268 results on '"F, Daffos"'
Search Results
102. [Direct collection of fetal blood from the umbilical vein under echography. First results, prospects]
- Author
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F, Daffos, M, Capella-Pavlovsky, and F, Forestier
- Subjects
Blood Specimen Collection ,Umbilical Veins ,Pregnancy ,Prenatal Diagnosis ,Humans ,Female ,Fetal Blood ,Ultrasonography - Published
- 1983
103. [Immunization against the ZWa (PLA1) platelet antigen: group at risk, prevention of complications. Apropos of 132 cases]
- Author
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M F, Reznikoff-Etievant, J Y, Muller, C, Kaplan, C, Patereau, S, Clémenceau, N, Simonney, F, Castellano, F, Daffos, F, Forestier, and M H, Poissonnier
- Subjects
Blood Platelets ,Risk ,Isoantigens ,Infant, Newborn ,Integrin beta3 ,Transfusion Reaction ,HLA-DR Antigens ,Thrombocytopenia ,HLA-DR3 Antigen ,HLA Antigens ,Isoantibodies ,Pregnancy ,Blood Group Incompatibility ,Humans ,Antigens, Human Platelet ,Female - Abstract
The identification of anti-ZWa (-PLA1) alloimmunisation is not very frequent. It can be observed in most perinatal alloimmune thrombocytopenias (PAT) and rare post transfusional purpuras (PTP). On the other hand, the clinical consequences of these immunisations are often dramatic, particularly for the foetuses for which there has been no prevention so far. The retrospective study of 132 cases, 123 PAT and 9 PTP, shows the possible irreversible complications for 18% of the newborns with PAT, but especially for 10% of the foetuses which will show PAT at birth. HLA markers are very useful to detect the people who are likely to develop an anti-PLA1 immunization for they are PLA1 negative and HLA DR3. Then, it becomes possible to prevent the complications of these immunisations. It is what we tried to do through the diagnosis and the treatment of PAT in 3 foetuses.
- Published
- 1986
104. Technical aspects of prenatal samplings and fetal transfusion
- Author
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F, Daffos
- Subjects
Pregnancy ,Prenatal Diagnosis ,Blood Transfusion, Intrauterine ,Humans ,Female ,Fetal Blood ,Thrombocytopenia - Published
- 1988
105. Possibility of prenatal diagnosis of hereditary triose phosphate isomerase deficiency
- Author
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F. Forestier, F. Daffos, Raymonde Rosa, Marie-Claude Calvin, and Marie-Odette Prehu
- Subjects
Male ,medicine.medical_specialty ,Heterozygote ,Dehydrogenase ,Prenatal diagnosis ,Biology ,Anemia, Hemolytic, Congenital ,Umbilical cord ,Triosephosphate isomerase ,Pregnancy ,Internal medicine ,Prenatal Diagnosis ,parasitic diseases ,medicine ,Humans ,Genetics (clinical) ,Fetus ,Infant, Newborn ,Obstetrics and Gynecology ,Heterozygote advantage ,medicine.disease ,Fetal Blood ,Fetal Diseases ,Endocrinology ,medicine.anatomical_structure ,In utero ,Female ,Carbohydrate Epimerases ,Metabolism, Inborn Errors ,Triose-Phosphate Isomerase - Abstract
Prenatal diagnosis has been performed on umbilical cord blood of an 18 weeks fetus of heterozygous triosephosphate isomerase (TPI) deficient parents. After excluding maternal blood contamination, TPI activity was measured and found to be 60 per cent of the normal mean whereas the value of glucose-6-phosphate dehydrogenase activity was in the normal range of fetal blood. In addition, the analysis of the characteristics of fetal TPI, i.e. Km measurements for glyceraldehyde-3-phosphate, heat stability tests and electrophoretic studies, did not show any evidence of a special form of TPI in fetal blood. These results were consistent with the heterozygous state and were confirmed at birth.
- Published
- 1986
106. [Prenatal detection of coagulation disorders and hemophilia]
- Author
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F, Forestier, F, Daffos, Y, Solé, M, Rainaut, and D, Descombey
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Pregnancy ,Prenatal Diagnosis ,Humans ,Female ,Blood Coagulation Disorders ,Fetal Blood ,Hemophilia A - Published
- 1987
107. Die ultraschallgestützte Entnahme von Fetalblut
- Author
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F. Forestier and F. Daffos
- Abstract
Seit 1972 ist es moglich, wahrend der Schwangerschaft fetale Blutproben zu entnehmen. Bis 1982 wurde die Blutentnahme mit Hilfe der Fetoskopie, einem schwierigen, invasiven Verfahren durchgefuhrt, das mit einem erheblichen Risiko fur den Feten verbunden war. Diese Technik war daher auf sehr wenige spezialisierte Zentren in der Welt begrenzt und wurde nur zur pranatalen Diagnostik bestimmter Erbkrankheiten (Hamoglobinopathien, Hamophilie) angewandt.
- Published
- 1989
108. Gradual appearance of total IgM in fetal serum during the second trimester of pregnancy. Application to the prenatal diagnosis of fetal infections
- Author
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F, Daffos, F, Forestier, L, Grangeot-Keros, and M C, Pavlovsky
- Subjects
Immunoglobulin M ,Pregnancy ,Pregnancy Trimester, Second ,Prenatal Diagnosis ,Humans ,Female ,Fetal Blood ,Rubella ,Toxoplasmosis, Congenital - Published
- 1984
109. T-cell subpopulations of fetuses infected by Toxoplasma gondii
- Author
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F. Derouin, S. Marion, F. Daffos, B. Lecolier, and G. Sarrot
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,Fetus ,business.industry ,T cell ,T-Lymphocytes ,General Medicine ,Fetal Blood ,Virology ,Toxoplasmosis, Congenital ,Fetal Diseases ,Leukocyte Count ,Infectious Diseases ,Medical microbiology ,medicine.anatomical_structure ,Pregnancy ,Prenatal Diagnosis ,Medicine ,Animals ,Humans ,Female ,business - Published
- 1989
110. [Fetal blood sampling: a new technic under echographic control]
- Author
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M, Capella-Pavlovsky, F, Daffos, and F, Forestier
- Subjects
Blood Specimen Collection ,Pregnancy ,Humans ,Female ,Fetal Blood ,Ultrasonography - Published
- 1983
111. Pränatale Diagnostik der kongenitalen Röteln und Toxoplasmose durch fetale Blutentnahme unter Ultraschallsicht
- Author
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F. Forestier and F. Daffos
- Abstract
Durch die Fetoskopie ist es seit 1973 moglich geworden, reines fetales Blut im 2. Schwangerschaftstrimenon zu gewinnen; aber wegen der Schwierigkeit dieser Methode sind auf der ganzen Welt bisher erst einige Tausend solcher fetalen Blutentnahmen vorgenommen worden.
