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M Delignette

Publications and source records attributed to M Delignette.

3 recordsLinked to original sources

[Induction of labor by prostaglandins].

The synthesis pathways for prostaglandins (PG) are derived from membrane phospholipids via arachidonic acid. The prostaglandins are the most active substances in inducing maturation of the cervix. They include PGF2 alpha which induces contractions of the uterine muscle and PGE2, which is active on the cervical connecting tissue with no effect on the body. The authors recall the role of the prostaglandins in triggering the spontaneous onset of labour, and suggest the use of PGE2 in the artificial induction of labour. PGE2 can be administered by local or systemic route. The authors report their personal experience with cervical maturation in a retrospective study covering a wide range of clinical circumstances. A prospective study in cases of premature rupture of the membranes, already reported, concludes that labour is induced earlier in a population receiving PGE2 than in a control population. The authors then discuss the literature data and stress the possible use of PGF2 alpha. To conclude, if prostaglandin-induced maturation appears to be more effective, it is nonetheless not the ideal method in view of the side effects and concomitant effects on uterine labour and the cervix. This method has the advantage of being usable in difficult cases.

Contraindications↗

[Chorionic villi sampling. Amniocentesis. Cordocentesis].

For early antenatal diagnosis, chorionic villus sampling (CVS) represents a valid alternative to early amniocentesis. It gives rapid results with minimal increase in risks (miscarriage about 1.5 p. cent). The indications of CVS are therefore likely to broaden. For late antenatal diagnosis, linked to an echographic or clinical anomaly, sampling of fetal blood by funicular puncture is taking precedence over sampling of amniotic fluid. Results can be obtained easily and much more quickly at low risk (about 1 p. cent). These techniques are in no way alternatives, but rather complement one another. It is always advisable to choose with care the technique that offers the greatest information with maximum safety.

Amniocentesis↗

[Management of a pregnant woman with Streptococcus group B].

The relative rarity (1 to 5 cases for 1,000 births) of neonatal infections secondary to B Streptococcus, the epidemiological characteristics of this germ, especially the unstable vaginal carriage, make it difficult to select a therapeutic approach. Systematic screening of B Streptococcus and the treatment of all carriers or only of high-risk patients, present several practical problems, are complex to implement but the cost/benefit ratio seems however acceptable. Prophylactic intrapartum antibiotic treatment of known carriers of B Streptococcus does not seem debatable any longer, at least the treatment of those presenting other risk factors: premature delivery, premature rupture of the membranes, fever occurring during delivery. Today, the best prophylaxis of neonatal infections seems to be the intrapartum antibiotic treatment (ampicillin) resulting in a spectacular decrease of the frequency of neonatal contamination.

Ampicillin↗