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Biomedical subjects

D Dargent

Publications and source records attributed to D Dargent.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Doppler umbilical artery velocimetry during labor in normal pregnancies].

A prospective study using umbilical artery velocimetry was carried out with continuous Doppler wave forms coupled to a spectral analyser (D.F.P.C. Slous) with placement of Pourcelot's placental resistance index in 94 deliveries at term of singleton normal pregnancies. Neither the position of the patient, rupture of the membranes, epidural anaesthesia, oxytocics, Dextrofemine, nor the length of labour, change the placental resistance levels during the delivery. These remain constant and equal R = 0.51 +/- 0.10 (M +/- 2 DS) whatever the appearance of the RCF at the start of labour, during dilatation and during the delivery. We considered term as being between the 38th and the 42nd week of amenorrhea. Our results show that changes in the index of resistance in the umbilical artery do not help in assessing deliveries in normal pregnancies.

Blood Flow Velocity↗
PubMed1989

[The obstetrical outlook in uterine malformations].

The authors start with an anatomical description which makes it possible to distinguish from one another septate, bicornuate unicornuate and pseudo-cornuate uteri. The diagnosis is often suggested by the clinical features and is made by using complementary examinations such as ultrasound, hysterography, hysteroscopy and laparoscopy. Although it is difficult to be sure of the incidence of the condition it is thought to be around 1%. In the 10 years from 1978 to 1987 the authors have studied 296 pregnancies occurring in 109 patients who were not operated on and 34 pregnancies occurring in 21 patients who had plastic operations on their uteri. They show that the condition has an effect at all stages of pregnancy and delivery and in the first category of patients (abortion in 38%, extra-uterine pregnancy in 8%, prematurity, pre-eclampsia and malpresentation in 28%, with a high rate for caesarean section in 37%). The prognosis was quite different in patients who had been operated on. The published literature confirms these findings. The authors discuss the different ways of carrying out surgical treatment (simple section or excision of the septum, or Bret-Palmer's plastic operation on the uterus with treatment of the associated vaginal abnormalities), plus the medical treatment (with rest and the use of vasodilatators and drugs for anti-platelet aggregation) to be used during the pregnancy. They conclude that it is necessary to make a diagnosis of what type of malformation is present, to decide which surgical procedures to carry out as this does improve the prognosis greatly.

Female↗
PubMed1988

[Ovarian cysts: ultrasound-guided puncture, celioscopy or laparotomy?].

The authors report a series of 262 "ovarian tumors" operated on between 1982 and 1986. The place of "primary" laparoscopy went from 79% in 82-84 to 83% in 85 and 85% in 86 and the place of "pure" laparoscopic treatment went from 39% to 57% and 60%, respectively, excluding patients with an obvious cancer, patients over 40 and pregnant women over 16 weeks, in whom a primary laparotomy is indicated. The indications of the laparoscopic treatment may be carried further. And there is a place for a tap under ultrasonographic control. Various approaches are presented.

Adult↗
PubMed1988

[Vulvar intra-epithelial neoplasms. Development of ideas and facts].

The authors report their personal experience concerning the recent increase in the frequency of VINs and demonstrate how the mean age of the patients has decreased. They advocate "vulvoscopy" and guided biopsy for screening. VIN I and II may be treated with local chemotherapy and/or laser vaporisation. VIN III must be treated surgically (superficial tailored resection).

Adult↗
PubMed1988

[The contribution of umbilical Doppler velocimetry in suspected echographic IUGR].

Doppler pulses or continuous flow in the umbilical artery is a technique recently used in practical obstetrics and of value particularly in screening at risk pregnancies. The authors wish to study its value as a diagnostic and prognostic tool in the special cases where ultrasound has given rise to a suggestion that there may be intra-uterine growth retardation (I.U.G.R.). In a preliminary publication they report their experience in 100 normal pregnancies so that they have obtained a control diagram. Then, working on a population of 117 pregnancies with ultrasonically diagnosed I.U.G.R. they studied the birth-weight, the early neonatal morbidity and the neonatal mortality as a function of the Pourcelot S - D/S index. They were able to separate out 63 cases of I.U.G.R. without any hypertension and 54 cases associated with hypertension. They analyse the same parameters. They then discuss first the value of the diagram they have made in comparison with other known curves, also the diagnostic and prognostic performance of the method. They conclude that there is a moderate diagnostic value in Doppler velocimetry. The prognostic value is much better because the Doppler can differentiate those case of slow growth that are going to do well against those that are going to do badly.

Birth Weight↗
PubMed1988

[Non-immunologic fetal ascites and anasarca. Apropos of 44 cases].

Between January 1980 and July 1987 there were 44 cases of fetal non-immune ascites and generalised oedema. These are presented. This pathological condition which occurs rarely (1/1,600 to 1/3,500), is considered by most authors to have a very high mortality (80-95%). An aetiological study shows that for the main part the causes are fetal (75%) and among those there is an important place for cardiac abnormalities (20.4%). These are principally faults in fetal cardiac rhythm. The second most common abnormalities are chromosomal (13.6%). These should be sought out by ultrasound. A typical malformation should lead to karyotyping. Idiopathic cases (9%) are fewer comparatively than in old series because of more accurate investigation. 34% survived out of the whole series of all the pathological conditions together. The only way to arrive at accurate antenatal diagnosis is by looking hard for the aetiological causes. These, when found, will show the way to handle the cases both obstetrically and after delivery. It will also help to identify the prognosis and to improve the chances of survival for those fetuses that can be saved.

