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Biomedical subjects

B Maria

Publications and source records attributed to B Maria.

At least 37 records · Page 2Linked to original sources

[Prevalence of hepatitis C virus antibodies (tests ELISA 2 and RIBA 2) in a population of pregnant women in France].

We studied the prevalence of anti-HCV antibodies in a population of 2,367 pregnant women attending three public Parisian suburban hospitals. Of this group, 1,614 (68 percent) were French and 753 (32 percent) were immigrant women. The geographic origin of the immigrant population was North Africa (40 percent), West Africa (33 percent), Asia (14 percent), and South Europe (13 percent). Anti-HCV antibodies were tested by the Ortho ELISA second generation test. If present, the Ortho's four-antigen RIBA test and serum alanine aminotransferase determinations were done routinely. The overall prevalence was 1.73 percent. It was 1.55 percent in French women and 2.13 percent in immigrant women. Risk factors associated with anti-HCV were found in 68 percent of the anti-HCV positive French women and in 44 percent of the positive immigrant women. Risk factors were significantly more frequent in anti-HCV positive women in both groups. Among the 41 women with a positive ELISA test, 16/25 French women (64 percent) and 8/16 immigrants (50 percent) had a positive four-antigen RIBA test. Thus, the prevalence of a positive RIBA test was similar in both groups (0.99 and 1.06 percent), due to a higher proportion of false positive ELISA tests observed in the immigrants. These results show that, in French pregnant women: a) the prevalence of anti-HCV is twice as high as that found in blood donors and is a better estimation of the actual prevalence of these antibodies in France; b) positive ELISA 2 tests are most often confirmed by a positive RIBA 2 test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Predictive value of the active renin assay for the diagnosis of ectopic pregnancy.

The increasing frequency of EP and the need for its early diagnosis have focused our interest on the research of biochemical markers. We have established hormonal values in the plasma of 99 spontaneous ongoing pregnancies between the 4th and 10th weeks of amenorrhea, in 21 EPs, and 20 cases of early abortion. We have examined the predictive values of trophoblastic and CL production in pathological pregnancies. The association of low hCG and low active renin appears to be able to discriminate between ectopic and abortive spontaneous gestations.

Abortion, Spontaneous↗

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↗

Termination of early pregnancy through a combination of the antiprogestin and prostaglandin analogue.

Termination of early pregnancy (less than 49 days of amenorrhea) was induced in 75 patients with the combination of the antigestagen mifepristone and a prostaglandin analogue, meteneprost. After 48 h a single oral dose of 600 mg of mifepristone was followed by a 10 mg meteneprost vaginal pessary. Pregnancy was confirmed by clinical and ultrasound examinations and plasma HCG assessment. Complete abortion occurred in 72 patients (96%) and the three others required a surgical uterine aspiration. Bleeding continued for 4 to 12 days (mean = 8). Uterine pain and side effects occurred during the 3 h following the use of prostaglandin. Only minor analgesic were required in 30 patients. The combination of mifepristone and meteneprost is a safe and effective method to terminate an early pregnancy.

16,16-Dimethylprostaglandin E2↗

[Antiprogesterone, prostaglandin analogues and the early interruption of pregnancy].

Early termination of pregnancy, or menstrual regulation, is recommended for use within 7 weeks of amenorrhea, ie 49 days. Aspiration is a widely used method, with a failure rate of 2 to 5 p. cent and a complication rate of 4 p. cent. But, aspiration need experienced practitioners. Prostaglandins may be used with efficacy. New analogues (sulprostone, meteneprost, gemeprost) are studied. The success rate is over 90 p. cent, but severe uterine pains occurred in 50 p. cent of cases, as gastro-intestinal side effects. Mifepristone is an antiprogesterone steroid which is able to terminate early pregnancy with a success rate of 80 p. cent and very few side effects. The combination of mifepristone and a low dose of a prostaglandin-analogue is a very well tolerated procedure with a success rate of 95 p. cent. It seems to be a good alternative to early aspiration.

Abortifacient Agents↗

[The diagnosis of a pseudo-unicornous uterus. Apropos of a pregnancy in a rudimentary uterine horn].

