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Biomedical subjects

M F Sarramon

Publications and source records attributed to M F Sarramon.

At least 37 records · Page 2Linked to original sources
PubMed1991

Astomia-agnathia-holoprosencephaly association. Prenatal diagnosis of a new case.

A case of agnathia-astomia-holoprosencephaly with prenatal ultrasound diagnosis at 23 weeks is reported and discussed. This lethal neurocristopathy, well known in mammalians, is rarely observed in humans. Prenatal diagnosis features are intrauterine growth retardation, mandibular absence or major hypoplasia, holoprosencephaly, cyclopia or hypotelorism, and in some instances frontal proboscis. This malformation is usually sporadic, but may be genetically determined as an autosomal recessive trait, since two cases in the same sibship have been reported.

Abnormalities, Multiple↗
PubMed1991

[Prenatal diagnosis of neuroblastoma].

One of the prognostic factors for neuroblastoma is age at the time of diagnosis: neuroblastoma detected prenatally or in the first year of live have a more favorable outcome. Antenatal diagnosis is essential early management. Knowledge of local tumor extent is invaluable in determining the appropriate treatment, and MR imaging has proved to be the most useful procedure in this regard.

Female↗
PubMed1991

[Maternofetal infection with human parvovirus B19. Apropos of 2 cases].

Two cases of maternal-fetal human parvovirus B19 infection are reported. The first case involved a feto-placental anasarca occurring during the third trimester and complicated by in-utero death with expulsion of a fetus with multiple malformations. The second case involved meconial peritonitis during the second trimester with favourable outcome after cesarean section and resolution of the digestive syndrome. Proof of PV B19 infection was obtained by identifying M specific immunoglobulins and viral DNA. After a review of the clinical situations most often encountered and the particular features of these two cases, therapeutic attitudes are proposed for this infection of major gravity during pregnancy.

Adult↗
PubMed1989

[Ultrasonic prenatal diagnosis of the Jarcho-Levin syndrome].

The Jarcho-Levin syndrome is an autosomal recessive disease characterized by spinal and rib malformations (spondylocostal dysplasia). The case reported concerns a fetus with a dorsal spine angulation noted at the 15th week of gestation. A more accurate ultrasound study performed at 20 weeks revealed shortness of the neck and thorax, irregular ribs and vertebrae and absence of other visceral abnormalities. The karyotype was normal. Therapeutic abortion proposed was finally accepted by both parents at 27 weeks. The diagnosis was confirmed by post mortem radiography. No parental consanguinity was noted.

Abortion, Therapeutic↗
PubMed1988

[A new case of hydatidiform mole occurring on one of the ova of a twin pregnancy].

The authors report here a new case of hydatid mole in one of the eggs of a mole pregnancy. 48 other cases have been reported in 13 publications. The birth of a viable, well-developed fetus is described in 13 instances (27%), fetal death in utero in 22 instances (46%), birth of a non-viable fetus 11 times (23%) and malignant degeneration twice (4%). Medical interruption of the pregnancy is indicated for the slightest sign of fetal anomaly or maternal complication. Prostaglandins may be used for that purpose. However, it is possible to let such a pregnancy follow its course.

Female↗
PubMed1988

[From failure to success? A case of reduction of the number of embryos in a septuplet pregnancy].

The authors report a case of septuplet pregnancy that occurred after stimulation of ovulation using h.M.G.-h.C.G. This multiple pregnancy occurred because of failure of the triple surveillance using clinical, biological and ultrasound techniques. The number of embryos was reduced by needling through the abdominal wall. Two procedures were necessary. The technique that was used is described in detail and illustrated. The twin pregnancy that was left carried on successfully. This describes a technique that should be used rarely and should not in any way modify the strict rules for monitoring ovulation.

Adult↗
PubMed1988

[Ultrasonic control immediately after voluntary interruption of pregnancy. Apropos of 144 cases].

This study has led to two conclusions: the first is that ultrasound examinations of the pelvis are often asked for immediately after termination of pregnancy because clinicians suspect there may be complications. On the other hand these ultrasound pictures are difficult to interpret and so often, therefore, curettage is carried out which in fact is not necessary. The authors describe a prospective study carried out on 144 cases of termination of pregnancy for which pelvic ultrasound was routinely carried out following termination of pregnancy. The results of this study show that there are several types of ultrasound pictures found immediately after termination of pregnancy; these contain some that can be considered to be reassuring and others that are doubtful. The conclusion depends on the answer to several questions: is it correct to carry out routine ultrasound immediately after termination of pregnancy and has it a real practical purpose? From this can one say that it is necessary to do an ultrasound after every termination of pregnancy? If not, are there special indications for the procedure?

Abortion, Induced↗
PubMed1987

[Fetal blood sampling under ultrasonic control].

Withdrawing foetal blood from the umbilical cord under ultrasonic control requires close co-ordination between obstetricians and echographists. The most important indications for this procedure are infections and foetal karyotype determination.

Blood Specimen Collection↗
PubMed1987

Randomized trial of two media used for in vitro fertilization.

Culture media are important components of IVF. Their selection must meet the need for efficiency, and also economic and practical requirements. From these standpoints, we compared two widely used media: Ham's F10 supplemented with cord serum and Menezo B2 used without serum. The test followed a randomized protocol using two series of 159 and 162 oocytes. Since no difference was seen in efficiency assessed from cleavage rate, the discussion focuses on cost and ease of use.

Cleavage Stage, Ovum↗
PubMed1987

Choice of an ovarian stimulation protocol according to the follicular puncture method in an in vitro fertilization programme.