Ascites↗
PubMed1988

[Influence of the mode of delivery on perinatal mortality in infants less than 32 weeks gestational age].

Survival rate of 96 low-birth-weight infants less than 32 weeks post-conceptional age at birth was studied in relation with the mode of delivery. Twenty-two infants were delivered by elective cesarean section because of abnormalities during pregnancy with 3 neonatal deaths. Seventy-four infants were born after untreatable premature onset of labor with 9 intrapartum and 7 neonatal deaths. Poor prognosis was associated with gestational age (less than 29 weeks), non cephalic vaginal delivery and multiple births. In these cases, cesarean section should be discussed.

Delivery, Obstetric↗
PubMed1988

[Pain following the treatment of vulvo-vaginal condylomatous lesions. Efficacy of benzydamine].

A clinical study with Opalgyne was undertaken in order to relieve the pain due to the treatment of vulvo-vaginal condylomas. This study was performed on 16 women, 8 treated with laser, and 8 with 5 fluoro-uracil ointment. The efficacy of Opalgyne is both remarkable and regular. Therefore the experimental protocols seem to be quite heavy. The laser vaporization is definitely the best solution. But it is necessary to keep this indication only for more or less atypical viral lesions.

Adult↗
PubMed1988

[Pregnancy in women undergoing dialysis in chronic renal insufficiency. Apropos of 3 cases].

There are few cases of chronic renal deficiency associated with pregnancy for the following reasons: lowered fertility, a high level of spontaneous early abortions and unwillingness of doctors to allow such pregnancies to continue. The authors report their personal experience of three cases with different outcomes: one, delivery nearly at term, one premature delivery without complications and one premature delivery with neonatal death. The authors, having studied the literature, point out that there are different problems, on the one hand because od kidney conditions requiring more frequent dialysis and on the other hand the obstetrical conditions and in particular high blood pressure with its risk of premature delivery, and finally of intrauterine growth retardation. Finally, the authors point out how important it is to have effective contraception and, if pregnancy does occur, how important it is for the nephrologist, the obstetrician and the paediatrician to cooperate in the care of the patients.

Adult↗
PubMed1988

[Spinal fixation of the vagina in the treatment of prolapse after hysterectomy].

An elegant and only weakly traumatic solution to the often difficult problem of treatment of prolapse after total hysterectomy is by spinal fixation of vagina: anchoring of base of vagina to sacroiliac small ligament approached through "natural pathways" by means of median colpotomy and section of "pillar of rectum". The technic is described and results published in the literature reviewed.

Female↗
PubMed1987

[Mastectomy with immediate reconstruction by transposition of a transverse abdominal skin flap attached to the rectus abdominis muscle].

The technique of mastectomy with immediate reconstruction, using a skin flap attached to the rectus abdominis muscle, is described. Its drawbacks and advantages are analyzed from a series of 27 cases. The principal complication is necrosis of the flap; it occurred in 6 cases of our series but always remained partial. On the other hand, the flap has the advantage of providing a substantial amount of material, so that prosthesis is unnecessary, and it can be installed immediately after the mastectomy without repositioning the patient.

Female↗
PubMed1987

Influence of vitamin E administration on platelet functions in hormonal contraceptive users.

Platelet functions (aggregation, clotting activity), platelet lipid biosynthesis, sterol composition and phospholipid fatty acids were studied in relation to plasma lipids and fatty acids as well as dietary habits at day 5 and 21 of the menstrual cycle in 30 women having used hormonal contraceptive for several years. The women were studied again on day 21 of the second cycle after they had taken for two months 200 mg vitamin E per day in addition to the contraceptive. At day 21 (after 3 weeks of hormonal contraceptive) as compared to day 5, there was a significant increase in the clotting activity of platelets and the response to ADP-induced aggregation concomitant with a decrease in plasma vitamin E. After vitamin E administration, platelet activity at day 21 was markedly decreased, being similar to the activity at day 5, with a significant increase in the level of vitamin E in plasma and platelets. The high response of platelets to aggregation in women using contraceptives does not seem to be associated with the intake of saturated fat but rather with that of 18:2. The aggregation to thrombin was mostly related to lanosterol biosynthesis and the aggregation to ADP to platelet cholesterol, but not to plasma lipids or apoproteins. The present pilot study suggests that the platelet hyperactivity of long-term hormonal contraceptive users might be dependent upon a low level of platelet alpha-tocopherol which can be rapidly overcome by giving a supplement of vitamin E.

Adult↗
PubMed1987

[Risk of transmission of cytomegalovirus infection from mother to newborn infant].

A systematic prospective study of the incidence of cytomegalovirus (CMV) infection during pregnancy and contamination of the neonate was set up in a Maternity Hospital in Lyons. Over 7,000 pregnancies have been followed up since 1982 with serological and virological investigations. CMV infection was found in 5 p. 100 of patients. A urine collection was obtained at birth in 641 of the neonates. CMV was isolated in 16 cases and the transmission of the infection was studied with respect to the immune status of the mother. When CMV infection was demonstrated in the mother by serology and excretion of the virus, 45.5 p. 100 of babies were contaminated (10/22). In cases of reinfection, the incidence of neonatal contamination was 3.1 p. 100 (3/98). Ten of the 11 primary infections diagnosed were associated with viral excretion and the infection was transmitted to the child in 50 p. 100 of cases (5/10). The high incidence of transmission of CMV infection after a primary maternal infection supports data previously published by Stagno and Kumar in the U.S.A. and Ahlfors in Sweden.

Cytomegalovirus Infections↗