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1. Analysis of the transplacental transmission of SARS CoV-2 virus and antibody transfer according to the gestational age at maternal infection

Author

Lucot-Royer, Louise, Nallet, Camille, Vouga, Manon, Puyraveau, Marc, Mauny, Frederic, Marty-Quinternet, Solène, Bertholdt, Charline, Bory, Jean-Paul, Devalland, Christine, Canaguier, Margaux, Copolla, Camille, Eszto, Marie-Laure, Montoya, Yohny, Roesch, Marion, Reviron, Sandrine, Riethmuller, Didier, Rufenacht, Emma, Simon, Emmanuel, and Mottet, Nicolas

Published
2024
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2. Mort fœtale : consensus formalisé d’experts du Collège national des gynécologues et obstétriciens français

Author

Garabedian, Charles, Sibiude, Jeanne, Anselem, Olivia, Attie-Bittach, Tania, Bertholdt, Charline, Blanc, Julie, Dap, Matthieu, de Mézerac, Isabelle, Fischer, Catherine, Girault, Aude, Guerby, Paul, Le Gouez, Agnès, Madar, Hugo, Quibel, Thibaud, Tardy, Véronique, Stirnemann, Julien, Vialard, François, Vivanti, Alexandre, Sananès, Nicolas, and Verspyck, Eric

Published
2024
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6. Impact of discontinuing oxytocin in active labour on neonatal morbidity: an open-label, multicentre, randomised trial

Author

Girault, Aude, Sentilhes, Loïc, Desbrière, Raoul, Berveiller, Paul, Korb, Diane, Bertholdt, Charline, Carrara, Julie, Winer, Norbert, Verspyck, Eric, Boudier, Eric, Barjat, Tiphaine, Levy, Gilles, Roth, Georges Emmanuel, Kayem, Gilles, Massoud, Mona, Bohec, Caroline, Guerby, Paul, Azria, Elie, Blanc, Julie, Heckenroth, Hélène, Rousseau, Jessica, Garabedian, Charles, and Le Ray, Camille

Published
2023
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10. External validation of and improvement upon a model for the prediction of placenta accreta spectrum severity using prospectively collected multicenter ultrasound data

Author

Kolak, Magdalena, Gerry, Stephen, Huras, Hubert, Al Naimi, Ammar, Fox, Karin A., Braun, Thorsten, Stefanovic, Vedran, van Beekhuizen, Heleen, Morel, Olivier, Paping, Alexander, Bertholdt, Charline, Calda, Pavel, Lastuvka, Zdenek, Jaworowski, Andrzej, Savukyne, Egle, Collins, Sally, Kolak, Magdalena, Gerry, Stephen, Huras, Hubert, Al Naimi, Ammar, Fox, Karin A., Braun, Thorsten, Stefanovic, Vedran, van Beekhuizen, Heleen, Morel, Olivier, Paping, Alexander, Bertholdt, Charline, Calda, Pavel, Lastuvka, Zdenek, Jaworowski, Andrzej, Savukyne, Egle, and Collins, Sally

Abstract

Introduction: This study aimed to validate the Sargent risk stratification algorithm for the prediction of placenta accreta spectrum (PAS) severity using data collected from multiple centers and using the multicenter data to improve the model. Material and Methods: We conducted a multicenter analysis using data collected for the IS-PAS database. The Sargent model's effectiveness in distinguishing between abnormally adherent placenta (FIGO grade 1) and abnormally invasive placenta (FIGO grades 2 and 3) was evaluated. A new model was developed using multicenter data from the IS-PAS database. Results: The database included 315 cases of suspected PAS, of which 226 had fully documented standardized ultrasound signs. The final diagnosis was normal placentation in 5, abnormally adherent placenta/FIGO grade 1 in 43, and abnormally invasive placenta/FIGO grades 2 and 3 in 178. The external validation of the Sargent model revealed moderate predictive accuracy in a multicenter setting (C-index 0.68), compared to its higher accuracy in a single-center context (C-index 0.90). The newly developed model achieved a C-index of 0.74. Conclusions: The study underscores the difficulty in developing universally applicable PAS prediction models. While models like that of Sargent et al. show promise, their reproducibility varies across settings, likely due to the interpretation of the ultrasound signs. The findings support the need for updating the current ultrasound descriptors and for the development of any new predictive models to use data collected by different operators in multiple clinical settings.

