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Biomedical subjects

A van Assche

Publications and source records attributed to A van Assche.

10 recordsLinked to original sources
PubMed1999

Factors influencing recruitment and retention of academic staff in the European Union.

Academic medicine plays an essential role in the organization of health care in the European Union. Academic hospitals have been the Mecca for advanced medicine. Academic hospitals differ from country to country. Some are public institutions and others are largely private hospitals. Financial pressures on patient care are now threatening research activities in the university hospitals and universities have a responsibility to safeguard the structure of clinical academic obstetrics and gynaecology. In many European teaching hospitals, little importance is placed on research and the academic posts are a mechanism for developing private practice.

European Union↗
PubMed1994

Immunohistochemical detection of lipoprotein(a) in the wall of placental bed spiral arteries in normal and severe preeclamptic pregnancies.

In normal pregnancy trophoblast invades the spiral arteries and produces the physiological fibrinoid degeneration of the vessel wall. In pre-eclampsia, physiological change is restricted and pathological change develops in the non-invaded arteries, including acute atherosis. This study was undertaken to determine if lipoprotein(a) [Lp(a)], which is associated with atherogenesis is present in the wall of spiral arteries that have undergone physiological and pathological change. One hundred and sixteen spiral arteries were examined from 18 normal and 24 severe pre-eclamptic pregnancies. Lp(a) was detected in all atherotic and necrotic lesions, in 57% of spiral arteries with medical disorganization or hyperplasia, and in 45% of those with physiological change. When Lp(a) was detected differences were found in the amount seen: it was most in atherosis, less in necrosis, less still in medical change, and least in physiological change. For the same vascular change generally more Lp(a) was detected in the pre-eclamptic group than in the normal group. The detection of Lp(a) helps to distinguish physiological fibrinoid from atherotic and necrotic fibrinoid. Many atherotic and necrotic areas initially overlooked using standard histology were highlighted using immunohistochemistry. Atherosis can develop in spiral arteries that have been invaded by trophoblast. In those with pre-eclampsia, atherosis was found in 56% of decidual but only in 8% of myometrial spiral arteries. Small areas of necrosis were common in physiologically changed arteries from normal pregnancies.

Antibodies, Monoclonal↗
PubMed1991

Placental bed spiral arteries in the hypertensive disorders of pregnancy.

OBJECTIVE: The investigation of the histology of the placental bed spiral arteries in normal pregnancy and in pregnancies complicated by hypertension, with or without proteinura. DESIGN: An observational study, based on women having caesarean sections for clinical reasons. SUBJECTS: 17 normal pregnant women, 43 with gestational hypertension, of whom 39 had proteinuria, 17 with chronic hypertension, of whom 6 had proteinuria, and 5 with unclassified hypertension. INTERVENTIONS: Placental bed biopsies obtained during caesarean section. MAIN OUTCOME MEASURES: Histological appearance of sections stained with haematoxylin and eosin PAS and Lendrum's MSB. RESULTS: Biopsies containing spiral arteries were obtained from 6 normotensive and 44 hypertensive women. Trophoblastic invasion was present in 5 of the 6 normotensive biopsies but absent in the majority of those with hypertension. Subintimal proliferation was seen in all the normotensive biopsies but in only 8 of 28 from those with gestational hypertension and proteinuria. Other features seen predominantly or only in the hypertensive biopsies, in order of frequency, were medial hyperplasia, fibrin deposits, acute atherosis, endothelial vacuolation and thrombosis. CONCLUSION: Absence of physiological changes may not be peculiar to preeclampsia but may be associated or even a result of various forms of hypertension in pregnancy. Spiral arteries show a spectrum of changes in hypertensive pregnancies that do not appear to bear a clear-cut relation to the clinical signs.

Arteries↗
PubMed1990

Efficacy, safety and tolerance of oral sustained-release ritodrine given after intravenous administration in the treatment of premature labor.

45 patients in premature labor entered the study, four dropped out for administrative reasons. The remaining 41 patients started all with an intravenous treatment followed by oral treatment with sustained-release ritodrine at a daily dosage of 120 mg per day until the 36th week of gestation. The mean gestational age at entry was 31.26 weeks +/- 3.27 and at delivery 37.76 weeks +/- 2.11 or a mean gain in days of 44.61 days +/- 20.85. A cluster analysis splitting the patients into four groups regarding the gestational age at entry and the Baumgarten tocolytic index showed that even the high-risk patients benefit remarkably by the treatment. The side effect rate was low as well for palpitation as for tremor. The patient compliance was excellent. No neonatal deaths or stillborns occurred during this study.

Adult↗
PubMed1989

Maternal mortality and morbidity in Belgium.

The Belgian maternal mortality rate was 8.6/100,000 births in 1984 but it is probable that underreporting occurred. Data on morbidity from one Belgian hospital are presented. Gestational hypertension occurred in 9% of the women who delivered between 1982 and 1987. Gestational diabetes was observed in 2% of the cases during the same period. Data on antepartum haemorrhage are also discussed.

Belgium↗
PubMed1983

Thrombosis of the right umbilical artery, presumably related to the shortness of the umbilical cord: an unusual cause of fetal distress.

This case report concerns a late pregnancy complication, clinically apparent as severe variable decelerations in the first stage of labor. Emergency cesarean section delivered a mildly asphyxiated full-term newborn infant. Examination of the umbilical cord revealed a thrombus of the right umbilical artery, near the fetal side, confirmed by histological examination. The total length of the umbilical cord, only 30 cm, was below the limit necessary for uncomplicated delivery of the fetus near term. Transient stretching during fetal descent is thought to be responsible for constriction of the umbilical arteries, blood flow sludging and thrombosis. Although only a few cases have been reported, thrombosis of the umbilical vessels has to be considered whenever the fetal heart rate pattern shows unexplained variable decelerations.

Adult↗