Biomedical subjects

D Vauthier-Brouzes

Publications and source records attributed to D Vauthier-Brouzes.

27 records · Page 2Linked to original sources

PubMed1994

How many embryos should be transferred in in vitro fertilization? A prospective randomized study.

OBJECTIVE: To maintain the rate of pregnancy, while suppressing high rank multiple pregnancies by limiting the number of fresh embryos transferred after IVF, in a population selected for potential success. DESIGN: A prospective, randomized study. SETTING: Département de Gynécologie Obstétrique, Centre Hospitalo Universitaire, Paris VI, France. PATIENTS: There were two groups of 28 couples. Women were < or = 35 years of age, with > or = 70% cleavage rate and at least four morphologically regular embryos. INTERVENTION: On the day of ET, either four fresh embryos were transferred (group 1) or two fresh embryos were transferred and two were frozen for later transfer (group 2). MAIN OUTCOME: Pregnancy rate and multiple pregnancy. RESULTS: The pregnancy rate was the same in the two groups with one-third of the high rank pregnancies in group 1 and no pregnancies in group 2. CONCLUSION: Only two fresh embryos need to be transferred in this selected population.

Adult↗

PubMed1993

[Internal jugular vein thrombosis during pregnancy after ovarian hyperstimulation for in vitro fertilization].

The case reported consists of thrombosis of the left internal jugular vein occurring on the 22nd week of amenorrhea of a pregnancy achieved by IVF. No etiological factor other than biochemical ovarian hyperstimulation was found. Maternal outcome was positive but intrauterine fetal death occurred 7 weeks later at 29 weeks of amenorrhea. The late occurrence of this thrombosis after ovarian hyperstimulation need to be stressed.

Adult↗

PubMed1993

[Comparison of 3 long ovarian stimulation protocols for in vitro fertilization using a delayed acting GnRH analogue].

Three long protocols of ovarian stimulation for IVF using long acting GnRH agonist and hMG were compared. 3 molecules were used: Triptoreline (Décapeptyl* 3.75 mg), gosereline (Zoladex*) and leuproreline (Enantone* 3.75 mg). Assigning of these 3 protocols were randomised. 63, 68 and 67 cycles of stimulation were studied. Results in term of pregnancy are the same in the 3 groups. Only a tendency of lower frequency of ovarian hyperstimulation in Décapeptyl 3.75 mg group is found, associated with less embryo and less cycles with cryopreservation of supernumeraries embryos (p = 0.1).

Adult↗

PubMed1993

[The vaginal cesarean, a necessary review].

Having carried out four cases of vaginal caesarean section the authors describe the technique they used. The advantages of the operation are: it is simple and can be carried out quickly, future obstetric behaviour is not compromised. It is important to avoid two complications of the operation: haemorrhage and injury to the bladder. These are reduced if the vertical incision in the cervix is made in the midline and long enough. The ideal indications for the operation are absence of cervical dilatation, or the occurrence of severe maternal haemorrhage during the operation to terminate a pregnancy, or while the uterine contents are being expelled towards the end of the second trimester. It is disputable whether there is a place for vaginal caesarean operation when the fetus is alive, in view of the recent studies on fetal prognosis.

Adult↗

PubMed1992

[Laparoscopic surgery versus laparotomy. Comparative analysis of stress markers].

The place of laparoscopic surgery continues to increase in the field of surgery in our specialty. Although the advantages would seem to be obvious, it seemed to us interesting to quantify, if possible, the parameters of operative stress and compare laparoscopic surgery with conventional surgery. Markers studied are Prolactin, Cortisol, Adrenaline, Nor-Adrenaline, Dopamine and the Beta-Endorphins. The only marker that shows any difference in the two procedures in our study is Beta-Endorphin which is significantly less raised in laparoscopic surgery directly after the operation (p less than 0.01). This was very specific for pain, which is one of the benefits of this technique and shown in this parameter which confirms the clinical impression. The curves of the changes in the different markers have been analysed and discussed.

Adult↗

PubMed1992

Selective reduction in multifetal pregnancies: technical and psychological aspects.