- Published
- 1987
112. [Prenatal pharmacology of low molecular weight heparin and pentosan polysulfate]
- Author
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M, Rainaut, F, Forestier, F, Daffos, A M, Fisher, and M, Aiach
- Subjects
Pentosan Sulfuric Polyester ,Polysaccharides ,Pregnancy ,Pregnancy Trimester, Second ,Pregnancy Trimester, Third ,Anticoagulants ,Humans ,Female ,Heparin, Low-Molecular-Weight ,Fetal Blood ,Blood Coagulation ,Maternal-Fetal Exchange - Abstract
The aim of prenatal pharmacology is to evaluate the biologic effects to the fetus of a drug taken during pregnancy. Development of a new technic for collection of fetal blood samples in utero under ultrasound guidance allowed, by evaluation of maternal and fetal hemostasis, study of two low molecular weight heparins, PK 10169 (Lovenox) (table I) and CY 216 (Fraxiparine) (tableau II) and of pentosan polysulfate (Hemoclar) (table III). Under the operating conditions applied, the three molecules failed to diffuse across placenta during 2nd and 3rd pregnancy trimesters. This permitted treatment of eleven women at risk for eclampsia or thromboembolism with good clinical results, white confirming absence of circulating heparinemia at birth (umbilical cord blood).
- Published
- 1987
113. Absence of transplacental passage of pentosan polysulfate during mid trimester of pregnancy
- Author
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F, Forestier, A M, Fischer, F, Daffos, S, Beguin, and H, Diner
- Subjects
Pentosan Sulfuric Polyester ,Hemostasis ,Fetal Blood ,Polysaccharides ,Pregnancy ,Pregnancy Trimester, Second ,Factor X ,Factor Xa ,Injections, Intravenous ,Humans ,Female ,Partial Thromboplastin Time ,Blood Coagulation ,Maternal-Fetal Exchange - Abstract
Eight women who were going to have an abortion between the 18th and 23 week of gestation for chromosomal abnormalities or haemoglobinopathies received intravenously 50 mg of pentosan polysulfate (PSP). Maternal results of haemostasis prior and after the injection of the drug were compared. Fetal coagulation parameters were tested on samples obtained by direct puncture of the umbilical cord under ultrasound guidance, 30 min after injection. Results were compared to those of normal fetuses at the same stage of gestation, obtained in the same conditions. In mothers' plasma, 30 min after injection, APTT was prolonged, factor Xa generation was markedly impaired, and factor V level was deeply decreased. By contrast, no modifications of these parameters were observed in fetal plasma, 30 min after the injection of PSP to their related mothers when compared to control fetuses. Thus the absence of biological modifications induced by PSP injection could demonstrate that this drug does not cross through the placenta.
- Published
- 1986
114. Allo-immune thrombocytopenias, definition of a group at risk; a prospective study
- Author
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M F, Reznikoff-Etievant, C, Kaplan, J Y, Muller, F, Daffos, and F, Forestier
- Subjects
Blood Platelets ,HLA-D Antigens ,Isoantigens ,Infant, Newborn ,Integrin beta3 ,Thrombocytopenia ,HLA Antigens ,Isoantibodies ,Pregnancy ,Risk Factors ,Humans ,Antigens, Human Platelet ,Female ,Prospective Studies - Published
- 1988
115. Placental transfer of vitamin K1 and its implications in fetal hemostasis
- Author
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L, Mandelbrot, M, Guillaumont, M, Leclercq, J J, Lefrère, D, Gozin, F, Daffos, and F, Forestier
- Subjects
Hemostasis ,Spectrometry, Fluorescence ,Vitamin K ,Pregnancy ,Humans ,Female ,Fetal Blood ,Maternal-Fetal Exchange - Abstract
Vitamin K status was evaluated using coagulation studies and/or vitamin K1 assays in a total of 53 normal fetuses and 47 neonates. Second trimester fetal blood samples were obtained for prenatal diagnosis under ultrasound guidance. Endogenous vitamin K1 concentrations (determined by high performance liquid chromatography) were substantially lower than maternal levels. The mean maternal-fetal gradient was 14-fold at mid trimester and 18-fold at birth. Despite low vitamin K levels, descarboxy prothrombin, detected by a staphylocoagulase assay, was elevated in only a single fetus and a single neonate. After maternal oral supplementation with vitamin K1, cord vitamin K1 levels were boosted 30-fold at mid trimester and 60-fold at term, demonstrating placental transfer. However, these levels were substantially lower than corresponding supplemented maternal levels. Despite elevated vitamin K1 concentrations, supplemented fetuses and neonates showed no increase in total or coagulant prothrombin activity. These results suggest that the low prothrombin levels found during intrauterine life are not due to vitamin K deficiency.
- Published
- 1988
116. In utero fetal sampling in neonatal alloimmune thrombocytopenia: justification and usefulness
- Author
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J Y, Muller, C, Kaplan, M F, Reznikoff-Etiévant, C, Patereau, F, Daffos, F, Forestier, M C, De Puy Montbrun, D, Lyon-Caen, and C, Salmon
- Subjects
Blood Platelets ,Isoantigens ,Cesarean Section ,Infant, Newborn ,Integrin beta3 ,Blood Transfusion, Intrauterine ,Platelet Transfusion ,Fetal Blood ,Prognosis ,Thrombocytopenia ,Antigen-Antibody Reactions ,Fetal Diseases ,Isoantibodies ,Pregnancy ,Prenatal Diagnosis ,Humans ,Antigens, Human Platelet ,Female - Published
- 1988
117. ANTENATAL DIAGNOSIS OF THROMBOPATHY
- Author
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F Daffos, Bernadette Boizard, J L Wautier, Yves Gruel, Jacques P. Caen, and F Forestier
- Subjects
Thrombopathy ,Pediatrics ,medicine.medical_specialty ,business.industry ,medicine ,business - Abstract
We previously determined platelet antigens and glycoproteins in the human fetus after 19 weeks of intrauterine life (Blood 68, 488-92,1986). These results obtained in fetuses with normal platelets allowed us to do the first attempt of antenatal diagnosis in Glanzmann thrombasthenia. The fetal propositus was tested with monoclonal (AP2, AP3) or polyclonalantibodies (IgGL) directed against GPIIbllla or platelets antigen (PLA1, Leka). The foetus was found to be heterozygous for GT and similar results were foundafter his birth.Grey platelet syndrome is a rare congenital platelet defect caracterized by an alpha granule deficiency and is transmitted on the dominant feature. To be able to detect this abnormality before birth we have measured the platelet content of alpha granules.The amount of Beta thromboglobulin (gTG) at 18 weeks of intrauterine life was32±4.3 mg/109 platelets in normal platelets (adults 60 mg/10^ platelets). The foetus of the mother with grey platelet syndrome was sampled at 19 weeks when the mother was under platelet transfusion and the platelets were studied by electron microscopy and for their BTG content. The platelet morphologyshowed the presence of alpha granules and the $TG content was in the range of the control fetuses (42mg/109 platelets). The baby was born after artificial delivery under platelet transfusion. These results showed that the antenatal diagnosis of thrombopathies is feasible and can permit a therapy to avoid dramatic haemorrhage during pregnancy or delivery.
