[In response to the article by M. Akotionga et al. ].
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Africa↗
Biomedical subjects
J C Berardi
Publications and source records attributed to J C Berardi.
[Oxytocic use and duration of labor under peridural ambulatory analgesia].
OBJECTIVE: Extradural analgesia is associated with an increase duration of labor and oxytocin use. MATERIAL AND METHODS: We conducted a study of walking during active labor under extradural analgesia among 41 women. This group, with uncomplicated pregnancies, was similar to associate with a usual-care group according to the following criteria: maternal age, parity, gestational age, Bishop's score at the admission, and labor entrance mode. Analgesia was performed by using combined spinal-epidural analgesia and patient controlled extradural analgesia. Fetal heart and uterine contractions were continuously monitored using Telemetry. Anesthetic and obstetrical parameters were noted every hour. The main criteria were length of labor and oxytocin consumption. Statistical analysis was performed using Student's t-test and Fischer's exact test. RESULTS: Duration of the 1st and 2nd stage of labor, and oxytocin consumption were not statistically different in the two groups, neither was mode of delivery. No neonates had an Apgar score less than 5 at one minute. Parturients walked about 2 h 30 for about 2,000 m. CONCLUSION: Obstetrical parameters and oxytocin consumption are not modified during walking extradural analgesia. No maternal or neonatal adverse effects were noted in our study.
Analgesia, Epidural↗
[3-dimensional (3D) echography in obstetrics. Advantages and limits].
Three-dimensional ultrasound (3D) offers new options in imaging modes: such as simultaneous rotation and translation of the three perpendicular planes displayed, surface rendering, or transparent mode providing an imaging of structures with high echogenicity (bones, skull). This new imaging mode is extending the field of conventional two-dimensional ultrasound, but for now it has to be evaluated.
Endosonography↗
[Study of amniotic fluid bacterial colonization sampled by amniocentesis in cases with premature rupture of membranes. Prospective multicenter study].
OBJECTIVE: To determine the relationship between bacterial colonization of the amniotic fluid sampled by amniocentesis and premature rupture of the membranes. METHODS: A prospective multicentric study conducted over a one year period in 6 maternity wards in the suburban area of Paris. Thirty-six women with premature rupture of the membranes were studied. RESULTS: There were 11 patients (30%) with contaminated fluid at the first amniocentesis. Twenty-five patients had sterile fluid. In 7 patients with prolonged rupture for more than one week, repeated amniocentesis. Twenty-five patients had sterile fluid. In 7 patients with prolonged rupture for more than one week, repeated amniocenteses were used to follow bacterial colonization. In one patient, Proteus mirabilis in the amniotic fluid was eradicated by adapted antibiotic therapy. In patients with sterile amniotic fluid, there was no secondary colonization. In the 11 cases with colonized liquid, the vaginal swab could only be considered as positive in 4 cases. Amniocentesis was able to discover 7 bacterial colonizations of the amniotic fluid in patients with an indeterminant vaginal swab. Likewise, C-reactive protein levels were raised only in 26% of the cases with a colonized amniotic fluid.
Amniocentesis↗
[Prematurity due to medical decisions. Analysis of a retrospective study of 18 maternity hospitals in the periphery of Paris].
We have analysed induced prematurity in a retrospective study of 18 maternity hospitals located in the area of Paris: the Ile-de-France. The rate of induced prematurity was 1.4%, whereas the total rate of prematurity in our study was of 4.6% for a total number of 16,337 deliveries. The great majority of those medically induced prematurity was decided at and after 33 weeks, and the main cause was intrauterine growth retardation. Caesarean section was performed in 60% of the cases.
Causality↗
[System of decision support in obstetrics. The computerization of prenatal consultations].
The aim of this study was to realize a prototype of a computer-aided decision support for prenatal visits. He has been developped on a microcomputer. We used procedural programming to represent the medical knowledge. This prototype has several interfaced units: a computerized prenatal record, the computing of quantitative variables (term, fetal biometry, uterine height) and the two computer-aided units (preterm births and modelization of weight gain during pregnancy). The next step will be the medical evaluation of this computer-aided decision support in obstetrics.
Anthropometry↗
[The value of C-reactive protein in the detection of chorioamnionitis in cases of premature rupture of membranes].
In a context of premature rupture of the membranes, the authors compare the sensitivity and ability to predict the onset of chorio-amnionitis of the conventional clinical signs (hyperthermia, fetal tachycardia, discolored amniotic fluid) and paraclinical signs (hyperleukocytosis and bacteriology of the amniotic fluid) with those of the assay of C reacting protein in the maternal plasma. The latter test is apparently more sensitive and of greater positive predictive value in this disorder.
