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G Boog

Publications and source records attributed to G Boog.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Microvolume dosage of lactate in cord blood for the evaluation of the neonatal well-being].

A preliminary experience about a new microvolume lactate meter (Lactate Pro) is reported from 200 consecutive term deliveries. Comparison between lactate and pH in umbilical artery revealed a significant negative correlation between the two variables (r=-0.0693; p<0.0001). For the diagnosis of acidosis (pH<7.15) a lactate cutoff value at 6 mmol/l had a sensitivity of 50% and a specificity of 92% in a population with a prevalence of 8%. The study also demonstrated a better correlation between the concentrations of lactate and the base excess from 44 cord blood samples in high risk deliveries (r=0.837; p<0.0001). A lactate value higher than 6mmol/L predicted a metabolic acidosis (BE>- 8 mmol/l) with a sensitivity of 50% and a specificity of 94% from a collective with a prevalence of 16%. Considering the simplicity of the method, lactate measurements in cord blood could be extended to all birth centers for a systematic evaluation of the fetal condition in combination with the APGAR score. According to the minimal sampling volume (5 microliter) and the better prediction of metabolic acidosis this new method could replace the determination of the pH on fetal scalp.

Acidosis↗
PubMed2002

[Spontaneous hematoma of the rectus sheath during pregnancy: a case report].

A case of spontaneous rectus sheath hematoma is reported in a 32-year-old multigravida transferred to our antepartum unit for premature labor and persistent cough related to Candida dubliniensis upper airway infection. In pregnant patients presenting sudden-onset severe abdominal pain and parietal tenderness, there are two main differential diagnoses: abruptio placentae and aseptic necrobiosis of a uterine leiomyoma. The correct diagnosis may be obtained by ultrasonography and sometimes by computed tomography. In the present case an emergency cesarean section was performed at 35 weeks gestation after a 40% decrease in maternal hemoglobin and onset of fetal heart rate anomalies.

Adult↗
PubMed2001

Amniocentesis and amnioinfusion during pregnancy. Report of four complicated cases.

We report two foetal complications after amnioinfusion with dye injection for evaluation of severe oligohydramnios in pregnancy. In the first case, an underskin colouring was to disappear within a few days. In the second case, an irreversible skin after-effect with muscular atrophy and lesion of the underskin tissues developed progressively, although the trained practitioner did not notice any particular resistance during the injection of the dye and the ultrasonographer did not point out that the foetus had been stuck by the needle. Both later reported cases concern two life threatening maternal complications due to amniocentesis for foetal karyotyping indicated by maternal age, a septic shock occurred 24h after entering the amniotic cavity, leading to a long stay in intensive care units. In one of those cases, the patient recovered from a cardiac arrest. We come to the conclusion that the essential continuous ultrasonographic monitoring cannot avoid all complications, some of which may lead to severe adverse foetal effects and others may need an intensive medical care for the mother, mainly after iatrogenic chorioamnionitis. Experience of the perinatologist remains an important factor to limit the complications without avoiding them completely. The indications must be carefully evaluated, the information given to the patients must be clear and in the future, intraamniotic injections of dyes will have to be avoided and replaced by non-invasive tests for diagnosis of preterm premature rupture of membranes, such as diamine-oxidase, foetal fibronectin or PROM-tests. The rules of a good practice will have to be defined and widely spread.

Adult↗
PubMed2001

[Computer analysis of fetal heart rate by the Sonicaid Oxford 8002 System during pregnancy and labor. Personal experience and report of the literature].

Computer analysis of the fetal heart rate (FHR) was first described at Oxford University by the late Professor Dawes and by Redman for the prenatal surveillance of high risk pregnancies. We present our experience with this technique applied to the management of induced prematurity under 32 weeks' gestation in a tertiary perinatal center, by comparing our perinatal results with the preceding period of visual analysis of the FHR. Our analysis of the literature reports the results obtained with this technique in various high risk pregnancies and describes the modifications of computerised cardiotocography consecutive to obstetrical maneuvers or diverse maternal drug administrations. Finally we report our preliminary experience with the recently available Sonicaid Team IP System recommended for fetal monitoring during labor.

Female↗
PubMed2001

[Acute fetal distress].