- Published
- 1987
118. PRENATAL DIAGNOSIS OF HEMORRHAGIC DISORDERS
- Author
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P. Champeix, F Forestier, Cécile Kaplan, and F Daffos
- Subjects
medicine.medical_specialty ,business.industry ,Obstetrics ,Medicine ,Prenatal diagnosis ,business ,Hemorrhagic disorder - Abstract
Utilizing an easy and safe procedure for fetal blood sampling in utero. we have studied 123 fetuses for congenital oracquire hemorrhagic disorders.Usually, the diagnosis is performed at the 18th week of gestation. To date, no fetal less or premature labor has beenattributed to these fetal samplings. Theduration of the procedure was less than 10 minutes in 90 % of the cases. Direct blood sampling with a needle guided by ultrasound is safer for fetuses and simpler for the patients than fetoscopy. Among the 1.465 samplings the mortality rateis 0.2 %. We have established the basis values for fetal hemostasis when the samplings were performed for non hematological purpose, and could determine the fetal sex which play a role in hereditary disorders. Hemophilia A and B [92 cases]. Willebrand disease, factor XIII, V and VII deficiencies were diagnosed on the existence of a specific fetal deficit. Theknowledge of the fetal primary hemostasis let us to establish the diagnosis of May Hegglin syndrome. Gray platelet syndrome. and Glanzmann's thrombasthenia. There were no diagnostic errors. This procedure offers a new possibility of easily taking iterative samples, until the end of pregnancy, which represents a particular interest in prenatal diagnosis.
- Published
- 1987
119. [Pulmonary scintigraphy in check-up and surveillance of oral contraception]
- Author
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C, Beck, J, Germouty, J H, Baudet, D, Pichereau, J, Zago, F, Daffos, and J L, Tabaste
- Subjects
Adult ,Adolescent ,Humans ,Pulmonary Diffusing Capacity ,Female ,Pulmonary Embolism ,Radionuclide Imaging ,Contraceptives, Oral ,Follow-Up Studies - Published
- 1975
120. PERNATAL MANAGEMENT OF FETAL THROMBOCYTOPENIA
- Author
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F Forestier, F Daffos, C Kaplan, and J Y Muller
- Subjects
medicine.medical_specialty ,Obstetrics ,business.industry ,medicine ,business ,Fetal thrombocytopenia - Abstract
Fetal thrombocytopenia resulting from alloimmunisation (NAIT] or from autoimmune pathology (ITP) may contribute to morbidity from hemorrhage particularly when bleeding occurs into the central nervous system.Utilizing a safe procedure for in utero blood samplings i.e. directpuncture under ultrasound guidance, we are able to propose a prenatal management. Considering NAIT we haveuntil now treated 6 patients. We propose a screening protocol for highrisk group based on maternal antecedents and immunological grounds. Fetal blood sampling is performed at 20th week of gestation allowing platelet count and typing. If there isincompatibility between the fetus and his mother two ways can be consFdered : absence or presence of thrombocytopenia. If the platelet countis normal, nothing is done until 37th week of gestation. In the other case, frequent ultrasound examinations are done. At the 37e week, a fetal blood sampling is performed andin utero maternal platelet transfusion is done in the case of thrombocytopenia, before the delivery. It is possible with this prenatal treatment to have vaginal delivery. Considering ITP. when the maternal status permit it. fetal blood samplingslet us to know exactly the fetal platelet count. By this way. the indication of delivery can be documented.This procedure offers a new possibility of easily taking iterative samples. until the end of pregnancyand represents a particular interest in the prenatal treatment of suchhemorrhagic disorders.
- Published
- 1987
121. Plasma human chorionic somatomammotropin deficiency in a normal pregnancy is the consequence of low concentration of messenger RNA coding for human chorionic somatomammotropin
- Author
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F. Mondon, C. Hubert, D. Descombey, and F. Daffos
- Subjects
Adult ,medicine.medical_specialty ,Human chorionic somatomammotropin ,Biology ,Normal pregnancy ,behavioral disciplines and activities ,Pregnancy ,Internal medicine ,mental disorders ,medicine ,Humans ,RNA, Messenger ,Volume concentration ,Messenger RNA ,Estriol ,Infant, Newborn ,Obstetrics and Gynecology ,Plasma levels ,medicine.disease ,Placental Lactogen ,Prolactin ,Endocrinology ,Growth Hormone ,embryonic structures ,Gestation ,Female ,sense organs ,alpha-Fetoproteins ,Hormone - Abstract
Human chorionic somatomammotropin (hCS) is important in the hormonal monitoring of human pregnancies. Presented is the case of a clinically normal pregnancy in which a very low plasma level of hCS was detected. The concentration of messenger ribonucleic acid (mRNA) coding for hCS was evaluated to determine the level on which the deficiency occurred.
- Published
- 1983
122. [Fetal hormonology by direct sampling of fetal blood during the 2d trimester of pregnancy. Study of fetal and maternal 5-ene steroid sulfates]
- Author
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F, Daffos, F, Forestier, K, Nahoul, M, Castanier, M, Capella-Pavlovsky, M, Chartier, and R, Scholler
- Subjects
Male ,Blood Specimen Collection ,Dehydroepiandrosterone Sulfate ,Pregnancy ,Pregnancy Trimester, Second ,Pregnenolone ,Prenatal Diagnosis ,Adrenal Glands ,Humans ,Female ,Dehydroepiandrosterone ,17-alpha-Hydroxypregnenolone ,Fetal Blood - Published
- 1984
123. MAY LMW (CY 216) BE ADMINISTERED DURING PREGNANCY ?
- Author
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F Toulemonde, P Cornu, A Deschamps, M Rainaut, F Forestier, and F Daffos
- Subjects
Pregnancy ,business.industry ,medicine ,Physiology ,medicine.disease ,business - Abstract
One of the main problems related to the use of fractionated heparin during pregnancy concerns its transplacental passage.Previous studies showed LMW heparin fraction CY 216 has no teratogenic effects, and when labelled, does not cross the placental barrier in animal, and does not appear into the milk.We studied the transplacental passage following subcutaneous administration of large dosage (17.500 AXa IC u) in 7 women who where going to have an abortion during the third trimester of gestation because of severe fetal malformation, after informed consent.Blood samples were taken before and 3 h after injection from che mother , from the fetuses 3 h after mother injection -using ultrasound guidance of the needle and aspiration of blood in the umbilical vein.Biological assays showed that the effects are clearly observable in mother, whereas no change was observed from the fetus.Thus, it was justifiable to treat, for several reasons, 22 patients using CY 216 during a period of 2 to 5 weeks before delivery. Treatments were successful and no complication has been observed. The cord blood samples at birth never showed any biological activity.These data seem to clearly indicate that there is no passage through the placental barrier of CY 216 which offers a new possibility of treatment during pregnancy.
- Published
- 1987
124. Congenital toxoplasmosis
- Author
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F. Daffos
- Subjects
Pharmacology ,General Medicine - Published
- 1989
125. INSULIN-LIKE GROWTH FACTORS AND THEIR BINDING PROTEINS (IGF-BP) IN HUMAN FOETAL SERUM
- Author
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Claudine Lassarre, F Forestier, S Hardouin, Michel Binoux, and F Daffos
- Subjects
medicine.medical_specialty ,business.industry ,animal diseases ,Insulin ,medicine.medical_treatment ,Serum samples ,DNA-binding protein ,Umbilical cord ,nervous system diseases ,Endocrinology ,medicine.anatomical_structure ,In utero ,Internal medicine ,embryonic structures ,Pediatrics, Perinatology and Child Health ,medicine ,business ,reproductive and urinary physiology - Abstract
IGF I and IGF II were measured in serum samples collected from the umbilical cord in healthy foetuses (in utero) and newborns. Results (mean tSE) were as follows
- Published
- 1986
126. The prognostic value of ultrasound abnormalities and biological parameters in blood of fetuses infected with cytomegalovirus.