Published
2024

14. Impact of Discontinuing Oxytocin in Active Labour on Neonatal Morbidity: An Open-Label, Multicentre, Randomized Trial.

Author

Girault, Aude, Sentilhes, Loïc, Desbrière, Raoul, Berveiller, Paul, Korb, Diane, Bertholdt, Charline, Carrara, Julie, Winer, Norbert, Verspyck, Eric, Boudier, Eric, Barjat, Tiphaine, Levy, Gilles, Roth, Georges Emmanuel, Kayem, Gilles, Massoud, Mona, Bohec, Caroline, Guerby, Paul, Azria, Elie, Blanc, Julie, and Heckenroth, Hélène

Published
2024
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17. Transplacental transmission of SARS CoV-2 virus and antibodies in pregnant women and their new-borns according to the trimester of maternal infection: A French multicentre prospective study

Author

Lucot-Royer, Louise, primary, Bertholdt, Charline, additional, Marty-Quinternet, Solene, additional, Bory, Jean Paul, additional, Devalland, Christine, additional, Canaguier, Margaux, additional, Coppola, Camille, additional, Eszto, Marie-Laure, additional, Ramirez, Edgar Montoya, additional, Reviron, Sandrine, additional, Riethmuller, Didier, additional, Rufenacht, Emma, additional, Roesch, Marion, additional, Simon, Emmanuel, additional, Puyraveau, Marc, additional, Mauny, Frederic, additional, and Mottet, Nicolas, additional

Published
2023
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18. Reducing neonatal morbidity by discontinuing oxytocin during the active phase: the STOPOXY trial

Author

Girault, Aude, primary, Sentilhes, Loïc, additional, Desbriere, Raoul, additional, Rozenberg, Patrick, additional, Korb, Diane, additional, Bertholdt, Charline, additional, Carrara, Julie, additional, Winer, Norbert, additional, Verspyck, Eric, additional, Boudier, Eric, additional, Barjat, Tiphaine, additional, Levy, Gilles, additional, Roth, Georges Emmanuel, additional, Kayem, Gilles, additional, Massoud, Mona, additional, Bohec, Caroline, additional, Guerby, Paul, additional, Azria, Elie, additional, Blanc, Julie, additional, Heckenroth, Helene, additional, Garabedian, Charles, additional, and Le Ray, Camille, additional

Published
2023
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20. Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum

Author

Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M., Pateisky, Petra, Chalubinski, Kinga M., Nonnenmacher, Andreas, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Beekhuizen, Heleen J. Van, Collins, Sally L., Calda, Pavel, Chantraine, Fredric, Duvekot, Johannes J., Fox, Karin A., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Paavonen, Jorma, Petit, Philippe, Rijken, Marcus, Ropacka, Mariola, Tikkanen, Minna, Weichert, Alexander, Weizsäcker, Katharina, International Society For Placenta Accreta Spectrum (IS‐PAS), HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Helsinki University Hospital Area, University of Helsinki, UCL - (SLuc) Service d'obstétrique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Università degli studi di Napoli Federico II, Università degli studi della Campania 'Luigi Vanvitelli', Freie Universität Berlin, Humboldt-Universität zu Berlin, Cliniques Universitaires Saint-Luc [Bruxelles], Université médicale de Vienne, Autriche, Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Nuffield (Nuffield), University of Oxford [Oxford], John Radcliffe Hospital [Oxford University Hospital], Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M, Pateisky, Petra, Chalubinski, Kinga M, Nonnenmacher, Andrea, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Van Beekhuizen, Heleen J, Collins, Sally L, Obstetrics and Gynaecology, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Gynecological Oncology, and Obstetrics & Gynecology