Three different clinical patterns of acute fetal distress may be observed during labor: an ante-partum hypoxia with a persistent nonreactive and "fixed" fetal heart rate (FHR) on admission to the hospital, a progressive intra-partum asphyxia manifested, as the labor continues, by a substantial rise in baseline heart rate, a loss of variability and repetitive severe variable or late decelerations, and finally, as a result of a catastrophic event, a sudden prolonged FHR deceleration to approximately 60 beats per minute lasting until delivery. However the majority of fetuses with nonreassuring tracings of FHR are neurologically intact, as evidenced by the high false-positive rate of electronic fetal monitoring (EFM). Therefore the diagnosis of fetal distress must be corroborated by complementary methods, such as continuous recording of the fetal electrocardiogram or computed-assisted EFM, fetal pulse oximetry or fetal scalp sampling with immediate determination of blood gases or lactates. Defavorable outcome of an acute fetal distress leading to neonatal encephalopathy or death is best predicted by a persisting low Apgar score (<3) for more than 5 minutes and by a severe metabolic acidosis (umbilical artery pH<7,00 and base-excess>-12mmol/l).

Acute Disease↗
PubMed2000

[Gravely ill newborns (excluding greatly premature) in 1986 and 1995 in three deparments of Pays de la Loire].

AIM: Evaluation of the progress in the treatment of seriously ill newborn infants under hospital care over the nine-year period from 1986 to 1995 in three departments of the Pays de la Loire region in France. POPULATION AND METHODS: The category of seriously ill newborn infants included only infants born after at least 32 weeks of gestation and having a Cullen severity score higher than 2. The two groups of seriously ill newborn infants at risk in 1986 and 1995 were first compared to a control group of healthy newborn babies delivered during the same years. The two groups were then compared with each other. RESULTS: In 1986 and 1995, the numbers of births were respectively 32,876 and 29,446, and the numbers of seriously ill newborn infants under hospital care were respectively 307 and 245. However, between 1986 and 1995 the risk factors as well as the causes of morbidity had changed. The average period of hospitalization decreased by five days. The mortality rate dropped from 0.16% to 0.09% (P < 0.05) and the number of serious complications decreased from 0.07% to 0.03% (P < 0.05). CONCLUSION: The improvement in the care of seriously ill newborn infants between the two reference periods, 1986 and 1995, may be attributed not only to technical progress but also to a better organization of the perinatal care in our region.

Female↗
PubMed2000

[Regional survey of Pays-de-la-Loire on the quality of sonography in the first trimester of pregnancy].

The aim of this investigation carried out by the Medical Insurance team of the five counties of the Pays-de-la-Loire region was to evaluate the quality of first trimester sonographies from the medical reports of all patients whose pregnancies began between the 1(st) and 31(st) of October 1997. Two populations could be distinguished: one of 252 women who were refunded after a first trimester ultrasonic examination and another of 111 patients for whom this exploration was not recorded. Communication of the sonographic protocol was obtained in 80% of cases. According to the established applications of the literature and to the recommendations of the French Club of Fetal Sonographers, these reports could then be classified as complete (31.2%), incomplete (31.6%) or unsatisfactory (37.2%). This regional investigation outlines the obsolete nature of the nomenclature of medical procedures and the need for a better initial and continuous education of French sonographists, considering the fixed practice of so many specialists in Obstetrics and Radiology.

Adult↗
PubMed1999

Brachmann-de Lange syndrome: a cause of early symmetric fetal growth delay.

Brachmann-de Lange syndrome is characterized by pre- and postnatal growth retardation, microbrachycephaly, hirsutism, various visceral and limb anomalies and a typical face. A sonographic prenatal diagnosis at mid-trimester is reported in a case of severe, symmetrical fetal growth delay at 20 weeks gestation, with a thickened skin on the forehead, a small nose and a marked depressed nasal bridge, a long philtrum, micrognathia and a persistently flexed right forearm, with a single bone associated to oligodactyly. Due to the severe mental impairment with a commonly estimated intelligence quotient under 60, the pregnancy was terminated after parental consent.

Adult↗
PubMed1999

[Fetal and neonatal mortality from 22 weeks of amenorrhea in the Loire area].

