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Biomedical subjects

F Beguin

Publications and source records attributed to F Beguin.

At least 19 recordsLinked to original sources
PubMed1993

Alterations of calcium and phosphate metabolism in primary hyperparathyroidism during pregnancy.

Primary hyperparathyroidism (PHP) is rare during pregnancy and has been claimed to be associated with significant increase of neonatal morbidity and mortality. Whether the well recognized changes in calcium (Ca) and phosphate (Pi) homeostasis occurring in pregnancy might influence the biochemical expression of PHP is unclear. We evaluated biochemical parameters of calcium and phosphate metabolism in two cases of PHP in pregnancy diagnosed in the third trimester (patient 1) and in the second trimester (patient 2). Both patients displayed increase in protein-adjusted plasma Ca, bone resorption evaluated by the fasting urinary Ca-to-creatinine ratio, renal tubular reabsorption of Ca, urinary cAMP excretion and decrease in renal tubular reabsorption of Pi. These alterations were identical to those found in 12 non-pregnant women with PHP. The biochemical expression of PHP did not change after delivery in patient 1. This patient underwent the excision of a 1 g parathyroid adenoma on the 13th day after delivery, which led to normalization of all biochemical parameters. The lowest plasma Ca of the newborn of patient 1 was 2.02 mM 72 hours after birth. Thus, the results indicate that these two pregnant women with PHP displayed biochemical alterations of calcium and phosphate metabolism similar to those observed in non-pregnant women with primary hyperparathyroidism.

Adult↗
PubMed1989

Ultrasound screening for congenital cardiac malformations in the fetus. Its importance for peri- and postnatal care.

Congenital cardiac malformations (CCM) are the commonest congenital anomalies. Using ultrasonography (US), the incidence of CCM in a selected group of fetuses and the impact of CCM on perinatal and postnatal care was evaluated. The indication for fetal echocardiography (F-ECHO) in 152 pregnancies was a positive family history in 61, fetal arrhythmias seen by routine obstetrical controls in 53, suspected CCM during obstetrical US in 9, growth retardation in 3 and contracted maternal factors in 6. Twenty pregnancies had no special indication. F-ECHO was performed between the 18th and the 39th gestational week. Twenty-seven cardiac malformations were found (18%), 10 of which were important; 3 succumbed at birth, 2 after surgical intervention, 1 was aborted and 4 needed intensive care at birth. Of 53 cases with arrhythmias, 3 needed special care during pregnancy: Digitalis in a case of atrial flutter, sick leave and bedrest in 2 with supraventricular tachycardia, premature delivery in 1 case with complete AV block due to an intraventricular tumor. The extremely high incidence of CCM in this group proves the need for careful fetal evaluation to detect malformations. Nowadays F-ECHO can and should be performed as early as in the 18th gestational week, allowing either to interrupt a pregnancy or to plan delivery in a well-equipped center which provides the necessary measures for these newborns.

Echocardiography↗
PubMed1987

[Cerclage by the abdominal route].

The authors, having carried out two cerclage operations through the abdominal route for cervico-isthmic incompetence, review the literature and assess the advantages and disadvantages of this method. This surgical technique makes it possible to put the stitch exactly at the level that is needed. It can be carried out when the cervix is very short, effaced or totally distorted. The results that have been obtained in the larger series are striking: the percentage of infants that survived before the operation was between 10.4% and 24% and after the operation between 70% and 95%. The complications described in the literature have been rare: haemorrhage from damage to the veins at the time of the operation: fetal death in the days after the stitch had been placed badly so that the uterine vessels were occluded. As far as we know, there has never been a case of infection.

Abdomen↗
PubMed1986

[Multicenter experiences with the intracervical administration of a new PGE2 gel in labor induction].

With the participation of four Swiss obstetric clinics, medically indicated inductions of birth (with living fetuses) were performed using a new, stable PGE2 gel, and documented according to a uniform protocol. The study was conducted to investigate the efficacy of 0.5 mg of PGE2, in 2.5 ml of a vehicle (Triacetin) not yet commercially available, for local cervical maturation (n = 41). Thirty-nine patients selected by prospective randomization, in whom birth was induced conventionally, served as a control group. The efficiency of the prostaglandin gel alone or respectively with additional administration of oxytocin was evaluated on the basis of the clear changes in the cervical findings observed within 12 or respectively 24 hours, the spontaneous births, or, in the case of cesarean deliveries, according to the pelvic score. Application of PGE2 alone led to impressive changes of the cervix score and, in 34 of the 41 cases, to regular contractions after an average time of 87 minutes. After 12 hours, prior to administration of oxytocin, 43% of the patients were already delivered. The combination of locally applied PGE2 gel with conventional oxytocin induction significantly increases the number of successful inductions. The percentage of unsuccessfully attempted inductions was reduced to 24% in the PGE2 gel group as compared to 44% in the control group.

Adolescent↗
PubMed1986

[Peridural anesthesia in obstetrics: impact on the lower urinary tract].