The following is a report of an unusual case of a patient who had a rupture of the rudimentary horn at 21 weeks of pregnancy. Hysterography had shown that she had a unicornuate uterus but she had not had a laparoscopy. Later ultrasound pictures at the beginning of pregnancy failed to reveal that the pregnancy sac was ectopic. The authors also stress the absolute need to carry out laparoscopy in cases of unilateral Müllerian hypoplasia. They show how to read ultrasounds in cases of pregnancies in rudimentary horns. They try to point out the best procedures for diagnosis using the literature.

Adult↗

Termination of early pregnancy using mifepristone in combination with prostaglandin analogs.

Mifepristone, (RU 486), is an antiprogesterone which, when administered alone will terminate early pregnancy in 80% of cases. Prostaglandins at high doses have also been used to terminate pregnancy but there are often unacceptable side effects. The combined treatment of mifepristone with low doses of prostaglandin analogs appears to be an effective method for termination of pregnancy, with a high success rate and a reduction in the side effects observed with prostaglandins.

16,16-Dimethylprostaglandin E2↗

Termination of early pregnancy by a single dose of mifepristone (RU 486), a progesterone antagonist.

Mifepristone (RU 486) is a new steroid which is a progesterone antagonist and which is able to interrupt early pregnancy without any major side-effects. The purpose of our study was to evaluate the clinical effect of a single oral dose of 600 mg on early pregnancy. The study included 150 healthy women applying for a legal abortion with an amenorrhea of no more than 42 days. Pregnancy was confirmed by clinical and ultrasound examination and plasma HCG assessment. Success was assumed by repeating these exams on the eighth day. 131 patients had a complete abortion (87.3%), with a very few side-effects. Only two patients needed curettage for heavy bleeding. Mifepristone is able to terminate early pregnancy by an easy ambulatory method under medical supervision.

Abortifacient Agents↗

[Early pregnancy interruption using an antiprogesterone steroid: Mifepristone (RU 486)].

Mifepristone (RU 486) is a new steroid which is a progesterone antagonist and which is able to interrupt early pregnancy. The purpose of our study was to evaluate clinical efficacy and tolerance of two doses of Mifepristone (600 and 200 mg) in a single intake. The study included 205 women applying for a legal abortion with pregnancies under 7 weeks. Clinical examination was confirmed by ultrasound and plasma HCG assessment. Success was assumed by repeating these exams on 8th day. 175 patients took 600 mg of Mifepristone and 147 (84%) had a complete abortion. 30 patients took 200 mg of mifepristone and only 19 (63%) had a complete abortion. Very few side effects were observed. So, Mifepristone in able to terminate early pregnancy under medical supervision.

Abortifacient Agents↗

[Cervical dilatation by use of a vaginal suppository of meteneprost before voluntary interruption of the pregnancy in the first trimester].

Instrumental dilatation of the cervix prior to first trimester absorption may be difficult and source of complications. Pharmacological dilatation is proposed in a prospective random study using vaginal suppository containing 10 mg of 9-deoxo, 16-16 dimethyl, 9 methylene PGE2 (Meteneprost). Mean cervical dilatation, 3 hours after treatment, was significantly higher in the treated group (8.1 vs 6 mm) and additional dilatation was facilitated by cervical softening. Side effects occurred in most of the treated patients (uterine pain) but on a minor scale. This procedure may be considered as effective, safe and easy.

16,16-Dimethylprostaglandin E2↗

[Maturation of the cervix uteri using prostaglandin F2 alpha before induction of labor in pathologic pregnancies].