OBJECTIVE: To evaluate efficiency and safety of a very early transvaginal selective reduction procedure in multifetal pregnancies. DESIGN: Prospective study. SETTING: Obstetric and Gynecology Department, University of Paris VI. PATIENTS: Twenty-two patients with multifetal pregnancies: 14 triplets, 8 quadruplets, and 1 quintuplet. INTERVENTION: Selective embryonic reduction was performed at 7 weeks of amenorrhea under general anesthesia by transvaginal embryo puncture and aspiration. Two embryos were left in place. MAIN OUTCOMES: Pregnancy outcome (immediate or delayed complication, term of delivery, newborns) and psychological impact. RESULTS: No complication occurred. The 22 patients now have delivered at 36.5 weeks of amenorrhea, on average giving birth to 44 neonates with no congenital malformation. If the procedure generates anxiety, it is nevertheless perceived as necessary for the successful outcome of the pregnancy. CONCLUSION: Early mechanical transvaginal embryo reduction performed at 7 weeks of amenorrhea, leaving two embryos is, in our opinion, a simple and safe procedure with no affect on remaining fetuses. It is necessary when there are four or more embryos, and it should also be proposed for triplets. In these circumstances, patients saw reduction as a necessary procedure.

Abortion, Induced↗

PubMed1991

[Celioscopy with peridural anesthesia. Techniques, indications, results in 220 cases].

The authors used epidural anaesthesia to carry out laparoscopy in 220 patients. The chief indications for the laparoscopies were GIFT (intratubal transfer of gametes) and tubal sterilization. The technique used was slightly different according to the indications for the use but they had to be sure of anaesthetising up to T4. In 90% of cases the patients tolerated the procedure well. No change in ventilation or in metabolic measurements. As far as fertilization was concerned studies carried out in various parameters failed to show any untoward side effects due to the use of local anaesthetics. Finally so long as the anaesthesia is only used for a short length of time this technique seems to be suitable for day cases.

Ambulatory Care↗

PubMed1991

[Heart transplantations: impact on female fertility].

Improvements in the management of patients with cardiac transplantation make it possible for these patients in the child-bearing age to expect a pregnancy. In fact, since 1987, several cases of pregnancy after cardiac transplantation have been reported. We report here two cases of successful pregnancy two years after cardiac transplantation. First Case. Pregnancy was uneventful until 36 weeks of gestation with no evidence of transplant rejection. At 38 weeks of gestation, a cesarean section was performed for increasing blood pressure, cholestatic pruritus and cephalopelvic disproportion. Cesarean section was performed under regional anesthesia and a healthy baby boy of 2680 gr was delivered. The patient was discharged one week after. Eighteen months after, both the mother and the baby are in good condition. Second case. Pregnancy was complicated by severe maternal anemia and fetal hypotrophia. Because of increasing renal insufficiency and pre eclampsia, a cesarean section was performed under regional anesthesia at 36 weeks of gestation. Delivery of a healthy baby girl of 1700 g. Five other cases have been reported. Cesarean section performed in september 1984 for a patient who underwent cardiac transplantation in 1980. Delivery of a healthy baby of 3280 gr. Death of the mother five months after following heart transplant rejection. Vaginal delivery performed in august 1986 for a patient who underwent cardiac transplantation in 1984. Delivery of a preterm baby at 31 weeks of gestation who survived without any sequelae. Vaginal delivery performed in august 1987 for a patient who underwent cardiac transplantation in april 1985. Delivery of a healthy baby of 2550 gr at 38 weeks of gestation. Vaginal delivery of twins (baby girl of 1200 and 1100 gr) in april 1988 of a patient who underwent cardiac transplantation in 1986. Vaginal delivery at 38 weeks of gestation performed in november 1990 for a patient who underwent cardiac transplantation in 1986. All the cases reported showed that: The foetus is not affected by the immuno-suppressive treatment of the mother. This was already known for pregnant patients with renal transplant. The cardiovascular changes associated with pregnancy are well tolerated by the heart transplant. Preexisting hypertension is increased, particularly during the third trimester of pregnancy and during labour. The incidence of preterm labor is increased in patients with heart transplant. Transplant rejection never occurred during pregnancy.

Adult↗

PubMed1990

[Fertilization in vitro with failure of cleavage. A proposal of therapeutic or diagnostic management for future trials].

This is a retrospective study of IVF cycles with failure of cleavage at the PMA centre of the University Hospital, Pitie-Salpetriere occurring between May 1985 and December 1988. Failures of cleavage occurred in 23% of the cycles where at least one oocyte was recovered (170 out of 729 cycles). There were three groups of conditions which were analysed: 1. The male factor which was known about before the attempt at IVF (38 cycles - 23% of failures of cleavage). 2. No previously known male factors (126 cycles-74% of failures of cleavage). 3. IVF with frozen donor sperm (6 cycles-3% of failures of cleavage). These couples had a total of 340 cycles with 25 pregnancies. The prognosis differs according to the category mentioned above. If there is a male factor, one attempt at IVF with this partner's sperm seems absolutely justified before proceeding to IVF with donor sperm or to AID. If there is no male factor the oestradiol curve does not make it possible to foresee a failure of cleavage and it is necessary to carry out a second IVF cycle to handle these couples.

Adult↗