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Biomedical subjects

O Chevrant-Breton

Publications and source records attributed to O Chevrant-Breton.

At least 19 recordsLinked to original sources
PubMed2000

[Percutaneous umbilical blood sampling in pregnant women with thrombocytopenia. Apropos of 35 cases].

OBJECTIVE: To determine the interest of percutaneous umbilical blood sampling in maternal thrombocytopenia. PATIENTS AND METHOD: We performed a retrospective study of 36 percutaneous umbilical samples in pregnant women with thrombocytopenia. We included patients with a platelet count less than 100,000/mm(3) or a previous diagnosis of idiopathic thrombocytopenic purpura. Patients were divided into two groups. Group A consisted of women whose thrombocytopenia was caused by idiopathic thrombocytopenic purpura. The other patients were included in the group B. Percutaneous umbilical blood samples were performed by direct ultrasound guidance under sterile conditions, after 37 weeks gestation. Cesarean section was indicated if the fetal platelet count was < or =50 000/mm(3), in other cases obstetric indications were followed. RESULTS: Percutaneous umbilical blood samples were performed at a mean age of 38.5 gestational weeks. Fetal blood sampling was successful in 34 of the 36 cases. There was no fetal complication. In group A, two fetuses had low cord-blood platelet counts (20,000 and 98,000 per cubic millimeter). There was no fetal thrombopenia in group B. Three cesarean sections were performed, in one case because of severe fetal thrombocytopenia and in 2 cases because of an unsuccessful percutaneous umbilical blood sampling (in both, neonatal platelet count was normal). There was no significant complication in infants. There was a significant correlation between fetal and neonatal platelet count. CONCLUSION: There is no maternal predictive factor for fetal thrombocytopenia. Percutaneous umbilical blood sampling is feasible and has a good diagnostic value. The overall risk of fetal loss is low. But there is no indication of percutaneous umbilical blood sampling in the management of thrombocytopenia in pregnancy because severity of thrombopenia is not directly related to the severity of maternal disease and there are no series large enough to assess the association between delivery method and intracranial hemorrhage in thrombocytopenic infants born of mothers with idiopathic thrombocytopenic purpura. More subjectively than on scientific arguments a percutaneous umbilical blood sampling could be performed for patients with idiopathic thrombocytopenia purpura and a past history of neonatal intracranial hemorrhage. A cesarean section could be done if the platelet count is less than 100 000/mm(3), no intracranial hemorrhage has been described above this level.

Cordocentesis↗
PubMed1999

[Multicystic neonatal encephalopathy after a traffic accident with minor maternal injuries].

We report a case of traffic accident at 30 weeks of gestation. The maternal injuries were minor. The fetal heart rate patterns showed tachycardia and decreased modulation. Ultrasound scanning was normal, without abruptio placentae. Ten days after the accident, a cesarean section was done on altered fetal heart rate with a normal infant at birth. This baby died 17 days latter from an ischemic multicystic encephalomalacia. With the view of the literature, we try to explain the pathophysiological mechanism of this severe fetal outcome despite minor maternal injuries. Hypovolemic collapsus, caval syndrome and maternal stress could be the cause of placental hypoperfusion. Abruptio placenta and feto-placental hemorrhage are others explanations. We propose the management for first aid workers and the specialized unit care.

Accidents, Traffic↗
PubMed1991

[Nasopharyngeal cancer and pregnancy. Review of the literature. Report of a case].

We present a case of a rare condition of nasopharyngeal cancer and pregnancy occurring together. We review the unusual epidemiological, clinical and prognostic features of this type of cancer. Because of the immunological changes that occur in pregnancy and because of the potential oncogenic role of Epstein Barr virus we consider that pregnancy worsens the prognosis for nasopharyngeal cancer. After having pointed out the risks of radiotherapy and particularly of chemotherapy in pregnancy, we discuss the need to carry out a therapeutic abortion because of the effect that pregnancy will have if it is allowed to go on to term.

Adult↗
PubMed1990

[Resistance to contraception].

While contraception has been an acquired freedom for more than 10 years, a number of women present clinical manifestations resulting in the restriction or the suppression of this freedom. The symptoms are extremely diversified, from forgetting the pill to severe depression, from repeated infections to personality disorders. If many symptoms may be explained from an organic standpoint, others only derive from an unconscious resistance to contraception. The authors attempt to determine the origins of such resistance, their possible variations and advocate a management protocol for patients presenting this type of disorder.

Adult↗
PubMed1988

[Circumstances in the detection of carcinoma in situ of the breast. Apropos of 12 cases].

In France, 7,000 women die yearly of cancer of the breast, and 25,000 new cases are registered. The seriousness of the illness and its frequency show how important it is to diagnose it early at a stage before invasion or in situ (where 95 to 100% can be cured). In 4 years, at the University Hospital of Rennes, 90 out of 446 patients who were operated on for breast lesions had invasive cancer of the breast, i.e. 20%. 12 had a carcinoma in situ of the breast (C.I.S.E.), constituting 2.6%, of which 9 were in situ duct carcinomas and 3 in situ lobular carcinomas. In situ carcinoma of the breast can take almost any clinical form (a nodule, pain in the breast, mastitis, blood stained discharge from the nipple or Paget's disease). This means that lobular carcinoma in situ is always a surprise when diagnosed histologically in a lesion that is clinically benign. Since the anatomo-pathological diagnosis is difficult, a simple examination of the breast is not to be relied on in cases of carcinoma in situ of the breast. Mammography is the only truly valuable investigation in early diagnosis of C.I.S.E.

