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E Verspyck

Publications and source records attributed to E Verspyck.

At least 37 records · Page 2Linked to original sources
PubMed2004

[Acceptability of the etonogestrel-containing contraceptive implant (Implanon)].

OBJECTIVES: To estimate the exact satisfaction of women toward Implanon, the sole contraceptive implant available in France. To clarify the indications of this type of contraception. MATERIAL AND METHOD: Among a population of 182 women with Implanon" inserted in a same family planning service between May 22, 2001 and February 14, 2003, 108 women agreed to answer a questionnaire of satisfaction. Implants were inserted in one third of cases after childbirth, in another third after abortion. The average duration of use of the implant was of 16 months (2 in 24 months). Twenty-nine removals among the 108 insertions (27%) were recorded. RESULTS: Possibility of a long-term and easy -to-use contraception was the most common reason for choosing Implanon (74% of the women). Eighty-one percent of the women were globally satisfied with Implanon but one out of two women had side-effects. Only 62% of the women were ready to use it again. Adverse events were first, menstrual disturbance in 83% of the women, mainly amenorrhea (26%) and bleeding irregularity (40%). Bleeding irregularity was one of the main motives for discontinuing the implant in 41% of cases. Except weight gain present for 37% of patients, the other side-effects, even though they were frequent, were less often the reason for removal. Headache, acne, breast pain, mood and decreased libido were the main reasons for removal. CONCLUSION: Implanon has certainly a place among current contraceptive methods. Because of the frequency raised by adverse events and by their lower tolerance in Europe, this place has to remain limited to the incapacity of classic methods. Preinsertion counseling announcing Implanon's benefit and risk effects is necessary to minimize the early discontinuation rates.

Adolescent↗
PubMed2004

[Factors associated with fecal incontinence after childbirth. Prospective study in 525 women].

OBJECTIVE: To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors. METHODS: This was a prospective observational study with a consecutive inclusion of 525 women who delivered over a three months period. Women were questioned about their fecal continence four days and six weeks after delivery. RESULTS: The incidence of fecal incontinence four days and six weeks after childbirth was respectively 8.8% and 3.3%. The risk factors for fecal incontinence at 4 days after childbirth were instrumental delivery by forceps (adjusted odds ratio 8.64, 95% confidence interval 3.55-21.0, p < 0.001) and unassisted delivery at home (adjusted OR 8.06, 95% CI 1.30-50.0, p = 0.025). Independent risk factors for the presence of fecal incontinence 6 weeks later were: instrumental forceps delivery (adjusted OR 10.8, 95% CI 2.82-41.3, p = 0.001), unassisted delivery at home (adjusted OR 50.0, 95% CI 3.09-802, p = 0.006), bi-parietal diameter of the newborn > 93 mm (adjusted OR 4.56, 95% CI 1.46-14.1, p = 0.009) and maternal age >30 years (adjusted OR 4.60, 95% CI 1.11-19.1, p = 0.036). CONCLUSION: Fecal incontinence is common after childbirth and its prevalence is predominantly associated with instrumental delivery, unassisted delivery at home, bi-parietal diameter of the newborn and maternal age.

Adult↗
PubMed2004

[Prevention strategies during pregnancy].

This chapter deals with how to reduce, before delivery, postpartum hemorrhage. The strategy is explained for two risk levels, high and low. Means of prevention such as: logistical organisation; oral and parenteral iron therapy; erythropoietin; autologous blood transfusion; acute hemodilution; transfusion; bleeding disorders treatment; hospitalization, tocolysis, choice of mode of delivery, caesarean section and anaesthetic techniques for placenta praevia or accreta; interest of corticosteroids therapy and magnesium sulfate bleeding risks in severe pre-eclampsia, are addressed in turn. The chapter closes with professional recommendations ranked according levels of evidence founded in the literature.

Female↗
PubMed2003

[Crohn's disease and pregnancy. About 34 cases. Review of the literature].