C-Reactive Protein↗
Evaluation of the benefit of setting up a decentralised obstetric-surgical structure in order to reduce maternal mortality and transfers in the Ivory Coast.
Our purpose is to study the way to reduce maternal mortality when introducing a structured obstetric and surgical center to a community previously without such a center. The study was done in Ivory Coast, where such a structure was set up in 1982 in a rural hospital at Divo. It has been observed that with such a structure there are no more transfers of women from Divo to the teaching hospital at Cocody, and a reduction in maternal mortality at Divo. This observation regarding the value of bringing obstetric services to communities currently without them could be a way among those available to reduce maternal mortality in a developing country such as the Ivory Coast.
Cote d'Ivoire↗
Decentralization of maternity care.
One of the main reasons for the high maternal mortality rates in developing countries is the need to transfer patients long distances to city hospitals when they develop complications. Local obstetric facilities would relieve this situation.
Cote d'Ivoire↗
[Systems in support of medical decisions using algorithmic methods].
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Algorithms↗
Neonatal meningitis due to Gardnerella vaginalis.
A case of meningitis due to Gardnerella vaginalis occurred in a five-day-old newborn who had clinical signs of fever, polypnea and a grey complexion. After treatment with ampicillin, cefotaxime and netilmicin, the patient's condition improved, and no sequelae were observed. The bacterium isolated from a pure culture of the cerebrospinal fluid was identified by biochemical characteristics to be Gardnerella vaginalis, but it was not possible to define the source and mode of contamination.
Ampicillin↗
[Prevention of prematurity in a community. Study in a community of Maghrebian immigrants].
The North African migrants who deliver at the hospital of Mantes La Jolie have a very low premature delivery rate (2.9%). This is surprising because they would classically be at high risk for prematurity and they often fail to take any notice of our suggestions to prevent this. A study of the mechanisms that could be invoked to explain this good result has led us to describe a prophylactic system that works in the North African community of this town. This system is based on mutual exchanges and aids established as a kind of network. The authors have set out in the list of this population of North Africans which they studied three groups of women A, B, C, who are classified according to the degree of culture they have acquired. This culture makes it possible for others to take part within the network of communal aid; the most cultured of the women (who are the most westernized) are the least involved in this system. This preventive system within the community allows the very low use of the hospital to put the women to rest and very low numbers who have to take beta-mimetics.
Adult↗
[Neonatal gonococcus conjunctivitis (prevention-epidemiology)].
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Adult↗
[Obstetrical consequences of female circumcision. Study in 71 circumcised African women].
The delivery of 71 African women who had been circumcised was studied against a control of 781 women who were not circumcised. We have not been able to find any difference as far as caesarean section, forceps delivery or fetal distress in the two groups that were studied. The only difference is a higher frequency of perineal injury in the group of circumcised women.
Circumcision, Male↗
[A study of the mean concentration of plasma antithrombin III in arterial hypertension in pregnancy].
Plasma antithrombin III (AT III) level was examined in 30 pregnant women with hypertension and 44 without hypertension. AT III level is significatively lower in the group of hypertension. The degree of reduction in plasma AT III level seems to be correlated with hyper uricemia but not with count of platelets or fibrinogen.
Antithrombin III↗
[Acute hepatic steatosis in pregnancy: with special reference to a new case].
Acute fatty infiltration of the liver in pregnancy as defined by Sheehan in 1940 often has a fatal outcome for the mother and the child. The authors report a case of acute fatty infiltration of the liver in pregnancy with a favourable outcome. They found 15 cases in the French literature: the outcome is fatal in 50% of the cases because of hepatocellular failure or of the hemorrhagic syndrome. When the outcome is successful the hepatic lesions disappear completely.
Acute Disease↗
[Sexually transmissible diseases in adolescence (author's transl)].
Sexually transmissible diseases affect adolescents as well as the rest of the French population. It is difficult to estimate their frequency from official statistics since not all cases are reported. However, the recrudescence of these diseases is certain, with adolescents representing 10 to 50 0/00 of all cases. These diseases threaten the obstetrical and gynecologic future of adolescents and cost society a great deal of money. In the combat against them, prevention and public education are as important as early screening.
Adolescent↗
[Lysozyme content of amniotic fluid (A.F.) (author's transl)].
Lysozyme content of 47 A.F. collected at different stages of pregnancy has been measured. At the same time creatinine concentrations of 33 of those A.F. have been measured. Lysozyme content increases with the progress of the pregnancy. A similar increase is apparent when lysozyme concentration is correlated with A.F. creatinine.
Amniotic Fluid↗