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Biomedical subjects

P Maghioracos

Publications and source records attributed to P Maghioracos.

14 recordsLinked to original sources
PubMed1991

[Rupture of a healthy uterus in a prostaglandin-induced abortion in the second trimester].

The authors report one case of uterine rupture in a non scarred uterus when an analogue of prostaglandin E2 was being transfused. It was Sulprostone used to terminate a pregnancy because of fetal death in utero after 27 weeks of amenorrhea. This case history and an analysis of the literature makes it possible to point out the need to reach the diagnosis before signs become too severe and to show that pharmacological knowledge of the drug has to be improved as well as the ways of administering prostaglandin analogue. This is to be conducted together with improving the ways of terminating pregnancies in the second trimester. It shows that mechanical accidents can occur even where there are no obvious risk factors. In this case, pain continued from the time of the rupture under epidural anaesthesia. The physiopathology is reviewed. Finally, conservative treatment of the uterus should be carried out whenever possible in order to allow a new pregnancy to occur and to lessen the morbidity of the operation.

Abortifacient Agents, Nonsteroidal↗
PubMed1990

[Changes in the cesarean section percentage].

More and more cesarean sections (C/S) are done, rate multiplied by 3 or 4 in occidental countries in these post two decennials, but are really too many done (?), as it is regularly reproched to the obstetricians, even though perineonatal morbidity and mortality rates have improved. By help of files studied in the gynecological and obstetrical Ward of Saint Antoine's Hospital Paris over 60 years, the authors have tried to answer to a few basic questions: The reason to be of the first C/S before labor and during labor, and the reason to be of iterative C/S in the same conditions. What results is: The rate of C/S has barely changed fur the following causes: Important dystocia known before or during labor, or Chronic foetal distress. On the other hand it increased because of: Acute foetal distress revealed during labor by alteration of the foetal heart beat (FHB). Stagnation of dilatation often accompanied by alteration of the FHB. An increase of iterative C/S due themselves to the increased number of scarred uteri. To reduce the progression of the number of C/S, we should therefore try to: Reduce the amount of scarred uteri, therefore have better knowledge of the indication of the first C/S. But is it feasible without compromising the benefits acquired by modern obstetrics, in means of perineonatal mortality and morbidity? Accept more often birth by vaginal route on the scarred uteri, the actual means of surveillance of labor appear to be able to permit it.

Cesarean Section↗
PubMed1988

[Clinical and urodynamic results of the Burch colposuspension operation in the treatment of female urinary stress incontinence. A study apropos of 370 cases].

The surgical treatment of female genuine stress incontinence remains a not wholly solved problem. We prefer since 1980 the indirect colposuspension according to Burch as it represents 76% of our operations for genuine stress incontinence. We report 370 cases. The operation has been: isolated in 153 cases; associated with a total hysterectomy in 160 cases; associated with an indirect sacral fixation with a prosthesis of non adsorbable tissue in 57 cases. Clinical examination has always been completed with a urodynamic investigation pre-operatively and in the year following the operation. After two years or more, 188 urodynamic controls could be done. Clinical and urodynamic results are excellent and lasting after 5 years. Clinical failures represent only 4.6% of the cases and seem to be in relationship with technical defects as they occur in 78.4% of the cases in the first year following surgery. Associated sacral fixations, second hand cases, sphincter insufficiency appearing after surgery are the main factors giving way to the failures.

Adult↗
PubMed1988

[Treatment of urogenital prolapse with exertion-induced urinary incontinence using the Bologna technic. Apropos of 90 cases].

The authors describe this operation, which is carried out as a single procedure which they have been doing since 1982. Then the results in 90 patients are studied. The post-operative controls carried out on the clinical state of the patient and on the urodynamic tests show that this operation is very successful, both in curing stress incontinence and in giving a good anatomical result for correcting prolapse of the anterior wall of the vagina. In over one-third of the cases the post-operative follow-up has been carried out for 2 years or more. This follow-up has shown that the relapse rate over a period of time, both for the stress incontinence and the prolapse, is nil. The principal snags that still remain are: post-operative infection in about a third of cases; the rare but possible development of an enterocele and of dyspareunia (2%).

Adult↗
PubMed1987

[Changes in indications for cesarean section from 1977 to 1983. Apropos of 18,605 deliveries].

Between 1977 and 1983 there were 18,605 women delivered in the maternity unit of St-Antoine Hospital. Of these 2,382 had caesarean operations, which is a percentage of 12.8. This percentage rose in a statistically significant way between 1977, when it was 8.8% and 1984 when it was 14.9%. Three groups of indications for caesarean operations were classified. These are: absolutely essential caesareans (feto-pelvic disproportion, placenta praevia, transverse lies). Prophylactic caesareans (uterine scars, breech presentations and fetal distress) and caesarean operations judged eventually to be necessary (dystocia in labour, high blood pressure and maternal pathology). The rise in the caesarean operations in the period of years studied came mainly from the increase in prophylactic caesarean operations, which reflected a progressive change in the attitude of obstetricians in the department. A study of the literature shows that this change coincided with a parallel change in many countries without there having been any concerted action between the countries, and also because there was a general desire to control the great rise in the number of caesareans and to find the optimum number that should be performed.

Cesarean Section↗
PubMed1985

[Luteal insufficiency and endometriosis. Comparative study of plasma progesterone and of the evolutionary stage].

