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R Maillet

Publications and source records attributed to R Maillet.

At least 19 recordsLinked to original sources
PubMed1998

Use of energy color Doppler in visualizing fetal pulmonary vascularization to predict the absence of severe pulmonary hypoplasia.

OBJECTIVE: The aim of our study was to determine if the assessment of pulmonary vascularization by energy color Doppler during ultrasound examination can predict the absence of pulmonary hypoplasia before birth in situations where it is a high risk. METHODS: In a prospective study of 12 pregnancies presenting a risk of pulmonary hypoplasia (5 early and prolonged premature ruptures of the membranes, 1 diaphragmatic hernia, 1 chylothorax, 1 pulmonary sequestration, 1 omphalocele, 1 anamnios and 2 Potter's syndromes) energy color Doppler was used to visualize pulmonary vascularization. RESULTS: In 10 cases where pulmonary vascularization could be visualized, none of the infants had pulmonary hypoplasia. In the 2 cases of Potter's syndrome where pulmonary vascularization was not visualized there was a pulmonary hypoplasia. CONCLUSION: The visualization of fetal pulmonary vascularization with energy color Doppler in situations with a high risk of pulmonary hypoplasia can predict the absence of severe pulmonary hypoplasia.

Adult↗
PubMed1997

[A rare cause of postpartum hemorrhage: a genital thrombus].

Puerperal hematoma is a grave but fortunately rare hemorrhagic post-partum complication (occurring in less than 1:1000 deliveries). The hematoma arises due to detachment of para-vaginal conjunctive tissue. In this type of tissue, no natural hemostasis take place and the hematoma may spread into the retroperitoneal cavity. The different risk factors include primiparity, instrumental extraction of the foetus, pre-eclampsia, twin pregnancy and the presence of vulvo-vaginal varicose veins. External bleeding may not always be evident and other clinical symptoms may be delayed. Despite this, rapid course may still occur with drastic consequences. When a case is referred, an examination of the vulvo-vaginal region is mandatory, resuscitation and surgery performed immediately. If this fails angiographic embolization should be carried out. The prognostic outcome of this rare case of post-partum hemorrhagia is highly dependent on early diagnosis and rapid treatment involving close cooperation between obstetricians and anesthetists, and also of rapid embolization to prevent possible intractable hematomas.

Adult↗
PubMed1997

[Is the Mauriceau maneuver deleterious? Study of 103 cases].

The Mauriceau manoeuvre has a poor reputation in France where some obstetricians believe it leads to an increase in the number of neonatal traumal injuries. To evaluate this hypothesis we examined the results of a personal series of 103 cases of breech extraction where foetal head extraction was performed using the Mauriceau manoeuvre. Our study showed that the level of traumal complications was not worse than that of the general neonatal population. We therefore conclude that this active and organized method of breech delivery is safe and provides a young obstetrician with valuable experience of practical obstetrical manipulation.

Adolescent↗
PubMed1997

[Estimation of the treatment cost of cervical cancer].

BACKGROUND: The goal of this study was to estimate direct costs induced by the first year of treatment of cervix cancers according to the stage at diagnosis. METHODS: Fifteen patients of the Gynaecology Department of the Besançon hospital (Doubs, France) were involved in a prospective study to estimate the real cost of treatment of carcinomas in situ (CIS) by conization and of microinvasive carcinomas (MIC) by simple hysterectomy. Costs of invasive cancers were obtained from a retrospective analysis of 24 hospital records in the Radiotherapy Department. RESULTS: The average real cost of treatment for the CIS was 5023 FF (1995 French Francs). Real treatment cost of the MIC was 15,867 FF. The average cost of treatment for the IB and IIA cancers stage (FIGO classification) was 61,540 FF and 145,314 FF for the IIB to IV stage cancers. CONCLUSIONS: Cost-estimation of cervix cancer treatment according to the stage of diagnosis has to be done before starting a cost-effectiveness analysis of mass screening for cervix cancers. This study will allow us to take into account changes in the stages distribution following on a screening campaign.