OBJECTIVE: To define the optimal conditions of pregnancy in patients affected by Crohn's disease. MATERIAL AND METHOD: Retrospective study of 25 patients affected by Crohn's disease, followed during eight years at Rouen's University Hospital. RESULTS: Twenty patients added up 34 pregnancies. Seventeen patients at least had a child, adding up 26 livebirths. Among the 17 pregnancies beginning with an active Crohn's disease, this proved to be still active in 16 cases. Among the eight interrupted pregnancies, six had an active disease. Out of the five menaces of preterm delivery stopped or not, four were in push. Eight neonatal hypotrophies were connected to a push. DISCUSSION AND CONCLUSIONS: From a confrontation between the data of the literature and our experience, it emerges the following essential points: when Crohn's disease is quiescent, it does not affect the pregnancy, except a moderate fetal hypotrophy. When the disease is active, the risk of abortion and prematurity increases. There is no influence of the pregnancy on Crohn's disease, when pregnancy arises during a period of quiescence of the disease. Two thirds of the pregnancies of these women take place without new push of their disease. During pregnancy, there is no contraindication as far as the usual treatments of Crohn's disease are concerned, with a limitation however for the use of immunosuppressants.

Abortion, Spontaneous↗
PubMed2003

[Management of ectopic pregnancies complicating in vitro fertilization: a remarkable case of bilateral ectopic pregnancy with independent courses of the pregnancies].

OBJECTIVE: To define management rules for ectopic pregnancy complicating in vitro fertilization. PATIENT AND METHOD: We describe a case of bilateral ectopic pregnancy complicating in vitro fertilization which led to two separate laparoscopic procedures. RESULTS: A first laparoscopy was required to perform salpingectomy for ectopic pregnancy. A second laparoscopy was later required for a second salpingectomy for a second ectopic pregnancy complicating the same in vitro fertilization. DISCUSSION AND CONCLUSION: Pre-existent tubal lesions are frequently observed in women who develop ectopic pregnancies after in vitro fertilization. If serum beta-hCG levels and pelvic ultrasound results are not taken into consideration with sufficient care, delayed diagnosis may lead to the unsuitable management. Women with multiple embryonic reimplantations must be monitored rigorously. Salpingectomy is the best treatment option for this type of complication.

Adult↗
PubMed2003

[Management of meconium peritonitis: a remarkable case of idiopathic meconium peritonitis diagnosed antenatally].

Meconium peritonitis is an inflammatory peritonitis induced by meconium extruding into the peritoneal cavity through a perforation of the fetal intestine. Antenatal diagnosis is possible. Prognosis depends on the pathology having caused perforation. This is often unknown. The objectives of this article are to analyze the contribution of antenatal investigations to estimating neonatal prognosis of meconium peritonitis, and to define optimal management. We describe a case of meconium peritonitis diagnosed in utero with particularly severe ultrasound presentation suggesting a potentially lethal course for the neonate. An eutrophic infant was delivered vaginally after preliminary aspiration of the meconium ascites. The neonate presented with a very distended abdomen and responded well to neonatal resuscitation. Laparotomy exploration confirmed the diagnosis of meconium peritonitis. No cause was identified. No obvious perforation was found. The postsurgery period was uneventful. At later follow-up the infant was doing well, free of further problems notably of any digestive disorder. Antenatal ultrasound features suggestive of severe meconium peritonitis are distended fetal bowel loops, huge cystic masses, major meconium ascites, and polyhydramnios. These neonates have a high risk of obstruction and intestinal perforation. Intestinal resection is frequently required. Cardiopulmonary resuscitation is necessary more often in these neonates with a higher risk of fatal outcome due to respiratory distress syndrome or surgery complications. Prognosis remains good after antenatal diagnosis for neonates free of cystic fibrosis, providing delivery takes place in a center with adequate technical facilities.

Adult↗
PubMed2003

[Amniotic band syndrome: pathogenesis, prenatal diagnosis and neonatal management].

Amniotic band syndrome is a collection of fetal congenital malformations, affecting mainly the limbs, but also the craniofacial area and internal organs. Two mains pathogenic mechanisms are proposed: early amnion rupture (exogenous theory) leading to fibrous bands, which entrap the fetal body; the endogenous theory privileges vascular compromise, mesoblastic strings not being a causal agent. The outcome of the disease depends on the gravity of the malformation. Termination of the pregnancy is usually proposed at the time of the diagnostic of severe craniofacial and visceral abnormalities, whereas minor limb defects can be repaired with postnatal surgery. In case of an isolated amniotic band with a constricted limb, in utero lysis of the band can be considered to avoid a natural amputation. However, as the exact etiology of amniotic band syndrome remains unknown and its natural course unpredictable, prenatal surgery continues to be controversial. Doppler studies of the constricted limb could be of useful predictive value of in utero amputation, and therefore could be helpful to determine when in utero treatment should be considered.

