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D Riethmuller

Publications and source records attributed to D Riethmuller.

44 records · Page 3Linked to original sources
PubMed1996

[Breech extraction of the second twin. 56 cases and review of the literature].

The best indication for breech extraction, and undoubtedly the last, is for delivery of the second twin with a non-cephalic presentation. At the Besançon University Hospital, we have used this technique routinely and without delay in case of non-cephalic presentation of the second twin. In order to evaluate the results of this approach, we studied 56 patients files retrospectively in a continuous series of case over a 7-year period. The following data were noted: birthweights, APGAR score at 5 minutes, requirement for paediatric intensive care, hospitalization in paediatric ward, and death. Gestational age and rate of prematurity were calculated. We also recorded the rate and type of antalgisia used, as well as the frequency of episiotomy. Both the obstetrical and neonatal results indicated that breech extraction of the second twin is a reliable effective technique in terms of mortality and morbidity for the second twin. Using this technique should not raise any legal problems since the other techniques for delivering the second twin have not been shown to give better results. When planned and performed under precise conditions by an experimented physician, this route does not give any poorer results than cesarean. Breech extraction should be an exceptional technique all obstetricians can use, together with cesarean, for delivering the second twin.

Adult↗
PubMed1996

[Hereditary angioneurotic edema in gynecology-obstetrics. Management].

Hereditary angioneurotic edema is a rare disease (250 cases currently identified in France). It is the most frequent among hereditary deficiencies of the complement system. This severe disease is fatal in 15-20% of the patients before 40 years of age. Death can be prevented if correct steps are taken in case of even minor trauma, which often trigger acute, potentially fatal, episodes. Danazol is used as preventive therapy before surgery and C1-esterase inhibitor or fresh frozen plasma is given for acute episodes. In case of obstetrical trauma, C1-esterase inhibitors should be used either as prophylaxy or as treatment. Fresh frozen plasma is used if C1-esterase inhibitors are not available. We report here our experience with three patients with known hereditary angioneurotic edema. Gynecology surgery was required in two.

Adult↗
PubMed1996

[Obstetrical epidural analgesia: an epidemiological in Bourgogne and Franche-Comté 1993].

Many publications report the number of epidural analgesias carried out for the last years in English-speaking countries. On the other hand, very little information exists about the incidence of obstetrical epidural analgesia performed in South and Central Europe, particularly in France. A retrospective study within the regions of Bourgogne and Franche-Comté was carried out for the year 1993 firstly, to determine the number of obstetrical epidural analgesias performed and the drugs used; and secondly, to describe the organization and the problems encountered. The result of this study leads to one major question: what is the best type of organization in order to guarantee the highest safety, given the increasing demand for epidural analgesia in obstetrics?

Analgesia, Epidural↗
PubMedDate not supplied

[Cesarean section for failed vacuum extraction: risk factors and maternal and neonatal outcomes].

OBJECTIVE: To evaluate risk factors associated with failed attempts of vacuum extraction and their outcomes. PATIENTS AND METHODS: All trial vacuum extractions (metal Minicup) from 1992 to 2000 in Besançon University Hospital Center were retrospectively analysed, namely 2447 cases. Univariate and multivariate analyses of failed vacuum extraction risk factors and descriptive analyse of outcomes were performed. RESULTS: The rate of failed vacuum extractions was 3.47% (85/2447). A multivariate analysis showed the following independent risks factors in failed extraction: extraction above pelvic level + 2 (OR = 1.8; CI 95%: 1.1-3), newborn weight (OR = 2.9; CI 95%: 1.8-4.9), parity >2 (OR = 0.08; CI 95%: 0.01-0.6). In case of failed vacuum extraction, newborns had a significantly higher rate of Apgar score <7 at 1 min (P = 0.0002), but not at 5 min. These newborns were most regularly admitted in pediatric care units (P = 0.01). CONCLUSION: The failed trial attempt vacuum extraction rate stays low. These failed instrumental extractions are more common in an extraction above pelvic + 2, a high fetal weight and an arrest during the second stage of labor. There is an increased adverse neonatal outcome. Clinical fetal weight estimation and diagnosis of presentation level in mother pelvis must be performed before vacuum extraction.

Adolescent↗
PubMedDate not supplied

[Biology of the papillomavirus infections: V. Vaccine developments].

Several genotypes of human papillomaviruses (HPV) are recognised as aetiologic factors for cervical cancer, and viral DNA account for more 99% of cases. Thus, prevention of HPV infection by, for example, types 16 and 18, should reduce the world-wide incidence of cervical cancer. Many strategies are being developed for the control of HPV-associated lesions of the uterine cervix: prophylactic vaccines which elicit neutralizing antibodies to prevent HPV infection, and therapeutic vaccines which induce a T-cytotoxic response to early viral oncoproteins. Experimental trials are being conducted to test mucosal immunization with an ideal antigen delivery system. Vaccination strategies elicit a protective antibody response in animal species, but in humans, strategies which are likely to be effective in the control of HPV-associated preneoplastic and neoplastic lesions of the uterine cervix are still under investigation.

Animals↗
PubMedDate not supplied

[Unrecognized hemorrhages during delivery].

On the basis of a series of 600 deliveries between January 1 and May 1 1993, the authors analyze cases of unrecognized delivery-related hemorrhage. Hemorrhage of this type, defined retrospectively on the basis of a difference of at least 3g/100 ml in hemoglobin levels at the time of admission to the labor ward and on the 2nd day post-partum, were found in 3.83% of deliveries and were responsible for 51.11% of falls in hemoglobin of 3g/100 ml or more. Primiparity, induced labor (oxytocics), episiotomy, forceps extractions and cesarean section are their etiologic factors. Particular care should be taken in the presence of any of these factors and induced labor may be useful in the prophylaxis of these unrecognized hemorrhages.

Adult↗