- Author
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Benoist G, Salomon LJ, Jacquemard F, Daffos F, and Ville Y
- Subjects
- Cytomegalovirus Infections blood, Female, Fetal Diseases diagnostic imaging, Gestational Age, Humans, Multivariate Analysis, Pregnancy, Pregnancy Outcome, Retrospective Studies, Ultrasonography, Prenatal, Viremia diagnosis, Biomarkers blood, Cytomegalovirus Infections diagnostic imaging, Fetal Blood virology, Fetal Diseases virology, Fetus abnormalities, Pregnancy Complications, Infectious virology
- Abstract
Objective: To evaluate the prognostic value of ultrasound abnormalities and of selected biological parameters in blood of fetuses infected with cytomegalovirus (CMV)., Design: Retrospective observational study., Setting: Two fetal medicine units in Paris, France., Population: All fetuses infected with CMV referred between 1998 and 2006., Methods: We retrospectively analysed data collected prospectively in 73 fetuses infected by CMV with a positive CMV polymerase chain reaction in amniotic fluid. Fetal blood sampling (FBS) was performed for evaluation of platelet count, plasma levels of aminotransferases and gamma-glutamyl transpeptidases (GGT), presence of viraemia and specific fetal immunoglobulin M. Targeted ultrasound examination was performed every fortnight. Ultrasound findings were categorised into normal examination and any ultrasound abnormality, which was further grouped as ultrasound abnormality of the fetal brain and noncerebral ultrasound abnormality., Main Outcome Measures: A combination of histological findings after termination of pregnancy and evidence of cytomegalic inclusion disease at birth when pregnancies were continued. Clinical symptoms at birth or histological lesions attributable to CMV were considered as poor outcome. Statistical analysis was conducted to determine the value of each parameter to predict outcome. Logistic regression was used to build up a multivariate model combining the relevant parameters., Results: In univariate analysis, only thrombocytopenia and the presence of any ultrasound abnormality were associated with a poor outcome (P < 10(-4) for both abnormalities). In the multivariate analysis, both thrombocytopenia and the presence of ultrasound abnormalities remained significant independent predictors of a poor outcome. Based on univariate logistic regression, odds ratio for a poor outcome were 1.24, 7.2, 22.5 and 25.5 for each 10,000/mm(3) decrease in platelet count, the presence of noncerebral, any ultrasound and cerebral ultrasound abnormalities, respectively., Conclusions: The prognosis of CMV-infected fetuses relies independently on both targeted ultrasound examination and fetal platelet count. FBS for platelet count may therefore justify FBS in infected fetuses even in the absence of ultrasound. features of brain involvement.
- Published
- 2008
- Full Text
- View/download PDF
127. Successful treatment of a severe second trimester fetomaternal hemorrhage by repeated fetal intravascular transfusions.
- Author
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Votino C, Mirlesse V, Gourand L, Parnet-Mathieu F, Bessières B, and Daffos F
- Subjects
- Adult, Anemia therapy, Blood Flow Velocity, Female, Hematocrit, Humans, Infant, Newborn, Middle Cerebral Artery physiology, Pregnancy, Pregnancy Trimester, Second, Severity of Illness Index, Blood Transfusion, Intrauterine, Fetomaternal Transfusion therapy
- Abstract
Objective: It was the aim of this study to report a case of fetomaternal hemorrhage (FMH) that was successfully treated with fetal intravascular transfusions in which the middle cerebral artery peak systolic velocity (MCA-PSV) detected fetal anemia., Methods: A massive FMH occurred twice in a healthy 33-year-old pregnant woman at 26 and 29 weeks of gestation with no evident cause. Four repeated intravascular transfusions were performed. The MCA-PSV increased in the presence of anemia and decreased following correction of fetal hematocrit., Results: A healthy neonate was delivered at 33 weeks of gestation., Conclusion: MCA-PSV detected fetal anemia both before the first transfusion and following the next intravascular transfusions. In our case, the change in fetal blood viscosity following transfusion with adult blood did not affect the MCA-PSV value for detection of fetal anemia., (Copyright 2009 S. Karger AG, Basel.)
- Published
- 2008
- Full Text
- View/download PDF
128. Comparison of CD8+ T Cell responses to cytomegalovirus between human fetuses and their transmitter mothers.
- Author
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Pedron B, Guerin V, Jacquemard F, Munier A, Daffos F, Thulliez P, Aujard Y, Luton D, and Sterkers G
- Subjects
- Case-Control Studies, Cytomegalovirus pathogenicity, Cytomegalovirus Infections transmission, Cytomegalovirus Infections virology, DNA, Viral blood, Female, Fetal Diseases virology, Fetus immunology, Humans, Immunologic Memory, Interferon-gamma, Lymphocyte Activation, Mothers, Phosphoproteins immunology, Pregnancy, Pregnancy Complications, Infectious virology, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Viral Load, Viral Matrix Proteins immunology, CD8-Positive T-Lymphocytes immunology, Cytomegalovirus immunology, Cytomegalovirus Infections congenital, Cytomegalovirus Infections immunology, Fetal Diseases immunology, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious immunology
- Abstract
Background: The mechanisms responsible for the increased susceptibility of fetuses to cytomegalovirus (CMV) were studied by comparing CD8(+) T cell responses to the virus in susceptible fetuses to those in their comparatively more resistant mothers., Methods: Included in the study were 16 transmitter mothers who underwent seroconversion during the first trimester of pregnancy as well as their fetuses, who were positive for CMV in amniotic fluid by polymerase chain reaction at 17-19 weeks of gestation. Fetal and maternal blood samples were collected between the 22nd and 39th week of gestation. Cytotoxic T lymphocytes (CTLs) that had activated (HLA-DR(+)), effector/memory (CD28(-)), and memory (CD18(high)) phenotypes; that stained with the HLA-A2/pp65 or the HLA-B7/pp65 multimer; and that secreted interferon (IFN)- gamma were enumerated by flow cytometry. Viral loads were determined simultaneously., Results: The results showed (1) similar levels of activated, effector/memory, and memory CTLs in fetuses and mothers but a smaller pp65-specific CTL pool in fetuses (median, 0.015% vs. 0.99%; P=.003); (2) similar percentages of CTLs secreting IFN- gamma after stimulation with ionomycin/phorbol myristate acetate in fetuses and mothers but lower percentages of CTLs secreting IFN- gamma after stimulation with a CD3 monoclonal antibody in fetuses (median, 1% vs. 14%; P=.01); and (3) higher viral loads (mean, 17,290 vs. <250 genome equivalents/mL) in fetuses., Conclusion: Impaired viral clearance might be related to a defective expansion of the pp65-specific CTL pool and/or to the immaturity of IFN- gamma -secreting cells in fetuses.
- Published
- 2007
- Full Text
- View/download PDF
129. [Abnormal placental caryotype in severe intrauterine growth retardations (IUGR). Case report].
- Author
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Colmant C, Mirlesse V, Beaujard MP, Bessières B, and Daffos F
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Infant, Newborn, Karyotyping, Pregnancy, Fetal Growth Retardation genetics, Fetal Growth Retardation pathology, Placenta pathology, Polyploidy
- Abstract
Except for cases due to maternal hypertension, severe and early intrauterine growth retardations are most usually due to fetal abnormalities. We report a case of confined placental homogenous tetraploidy associated with major fetal growth retardation leading to the premature delivery of a life born baby with a normal caryotype. We discuss the interest of chorionic villus sampling in cases of unexplained severe fetal growth retardation.