Subjects
Emergency Medical Services, Databases, Factual, Maternal Health, Cohort Studies, maternal morbidity, placenta accreta spectrum, 0302 clinical medicine, Retrospective Studie, Pregnancy, 3123 Gynaecology and paediatrics, 030212 general & internal medicine, gestational age, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, General Medicine, Pregnancy Complication, 3. Good health, Europe, Gestation, Female, medicine.symptom, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Human, United State, Adult, medicine.medical_specialty, Referral, Placenta accreta, Gestational Age, Hemorrhage, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Placenta Accreta, 03 medical and health sciences, abnormally invasive placenta, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Vaginal bleeding, Infant Health, Risk factor, Retrospective Studies, Antepartum hemorrhage, business.industry, Cesarean Section, neonatal morbidity, medicine.disease, Confidence interval, United States, Pregnancy Complications, Cohort Studie, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction: Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve maternal outcomes; however, the benefits must be weighed against the risk of iatrogenic prematurity. The aim of this study is to investigate the rates of emergency delivery seen for antenatally suspected PAS and compare the resulting outcomes in the 15 referral centers of the International Society for PAS (IS-PAS). Material and methods: Fifteen centers provided cases between 2008 and 2019. The women included were divided into two groups according to whether they had a planned or an emergency cesarean delivery. Delivery was defined as “planned” when performed at a time and date to suit the team. All the remaining cases were classified as “emergency”. Maternal characteristics and neonatal outcomes were compared between the two groups according to gestation at delivery. Results: In all, 356 women were included. Of these, 239 (67%) underwent a planned delivery and 117 (33%) an emergency delivery. Vaginal bleeding was the indication for emergency delivery in 41 of the 117 women (41%). There were no significant differences in terms of blood loss, transfusion rates or major maternal morbidity between planned and emergency deliveries. However, the rate of maternal intensive therapy unit admission was increased with emergency delivery (45% vs 33%, P =.02). Antepartum hemorrhage was the only independent predictor of emergency delivery (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency delivery due to vaginal bleeding was more frequent with false-positive cases (antenatally suspected but not confirmed as PAS at delivery) and the milder grades of PAS (accreta/increta). The rate of infants experiencing any major neonatal morbidity was 25% at 34+1 to 36+0 weeks and 19% at >36+0 weeks. Conclusions: Emergency delivery in centers of excellence did not increase blood loss, transfusion rates or maternal morbidity. The single greatest risk factor for emergency delivery was antenatal hemorrhage. When adequate expertise and resources are available, to defer delivery in women with no significant antenatal bleeding and no risk factors for pre-term birth until >36+0 weeks can be considered to improve fetal outcomes. Further studies are needed to investigate this fully.

Published
2021

22. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS)

Author

Schwickert, Alexander, Beekhuizen, Heleen J. Van, Bertholdt, Charline, Fox, Karin A., Kayem, Gilles, Morel, Olivier, Rijken, Marcus J., Stefanovic, Vedran, Strindfors, Gita, Weichert, Alexander, Weizsaecker, Katharina, Braun, Thorsten, Calda, Pavel, Chalubinski, Kinga M., Chantraine, Frederic, Collins, Sally, Duvekot, Johannes J., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Mhallem Gziri, Mina, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, Petit, Philippe, Ropacka, Mariola, Tikkanen, Minna, International Society For Placenta Accreta Spectrum (IS‐PAS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Baylor College of Medecine, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University Medical Center [Utrecht], University of Helsinki, Stockholm South Hospital, Medicine Charles University and General Faculty Hospital in Prague, Medizinische Universität Wien = Medical University of Vienna, Centre Hospitalier Universitaire de Liège (CHU-Liège), John Radcliffe Hospital [Oxford University Hospital], Rigshospitalet [Copenhagen], Copenhagen University Hospital, University of Naples Federico II, Cliniques Universitaires Saint-Luc [Bruxelles], University of the Study of Campania Luigi Vanvitelli, Helsinki University Hospital, Poznan University of Medical Sciences [Poland] (PUMS), Obstetrics and Gynaecology, BIRKER, Juliette, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, University of Naples Federico II = Università degli studi di Napoli Federico II, Department of Obstetrics and Gynecology, University Management, HUS Gynecology and Obstetrics, Gynecological Oncology, and Obstetrics & Gynecology

