarian function uninterrupted by a pregnancy or usage of oral contraceptives, anamnestic evidence of ovarian carcinoma in the family, some hereditary disorders, external insults (talcum powder). The synthesis of these various risk factors permits a comprehensive review of the hypotheses of pathogenesis concerning recurrence of tumors. But corollary epidemiologic studies are still needed to try to define better the high risk groups whose follow-up systematic detection and testing is a priority.

Europe↗
PubMed1985

[Bologna's treatment method for stress urinary incontinence. An interesting technic in large cystoceles].

The authors report a series of 25 operations using the Bologna technic in which 20 cases were examined with bladder function tests before and after surgery. This technic has curative results for vesical hernia or cystocele and urinary incontinence. In all but one case the abdominal pressure transmission defect to the upper urethra was corrected without deterioration of maximal urethral pressure.

Aged↗
PubMed1984

Continuous twenty-four hour recording of the fetal cardiac rhythm during normal pregnancies.

Recording the fetal cardiac rhythm (FCR) is currently the technique most widely used to assess the well being of the fetus. In view of the importance of the decisions taken on the modifications of the FCR, the authors have recorded and analysed over 24 consecutive hours 10 resting women manifesting a strictly normal pregnancy. They observed no modification in the basal cardiac frequency, very few declarations and above all, never any signs of a flat or sinusoidal rhythm. Flattening of the FCR is invariably pathological. It must not be interpreted as "fetal sleep" period, but it should intensify the surveillance.

Female↗