- Published
- 2007
- Full Text
- View/download PDF
130. Maternal administration of valaciclovir in symptomatic intrauterine cytomegalovirus infection.
- Author
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Jacquemard F, Yamamoto M, Costa JM, Romand S, Jaqz-Aigrain E, Dejean A, Daffos F, and Ville Y
- Subjects
- Acyclovir administration & dosage, Acyclovir pharmacokinetics, Administration, Oral, Antiviral Agents pharmacokinetics, Cytomegalovirus Infections blood, DNA, Viral analysis, Female, Fetal Blood cytology, Fetal Diseases blood, Humans, Pilot Projects, Platelet Count, Pregnancy, Pregnancy Complications, Infectious blood, Self Administration, Valacyclovir, Valine administration & dosage, Valine pharmacokinetics, Viral Load, Acyclovir analogs & derivatives, Antiviral Agents administration & dosage, Cytomegalovirus Infections drug therapy, Fetal Diseases virology, Pregnancy Complications, Infectious drug therapy, Valine analogs & derivatives
- Abstract
Objectives: To report early experience with treatment of intrauterine cytomegalovirus (CMV) infection using maternal oral administration of valaciclovir (VACV)., Design: Observational study of fetuses infected with CMV with or without treatment with valaciclovir., Population: Pregnancies with confirmed fetal CMV infection were treated with oral VACV (8 g/day)., Main Outcome Measures: Fetal viral load and drug concentration were monitored in amniotic fluid and in fetal blood. Data on the course and outcome of a group of untreated symptomatic fetuses infected with CMV are also reported., Results: Therapeutic concentrations were achieved in maternal and fetal bloods. The viral load in the fetal blood (VLFB) decreased significantly after 1-12 weeks of treatment (Wilcoxon paired test P = 0.02). Twenty pregnancies including 21 fetuses were treated at 28 weeks (median, range: 22-34) for 7 weeks (median, range: 1-12). Ten infants were developing normally at between 1 and 5 years of age. Two infants (both aged 2 years) had severe isolated unilateral deafness. One neonate presented with microcephaly and severe deafness but was also diagnosed with incontinentia pigmenti. Six out of seven cases that eventually required termination of pregnancy (TOP) had evidence of in utero progression of the disease with worsening cerebral lesions. One fetus died in utero. The outcome of 14/24 (58.3%) untreated symptomatic infected fetuses was poor with either TOP, intrauterine fetal demise or severe congenital infection disease of the neonate; the remaining ten infants were healthy at follow up., Conclusion: Maternal oral administration of VACV leads to therapeutic concentrations in the maternal and fetal compartments, with a decrease in VLFB. Our results suggest that in cases where TOP is declined, a randomised controlled trial to study this treatment option further is indicated.
- Published
- 2007
- Full Text
- View/download PDF
131. Contribution of prenatal imaging to the anatomical assessment of fetal hydrocolpos.
- Author
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Dhombres F, Jouannic JM, Brodaty G, Bessiere B, Daffos F, and Bénifla JL
- Subjects
- Abortion, Induced, Adult, Cloaca abnormalities, Counseling methods, Diagnosis, Differential, Fatal Outcome, Female, Humans, Infant, Newborn, Parents psychology, Pregnancy, Pregnancy Outcome, Twins, Dizygotic, Vagina abnormalities, Hydrocolpos diagnostic imaging, Ultrasonography, Prenatal methods, Urogenital Abnormalities diagnostic imaging
- Abstract
Hydrocolpos may be associated with a lower urinary tract obstruction in a spectrum of urorectal malformations ranging from persistent urogenital sinus to cloacal dysgenesis. As cloacal dysgenesis carries the worst postnatal prognosis, detailed prenatal ultrasound should focus on the fetal pelvic anatomy to provide the parents with appropriate prenatal counseling. We report three cases of fetal hydrocolpos associated with low urinary tract obstructions, including two with a normal appearance of the anal canal and rectum on prenatal ultrasound and one with a complex cloacal malformation which contributed to the precise prenatal assignment of the malformation in each case within the spectrum of urogenital sequence malformations.
- Published
- 2007
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- View/download PDF
132. Persistent maternal viremia after varicella infection during pregnancy as a possible cause of false positive prenatal diagnosis of fetal infection on amniotic fluid.
- Author
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Mirlesse V, Solé Y, Jacquemard F, Delhommeau F, and Daffos F
- Subjects
- Chickenpox congenital, False Positive Reactions, Female, Humans, Polymerase Chain Reaction standards, Pregnancy, Amniotic Fluid virology, Chickenpox diagnosis, Fetal Diseases diagnosis, Pregnancy Complications, Infectious, Prenatal Diagnosis standards, Viremia diagnosis
- Published
- 2004
- Full Text
- View/download PDF
133. Oto-onycho-peroneal syndrome: further delineation and first fetal report.
- Author
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Bessieres-Grattagliano B, Brodaty G, Martinovic J, Fallet-Bianco C, Delezoide AL, and Daffos F
- Subjects
- Abnormalities, Multiple diagnostic imaging, Abnormalities, Multiple genetics, Adult, Female, Genes, Recessive genetics, Humans, Male, Pregnancy, Shoulder abnormalities, Syndrome, Ultrasonography, Abnormalities, Multiple diagnosis, Ear abnormalities, Fetus abnormalities, Fibula abnormalities, Nails, Malformed
- Abstract
We report on the sixth case and first fetal description of oto-onycho-peroneal syndrome (MIM 259780). This entity consists in the association of ear anomalies (-oto), hypoplastic nails (-onycho), hypoplastic or absent fibulae (-peroneal), and shoulder anomalies. Described for the first time by Leiba et al. [1975: Birth Defects 11:67-73] in a male patient, coined by Pfeiffer [1982: Eur J Pediatr 138:317-320], and confirmed by Devriendt et al. [1998: J Med Genet 35:508-509] this condition is most likely autosomal recessive, given the occurrence in sibs of both sexes with normal parents., (Copyright 2004 Wiley-Liss, Inc.)
- Published
- 2004
- Full Text
- View/download PDF
134. Alphafoetoprotein and acetylcholinesterase in amniotic fluid as a factor suggesting fetal skin and nerve lesions in a case of congenital varicella syndrome.
- Author
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Mirlesse V, Duguy N, Cynober E, François Magny J, and Daffos F
- Subjects
- Adult, Amniotic Fluid chemistry, Amniotic Fluid enzymology, Amniotic Fluid virology, Autonomic Nervous System Diseases congenital, Autonomic Nervous System Diseases diagnosis, Autonomic Nervous System Diseases virology, Chickenpox complications, Chickenpox embryology, Female, Herpesvirus 3, Human genetics, Herpesvirus 3, Human isolation & purification, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Male, Polymerase Chain Reaction, Pregnancy, Pregnancy Complications, Infectious diagnosis, Pregnancy Complications, Infectious virology, Pregnancy Trimester, Second, Prognosis, Skin Diseases, Viral diagnosis, Skin Diseases, Viral virology, Ultrasonography, Prenatal, Acetylcholinesterase analysis, Chickenpox congenital, Chickenpox diagnosis, Prenatal Diagnosis, Skin Diseases, Viral congenital, alpha-Fetoproteins analysis
- Abstract
Background: Prenatal care of pregnant women exposed to varicella skin rash during the first half of pregnancy remains a frequent concern in countries that do not have access to systematic vaccination. The frequency of maternofetal transmission is low. Ultrasound is the usual tool for prenatal survey of exposed fetuses. But many anomalies due to VZV infection are not accessible to ultrasound alone., Case Report: We review a case in which the diagnosis of fetal infection suspected due to transient fetal bowel hyperechogenicity was confirmed in amniotic fluid by molecular biology (PCR)., Results: An unusual elevation of alphafoetoprotein in maternal blood and in amniotic fluid was associated with inguinal skin, muscular and nerve destruction., Conclusion: In fetuses diagnosed with in utero varicella infection, in addition to a precise diagnosis and follow-up, we suggest that elevated AFP levels in maternal blood and amniotic fluid together with the presence of acetylcholinesterase in amniotic fluid may be related to lesion of fetal skin and nerves., (Copyright 2004 John Wiley and Sons, Ltd.)
