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Biomedical subjects

Lionel Carbillon

Publications and source records attributed to Lionel Carbillon.

17 recordsLinked to original sources
PubMed2004

Doppler and immunohistochemical evaluation of decidual spiral arteries in early pregnancy.

OBJECTIVE: The purpose of this study was to estimate spiral artery subchorionic flow at 8-11 gestational weeks (GW) by Doppler ultrasound and then to analyze these vessels in the decidua basalis using histologic, morphometric and immunohistochemical analyses. METHODS: Subchorionic spiral arteries were evaluated in 5 women scheduled for aspiration at 8-11 GW. Flow velocity waveforms were sought using color and pulsed Doppler, and the diastolic/systolic (D/S) index was calculated. Transcervical biopsy specimens and aspiration products were thoroughly examined to investigate the structure of the spiral artery at the implantation site using cytotrophoblastic and arterial smooth muscle cell immunohistochemical markers (anti-cytokeratin 7 and anti-actin monoclonal antibodies). Spiral artery cross-sectional inner areas were measured and compared with the D/S index in each case. RESULTS: Low-impedance pulsatile flow could be detected below the trophoblastic ring in all cases. Complete obstruction of a spiral artery lumen was never observed and cytotrophoblastic cells were incorporated into the vessel wall starting from the perivascular cuff. CONCLUSION: Both techniques evidenced that decidual spiral arteries in the placental bed are not completely obstructed at 8-11 GW.

Actins↗
PubMed2004

Pathophysiology of preeclampsia: links with implantation disorders.

The phenomenon of implantation anchors the embryo into the uterine wall and produces a hemochorial placenta that maintains the pregnancy and fetal growth. Implantation and placentation are intimately linked and cannot be dissociated either in time or in space. Preeclampsia is characterized by hypertension and proteinuria. It is secondary to an anomaly of the invasion of the uterine spiral arteries by extra-villous cytotrophoblast cells, associated with local disruptions of vascular tone, of immunological balance and inflammatory status, and sometimes with genetic predispositions. Preeclampsia is a disease of early pregnancy, a form of incomplete spontaneous abortion, but is expressed late in pregnancy. Aspirin may play a favorable role in implantation which is related to the genesis of preeclampsia and some cases of intra-uterine growth restriction. The most important points in obtaining a preventive effect from low-dose aspirin during the pregnancy are early treatment (before 13 weeks of gestation) and the prescription of a sufficient dose (more than 100 mg per day).

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2002

[Indication for labor induction by prostaglandin E2 vaginal gel. Retrospective study of a continuous series of 170 patients].

OBJECTIVE: To assess the factors of efficacy, side effects and complications following vaginal application of prostaglandin E2 (PGE2). METHODS: Retrospective study of 170 women in whom a PGE2 vaginal gel was administered between June 1, 1999 and June 1, 2000. The efficacy (labor effectively induced), quality of myometrial response, side effects and complications were studied globally and in each clinical context: intra-uterine delayed growth (IUDG), pre-eclampsia without IUDG, diabetes, pregnancy prolonged without IUDG, anomaly in fetal heart rate (FHR) and/or in amniotic liquid without IUDG discovered during the systematic monitoring at the end of pregnancy, premature rupture of the membrane without IUDG. RESULTS: The overall success (defined as the onset of labor) was of 94.1%. This rate was of 90.7% in primiparous and of 100% in multiparous women. Twenty-three patients (13.5%) experienced side effects (hyperkinesia or hyperthermia) and 35 patients (20.6%) complications (hyperkinesia or hypertonia with fetal repercussion). The maternal-response to infection was significantly improved (p < 0.05) in cases of prolonged rupture of the membranes or anomaly discovered during monitoring, but only in patients with diabetes. In cases of IUDG of vascular etiology with multiparity, the total quantity of PGE2 necessary was only of 1.14 mg and 85% of patients subsequently delivered without ocytocine. CONCLUSION: IUDG and prolonged pregnancy are the principle indications for PGE2 vaginal gels. The quality of response depends on the clinical context. In cases of premature rupture of the membranes or of anomaly discovered during monitoring (FHR and amniotic liquid), response was only improved in diabetic patients. In cases of vascular IUDG and multiparity, the response was excellent and the majority of women subsequently delivered without ocytocine, thus confirming the quality of myometrial response. Hence, the quantity of PGE2 required varied, depending on the subjecent pathology. This strategy could limit the risk of excessive myometrial response (hyperkinesia or hypertonia) and thus improve fetal tolerance.

Administration, Intravaginal↗
PubMed2002

Various Doppler sonographic appearances and challenges in prenatal diagnosis of vasa praevia.

Rupture of vasa praevia is associated with a high rate of fetal or neonatal mortality. Since the recent development of color and spectral Doppler sonography, prenatal diagnosis of vasa praevia has been increasing but is not yet consistent. We report 2 cases that were diagnosed prenatally, enabling cesarean section to be performed under optimal conditions to prevent complications. A better knowledge of the characteristic Doppler sonographic appearances and the risk factors associated with vasa praevia could greatly facilitate the prenatal diagnosis of this condition and hence the fetal prognosis.

Adult↗