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Biomedical subjects

P Audra

Publications and source records attributed to P Audra.

At least 19 recordsLinked to original sources
PubMed1991

The use of micronized progesterone in the treatment of menace of preterm delivery.

The results of a study concerning the treatment of acute menace of preterm labor are given: beta-mimetics were administered intravenously in all cases (44) and micronized progesterone or placebo was administered orally after classical double-blind randomization (22 cases in each group). The mean index of pregnancy prolongation was the same in both groups. However the mean duration of the intravenous perfusion and the mean quantity of beta-mimetics administered intravenously were significantly reduced in the progesterone group (P less than 0.01). The mean duration of hospital stay was also significantly reduced (P less than 0.05). Cost and risks are finally significantly lessened.

Female↗
PubMed1991

[The administration of micronized progesterone in the treatment of threatened premature labor].

A randomised double-blind placebo-controlled trial concerning the treatment of threatened premature labour was undertaken using the following methodology: beta-mimetics were given intravenously to all patients (44) and micronised progesterone or the placebo were prescribed orally after randomisation (22 patients in each group). The mean index of prolongation of pregnancy was similar in both groups. However, the mean duration of the intravenous infusion and the mean dose of beta-mimetics administered intravenously were significantly lower in the oral progesterone group (p less than 0.01). Similarly, there was a significant (less than 0.05) decrease in the mean duration of hospitalisation. The cost and risks of treatment are thus significantly reduced when beta-mimetics and oral progesterone are used in combination.

Administration, Oral↗
PubMed1991

[Management of triplet and quadruplet pregnancies].

The management of multiple pregnancies is analyzed on the basis of the results in a series of 34 triple pregnancies and 5 quadruple pregnancies. Hypertension of pregnancy occurred in 6 of the patients, a threat of severe premature delivery in 15 patients. Severe cardiovascular complications, related to beta-mimetics, occurred in one case. Delivery was virtually always by Caesarian, with a mean gestational age of 31 weeks and 5 days for the triple pregnancies and 30 weeks and 5 days for the quadruple pregnancies. In 8.4% of cases, the offspring showed severely retarded intrauterine growth. The total mortality rate was 11.7% for the triple pregnancies and 15% for the quadruple pregnancies. Most deaths during the neo-natal period occurred in offspring from 4 pregnancies in which delivery occurred before 28 weeks of amenorrhea. After 28 weeks of amenorrhea, the adjusted total mortality was 4.2% for the triple pregnancies and no offspring of a quadruple pregnancy died. The prevention of the risk of threatened very early premature delivery led us to propose routine hospitalization after 26 weeks of amenorrhea, in order to improve the foetal prognosis in this age group. Carrying out a Caesarian later, after about 34 weeks of amenorrhea for the triple pregnancies and 32 weeks of amenorrhea for the quadruple pregnancies, made it possible to reduce the incidence of delayed intra-uterine growth and in utero foetal death and also made it possible to schedule the date of delivery. Good obstetric-pediatric coordination is also an essential factor in improving the prognosis for these high-risk pregnancies.

Adult↗
PubMed1991

[Echographic guided puncture of ovarian cysts. Possibilities and limitations].

Ultrasound-guided puncture is a simple and easy to perform procedure. It would seem to be a good idea to suggest simple puncture as a first intention in cases of an image of ovarian cyst. In theory, the advantages are obvious: a puncture is performed, the liquid is analyzed and an appropriate treatment is administered. Coelio-surgery could surely be avoided in cases of functional cysts and perhaps in some non-malignant ovarian cysts. In fact, it must be remembered that a cancer of the ovary in its early stages may have the appearance of a banal cyst, and that puncture does not allow pathological examination. Cytological examination is insufficient to totally rule out malignancy or to allow detailed histological diagnosis. There is, therefore, a risk of leaving in place the pocket of a cyst which may be organic and which may recur or even develop. For these reasons, ultrasound-guided puncture can be undertaken only in pre-selected patients and in the context of a specific protocol: 1) The ultrasound image of the cyst must be liquid, anechoic, unilocular (or bilocular with a fin wall), with no vegetation, the serum level of CA 125 must be low; 2) it the puncture liquid is oily, tarry or viscous, a celioscopy must be carried out as soon as possible, only a yellow-colored liquid can justify waiting; 3) the analysis of the cyst fluid is not always determinant, and the cytology findings are conclusive only if positive. A high 17 beta-estradiol level suggests a functional cyst.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Infants born to kidney transplant recipients].

Over a period of 24 years, 23 women who had undergone renal transplantation gave birth to 26 children whose gestational ages were above 28 weeks. The average duration of stable kidney function tests before the onset of pregnancy was 34.5 months (6 to 109 months). Immunosuppressive treatment consisted mostly of azathioprine and steroids (20/26), steroids and cyclosporin A (CyA) in one case, and azathioprine, steroids and CyA in 5 cases. Average gestational age at birth was 35.2 weeks (30-40 weeks), average birth weight was 2,330 g (1,160-3,700 g). Caesarean section was performed in 73% of cases. The most frequent neonatal pathological condition was the occurrence of respiratory distress, most often related to prematurity and the mode of delivery. No child presented with any lethal congenital malformation. Children born to mothers who were given CyA did not present with more congenital malformations or renal function impairment.

Adult↗
PubMed1990

[The management of pregnant women presenting with genital HPV infections].

The number of genital HPV infections has increased these past few years and, at present, 1 to 3% of pregnant women are infected. Before all treatment, a precise evaluation of the lesions is essential. The condylomata acuminata, and the plane condylomata associated or not to a slightly atypical lesion can be treated by CO2 laser spraying. This treatment is not recommended in cases of severe dysplasia because of possible adjacent micro-invasion. The questionable conization during the first trimester is not recommended after the latter. Systematic prophylactic caesarian section is indicated only in voluminous and diffuse florid condylomata which have not been treated or which persist after treatment.