- Published
- 2004
- Full Text
- View/download PDF
135. [An update on the fetal circulation].
- Author
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Jouannic JM, Fermont L, Brodaty G, Bonnet D, and Daffos F
- Subjects
- Female, Heart embryology, Heart Septum embryology, Humans, Lung blood supply, Lung embryology, Pregnancy, Ultrasonography, Prenatal, Umbilical Veins embryology, Fetus blood supply
- Abstract
The fetal circulation has been an exciting area of study for centuries. The principles which grew from the period of hypotheses have been demonstrated in several animal models. These experiments have shaped the major concept of fetal circulation. More recently, the improvement in ultrasound technology has allowed a non invasive study of the fetal circulation in humans. Although the general schema of the fetal circulation has been confirmed in humans, in some aspects some substantial differences have been demonstrated. They may not only reflect some inter-species differences, but also underscore the limitation of chronically instrumented animal studies.
- Published
- 2004
- Full Text
- View/download PDF
136. Perinatal-lethal Gaucher disease.
- Author
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Mignot C, Gelot A, Bessières B, Daffos F, Voyer M, Menez F, Fallet Bianco C, Odent S, Le Duff D, Loget P, Fargier P, Costil J, Josset P, Roume J, Vanier MT, Maire I, and Billette de Villemeur T
- Subjects
- DNA Mutational Analysis, Gaucher Disease genetics, Gaucher Disease mortality, Glucosylceramidase genetics, Glucosylceramidase metabolism, Hepatomegaly genetics, Hepatomegaly physiopathology, Humans, Infant, Infant, Newborn, Gaucher Disease physiopathology
- Abstract
Gaucher disease is a lysosomal storage disease caused by glucocerebrosidase deficiency. Although purely visceral in most cases, some Gaucher disease patients have neurological signs. Signs of Gaucher disease appear after a symptom-free period, except in rare cases with fetal onset. The description of such cases was based mainly on single reports and siblings. We report here a series of perinatal-lethal Gaucher disease cases highlighting the specificity of this phenotype. We retrospectively studied eight original cases of proven Gaucher disease with fetal onset. Non-immune hydrops fetalis was present in all cases but one, and associated with hepatosplenomegaly, ichthyosis, arthrogryposis, and facial dysmorphy. The similarities between our cases and 33 previously described cases allow us to better delineate the perinatal-lethal Gaucher disease phenotype. Hydrops fetalis, in utero fetal death and neonatal distress are prominent features. When hydrops is absent, neurological involvement begins in the first week and leads to death within three months. Hepatosplenomegaly is a major sign, and associated with ichthyosis, arthrogryposis, and facial dysmorphy in some 35-43% of cases. Perinatal-lethal Gaucher disease is a specific entity defined by its particular course and signs that are absent in classical type 2 Gaucher disease. Our study provides clues to the diagnosis of this likely underdiagnosed condition, which must be biochemically confirmed in order to propose appropriate genetic counselling., (Copyright 2003 Wiley-Liss, Inc.)
- Published
- 2003
- Full Text
- View/download PDF
137. [Foetal sampling techniques].
- Author
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Levy R, Arfi JS, and Daffos F
- Subjects
- Amniocentesis, Biopsy, Blood Specimen Collection methods, Fetal Blood, Humans, Trophoblasts pathology, Fetus, Prenatal Diagnosis methods, Specimen Handling methods
- Abstract
This article describes the current techniques of foetal sampling. All of them are actually ultrasound guided, and therefore generally very safe. Nevertheless, an elaborate learning process remains indispensable, in addition to a particular attention to the quality of the physician-patient dialogue. The choice of a technique depends on the indication and on the term of the pregnancy. The most frequently used technique is amniocentesis which presents a low risk of foetal loss, estimated between 0.2 and 0.5 percent. The interest of chorionic villus sampling is the possibility to obtain results at an earlier stage of pregnancy, with a lower risk taking when compared to early amniocentesis. We prefer the transabdominal chorionic villus sampling to the transvaginal. Foetal blood sampling is still required in some cases, but the risk of complications is higher--around 1 percent.
- Published
- 2003
- Full Text
- View/download PDF
138. [Fetal hemostasis].
- Author
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Daffos F
- Subjects
- Humans, Infant, Infant, Newborn, Vitamin K metabolism, Vitamin K pharmacology, Child Development, Hemostasis, Platelet Aggregation
- Published
- 2003
- Full Text
- View/download PDF
139. Prenatal diagnosis of zygosity by fetal DNA analysis, a contribution to the management of multiple pregnancies. A series of 31 cases.
- Author
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Levy R, Mirlesse V, Jacquemard F, and Daffos F
- Subjects
- Female, Fetal Diseases diagnosis, Fetal Diseases genetics, Fetofetal Transfusion diagnosis, Fetofetal Transfusion genetics, Humans, Male, Polymorphism, Genetic, Pregnancy, Prospective Studies, Amniocentesis methods, Pregnancy, Multiple, Twins, Dizygotic, Twins, Monozygotic
- Abstract
Objective: To evaluate the contribution of prenatal diagnosis of zygosity by fetal DNA analysis to the management of multiple pregnancies., Methods: Between March 1999 and March 2000, 31 same-sex multiple pregnancies, were referred to our Institute during their second trimester to have amniocentesis done. Fetal DNA variants were studied in addition to karyotype. The main indications for amniocentesis were fetal growth discordance, fetal malformations or selective pregnancy termination. Zygosity results were compared to the first-trimester ultrasound diagnosis., Results: 21 out of the 31 multiple pregnancies were dizygous, and 10 out of the 31 pregnancies were monozygous. First-trimester ultrasound provided information on chorionicity only in 24 out of the 31 cases (77%). Of these 24 reports, 21 proved to be correct (87.5%). Moreover, in 2 cases among 14 pregnancies with growth discordance, DNA analysis ruled out a twin-to-twin transfusion syndrome, while ultrasound could not yield a conclusion. In 2 twin pregnancies with fetal malformations affecting one of the fetuses, DNA analysis made it possible to assess the risk for the other twin. In the 5 cases leading to selective termination, prenatal diagnosis of zygosity had a decisive value for the surviving fetus., Conclusion: Fetal DNA analysis is a simple and highly useful test for prenatal diagnosis of zygosity in the management of complicated multiple pregnancies., (Copyright 2002 S. Karger AG, Basel)