Subjects
Databases, Factual, medicine.medical_treatment, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Blood Loss, Surgical, Uterotonic, high&#8208, Conservative Treatment, Cohort Studies, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Pregnancy, 030212 general & internal medicine, Embolization, hysterectomy, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Obstetrics, Obstetrics and Gynecology, General Medicine, 3. Good health, Europe, medicine.anatomical_structure, postpartum hemorrhage, Female, cesarean, Tranexamic acid, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, medicine.drug, Adult, medicine.medical_specialty, placenta, Placenta accreta, Placenta Percreta, high-risk pregnancy, Placenta Accreta, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 03 medical and health sciences, abnormally invasive placenta, Placenta, risk pregnancy, medicine, Peripartum Period, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Patient Care Team, Hysterectomy, business.industry, Cesarean Section, uterine scar, medicine.disease, Arterial occlusion, United States, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

INTRODUCTION: Placenta accreta spectrum (PAS) carries a high burden of adverse maternal outcomes, especially significant blood loss, which can be life-threatening. Different management strategies have been proposed but the association of clinical risk factors and surgical management options during cesarean delivery with high blood loss is not clear. MATERIAL AND METHODS: In this international multicenter study, 338 women with PAS undergoing cesarean delivery were included. Fourteen European and one non-European center (USA) provided cases treated retrospectively between 2008 and 2014 and prospectively from 2014 to 2019. Peripartum blood loss was estimated visually and/or by weighing and measuring of volume. Participants were grouped based on blood loss above or below the 75th percentile (>3500 ml) and the 90th percentile (>5500 ml). RESULTS: Placenta percreta was found in 58% of cases. Median blood loss was 2000 ml (range: 150-20 000 ml). Unplanned hysterectomy was associated with an increased risk of blood loss >3500 ml when compared with planned hysterectomy (adjusted OR [aOR] 3.7 [1.5-9.4], p = 0.01). Focal resection was associated with blood loss comparable to that of planned hysterectomy (crude OR 0.7 [0.2-2.1], p = 0.49). Blood loss >3500 ml was less common in patients undergoing successful conservative management (placenta left in situ, aOR 0.1 [0.0-0.6], p = 0.02) but was more common in patients who required delayed hysterectomy (aOR 6.5 [1.7-24.4], p = 0.001). Arterial occlusion methods (uterine or iliac artery ligation, embolization or intravascular balloons), application of uterotonic medication or tranexamic acid showed no significant effect on blood loss >3500 ml. Patients delivered by surgeons without experience in PAS were more likely to experience blood loss >3500 ml (aOR 3.0 [1.4-6.4], p = 0.01). CONCLUSIONS: In pregnant women with PAS, the likelihood of blood loss >3500 ml was reduced in planned vs unplanned cesarean delivery, and when the surgery was performed by a specialist experienced in the management of PAS. This reinforces the necessity of delivery by an expert team. Conservative management was also associated with less blood loss, but only if successful. Therefore, careful patient selection is of great importance. Our study showed no consistent benefit of other adjunct measures such as arterial occlusion techniques, uterotonics or tranexamic acid.

Published
2021

26. New ultrasound-angiographic techniques for the study of uteroplacental vascularization : fundamental and clinical evaluation of 3D Doppler and contrast enhanced ultrasound

Author

Bertholdt, Charline, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université de Lorraine, Olivier Morel, Marine Beaumont, and UL, Thèses

Subjects
[SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Vascularisation, Contrast enhanced ultrasound, Placenta, Vascularization, Échographie de contraste, Angiographie Doppler 3D, 3D Power Doppler, Placental, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics
Abstract