It is possible to induce labour in pathological pregnancies after artificial ripening of the cervix. The present study concerns 70 patients (45 primipara, 25 multipara). The main pathologies are hypertension of pregnancy and pregnancies past dates. Prostaglandin F2 alpha has been used with a Tylose gel containing 5 mg of PGF2 alpha introduced by the extra-amniotic route. The cervical change was noted using Bishop's score. The mean increase of the cervical score was 0.8 with the first PGF2 alpha gel. The total mean increase was 1.2. Two cases of hyperstimulation of the uterus were observed and they led to Caesarean section. Prostaglandin gel induced labour in 56% of the patients. The mean time between the introduction of the gel and the delivery was 14 h for primipara and 10 h for multipara. Other patients were induced with oxytocin on the following day. Epidural analgesia was widely used in this study (in 64% of cases). The mean duration of labour was 6 h 10 for primipara and 4 h 30 for multipara. 30% of the patients needed Caesarean section but there was a marked difference between primipara (36%) and multipara (4%). After a review of the literature the authors conclude that it is useful to ripen the cervix prostaglandin but, as foreign authors do, they think that PGE2 should be more efficient.

Cervix Uteri↗

[Therapeutic interruption of pregnancy in the second trimester after preparation of the cervix with prostaglandins F2 alpha].

The use of prostaglandins is one of the best techniques for second trimester abortion. The authors present 40 patients aborted by a new two stage technique: First: ripening of the cervix a tylose gel containing 5 or 10 mg PGF2 alpha every 12 hours during 3 days. Then, if abortion is not obtained, previously published techniques are used: intra-amniotic injection (40 mg PGF2 alpha) or intra-cervical infusion (2 mg/hour). The mean duration of these abortions is 52 hours using 29 mg of PGF2 alpha. 22 patients aborted during ripening (mean = 27 hours), 12 patients needed an intracervical infusion (mean = 88 hours) and 6, an intra-amniotic injection (mean = 72 hours). It seems that abortion is easier when pregnancy is earlier, under 20 weeks of gestation. Few side effects were observed: only three cases of fever with a single case of endometritis. Failure of this technique occurred in five patients (4 aborted outside the time allowed for, and one needed instrumental extraction). With this technique, the mean duration is longer than those previously described in the literature but the efficiency is over 90%.

Abortion, Therapeutic↗

[Comparative study of 15 borderline tumors and 31 cancers of the ovaries. Epidemiologic, diagnostic and therapeutic aspects].

46 epithelial tumours of the ovary were seen over a period of 5 years. These tumours could be subdivided into 15 borderline tumours and 31 invasive cancers. An epidemiological study did not make it possible to find special factors in relationship to these two types. Studying the circumstances under which diagnoses were made demonstrated the value of considering: pain, ultrasound pictures and cytology from the Pouch of Douglas. It is essential to carry out laparotomy in every case of an organic tumour of the ovary. It is only by histological examination that it is possible to tell whether a tumour is borderline of invasive. A protocol for carrying out treatment is suggested. The results confirm the excellent prognosis for borderline tumours and the seriousness of other epithelial cancers of the ovary.

Adolescent↗

[Cervical dilatation using PGF2 alpha gel before voluntary interruption of pregnancy during the first trimester].

To avoid complications of instrumental dilatation of the cervix prior to first trimester abortion, pharmacological dilatation by prostaglandins is proposed. The authors present a prospective randomized study using intra-cervical PGF2 alpha-gel, in 90 patients. Two groups (PGF2 alpha: 5 and 2.5 mg) were compared with a placebo group. The mean cervical dilatation observed in the two groups (8.2 and 8.4 mm) is higher than the placebo group dilatation (6.8 mm), but statistically higher only in group 2.5 mg. Side effects were observed: uterine pain (83 and 57%) and nausea (33 and 13%) in the first three hours after the gel. With the same cervical dilatation, side effects were less important in the low dose group (2.5 mg PGF2 alpha).

Abortion, Induced↗

[Pregnancy and injuries in traffic. Apropos of a case].

6.9% of women involved in accidents are pregnant. It is difficult to calculate all the fetal and maternal lesions that occur under these conditions. We are reporting a case of a 27-year-old primipara who had internal bleeding with shock without a precise aetiology. Very heavy vaginal bleeding occurred on the third day after admission so that a Caesarean had to be carried out in order to preserve the health of the mother and of the baby. Several complications can follow road traffic accidents in pregnant woman. The worst is usually fetal death and its mechanism is discussed. More frequently occurring, however, are fetal distress that threaten premature labour. Some lesions that are not lethal, such as bone fractures, can affect the long-term outlook for the pregnancy.

Accidents, Traffic↗