Abnormalities, Multiple↗
PubMed2002

Dilated coronary sinus in prenatal echocardiography; identification, associations and outcome.

The dilated coronary sinus (DCS) has only recently been clearly visualised in the fetus due to progress in prenatal echography. This is a retrospective study of 22 fetuses presenting with DCS revealed by prenatal echography. We report the circumstances leading to the detection of a DCS and the neonatal outcome of these fetuses. The coronary sinus was defined as dilated depending on its visualisation in cross-section from the '4 chamber' view, as well as a pseudo inter-atrial septal defect from a more posterior view. In each case the gestational age, circumstances of detection, associated anomalies and postnatal outcome are reported. The circumstances were: evaluation of a clearly identified DCS in four cases and during detailed fetal echocardiography because of suspected congenital heart disease in 18 cases. Five cases were associated with a cardiac anomaly, three with an extracardiac anomaly, six with both cardiac and extracardiac anomaly and eight were isolated. Postnatal outcome was related to the associated anomaly. In conclusion, it is important that the echography image be correctly interpreted, as a DCS often implies possible associated defects and therefore affects prognosis. When not associated with other anomalies this condition is not considered serious.

Coronary Vessels↗
PubMed2002

[Mechanisms of the stagnation of dilatation in the active phase of labor].

OBJECTIVE: Our study was designed to explain determinants of nonprogressive labor in nulliparous patients. STUDY DESIGN: One hundred consecutive nulliparous patients have got a cesarean section for active-phase arrest of labor after two hours of active management. Intrauterine pressure was monitored for all of them and a X-ray pelvimetry was done after surgery. RESULTS: Eighty-three percent of patients showed X-ray data considered as normal; hypotonic labor was found in 50% of cases and occiput posterior position in 60%. CONCLUSIONS: Our results suggest that occiput position and functional dystocia are more common in case of nonprogressive labor than abnormal measurements of the obstetrical pelvis.

Dystocia↗
PubMed2002

[Pregnancy, tuberculosis and inappropriate antidiuretic hormone secretion].

We report a pregnant woman presenting with seizure secondary to hyponatremia by inappropriate antidiuretic hormone secretion. Aetiology was unknown urinary and lung tuberculosis. This case report presents diagnosis strategy of inappropriate antidiuretic hormone secretion and the arguments for its aetiology.

Adult↗
PubMed2002

[Pregnancy: a possible etiology of pyoderma gangrenosum. A case report and review of the literature].

OBJECTIVE: We report an unusual case of pyoderma gangrenosum at 26 weeks gestation and review other cases reported in the literature in order to examine the underlying causes and determine the appropriate diagnostic and therapeutic approach to this uncommon skin disease. Patient and methods. The patient developed an acute abdominal syndrome at 26 weeks gestation (laparotomy was non contributive) followed by pyoderma gangrenosum of the abdominal wall. Seven other cases have been reported in the literature associating pyoderma gangrenosum with pregnancy. We analyzed the clinical findings in these cases. RESULTS: Corticosteroid therapy successfully controlled pyoderma gangrenosum in our patient. Pregnancy outcome was favorable with little effect on the newborn. Complete healing was achieved after several months of treatment. CONCLUSION: Histological lesions are nonspecific. Diagnosis of pyoderma gangrenosum is generally based on clinical signs. Systemic disease is associated in half the cases (inflammatory bowel disease, myelodysplastic syndrome, rheumatoid arthritis). The impact on pregnancy appears to be limited. Treatment is based on high-dose systemic corticosteroid therapy or cyclosporin. The two drugs may have to be combined. Search for an associated disease and appropriate treatment is particularly important for the outcome of pregnancy.

Abdominal Wall↗
PubMed2002

[Biochemical markers for preterm delivery (excepting markers of infection)].

