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M Deshayes

Publications and source records attributed to M Deshayes.

11 recordsLinked to original sources

[The HELLP syndrome. 13 cases].

The Hellp syndrome is a complication of raised blood pressure in pregnancy, haemolysis, a rise in liver enzymes and thrombopenia. In this retrospective study we report 12 cases of Hellp syndrome which occurred in the University Hospital Centre of Poitiers between 1982 and 1990 and we discuss causes, the progress, the prognosis and the management. Six patients were helped by prophylactic Caesarean operation. Two patients had eclamptic fits. Fortunately there was no maternal death. There were seven cases of intrauterine growth retardation, two of in utero fetal death and one of early neonatal death. When clinical and biological parameters of the Hellp syndrome come right following delivery, the outlook for the mother is quickly favourable, but the syndrome can continue and sometimes become worse after delivery. Stopping the pregnancy is the basic treatment and conservative treatment has only a very limited success. Finally, the prognosis for the future is usually good and it is unlikely to recur.

Anemia, Hemolytic

[The Harlequin Baby syndrome. A new case].

The Harlequin baby syndrome is a rare but lethal ichtyosis. We report a new case of a primiparous woman of 28 years of age who had a pregnancy that progressed normally with the delivery of a child of 2,450 grams whose Apgar was 9 at one minute and 10 at three minutes, but who died after living just 24 hours. The reason for this work is to try to analyse the features that are known about possible treatment and antenatal diagnosis of the Harlequin baby syndrome. It has been suggested that vitamin A supplements should be given for several years because the skin state may be improved. On the other hand morbidity is likely to remain serious particularly from the point of view of growth and psychomotor development. Antenatal diagnosis using skin biopsy can be obtained after 23 weeks of amenorrhoea using a fetoscope; it shows the 25% of cases recur. At present the only treatment if a recurrence does occur is to terminate the pregnancy.

Abortion, Therapeutic

[Q fever and fetal death in utero. Two cases].

Some cases of late abortion occurring after a Coxiella burneti infection, more often with a chronic evolution, have already been mentioned in the literature. We reported here two cases of early abortion, contemporaneous of an acute infection due to C. burneti. Two patients, after a contact, before and at the beginning of the pregnancy, with an animal susceptible to contaminate human beings by C. burneti, presented no clinical symptom characteristic of Q fever. The fetal death for the two cases was found out at the 17th week of amenorrhoea. All the investigations in order to search for an abortion etiology remained negative. Only, the specific serologies showed an acute infection due to C. burneti.

Adult

[Materno-fetal infection by Chlamydia psittaci transmitted by the goat: a new zoonosis?].

A case report is given of spontaneous abortion at 32 weeks brought about by Chlamydia psittaci following contact with a herd of goats. Severe symptoms were observed post-natally in this woman. Nine cases of materno-foetal infection with this pathogen are known, however, the source of infection is usually ewes suffering abortive chlamydiosis. Goats may also be infected, but caprine origin for the disease in pregnant women has not been reported previously.

Abortion, Spontaneous

[Delivery of large infants. Management and results of 198 cases].

We have studied the deliveries of 198 large fetuses over a period of 3 years between 1st January 1987 and 31st December 1989 in the University Hospital of Poitiers. By large fetus we mean the delivery of a child of 4,000 grammes or more. This occurs in 4.5% of deliveries. The following risk factors are present either singularly or together with others: previous delivery of a large child (12.6%), a previous history of pregnancy diabetes or its absence (2.5%), an increase of weight during pregnancy of more than 15 kgs (46.8%), obesity before the onset pregnancy (19.7%), the height of the uterus equal to or above 35 cms (75.8%). These factors were found in nearly 90% of the patients. Their presence should make one look for a large fetus. The obstetrical results were as follows: 18 ceasareans were carried out (9.09%); instrumental delivery was necessary in 43 cases (23.8%); there were 17 cases of shoulder dystocia treated by obstetrical manoeuvres (9.5%). There were therefore 122 vaginal deliveries without any interference (61%). Neonatal complications were: one lost because of malformation (0.5%), serious morbidity in 30 deliveries (15.15%); 16 fractures of the clavicle and two cases of brachial plexus paralysis of which one persisted, two facial palsies which recovered, six infections, three cases of hypoglycaemia and one serious fetal distress which recovered without any sequelae. Maternal complications were: no mortality, serious morbidity in 26 women (14.1%), 9 haemorrhages at delivery, 9 cases of trauma of the perineum, 6 infections, and 2 haematomata in the episiotomy wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[False pregnancies].

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Diagnosis, Differential