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Y Jacquemyn

Publications and source records attributed to Y Jacquemyn.

32 records · Page 2Linked to original sources

Doppler ultrasound of the fetomaternal circulation: a preliminary study on differences between ethnic groups.

PURPOSE OF INVESTIGATION: The aim of this study was to investigate whether the same reference values might be used for the pulsatility index obtained by Doppler examinations of the fetal umbilical and middle cerebral artery and the maternal uterine arteries in autochthonous Belgian, Turkish and Moroccan women in Belgium. Notching of the uterine artery was also studied in the three ethnic groups. METHODS: Doppler measurements were performed in 206 autochthonous Belgian, 36 Moroccan and 36 Turkish pregnant women between 20 and 24 weeks gestational age for the umbilical artery, middle cerebral artery and uterine arteries. The mean uterine artery pulsatility index and the placentocerebral index were calculated. Intra-observer variation was calculated by repeat measurements on 20 videotaped examinations and intrapatient variation was determined by repeat examination in 60 patients. RESULTS: Maternal length was higher and body mass index lower in Belgian women; more of these admitted smoking during pregnancy. There were no statistically significant inter-ethnic differences for the pulsatility index of the umbilical artery, middle cerebral artery, placental-site uterine artery and the placentocerebral index. The pulsatility index in the non-placental-site uterine artery and the mean uterine artery was lower in the Moroccan group. Intra-patient variation expressed as intra-patient standard deviation of the umbilical and middle cerebral artery pulsatility index was relatively large compared to inter-patient variation, being 57% to 88% of the inter-patient standard deviation. This was not the case for the uterine artery. Notching of the uterine artery was not contributive for the prediction of intrauterine growth restriction or preeclampsia in these ethnic groups. CONCLUSION: Only small statistically significant differences were demonstrated. For clinical practice, the use of different reference charts for fetomaternal Doppler measurement in Belgian, Turkish and Moroccan women is not warranted.

Arteries↗

Fetal biometry in different ethnic groups.

OBJECTIVE: The aim of this study was to determine whether differences in ultrasound-measured fetal biometry exist between pregnant woman of autochthonous Belgian origin and migrant women from Morocco and Turkey. METHOD: A prospective cross-sectional study was performed in which fetal biparietal diameter, head circumference, abdominal circumference and femur length were measured in pregnant women presenting between 18 and 40 weeks of gestation. Fetal weight was calculated using the formulae by Shepard and Hadlock. Only uncomplicated singleton pregnancies with a certain date of the last menstrual period, confirmed by early ultrasound, were included. The father of the child had to be of the same ethnic origin as the mother. Polynomial regression of the different measurements was performed for women of autochthonous Belgian origin and for migrant women from Morocco and from Turkey. RESULTS: Singleton fetuses numbering 524 were examined, including 369 Belgian, 78 Moroccan and 77 Turkish. Polynomial regression was performed for the three groups for the biparietal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight. No significant difference between the three different ethnic groups could be demonstrated for the biparietal diameter (P = 0.39). There was a significant difference for the head circumference (P = 0.017), the abdominal circumference (P = 0.0015), the femur length (P = 0.0014) and the estimated fetal weight for both formulae (Shepard P = 0.047; Hadlock P = 0.0006). CONCLUSION: In this set of cross-sectional data no significant difference for ultrasound-measured fetal biparietal diameter between autochthonous Belgian women and migrant women from Morocco and from Turkey could be demonstrated. Differences do exist for the head circumference, the abdominal circumference, the femur length and the estimated fetal weight. The use of adapted charts of fetal size for pregnant women of Turkish or Moroccan origin should be considered.

Belgium↗

Fetal binocular distance: no differences between ethnic groups.

OBJECTIVE: The aim of this study was to detect if interethnic differences for fetal binocular distance exist between the autochthonous Belgian population and immigrants from Turkey or Morocco, and to evaluate the need for different reference charts by ethnicity. METHODS: A prospective cross-sectional study was performed. In 246 pregnant women who presented for routine prenatal ultrasound between 18 and 40 weeks of gestation age the binocular distance was measured. Polynomial regression was performed for the three ethnic groups. RESULTS: The population consisted of 171 autochthonous Belgian women, 31 women from Turkish origin and 44 women from Moroccan origin. A statistically significant difference for the fetal binocular distance was noted between the Moroccan versus the autochthonous Belgian and Turkish fetuses (F test, p = 0. 047). The order of magnitude of this statistical difference is extremely small and does not result in clinical relevance. CONCLUSION: A small, but statistically significant difference exists for the fetal binocular distance between fetuses of Moroccan origin versus those of autochthonous Belgian or Turkish origin. This difference is of no clinical importance and there is no need to adapt reference charts for ethnicity when studying these three groups.