Breast Neoplasms↗
PubMed1986

[Contraception a year after voluntary interruption of pregnancy].

At the time of conception leading to a RLA, 94 percent of the women were not using medical contraception (intra-uterine contraceptive device or estroprogestin drug). One year after the RLA, only 12 percent of the patients were found not to be using medical contraceptives. Thus, RLA is an event which modifies considerably the contraceptive habits of the patients. It is remarkable that one year after a RLA, 3/4 of the patients continue to use the contraceptive prescribed immediately after RLA.

Abortion, Legal↗
PubMed1985

[Amniotic fibronectin in normal pregnancy and pregnancy with fetal anencephaly].

Fibronectin, which is an important protein in plasma and in surface cells was calculated in amniotic fluid using a laser ray nephelemetric technique. In normal pregnancies (in 72 samples studied) this protein which rises towards the 18th week of amenorrhoea (mean +/- S.D.: 60.8 +/- 16.0 mg/l), decreases steadily to term (mean 14.8 +/- 8.9 mg/l). In fetal anencephaly (10 samples tested) high levels were also found but the difference as compared with normal levels was not significant. This measurement does not therefore constitute an extra way of screening for closure of the neural tube.

Amniotic Fluid↗
PubMed1985

[Maternal death of obstetrical origin. Medicolegal aspects].

The authors have become interested in maternal mortality. This study has been carried out solely to look at the medico-legal aspect. Increasingly good health is seen as a right and the doctor the dispenser of this service. The rights of the mother (and of the infant) become of increasing importance. The improvement in obstetrical techniques, which are much better known to the public, have made families far more confident of the results of delivery. This is now seen as something without any danger. But delivering a baby still has lots of risks. Because of this, if an accident happens the obstetrician more than any other doctor perhaps can find himself in the courts. To avoid this he has to know very well the causes of maternal mortality in order to avoid them as far as possible. Furthermore, he must not undertake stupid emergency measures often initiated as measures of desperation caused by his emotional involvement for a patient who is approaching death. Finally, the expert should look for all the causes of death so that he does no wrongly blame the doctor for a maternal death.

Adolescent↗
PubMed1983

Rupture of the uterus during labor without apparent cause.

Spontaneous uterine rupture at term during labor of a non-scarred uterus under epidural anaesthesia is reported in a 17-yr-old primigravida. This exceptional event may lead to catastrophic maternal and fetal consequences. The authors discuss the prevention and diagnosis of this obstetrical complication.

Adolescent↗
PubMed1980

[Hydramnios and fetal malformations. A consecutive series of 50 cases which were under observation in the maternity unit of C.H.U. of Rennes between 1971 and 1978 (author's transl)].

50 cases of hydramnios were found in 17,528 deliveries. This gives a percentage of 0.29. These 50 cases of hydramnios gave birth to 53 fetuses which showed one or more of the following abnormalities. 20 malformations of which 12 were of the central nervous system; 6 twins; 6 cases of Rhesus allo-immunisation; 1 case of chorio angioma; 4 unexplained intra-uterine deaths; and 27 infants that died later. No etiological cause for this hydramnios was found in 20 cases. There was no maternal pathology to be found. Often the obstetrical histories of these women are pathological. In 3 per cent of the cases there was a previous abortion and in 18 per cent it appeared that there was previous hydramnios. We discuss what measures should be taken in cases of hydramnios. In our opinion a woman who has had a pregnancy with hydramnios should have genetic counseilling. The combination of hydramnios with delayed intra-uterine growth suggests that fetal malformation is present.

Female↗
PubMed1980

[Repair of duodenal defects by a pedunculated jejunal flap. Experimental study in the dog (author's transl)].

The authors operated 18 dogs on whom they carried out a large duodenal defect which was then repaired, in the same operation, by an open pedunculated jejunal flap. They studied the progress of this flap and the quality of the duodenal repair. After about 4 months, on average, the animals were re-operated to check the quality of the repair and to see if the vascular peduncle could be cut. Section of the vasculature was well tolerated because of the development of very small vascular anastomoses.

Animals↗
PubMed1980

[Multiple pregnancies. Apropos of 37 cases].

Induction with ovarian stimulators and especially HMG together with HCG are the principal causes of multiple pregnancies as has been revealed by the studies of 37 case histories of multiple pregnancies over and above twin pregnancies. It is important to be very careful and take strict precautions with these patients who often have psychological troubles that have to be treated first. It is useless to carry out cerclage (cervical stitching) after these triplet and quadruplet pregnancies have been diagnosed early by systematic echography, which should be used in every case where ovulation is induced. It is essential to supervise these patients in a special centre. The children tend to be small for datas and it is best to deliver them by cesarean section at 35 weeks onwards. It is important to avoid these very pathological pregnancies as far as possible. Echography of the ovary should be routine before induction of ovulation.

Cesarean Section↗
PubMed1979

[Comparative study of the fate of a pancreatic stump treated by ligature or by pancreatico-jejunal anastomosis (author's transl)].

The authors studied in a series of 23 dogs divided up into two groups the fate of the pancreatic stump treated either by pancreatico-jejunostomy with a Y loop, or by a simple ligature. They note that although the mortality is slightly higher in the anastomoses, histological lesions are constant in both series and are fairly similar. This agrees with the findings in man by Goldsmith and justifies ligature of the remaining pancreatic stump after cephalic duodeno-pancreatectomy.

Animals↗