PubMed Health⌕ Search

Biomedical subjects

R Maillet

Publications and source records attributed to R Maillet.

48 records · Page 3Linked to original sources

[Recording of fetal movements during pregnancy. Aid to the diagnosis and prognosis ascertained by Tococinon].

Objective recording of fetal movements has become operational since the use of the tococinon. At the beginning of pregnancy, from the twelfth week of amenorrhoea onwards, aberrant values seem to be linked to several factors such as mother's anxiety, urinary infection and anesthesia. If they are repeated that suggests there are abnormalities, such as trisomies or malformations in the central nervous system, and implies that other diagnostic methods must be used to make the diagnosis such as ultrasound or amniocentesis. A new definition for lowered activity by the fetus is proposed for the end of pregnancy. If these recordings are repeated before or at the same time as other signs of fetal distress have been found we must think of pathological features such as intrauterine growth retardation, post-maturity, infections, rhesus incompatibility and diabetes. Pharmacological influences, too, have to be thought of and they are usually correlated with rises in the fetal pulse rate and with using the apparatus when the patient is walking about.

Amniocentesis↗

[Current aspects of engagement dystocia].

It seems likely, in view of the large number of caesarean operations that are now being carried out and that too have complications, that the mechanism of obstetric procedures will sooner or later become of interest again to obstetricians. This study looks at a consecutive series of cases where dystocia in the upper part of the pelvis occurred and tries by analysing different obstetrical parameters to work out the best time for carrying out different obstetrical manoeuvres. It is possible to come to two conclusions, so long as both the mother and the fetus are watched carefully during the labour: the trial of delivery of the fetal head using the obstetric ventouse will bring about a significant reduction in the numbers of caesarean operations. it is always rewarding to be patient and it does not seem sensible to intervene too quickly. Two important results come from this approach: mechanical dystocia has practically disappeared, as it now only occurs in about 1% of labours. on the other hand, particularly in primiparous women, dystocia in the upper straight of the pelvis is quite common.

Adolescent↗

[Stenosis of hemodialysis grafts. Treatment with a short graft].

In elective or emergency operations 363 short venous or polytetrafluoroethylene grafts were inserted to correct stenosis of haemodialysis grafts. Such stenoses are located in the upper part of the graft or in the receiving vein in 80% of the cases. After 2 years, 74% of the short grafts were still permeable. This original technique has several advantages: the initial venous approach is respected, the graft can be used immediately for dialysis, and the patient's venous "capital" is spared.

Arteriovenous Shunt, Surgical↗

[The treatment of certain cases of sterility of infertility associated with an abnormal rise in urinary 17-ketosteroids by using cortisone derivatives (author's transl)].

45 women who were infertile with primary or secondary infertility were studied. The only abnormality that was found was biological, and it was a 24-hour excretion of urinary 17-ketosteroids higher than 35 micromoles. Treatment with cortisone derivatives resulted in 56 pregnancies, which were studied to their term whether it was abortion or delivery. The theoretical and practical aspects, as well as the diagnoses and treatments, are discussed.

17-Ketosteroids↗

[Uterine adenomyosis (author's transl)].

Uterine adenomyosis is a common, almost banal, lesion, since it is found in one uterus out of three by careful histological examination. In a continuous series of 926 hysterectomies for various indications, 246 adenomyosis lesions were demonstrated. In only 65 cases, adenomyosis was the sole histological lesion explaining bleeding or pain, symptoms refractory to routine conservative treatment (haemostatic curettage and/or hormone treatment) and therefore justifying surgical removal of the uterus. The role of adenomyosis in the failure of conservative treatment for diffuse fibromatosis at around the age of the menopause must be remembered. Almost 50% of specimens of hysterectomy for fibroma show evidence of associated histological lesions of internal uterine endometriosis. Whilst the hysterographic diagnosis may be suspected in almost 2/3 of cases, direct appearances of adenomyosis are found in only one case in four.

Adult↗

[Dynamic study of tissue circulation in the cervix uteri and the prognosis of the newborn infant].

A new machine has been developed to measure heat dissipated in the tissues especially by convection linked to the blood flow. Its use is simple and without any danger as far as application to the pregnant cervix goes. New discoveries are presented. A new concept of the micro-circulation is considered together with the consequences. The practitioner may be able to draw conclusions as to the prognosis, as to whether a small-for-dates fetus together with or without premature labour is likely. This depends on the tracings obtained which register the intrinsic activity of the periarteriolar muscles.

Cervix Uteri↗

[The effects of heparin in underdevelopment of the fetus due to maternal vascular conditions (author's transl)].

The use of heparin to interfere with the appearance of fetal maldevelopment (or to correct it) is logical but the results are difficult to prove because it is difficult to be certain of early diagnosis at the time when therapy has the best chances of being efficacious. The authors compare two groups of pregnant women in whom the muscular vascular tone of the cervix is abolished. The second group was treated with heparin. The results are statistically significant and prove that treatment with heparin is well based in cases of underdevelopment of the fetus when it is due to abnormalities in the maternal microscopic circulation (acute atherosis). They confirm that the enzyme, hormone and ultrasound parameters return to normal from the beginning of treatment with heparin.

Arteriosclerosis↗

[Unrecognized hemorrhages during delivery].

On the basis of a series of 600 deliveries between January 1 and May 1 1993, the authors analyze cases of unrecognized delivery-related hemorrhage. Hemorrhage of this type, defined retrospectively on the basis of a difference of at least 3g/100 ml in hemoglobin levels at the time of admission to the labor ward and on the 2nd day post-partum, were found in 3.83% of deliveries and were responsible for 51.11% of falls in hemoglobin of 3g/100 ml or more. Primiparity, induced labor (oxytocics), episiotomy, forceps extractions and cesarean section are their etiologic factors. Particular care should be taken in the presence of any of these factors and induced labor may be useful in the prophylaxis of these unrecognized hemorrhages.

Adult↗

[Non-specific fetal infections: possibilities and value of early diagnosis].

Notes of 4,000 obstetric and neo-natal cases have been analysed. The role of non-specific fetal infection (which means excluding syphilis, toxoplasmosis and German measles) has been defined with the backing of histopathological, bacteriological and clinical findings. Its role in perinatal mortality and neo-natal morbidity has been outlined. Possibilities for prevention of the condition are suggested, dealing with premature rupture of the membranes and clear-cut maternal infection. "At risk of infection" is the term that has been defined for neonates by studying carefully obstetrical clinical parameters where they are isolated or associated with other conditions but relatively innocuous. When the condition has been defined in particular cases, intensive supervision of the children at risk must be carried out so that as a result of bacteriological findings therapy can be started earlier, better adjusted to the condition and promising a better prognosis.

Female↗