Fetal fibronectin is an extracellular glycoprotein secreted at the maternal-fetal interface by the trophoblast. Fetal fibronectin testing may be useful in women with symptoms of preterm labor to identify those with negatives values and a reduced risk of preterm birth (NP 3). Fetal fibronectin could be either detected by cervical or vaginal sampling (NP 3). Concentrations of fetal fibronectin could be measured by an enzyme-linked immunosorbent assay or by a bedside dipstick technique (NP 3). There are numerous false-positive results in women with cervical dilatation, recent intercourse or cervical examination, and vaginal bleeding (NP 3). In most of the studies, a quantitative test was used with 50ng/ml as the cuttoff point for a positive results. There are no convincing data to recommend fetal fibronectin rather than cervical ultrasonography (and inversely), or to used these two tests together to predict preterm birth (NP 3). The choice should depend on the availability and the cost of each test. Other biochemical markers (salivary estriol or plasma CRH) are still under assessment and should not be used outside research protocols (NP 3).

Biomarkers↗
PubMed2002

[Gas embolism and hyperbaric oxygen treatment during pregnancy: a case report and a review of the literature].

We report the first case of a pregnant woman presenting with a paradoxical air embolism due to accidental removal of a central venous catheter. Secondary right hemiplegia associated with a confused state justified emergency hyperbaric oxygen therapy, which was followed by complete neurological recovery. The aim of this case report is to assess risk situations of gas embolism during pregnancy and puerperium, as well as indications and fetal effects of hyperbaric oxygen therapy.

Adult↗
PubMed2002

[Ovarian pregnancies: revaluation of diagnostic criteria].

OBJECTIVES: To clarify the clinical features of ovarian pregnancy and to show the incapacity of Spielberg's criteria to establish the diagnosis. MATERIAL AND METHOD: and method. Retrospective experience of ovarian pregnancies in a single maternity unit over seven years with comparison between new diagnostic criteria and those of Spiegelberg. RESULTS: Thirteen ovarian pregnancies identified (incidence=1 for 1400 deliveries). History of pelvic disease (one case), use of an IUCD (five cases), pelvic pain (all the cases), metrorrhagia (four cases), hemorrhagic shock (two cases). Diagnosis was evoked only once by ultrasound. Eleven patients were treated by laparoscopy. None of the ovarian pregnancies in the present series met the criteria of Spiegelberg's definition. CONCLUSION: Ovarian pregnancy is a rare form of ectopic pregnancy, but its incidence is certainly underestimated. Search for difficult to detect ultrasonographic features is essential. Criteria, other than those described by Spiegelberg, when present together confirm ovarian pregnancy: serum beta-hCG level > or = 1000 IU/l and uterine vacuity at vaginal ultrasonography; ovarian implication confirmed by surgical exploration, with bleeding, visualisation of chorionic villi or presence of an atypical cyst on the ovary; normal tubes; absence of serum beta-hCG after treatment of the ovary. Ovarian pregnancy does not compromise subsequent fertility of these patients. Recurrence is exceptional.

Adult↗
PubMed2001

Isolated mild fetal cerebral ventriculomegaly: a retrospective analysis of 26 cases.

We retrospectively studied 26 fetuses with isolated mild cerebral ventriculomegaly diagnosed between 1992 and 1998 and defined by a lateral ventricular atrial diameter of 10-15 mm without any other cerebral anomaly. Our objectives were to determine maternal risk factors, to evaluate complementary investigations, to assess developmental prognosis and to propose possible management. During pregnancy 10/26 patients had regressive ventriculomegalies, ten remained borderline at birth and six were confirmed postnatally. No maternal risk factors were identified. Prenatal investigations were carried out in 69% of cases but in only a few cases supplied any information. Postnatal examinations revealed one case of Down syndrome and one of porencephaly. Four children were lost to follow-up. In the 22 other cases, four had developmental delay. Early and unexplained mild ventriculomegaly appears to have a good prognosis. If ventriculomegaly is persistent, prenatal management should be carried out to investigate chromosomal abnormalities, viral infection, and fetal cerebral parenchymal damage. A long postnatal clinical follow-up is required.

Adult↗
PubMed2001

[Primary fibromatosis of the breast].

Primary fibromatosis of the breast is a very rare pathology which looks like a malignant tumor, clinically and radiologically. Fibromatosis of the breast is characterised by a local invasion and a risk of recurrence. Positive diagnosis is provided by histology and its treatment is surgical. The aim of this study was to report one case and to emphasize the difficulties encountered in the diagnosis and the treatment.

Adult↗