The results of non-invasive urodynamic examinations (urinary flow rates and ultrasound determination of residual urine in the bladder) and of urinary bacteriology were studied 4 or 5 days after delivery in 305 patients. The method of delivery and other clinical and obstetric parameters that could influence lower urinary tract function have been considered. The numbers of urines that contain bacteria in quantities of more than 10(5)/ml are significantly raised as compared with the control group after spontaneous delivery under continuous epidural analgesia (15% as compared with 4.5% - p less than 0.01). Continuous epidural anaesthesia increases the risk of urinary tract infection and is significantly associated with a prolongation of labour as well as an frequency of catheterisations as well as episodes of urinary retention. This compromises the likelihood of starting normal micturition after delivery.

Adult↗
PubMed1985

Antepartum nonstress fetal heart rate monitoring: systematic analysis of baseline patterns and decelerations as an adjunct to reactivity in the prediction of fetal risks.

A total of 1552 antepartum nonstress tests performed during the week before delivery are analyzed with respect to both reactivity and the presence of pathologic baseline patterns (tachycardia, bradycardia, diminished beat-to-beat variability) or decelerations. Correlation with mode of delivery and condition of the newborn infant shows that, irrespective of nonstress test reactivity, the presence of baseline anomalies and/or decelerations is associated with significantly increased perinatal morbidity and mortality. Nonstress test analysis, if systematic, that is, not restricted to reactivity alone, makes it possible to better detect fetuses at high perinatal risk, in which case closer surveillance would be indicated.

Apgar Score↗
PubMed1984

Circulating beta-2-microglobulin levels during pregnancy and their possible relationship with feto-maternal histocompatibility.

Plasma beta 2 microglobulin (beta 2m) levels have been measured by radioimmunoassay in normal pregnant women, in two successive pregnancies of a woman who shares HLA antigens with her husband, in normal twin pregnancies, in toxemic pregnancies and in hydatidiform moles. During normal pregnancy, plasma beta 2m levels decrease reaching a minimum at week 14 and increase thereafter to a maximum at week 34. In the two successive pregnancies of the one patient with HLA compatibility, beta 2m concentrations were significantly lower than in normal pregnancies. Women with monozygotic twins had significantly less beta 2m than women with heterozygotic twins. Toxemic patients bearing female fetuses had also statistically lower beta 2m levels than toxemic women with male fetuses. Patients suffering from hydatidiform moles had beta 2m levels in the range of normal pregnant patients. Since circulating beta 2m is produced by lymphocytes one might assume that low beta 2m levels reflect a reduced activity of lymphocytes. The results presented here allow to propose a hypothesis which will have to be verified that reduced beta 2m levels are associated with an increased feto-maternal histocompatibility.

Adult↗
PubMed1983

Are vaginal fluid concentrations of prolactin, alpha-fetoprotein and human placental lactogen useful for diagnosing ruptured membranes?

Vaginal fluid levels of prolactin (Prl), alpha-fetoprotein (AFP) and human placental lactogen (hPL) were assayed to investigate their usefulness in the diagnosis of ruptured membranes. Fifty-two patients at term were divided into those with intact membranes, and those with ruptured membranes. In patients with intact membranes the concentration of all three substances was low with few exceptions. The mean vaginal concentrations of the three proteins were significantly higher in patients with ruptured membranes, but low values were also found in this group. It is concluded, that because of the overlap between the values, Prl, AFP and hPL measurements in vaginal fluid do not represent a useful advance in the assessment of rupture of the membranes.

Body Fluids↗
PubMed1983

Effect of lumbar epidural analgesia on lower urinary tract function in the immediate postpartum period.

Urodynamic investigations including cystometry and electronic simultaneous urethro-cystometry were made in 27 primiparae between 2 and 5 days after delivery to assess possible effects of lumbar epidural analgesia on the function of the lower urinary tract. Three groups of patients were studied: 11 patients had vaginal delivery without epidural analgesia, 11 patients with similar obstetrical characteristics were delivered vaginally with epidural analgesia, and five others were delivered by caesarean section under epidural analgesia. The group of patients who were delivered vaginally under epidural analgesia had a significantly higher incidence (n = 4) of hypotonic bladders as determined by cystometry than the group without epidural analgesia (n = 0), (P less than 0.05). The maximum cystometric capacity was significantly greater (P less than 0.05) in the group who delivered vaginally with epidural analgesia than in the group without epidural analgesia, as well as the caesarean section group (with epidural analgesia), (P less than 0.01). Possible side effects of epidural analgesia implied by these results are discussed and a method for surveillance of urethrovesical function both during labour and after parturition is proposed.

Adult↗
PubMed1975

A study of fetal heart rate deceleration areas. II. Correlation between deceleration areas and fetal pH during labor.

Three FHR deceleration areas of fixed durations related to the onset of the concomitant uterine contraction were evaluated automatically with a small digital computer during labor. The correlations between these areas and the fetal scalp blood pH values were studied. The deceleration occurring 80 to 140 seconds after the onset of each uterine contraction during the 20 minutes preceding the fetal blood sampling presented the best correlation (r equals minus 0.453) with fetal pH values. In addition to FHR deceleration area, baseline FHR variability should be considered in predicting fetal condition.

Apgar Score↗