Carcinoma in Situ↗
PubMed1996

[Ultrasonic diagnosis and laparoscopic treatment of an ovarian pregnancy. A case report and review of the literature].

Ovarian pregnancy is an uncommon type of ectopic pregnancy. Incidence has been estimated at 1 per 7 000 pregnancies and 1 to 6% of ectopic pregnancies. Pathogenesis is different from tubal pregnancy. Generally it occurs as a single event in an otherwise healthy woman. Early diagnosis of ectopic pregnancy is essential and is now possible with the advent of endovaginal sonography associated with serum beta-hCG assay. There are various forms of ectopic pregnancies. Macroscopically, 4 forms can be distinguished: hematoma, clar ovum, embryonnized ovum, and placenta with fetus. Histology alone can confirm the diagnosis and distinguish between the 4 forms: intrafollicular, justafollicular, justacortical and interstitial pregnancy. For many authors, laparotomy is required in all cases, but in any case, the ovary can generally be preserved as implantation is usually superficial. We describe here a case of ovarian pregnancy after stimulated ovulation. Early diagnosis with correct localization was achieved with endovaginal sonography. Conservative treatment with laparoscopy was successful.

Adult↗
PubMed1996

[Breech extraction of the second twin. 56 cases and review of the literature].

The best indication for breech extraction, and undoubtedly the last, is for delivery of the second twin with a non-cephalic presentation. At the Besançon University Hospital, we have used this technique routinely and without delay in case of non-cephalic presentation of the second twin. In order to evaluate the results of this approach, we studied 56 patients files retrospectively in a continuous series of case over a 7-year period. The following data were noted: birthweights, APGAR score at 5 minutes, requirement for paediatric intensive care, hospitalization in paediatric ward, and death. Gestational age and rate of prematurity were calculated. We also recorded the rate and type of antalgisia used, as well as the frequency of episiotomy. Both the obstetrical and neonatal results indicated that breech extraction of the second twin is a reliable effective technique in terms of mortality and morbidity for the second twin. Using this technique should not raise any legal problems since the other techniques for delivering the second twin have not been shown to give better results. When planned and performed under precise conditions by an experimented physician, this route does not give any poorer results than cesarean. Breech extraction should be an exceptional technique all obstetricians can use, together with cesarean, for delivering the second twin.

Adult↗
PubMed1996

[Hereditary angioneurotic edema in gynecology-obstetrics. Management].

Hereditary angioneurotic edema is a rare disease (250 cases currently identified in France). It is the most frequent among hereditary deficiencies of the complement system. This severe disease is fatal in 15-20% of the patients before 40 years of age. Death can be prevented if correct steps are taken in case of even minor trauma, which often trigger acute, potentially fatal, episodes. Danazol is used as preventive therapy before surgery and C1-esterase inhibitor or fresh frozen plasma is given for acute episodes. In case of obstetrical trauma, C1-esterase inhibitors should be used either as prophylaxy or as treatment. Fresh frozen plasma is used if C1-esterase inhibitors are not available. We report here our experience with three patients with known hereditary angioneurotic edema. Gynecology surgery was required in two.

Adult↗
PubMed1996

[Obstetrical epidural analgesia: an epidemiological in Bourgogne and Franche-Comté 1993].

Many publications report the number of epidural analgesias carried out for the last years in English-speaking countries. On the other hand, very little information exists about the incidence of obstetrical epidural analgesia performed in South and Central Europe, particularly in France. A retrospective study within the regions of Bourgogne and Franche-Comté was carried out for the year 1993 firstly, to determine the number of obstetrical epidural analgesias performed and the drugs used; and secondly, to describe the organization and the problems encountered. The result of this study leads to one major question: what is the best type of organization in order to guarantee the highest safety, given the increasing demand for epidural analgesia in obstetrics?

Analgesia, Epidural↗