24 patients who had more than two years of infertility were checked by laparoscopic and hormone (plasma progesterone) tests at the 21st-23rd day of the cycle. Two comparable groups were found: Group A with no visible endometriosis, and Group B with obvious endometriosis (stage I, IIa, IIb according to Kistner's classification). There is a significant difference between the two groups as far as the levels of progesterone in the plasma are concerned, because they are lower in Group B than in Group A. On the other hand, there is no correlation to be demonstrated between the severity of the endometriosis and the low level of progesterone.

Adult↗
PubMed1983

[The epidemiological study of endometrial adenocarcinoma. From 74 cases seen at the Saint-Antoine Maternity Hospital].

The epidemiologic study of 74 invasive endometrial adenocarcinomas seen over five years confirms the following well-known risk factors: early menarche, disorders of menstruation, hypofertility, and late menopause. Obesity, a positive family history and the presence of another cancer are common findings. Hormone dependent endometrial cancer provides a valuable opportunity for studying hormone and cell receptor concentrations. Hormone dependency has a practical bearing on certain preventive measures and perhaps on a new therapeutic approach to this type of cancer.

Adenocarcinoma↗
PubMed1983

[Myomectomy in nonpregnant women. Indications. Technics. Apropos of 70 cases at the Saint-Antoine's Maternity Hospital].

Seventy cases of myomectomy performed over 5 years (1977 to 1982) in the department of Gynecology & Obstetrics of the St Antoine Hospital in Paris are analyzed. During the same period, 465 patients underwent hysterectomy for leiomyoma. A brief review shows that myomectomy is not the best surgical treatment of uterine leiomyoma because of its complications. Hemorrhagy, pelvic pain and infertility remain the principle modes of discovery of uterine leiomyoma in operated patients, whose median age is fairly low. Hysterosalpingography is still the main procedure for the investigation and diagnosis of leiomyoma. However, indications of echotomography have been extended with an increase in the frequency of diagnosis of leiomyoma due to a better semiology. Primary leiomyoma section followed by excision appears preferable to conventional enucleation, which is frequently hemorrhagic and blind. In determining the indications of myomectomy, certain factors must be borne in mind: age, parity, type and insertion of leiomyoma, gynecologic history and psychological status. Good postoperative results explain the recent favor of myomectomy as the conservative surgical treatment of leiomyoma; surgical abstention, however, remains the best decision in most cases.

Adult↗
PubMed1983

[Borderline ovarian tumors: an epidemiologic, diagnostic, prognostic and therapeutic study. Apropos of 20 cases reported at the Saint-Antoine Maternity Hospital].

Twenty cases of borderline ovarian tumors were seen in the Department of Gynecology and Obstetrics at the St. Antoine Hospital over 5 years. The epidemiological study of these 20 tumors, relative to 47 invasive ovarian carcinomas seen over the same period, shows that hypofertility is more prevalent and that patients are younger. Diagnosis rests mainly on the histological examination of the operative specimen. The overall prognosis is good but recurrences, which may be delayed, are possible. These patients, who are often young, may be managed conservatively, at the cost of prolonged follow-up, including cytologic and coelioscopic examinations.

Adult↗
PubMed1983

[Comparative study of 15 borderline tumors and 31 cancers of the ovaries. Epidemiologic, diagnostic and therapeutic aspects].

46 epithelial tumours of the ovary were seen over a period of 5 years. These tumours could be subdivided into 15 borderline tumours and 31 invasive cancers. An epidemiological study did not make it possible to find special factors in relationship to these two types. Studying the circumstances under which diagnoses were made demonstrated the value of considering: pain, ultrasound pictures and cytology from the Pouch of Douglas. It is essential to carry out laparotomy in every case of an organic tumour of the ovary. It is only by histological examination that it is possible to tell whether a tumour is borderline of invasive. A protocol for carrying out treatment is suggested. The results confirm the excellent prognosis for borderline tumours and the seriousness of other epithelial cancers of the ovary.

Adolescent↗
PubMed1983

[Cervical dilatation using PGF2 alpha gel before voluntary interruption of pregnancy during the first trimester].

To avoid complications of instrumental dilatation of the cervix prior to first trimester abortion, pharmacological dilatation by prostaglandins is proposed. The authors present a prospective randomized study using intra-cervical PGF2 alpha-gel, in 90 patients. Two groups (PGF2 alpha: 5 and 2.5 mg) were compared with a placebo group. The mean cervical dilatation observed in the two groups (8.2 and 8.4 mm) is higher than the placebo group dilatation (6.8 mm), but statistically higher only in group 2.5 mg. Side effects were observed: uterine pain (83 and 57%) and nausea (33 and 13%) in the first three hours after the gel. With the same cervical dilatation, side effects were less important in the low dose group (2.5 mg PGF2 alpha).

Abortion, Induced↗
PubMed1982

[External pelvic endometriosis: diagnostic study. Our experience in the maternity department of Saint-Antoine Hospital. A propos of 130 cases].

The circumstances leading to the diagnosis of pelvic endometriosis (adenomyosis excluded) were studied in 130 patients. From the epidemiological data yielded by these cases, the profile of women susceptible to this disease is delineated. Hysterosalpingography is the key to the diagnosis of endometriosis in most instances; however, coelioscopy and/or laparotomy are required to establish the diagnosis, as well as for staging the disease which is important for the choice of therapy.

Adult↗