BACKGROUND: The Pays de Loire has a low perinatal mortality indicators among French regions but this could be due to under-notification. OBJECTS: To explore this hypothesis we undertook a survey in order to identify all fetal and neonatal deaths occurring at a gestionnal age of 22 weeks or more. We also tried to examine and analyze the causes of death. METHODS: All maternity (26) and neonatal wards (5) in the region took part in the survey in 1995. Clinicians were asked to fill out a questionnaire for all deaths occurring from gestational age (GA) 22 weeks and/or concerning a birthweight of a least 500 g. Only perinatal deaths related to parents living in the Pays de Loire were included in the study. RESULTS: Two hundred and sixty seven perinatal deaths were identified out of a total 29,440 births (9.1 /1000). Eighty three (2.8 /1000) were termination of pregnancy for medical reasons, of which 82% were motivated by chromosomic illness. Ninety-nine stillbirths fell (3.4 /1000) into two GA periods: 24 to 27 weeks (20%) and 38 to 41 weeks (2%). The cause of stillbirths remained unknown in 50% of cases despite a post-mortem examination rate of 87%. There were 29 deaths (1 /1000) in the immediate per and post-partum, 40% of which occurred at GA 22 to 25 weeks. Another 38% occurred at GA 36 to 40 weeks and these were related to undectected malformations or infections. Neonatal and intensive care units reported 56 neonatal deaths (1.9 /1000). GA was under 33 weeks for 44% of them. Deaths were caused by usual complications of severe prematurity, neurologic diseases and malformations. Thirty-two percent of total deaths were not notified to the French Authority: 25% of deaths for termination of pregnancy for medical reasons and 7% for stillbirths and per and post partum deaths. CONCLUSION: This survey suggests that the Pays de Loire perinatal mortality indicators remained low compared with other French regions, even after adjustment for this under notification. This casts doubts on the validity of perinatal mortality monitoring based on official notifications. The cause may lie in the inadequacy of legislation of the particular circumstances of perinatal deaths.

Abortion, Induced↗
PubMed1998

Cervical ripening with mifepristone before labor induction: a randomized study.

OBJECTIVE: To determine the efficacy and safety of mifepristone for cervical ripening in post-term pregnancies. METHODS: Women with post-term pregnancies and Bishop scores less than 6 were assigned randomly to mifepristone (41 patients) or placebo (42 patients). Mifepristone was given orally in a dose of 400 mg. Efficacy was assessed by change in the Bishop score within 48 hours after treatment; a score of 6 or greater was considered a "strict" success. An "extended" success rate was defined, including all patients with scores of at least 6 or those who delivered within 48 hours of treatment. Antenatal safety was assessed by fetal heart rate testing before and throughout labor. Neonatal safety was assessed by Apgar score, arterial or venous pH of cord blood, and blood glucose level during the first 48 hours. Analysis used Student t test for continuous variables, Kruskal-Wallis test for ordinal data, and chi2 for categoric variables. RESULTS: Strict success was achieved in 10 of 18 mifepristone patients (55%) evaluated for Bishop score on day 2 versus 8 of 29 placebo patients (27.5%) (P=.004). Extended success was achieved in 33 mifepristone patients (80.5%) and 21 placebo patients (50.0%) (P=.004). There were no statistical differences with regard to number of cesareans or fetal and neonatal safety. CONCLUSION: Mifepristone proved effective for cervical ripening and reduced the time to delivery compared with placebo, but it did not improve the rate of cesarean. Our study did not include enough pregnancies to reach conclusions about fetal or neonatal safety.

Abortifacient Agents, Steroidal↗
PubMed1998

[Galen vein aneurysm. Review of the literature and report of 2 cases].

Aneurysm of the vein of Galen is a rare congenital disease, with a generally poor prognosis. It represents less than 1% of cerebral arteriovenous malformations. The intrauterine diagnosis of this vascular anomaly has been facilitated by vascular exploration with pulsed and color Doppler sonography. According to some studies focused on prognostical criteria, the perinatal prognosis seems to be invariably compromised when signs of cardiac decompensation develop prenatally, knowing that early delivery may generate additional complications in the very premature infant. Medical treatment is inefficient, because of the large, persisting systemic shunt, so that pregnancy termination may be performed, after parental consent, in some cases demonstrating all signs of cardiac decompensation. On the other hand, infants with normal velocity waveforms and a low extent of the systemic shunt have a good extrauterine adaptation. A full clinical evaluation of the affected neonates at the end of the first week of live is now the best way to select the infants for intravascular embolization.

Cerebral Veins↗
PubMed1997

[Monitoring of labor by fetal pulse oximetry in a case of fetal atrial-ventricular block].

We present our experience with fetal pulse oximetry during labor monitoring in a case of fetal atrio-ventricular block. Fetal pulse oximetry is a recent technique of fetal monitoring. It is based on the photometric properties of hemoglobin and reduced hemoglobin. The continuous and noninvasive method measured fetal saturation in oxygen. It can detect fetal hypoxia, cause of acute suffering. Saturation was continuously greater than 40%. Spontaneous delivery raised no problem, either for the fetus or the mother.

Acid-Base Equilibrium↗