- Published
- 2002
- Full Text
- View/download PDF
140. Perinatal management of fetal cardiac anomalies in a specialized obstetric-pediatrics center.
- Author
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Mirlesse V, Cruz A, Le Bidois J, Diallo P, Fermont L, Kieffer F, Magny JF, Jacquemard F, Levy R, Voyer M, and Daffos F
- Subjects
- Chromosome Aberrations statistics & numerical data, Female, Follow-Up Studies, France, Heart Defects, Congenital classification, Heart Defects, Congenital diagnostic imaging, Humans, Infant, Newborn, Obstetrics and Gynecology Department, Hospital statistics & numerical data, Outcome and Process Assessment, Health Care, Perinatology statistics & numerical data, Pregnancy, Prenatal Diagnosis methods, Program Evaluation, Referral and Consultation statistics & numerical data, Retrospective Studies, Ultrasonography, Abortion, Eugenic statistics & numerical data, Heart Defects, Congenital prevention & control, Obstetrics and Gynecology Department, Hospital organization & administration, Perinatal Care organization & administration
- Abstract
Perinatal teams dealing with fetal heart disease frequently wonder which pregnancies might be terminated, and when delivery should take place in a specialized surrounding. We present a retrospective study of 229 fetuses, in which prenatal ultrasound showed a cardiac anomaly not compatible with a standard maternity ward delivery. One hundred nineteen pregnancies were terminated (group I) while 110 pregnancies led to the birth of a live baby (group II). Pathology in group I was discovered earlier than in group II (24 vs. 29.3 weeks' gestation; p <0.01), and associated malformations or chromosomal anomalies were much more frequent in group I (80/119 vs. 9/110; p <0.001). Among live born babies, three infants with transposition of the great arteries underwent Rashkind atrioseptostomy in the delivery room. With a minimum follow-up of 12 months, 69 children (63%) have undergone surgery. Among 92 survivors (1 child is lost to follow-up), 78 (71%) are asymptomatic and 14 symptomatic. Early prenatal diagnosis of fetal heart anomalies significantly facilitates prenatal work-up and perinatal care. We present the types of pathology having led to termination and define the situations in which children are at risk of perinatal hemodynamic compromise.
- Published
- 2001
- Full Text
- View/download PDF
141. [Medical termination of pregnancy for fetal anomaly: the patient's point of view].
- Author
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Perrotte F, Mirlesse V, De Vigan C, Kieffer F, Meunier E, and Daffos F
- Subjects
- Abortifacient Agents, Adult, Analgesia, Anesthesia, Epidural, Female, Humans, Patient Education as Topic, Patient Participation, Polymers, Pregnancy, Surveys and Questionnaires, Abortion, Therapeutic psychology, Congenital Abnormalities
- Abstract
Objectives: To analyze the patient's point of view concerning pregnancy termination for fetal anomaly., Methods: A questionnaire concerning the different steps of medical termination of pregnancy was given to 103 women on day 2 after termination., Results: Most women thought that they were the ones who should make the decision (67%). Complete information prior to the procedure was greatly appreciated (81%). Physical pain remained one of the main concerns for patients given Dilapan. 94% of the women had epidural anesthesia before induction. Various mourning patterns were observed. Only 41% of the women wished to see their baby after termination; there was a correlation with age of pregnancy and social environment. Psychological assistance involved the entire team and a consultation with a pedopsychiatrist (81%). The most painful moment was the moment when breaking the new of the fetal anomaly., Conclusion: The women were very much in need of expressing their sorrow very soon after the event. Team work and lack of rigidity in care taking enhances the expression of individual resources, both by the medical team and the patients. Three points were highlighted by the patients.--the desire to participate in the decision making;--the importance of in-depth information on technical aspects of the procedure;--initial new breaking is recognized as a major trauma.
- Published
- 2000
142. High levels of circulating thrombomodulin in human foetuses and children.
- Author
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Menashi S, Aurousseau MH, Gozin D, Daffos F, D'Angelo A, Forestier F, and Boffa MC
- Subjects
- Adolescent, Adult, Age Factors, Child, Child, Preschool, Female, Humans, Infant, Newborn, Pregnancy, Blood Coagulation, Fetus metabolism, Thrombomodulin blood
- Abstract
Thrombomodulin (TM) is an endothelial cell surface proteoglycan with anticoagulant functions, also implicated in cell proliferation, cell-cell adhesion and differentiation. In this study we determined circulating plasma TM (pTM) levels in human foetuses at different stages of pregnancy, at birth and in childhood. TM levels increased with gestational age, the median level reaching a peak of approximately 165 ng/ml between the 23rd and 26th week, thereafter decreasing gradually, reaching a value of 108 ng/ml at birth. pTM continues to decrease progressively during childhood, reaching in the 5-15 years group a median of 56 ng/ml which approaches the adult value. The pTM peak was statistically significant and represents a specific foetal phenomenon as it was independent of the corresponding maternal values. As a whole, the pTM pattern during foetal maturation appears totally different from that of protein C, prothrombin and other coagulation activators and inhibitors and thus, TM may play in the foetus another role in addition to its well-known anticoagulant function.
- Published
- 1999
143. Haematological parameters of parvovirus B19 infection in 13 fetuses with hydrops foetalis.
- Author
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Forestier F, Tissot JD, Vial Y, Daffos F, and Hohlfeld P
- Subjects
- Anemia therapy, Anemia virology, Female, Gestational Age, Humans, Hydrops Fetalis virology, Leukocyte Count, Parvoviridae Infections blood, Parvovirus B19, Human, Platelet Count, Pregnancy, Pregnancy Complications, Infectious blood, Pregnancy Complications, Infectious virology, Pregnancy Outcome, Thrombocytopenia therapy, Thrombocytopenia virology, Fetal Blood virology, Hydrops Fetalis blood, Parvoviridae Infections complications
- Abstract
Thirteen cases of fetal parvovirus B19 infection with hydrops foetalis are reported. Viral DNA was identified by polymerase chain reaction (PCR) of amniotic fluid sampled between the 19th and the 29th week of gestation. Haematological examination revealed severe anaemia in all cases and thrombocytopenia in 11/13 cases, which was severe in two cases. Six fetuses died in utero; two after intrauterine transfusion. Complete recovery was observed in seven fetuses; five cases were treated by intrauterine transfusions, and in two cases spontaneous recovery occurred. Upon follow-up, no case of congenital anaemia was observed.
- Published
- 1999
- Full Text
- View/download PDF
144. [Means of diagnosing viral infections in the fetus].