Adult↗

Fetal transverse cerebellar diameter in different ethnic groups.

AIMS: Transverse cerebellar diameter has been described as a tool to check for gestational age, but there are no available studies that attempt to determine differences in transverse cerebellar diameter between groups of different ethnic origin. The present study was undertaken to check for differences in ultrasound-measured transverse cerebellar diameter between pregnant women of autochthonous Belgian origin and migrant women from Morocco and Turkey. METHODS: A prospective cross-sectional study was performed. Patients were pregnant women presenting between 17 and 40 weeks of gestational age. Only uncomplicated singleton pregnancies with a known date of the last menstrual period confirmed by first trimester ultrasound were included. The father of the child had to be of the same ethnic origin as the mother. Polynomial regression was fitted for the three different ethnic groups. RESULTS: The transverse cerebellar diameter was obtained in 471 singleton fetuses, including 333 Belgian, 69 Moroccan and 69 Turkish. F-tests on the residual sums of squares of different fits demonstrated significant effects of ethnicity on the regression of the measurement versus gestational age (P < 0.00005). In a third order polynomial regression model the second order coefficient was significantly higher and the third order coefficient was significantly lower for the Moroccan group. CONCLUSION: The transverse cerebellar diameter is not independent of the ethnic origin of the patient. When using the transverse cerebellar diameter for the evaluation of fetal growth or for dating a pregnancy, care should be taken to rely on charts appropriate for the ethnic group, as demonstrated here for Moroccan fetuses.

Anthropometry↗

Cervical pregnancy: three case reports and a review of the literature.

Three cases of cervical pregnancy are described: the incidence, the diagnostic approach and different therapeutic managements used for this rare type of ectopic pregnancy are discussed. The last case shows that hysterectomy can be avoided by early diagnosis and by an adequate tamponing technique to control haemorrhage. For this purpose, a three-way Dufour catheter was successfully used to rinse the uterus with heated saline, allowing evacuation of intrauterine blood after curettage and to tampon the cervix.

Adult↗

Successful triplet pregnancy in a patient with a unicornuate uterus with a cavitary communicating rudimentary horn.

In a patient with primary infertility, ovulation was induced by monitored stimulation with human menopausal gonadotrophins (HMG) because of polycystic ovarian disease. Infertility work-up had shown a unicornuate uterus with a cavitary communicating rudimentary horn. The husband showed a varicocele-related moderate oligo-asthenoteratozoospermia. A triplet pregnancy occurred in a third HMG ovulation induction cycle combined with intra-uterine insemination of the husband's washed semen. The pregnancy was carefully monitored, and measures to prevent premature delivery were taken. Because of the patient's obvious discomfort in the presence of premature labour, Caesarean section was performed at 33 weeks gestation and three healthy infants were delivered. This is the first report of a successful triplet pregnancy in a women with a unicornuate uterus. The reproductive and obstetric outcome of this condition in general, and in the case of multiple pregnancy, is discussed.

Adult↗

Disturbances in dexamethasone suppression test and lower availability of L-tryptophan and tyrosine in early puerperium and in women under contraceptive therapy.

This study investigates the function of the hypothalamic-pituitary-adrenal (HPA)-axis and the availability of L-tryptophan and tyrosine to the brain in postpartum women and in women taking long-term oral contraceptives. To this end, we have measured the following parameters in 50 women (i.e. 9 normal controls, 10 women taking oral contraceptives, and 31 postpartum females): plasma cortisol, L-tryptophan, tyrosine and the amino acids (CAA) known to compete with them for transport through the blood-brain barrier. We have determined the effects of 1 mg of dexamethasone on the above-mentioned biological markers in postpartum females. Plasma cortisol and tyrosine were significantly higher and lower, respectively, in puerperium and in women under contraceptive therapy as opposed to normal controls. L-Tryptophan was significantly lower in postpartum females, whilst the L-tryptophan/CAA ratio did not differ across the three study groups. Postpartum females revealed a significant negative relationship between the availability of L-tryptophan to the brain and postpartum mood, as measured by Zung's Depression and Anxiety Scales and State Anxiety Inventory. Dexamethasone had a significant suppressive effect on L-tryptophan/CAA and tyrosine/CAA ratios, with cortisol nonsuppression appearing in 82% of the postpartum females.

