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Biomedical subjects

T Beillat

Publications and source records attributed to T Beillat.

3 recordsLinked to original sources

[Polycythemia vera and pregnancy].

Polycythemia vera is a rare chronic myeloproliferative disease. Its exceptional association with pregnancy can lead to severe complications. Antithrombotic treatment could prevent such adverse outcome. A patient with two previous pregnancies complicated by preeclampsia, was treated by hydroxyurea for polycythemia vera. She started a new unexpected gestation without this myelosuppressive treatment and the pregnancy was conducted uneventfully with low molecular weight heparin and low dose aspirin. Thrombotic complications required the reintroduction of hydroxyurea. Diagnosis of polycythemia vera during pregnancy is a very difficult task due to physiologic changes occurring during gestation. Adverse outcome including severe vascular complications can be a preclinical phase of the disease. An adequate therapy could prevent these complications.

Adult↗

[Management of first trimester miscarriages].

INTRODUCTION: First trimester miscarriages complicating 15 to 20% of pregnancies, are the leading cause of gynecology emergencies. OBJECTIVES AND METHODS: This review exhaustively summarized the French and English reports found on Medline data base about the management of first trimester miscarriage. RESULTS: The treatment of reference remains surgical evacuation. It is generally used to avoid haemorrhage and intrauterine infection but is also required for women who wish an immediate termination of pregnancy. Recently, alternatives have been proposed, such as expectant management or medical treatment by misoprostol, to improve patient satisfaction and to reduce complications and costs generated by surgery. Expectant management allows to avoid curettage in most of incomplete miscarriages without any increase of the rate of complications or bleeding duration. Vaginal misoprostol allows complete expulsion in 70 to 90% of missed pregnancies without any increase of the rate of complications. CONCLUSION: Today, we can propose to motivated and informed patients an alternative to surgical treatment but large randomized studies still are needed to assess benefits and risks for each method.

Abortifacient Agents, Nonsteroidal↗

[Tocolysis with nifedipine: its use in current practice].

OBJECTIVES: To assess tocolysis with nifedipine in preterm labour during actual clinical practice in terms of efficacy and safety. PATIENTS AND METHODS: Retrospective observational study during two years including preterm labour between 26 and 33+6 weeks of amenorrhea. Preterm labour was defined by the presence of three or more uterine contractions in 10 minutes associated to cervical modifications diagnosed by vaginal sonography (length<or=25 mm). Patients were excluded if they had more than two fetuses or other gestational pathologies. Tocolysis resulted in oral taking of 30 mg of nifedipine (3x10 mg) with continuous follow-up of blood pressure. Tocolysis was modified when contractions did not disappear. Success was defined when delivery was delayed more than 48 hours. Failure was defined either by a delivery occurring in the first two days of tocolysis or when a modification of treatment was required. RESULTS: Fifty-eight patients were included, 10 of whom having a twin pregnancy. Success was obtained in 84% of patients (49/58). All of these women did not deliver during the first seven days after introduction of tocolysis. Five patients delivered in the first two days after tocolysis and four others required a change in tocolysis. Mean gestational age at delivery was 37+5 weeks and 35 weeks for single and twin pregnancies, respectively. No maternal or fetal side effects were described. DISCUSSION AND CONCLUSION: Nifedipine could be prescribed for tocolysis in actual clinical practice because it seems to have safety and excellent tolerance.

Adolescent↗