Condylomata Acuminata↗
PubMed1990

[Do any indications remain for vaginal delivery in breech presentation?].

The choice of the mode of delivery in breech presentations is still controversed, particularly in the primipara and in premature delivery. From the study of 277 cases of single pregnancy with a live baby in podalic position the authors analyze the indications for the mode of delivery as well as the foetal results. After 37 complete weeks of amenorrhea, labour was induced in 126 patients out of 248. 96 had a vaginal delivery. The labour comprises a certain number of risks, but gives the same results as the caesarian section. The primiparity does not seem to be a risk factor. Before 37 complete weeks of amenorrhoea, 7 babies were born by vaginal delivery and 22 by caesarian section. In case of foetal distress, the caesarian section decided too late does not avoid an unfavourable evolution, particularly in the very premature baby. Therefore, the indications for caesarian sections must be extremely large and decided without delay particularly before 32 complete weeks of amenorrhea.

Breech Presentation↗
PubMed1990

[The hazards of forceps: the viewpoint of the pediatrician and the obstetrician].

Neonatal and maternal complications observed after 410 forceps deliveries were retrospectively compared to those occurring after spontaneous vaginal delivery. Mild scalp and facial lesions as well as facial palsy were significantly increased in the forceps group. No severe maternal complications were observed. A short literature review was done, and other instrumental extractions were discussed.

Birth Injuries↗
PubMed1990

[Hospital infection in the maternity department. 3 years of surveillance in 9,204 deliveries of which 1,333 were cesarean sections].

Hospital or nosocomial infection, or infection acquired in hospitals, is a health problem in all hospital departments and particularly in the maternity department. We report on a prospective survey of surveillance of hospital-acquired infections both from the mother and the baby's point of view after delivery vaginally or with caesarean carried out at the obstetrical clinic of the Edouard Herriot Hospital in Lyon (France) over three successive years with a series of 9,204 deliveries. The incidence of infection in women who were delivered without caesarean section was 1.37% when urinary tract infections had been excluded but 13% in women who had caesarean sections. Endometritis, skin infections and urinary tract infections were the leading causes. As far as the newborn were concerned, hospital infection ran at about 2.60% and this in the main was due to staphylococcal pustules in the skin. These figures are still too high and prevention should be based on more information given and more care taken by the whole staff of such a hospital.

Cesarean Section↗
PubMed1989

Infective-hemorrhagic complications of cesarean section. A case review of 2220 subjects.

The authors consider the hemorrhagic-infective complications associated with cesarean section. The review comprised 2200 subjects undergoing cesarean section from 1983 to 1987 in the Obstetrics and Gynecology Unit (Director: D. Dargent) of the University of Lyon (France). The incidence of cesarean sections was 14.9%, and endometritis was diagnosed in 17% of cases. The incidence of infective complications was 25% of cases and that of major hemorrhage 1%. The authors conclude that the potential complications must be carefully considered whenever contemplating delivery by cesarean section.

Cesarean Section↗
PubMed1988

[Influence of the mode of delivery on perinatal mortality in infants less than 32 weeks gestational age].

Survival rate of 96 low-birth-weight infants less than 32 weeks post-conceptional age at birth was studied in relation with the mode of delivery. Twenty-two infants were delivered by elective cesarean section because of abnormalities during pregnancy with 3 neonatal deaths. Seventy-four infants were born after untreatable premature onset of labor with 9 intrapartum and 7 neonatal deaths. Poor prognosis was associated with gestational age (less than 29 weeks), non cephalic vaginal delivery and multiple births. In these cases, cesarean section should be discussed.

Delivery, Obstetric↗
PubMed1988

[Pregnancy in women undergoing dialysis in chronic renal insufficiency. Apropos of 3 cases].

There are few cases of chronic renal deficiency associated with pregnancy for the following reasons: lowered fertility, a high level of spontaneous early abortions and unwillingness of doctors to allow such pregnancies to continue. The authors report their personal experience of three cases with different outcomes: one, delivery nearly at term, one premature delivery without complications and one premature delivery with neonatal death. The authors, having studied the literature, point out that there are different problems, on the one hand because od kidney conditions requiring more frequent dialysis and on the other hand the obstetrical conditions and in particular high blood pressure with its risk of premature delivery, and finally of intrauterine growth retardation. Finally, the authors point out how important it is to have effective contraception and, if pregnancy does occur, how important it is for the nephrologist, the obstetrician and the paediatrician to cooperate in the care of the patients.

Adult↗
PubMed1988

[Deflected cephalic presentation. Apropos of 80 cases].

Between 1974 and 1986, we have observed 80 deflected cephalic presentations in the Maternity of Hopital Edouard Herriot in babies weighing more than 2,000 g. They are divided in 34 brow presentations, 27 faces and 14 Bregma. The diagnosis was often made late. Caesarean section is the rule in brow and mento-posterior face presentations. There was no fetal trauma.

Cesarean Section↗
PubMed1987

[Gynecological surgery under local anesthesia].

Local anesthesia allows interruptions of pregnancy until the 16th week; it also permits endo-uterine exploration, conization and treatment of synechiae. In terms of the breast, local anesthesia is indicated for the excision of palpable lesions, benign a priori, regardless of their size or location. The risk of overdose and vascular crossing is lower than with general anesthesia. It reduces hospital stay to a few hours but must be performed in a well-equipped operating suite in case of a possible complication.

Anesthesia, Local↗