- Author
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Daffos F
- Subjects
- Chickenpox diagnosis, Chickenpox embryology, Cytomegalovirus Infections diagnosis, Cytomegalovirus Infections embryology, Female, Fetus, Humans, Infant, Newborn, Measles diagnosis, Measles embryology, Parvoviridae Infections diagnosis, Parvoviridae Infections embryology, Pregnancy, Virus Diseases transmission, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious virology, Prenatal Diagnosis methods, Virus Diseases diagnosis, Virus Diseases embryology
- Published
- 1999
- Full Text
- View/download PDF
145. Prenatal diagnosis of congenital toxoplasmosis by PCR: extended experience.
- Author
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Forestier F, Hohlfeld P, Sole Y, and Daffos F
- Subjects
- Female, Humans, Pregnancy, Polymerase Chain Reaction, Prenatal Diagnosis methods, Toxoplasmosis, Congenital diagnosis
- Published
- 1998
146. Serum C24 bile acids in the developing human fetus.
- Author
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Courillon F, Gerhardt MF, Myara A, Daffos F, Forestier F, and Trivin F
- Subjects
- Alkaline Phosphatase blood, Alkaline Phosphatase metabolism, Bile Acids and Salts chemistry, Bile Acids and Salts classification, Bilirubin blood, Bilirubin metabolism, Cholesterol blood, Cholesterol metabolism, Cohort Studies, Female, Fetal Blood metabolism, Gas Chromatography-Mass Spectrometry, Gestational Age, Humans, Pregnancy metabolism, Reference Values, gamma-Glutamyltransferase blood, gamma-Glutamyltransferase metabolism, Bile Acids and Salts blood, Fetal Blood chemistry, Pregnancy blood
- Abstract
The C24 bile acids (BA) in the serum of 22 healthy human fetuses between weeks 20 and 37 of gestation were determined by capillary GC-MS. Fetal blood samples were taken in utero from the umbilical cord monitored by echography. There was no correlation between total bile acids (TBA) and gestational age. The TBA concentration was 5.14 +/- 2.13 microM. Primary BA (cholic acid and chenodeoxycholic acid) were the main BA (66.78 +/- 13.47%) with chenodeoxycholic acid being the main one. There were low concentrations of secondary BA (deoxycholic acid and lithocholic acid) (10.28 +/- 7.85%), which formed by intestinal bacterial 7 alpha-dehydroxylation of primary BA in the adult, despite the germ-free gut. The tertiary BA (ursodeoxycholic acid) was also detected (12.06 +/- 9.64%). There was 6 alpha-hydroxylation of chenodeoxycholic acid and of lithocholic acid to produce hyocholic acid and hyodeoxycholic acid respectively. Two 1 beta-hydroxylated BA were detected at different times of gestation. Cholic acid was rarely found in the 6 alpha- and 1 beta-hydroxylated forms. These additional hydroxylations could help to protect the fetal liver against the accumulation of cytotoxic bile acids at a time when other detoxification pathways are poorly developed. Traces of unsaturated bile acids like 3 beta-hydroxy-5-cholenoic acid were detected, showing that 27-hydroxylation of cholesterol does occur.
- Published
- 1998
- Full Text
- View/download PDF
147. [Intrahepatic arteriovenous fistula. Prenatal diagnosis, physiopathological study and neonatal management]l.
- Author
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Jouannic JM, Jacquemard F, Mirlesse V, Capella-Pavlovsky M, Fermont L, Brunelle F, and Daffos F
- Subjects
- Adult, Arteriovenous Fistula complications, Arteriovenous Fistula surgery, Cesarean Section, Female, Heart Failure etiology, Humans, Infant, Newborn, Male, Pregnancy, Pregnancy Trimester, Third, Ultrasonography, Doppler, Color, Ultrasonography, Doppler, Pulsed, Arteriovenous Fistula diagnostic imaging, Hepatic Artery abnormalities, Portal Vein abnormalities, Postnatal Care methods, Ultrasonography, Prenatal
- Abstract
A case of arteriovenous fistula of the liver diagnosed at 30 weeks of gestation is reported. The etiologies of an hypoechogenic structure in the fetal liver are discussed showing the contribution of pulsed wave Doppler and color Doppler to the diagnosis. The clinical evolution towards heart failure led us to examine the pathophysiology of such a lesion. The prenatal management of this arteriovenous malformation is exposed.
- Published
- 1998
148. Prenatal diagnosis of fetal varicella-zoster virus infection with polymerase chain reaction of amniotic fluid in 107 cases.
- Author
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Mouly F, Mirlesse V, Méritet JF, Rozenberg F, Poissonier MH, Lebon P, and Daffos F
- Subjects
- Chickenpox congenital, Chickenpox virology, Congenital Abnormalities virology, Female, Fetal Diseases virology, Gestational Age, Herpes Zoster congenital, Herpes Zoster diagnosis, Herpes Zoster virology, Herpesvirus 3, Human genetics, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome, Amniotic Fluid virology, Chickenpox diagnosis, Fetal Diseases diagnosis, Herpesvirus 3, Human isolation & purification, Polymerase Chain Reaction, Prenatal Diagnosis methods
- Abstract
Objective: Varicella, resulting from primary infection by varicella zoster virus, carries a risk of severe congenital varicella. Prenatal diagnosis is rarely applied because methods remain to be validated., Study Design: From 1989 to 1994, 107 women contracted clinical varicella before 24 weeks of pregnancy. Amniocentesis was performed in all cases, with simultaneous fetal blood sampling in 82 cases. Virus was detected in amniotic fluid by cell culture inoculation and polymerase chain reaction. Fetal blood was tested for anti-varicella zoster virus immunoglobulin M., Results: Of the 107 amniotic fluid samples tested, nine of 107 (8.4%) were positive by polymerase chain reaction, but only two of these (1.8%) were positive in cell culture; none of the blood samples from infected fetuses were positive for specific anti-varicella zoster virus immunoglobulin M. The outcome of 99 pregnancies was fully documented., Conclusion: The risk of transplacental passage before 24 weeks of pregnancy was 8.4% in our series. The risk of congenital varicella is 3 in 107 (2.8%) and that of isolated postnatal varicella zoster infection is 3 in 78 (3.8%). Polymerase chain reaction is more sensitive than cell culture for the detection of varicella zoster virus in amniotic fluid.
- Published
- 1997
- Full Text
- View/download PDF
149. Management of fetal and neonatal alloimmune thrombocytopenia.
- Author
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Kaplan C, Forestier F, Daffos F, Tchernia G, and Waters A
- Subjects
- Blood Platelets immunology, Cerebral Hemorrhage etiology, Cerebral Hemorrhage prevention & control, Female, Fetal Diseases therapy, Humans, Infant, Newborn, Isoantigens immunology, Maternal-Fetal Exchange, Platelet Transfusion, Pregnancy, Thrombocytopenia complications, Thrombocytopenia diagnosis, Treatment Outcome, Fetal Diseases immunology, Isoantibodies immunology, Thrombocytopenia immunology, Thrombocytopenia therapy
- Published
- 1996
- Full Text
- View/download PDF
150. Fetal gammaglutamyl transferase activity: clinical implication in fetal medicine.
- Author
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Mirlesse V, Jacquemard F, Daffos F, and Forestier F
- Subjects
- Chromosome Aberrations, Cystic Fibrosis enzymology, Female, Fetal Alcohol Spectrum Disorders enzymology, Gestational Age, Humans, Infections enzymology, Intestines abnormalities, Kidney abnormalities, Pregnancy, Reference Values, Retrospective Studies, Fetal Blood enzymology, Fetal Diseases enzymology, gamma-Glutamyltransferase blood
- Abstract
In a retrospective study of 3,129 fetal blood samples, we first determined normal values for gammaglutamyl transferase (GGT) activity and found 33 cases with a mean GGT level of 961.8 U/l (prevalence 1.05%) corresponding to more than 10-fold normal values. In such extreme cases, elevations of GGT activity in fetal blood have been poorly studied. The goal of this work was to correlate this highly abnormal biological finding with pathological fetal conditions and try to better understand the pathophysiological mechanisms. The most frequent underlying disorders were infections (n = 11), renal or bowel malformations (n = 12) and genetic abnormalities (n = 5). Two cases of cystic fibrosis and one case of fetal alcohol syndrome were also encountered. In another 2 cases, no explanation was found.
- Published
- 1996
- Full Text
- View/download PDF
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