In order to ascertain the adequacy of ovarian stimulation protocols with a type of follicular puncture, 126 women undergoing in vitro fertilization received either combination clomiphene/hMG or hMG alone according to a randomized test protocol. Within both groups patients for whom a pelvic examination was required had laparoscopies, while others had transvaginal ultrasonically guided punctures as far as possible. Clomiphene/hMG was more efficient than hMG alone as assessed from the cleavage rate (68% vs. 54%; p less than 0.01) and the pregnancy per attempt rate (16% vs. 5%; p less than 0.05). Laparoscopic punctures were more efficient than ultrasonically guided punctures (mean number of recovered oocytes: 4.8 +/- 2.6 vs. 3 +/- 2.5; p less than 0.001), but slightly better results were achieved by this latter method in ongoing pregnancy per puncture rate (18% vs. 8%; NS). With ultrasonically guided punctures, stimulation by clomiphene/hMG allowed better oocyte recoveries (3.8 +/- 2.5 vs. 2.3 +/- 1.9, p less than 0.05). Such results constitute an argument for preferential use of the clomiphene/hMG stimulation protocol with ultrasonically guided punctures.

Clomiphene↗
PubMed1987

[Evaluation of the economic burden in the respective indications of in vitro fertilization and tubal microsurgery at a regional hospital center].

The authors have calculated the cost of obtaining and maintaining an intrauterine pregnancy to term by IVF and by tubal surgery according to the four classical indications. They have worked this out from local experience. The indications are: reversal of sterilization, surgery on proximal lesions, surgery on distal lesions and multifocal lesions. IVF is superior to surgery where the lesions are multifocal and possibly also in proximal blocks. But surgery is indicated in a large number of distal blocks and particularly in reversal of sterilization. The authors point out how difficult it is to extrapolate from national or international statistics. The choice must depend particularly on the experience of the local teams.

Costs and Cost Analysis↗
PubMed1985

[Results of an experiment in systematic prenatal screening for neural tube malformations by assay of alpha fetoproteins in dried blood samples (12,480 pregnancies)].

Measurement of alpha-fetoprotein (AFP) in eluate of dried blood was carried out in 12,480 pregnant women, between the 10th and 30th weeks of amenorrhea. In 348 cases, AFP level was greater than normal (greater than 99th centile). 225 control measurements were performed (123 women dropped out of the study). In 173 cases, the AFP level returned to normal (1.4% false positives). In 52 cases, AFP title remained above the 99th centile: in 8 cases, the fetus was malformed (4 anencephalics, 1 spina bifida, 1 hydrocephalus, 1 laparoschisis, 1 exomphalos). Of the 44 remaining cases, 26 were multiple pregnancies, 5 were cases of acute fetal distress, 7 false positives normalized when a second control was made, 5 false positives up to the end of pregnancy, and 1 spina bifida (normal ultrasound scan on two different occasions). During this prenatal screening, 7 false negatives (0.56%) not detected by AFP assay should be noted: 3 anencephalics, 2 spina bifida, 1 hydrocephalus, 1 exomphalos. In all cases except one, the AFP test was carried out too early (before the 10th week) or too late (after the 30th week). The authors stress that screening must be done during the precise period between the 16th and 20th weeks of amenorrhea, and that close collaboration with a competent ultrasonographist is necessary. In 5 cases of false negatives where AFP assay and ultrasound scan had been carried out, the two methods are compared. Measurement of AFP in eluate of dried blood thus seems a reliable test which could be the first stage in a plan for systematic prenatal screening for certain serious fetal malformations with high incidence (1,2% in the Midi-Pyrenees region).

Anencephaly↗
PubMed1985

[Pregnancy in renal transplant patients].

Renal transplantation is compatible with pregnancy in women under permanent dialysis, and leads to no problems for the mother or the transplant. The seven pregnancies observed in the authors' center over the past fifteen years progressed satisfactorily. There were no rejections, no cases of renal failure. In two cases, however, there was an aggravation of hypertension with acute gravidic toxemia and spontaneous abortion. The effects on the fetus of immunosuppressive drugs are difficult to evaluate; the main risk is prematurity.

Adult↗
PubMed1983

[Unusual course of alpha-fetoprotein levels in a case of spina bifida detected by prenatal diagnosis].

The authors report the observation of a case of spina bifida detected at the 18th week from a systematic prenatal screening at the C.H.R. in Toulouse, from the assay of alpha foeto-protein on filter paper. The course of total alpha foeto-protein was particularly unique: high levels found at the 18th week with a progressive decrease in concentration until totally normal level was reached during the 28th week. Ecography confirmed the diagnosis of spina bifida. Total alpha foeto-protein concentration was also found at normal level during the 28th week in serum and in amniotic fluid. Therapeutic abortion confirmed the diagnosis of spina bifida. The authors discuss this unique course of alpha foeto-protein levels from the 18th week of development to the 28th week, made possible by this rather valuable observation.

Adult↗
PubMed1983

[Antenatal treatment of fetal urinary tract malformations. Apropos of the treatment of a case of posterior urethral valves].

Palliative in utero treatments of certain malformations of the fetal urinary tract are now possible. The most important of these is urethral obstruction by valves. A case of in utero treatment of such a disease is reported, with a six month follow-up of the infant. In utero diversion of urine was performed by means of a catheter placed in the bladder using a technique derived from intra-uterine transfusions. The purpose is to permit drainage of urine from the kidneys into the liquor to prevent permanent damage to the kidneys because of back pressure. The technical problems included deciding the correct size of catheter and the technique of localising the bladder and inserting the catheter under ultrasound control. The ethical problems are raised partly because there is no central ethical committee to make decisions and partly because of the need to evaluate and to inform the patients of the various risks. The patients take the risk on behalf of their children and the mother takes a small risk for her own health.

Abnormalities, Multiple↗