Adult↗

Ovarian function in the non-mosaic Turner syndrome; a case report.

A 19-year-old girl, with the 45,XO non-mosaic Turner syndrome, presented having spontaneous regular menstrual activity. Hormonal analysis showed normal ovulatory cycles; histology of the ovaries demonstrated primary follicles. Nevertheless, the karyotype of the ovary and of the peripheral lymphocytes was pure 45,XO. Comment on ovarian function in the 45,XO karyotype is given.

Adult↗

Comparison of HMG/HCG superovulation for AID with or without superactive GnRH agonist.

New methods of ovulation induction have been discovered and perfected in recent years. Among others, gonadotrophin-releasing hormone (GnRH) agonists are being used increasingly in the treatment of ovulatory infertility. In a prospective study, 24 women undergoing artificial insemination with donor sperm (AID) and facing failure of treatment because of ovulation disorders, were treated with human menopausal gonadotrophin/human chorionic gonadotrophin (HMG/HCG) superovulation with or without pituitary densensitization using a superactive luteinizing hormone-releasing hormone (LHRH) agonist, buserelin (BUS), Suprefact (Hoechst, Frankfurt a/Main, FRG). In 86 cycles stimulated with HMG/HCG no pregnancy occurred, whereas 12 pregnancies occurred in the same group of patients after a total of 43 BUS/HMG/HCG stimulation cycles. Superactive LHRH agonists have a definite place in the treatment of AID patients presenting with refractory ovulation disorders and/or luteal insufficiency.

Administration, Intranasal↗

Antenatal ultrasonographic diagnosis of trisomy 18 (Edwards syndrome).

A 35-yr-old G7P6A0 presented at 28 weeks of gestation with an acute polyhydramnios. On ultrasonographic examination the diagnosis of trisomy 18 in the fetus was suspected. This was confirmed by chromosome analysis of the cultured amniocytes. The value of a systematic ultrasonographic examination, especially in every abnormal pregnancy, is briefly discussed.

Adult↗

Intrathecal labor analgesia with bupivacaine and sufentanil: the effect of adding 2.25 microg epinephrine.

BACKGROUND AND OBJECTIVES: Epinephrine, 25 microg and 200 microg, has been found to prolong the duration of intrathecal labor analgesia when added to an opioid. In our hospital we use the standard epidural mixture, prepared by the pharmacist, containing epinephrine 1:800,000; i.e., 1.25 microg/mL for both spinal and epidural labor analgesia. We wanted to evaluate whether such a low dose, depending on its effect on duration or quality of analgesia, should be maintained or deleted in future mixtures. METHODS: Forty-five term parturients were randomly assigned to receive 1.8 mL intrathecally of a mixture containing bupivacaine 0.125% and sufentanil 0.75 microg/mL with or without epinephrine 1.25 microg/mL. The quality and duration of analgesia, side effects, and obstetric/neonatal outcome were compared. RESULTS: For both combinations, the onset until the first painless contraction was between 5 and 6 minutes. Most patients were pain free during the second uterine contraction. The duration of complete analgesia was 93.2 +/- 24.2 minutes in the epinephrine group and 79.3 +/- 18.1 minutes for patients not receiving epinephrine (P = .014). The quality of the block, bupivacaine consumption, side effects, and obstetric/neonatal outcome were not different between groups. CONCLUSIONS: It was concluded that epinephrine in a dose as low as 2.25 microg significantly prolonged the duration of intrathecal analgesia of bupivacaine-sufentanil by 15 minutes. No other differences were noticed. Diluting the commercially available bupivacaine 0.5% with epinephrine 1:200,000 may avoid the need of freshly prepared epinephrine solutions.

Adult↗