Preeclampsia (PE) and intrauterine growth retardation (IUGR) are two pathologies of placental origin characterized by the existence of alterations in maternal-fetal exchanges and a lack of vascularization.PE and IUGR are the leading cause of perinatal morbidity and mortality in developed countries. There is no "curative" treatment: only preterm birth can prevent adverse perinatal outcomes. Aspirin, started in the first trimester, is the only preventive treatment available; however, it has only been shown to be effective in women with a personal history of IUGR or PE. In the absence of a personal history, there is currently no validated individual screening test.Since the 1950s, the pathophysiological hypothesis has been based on the presence of trophoblastic plugs which, by their presence up to 12 weeks of gestation (WG), prevent maternal blood from entering the placenta (in the intervillous space ), thus offering a hypoxic environment favorable to the proper development of trophoblast cells, guaranteeing their future functionality. The too early disappearance of the "plugs" would lead to cellular oxidative stress responsible for the development of placental vascular pathologies.The theory of these trophoblastic "plugs" is now obsolete, since in 2017, Roberts showed, thanks to contrast enhanced ultrasound, an innovative functional imaging technique, that the placenta was in fact perfused by maternal blood as early as 6 WG. This dogma of trophoblastic "plugs" having been called into question, it is essential to formulate new pathophysiological hypotheses, especially since the absence of a reliable screening method is the direct consequence of this ignorance of pathophysiological mechanisms. The objective of this thesis was to address these two issues, the pathophysiological hypothesis and screening, by using functional imaging tools for the exploration of the placenta in vivo in the first trimester.Contrast ultrasound was used to explore pathophysiological mechanisms. This work began with an initial evaluation on an animal model before carrying out an exploratory study on a cohort of 42 women in the first trimester (HOPE study). For early detection purposes, 3D Doppler echo-angiography was evaluated on a cohort of 2200 women (SPIRIT study).The results of this work confirm the existence of an early placental perfusion which calls into question all the pathophysiological hypotheses of preeclampsia and intrauterine growth retardation so far formulated. The impact of maternal hemodynamics is also raised, which makes it possible to consider a new approach that is both diagnostic and therapeutic.3D Doppler ultrasound and contrast ultrasound are two innovative functional imaging techniques that have been used to better understand the pathophysiological mechanisms and consider individual screening for placental pathologies., La prééclampsie (PE) et le retard de croissance intra-utérin (RCIU) sont deux pathologies d'origine placentaire caractérisées par l'existence d'altérations des échanges materno-fœtaux et un défaut de vascularisation. PE et RCIU sont la principale cause de morbi-mortalité périnatale dans les pays développés. Il n'existe pas de traitement « curatif » étiologique : seule une naissance prématurée peut permettre d'éviter les issues défavorables. L'aspirine, débutée au premier trimestre, est le seul traitement préventif disponible : il n'a cependant fait la preuve de son efficacité que chez les femmes présentant un antécédent personnel de RCIU ou PE. En l'absence d'antécédent personnel, il n'existe actuellement aucun test de dépistage individuel validé. Depuis les années 50, l'hypothèse physiopathologique est basée sur la présence de « plugs » ou bouchons trophoblastiques qui, par leur présence jusqu'à 12 semaines d'aménorrhée (SA), empêchent le sang maternel de pénétrer dans le placenta (au niveau des chambres inter-villeuse), offrant ainsi un environnement hypoxique favorable au bon développement des cellules trophoblastiques, garant de leur fonctionnalité future. La disparition trop précoce des « plugs » entrainerait un stress oxydant cellulaire responsable du développement des pathologies vasculaires placentaires.La théorie de ces « plugs » trophoblastiques est à présent caduque, puisqu'en 2017, Roberts a montré, grâce à l'échographie de contraste, technique d'imagerie fonctionnelle innovante, que le placenta était en réalité perfusé par le sang maternel dès 6 SA. Ce dogme des « plugs » trophoblastiques ayant été remis en cause, il est primordial de formuler de nouvelles hypothèses physiopathologiques d'autant plus que l'absence de méthode fiable de dépistage est la conséquence directe de cette méconnaissance des mécanismes physiopathologiques. L'objectif de cette thèse était de répondre à ces deux problématiques, l'hypothèse physiopathologique et le dépistage, en utilisant des outils d'imagerie fonctionnelle pour l'exploration du placenta in vivo au premier trimestre.L'échographie de contraste a été utilisée pour l'exploration des mécanismes physiopathologiques. Ce travail a débuté par une première évaluation sur modèle animal avant de réaliser une étude exploratoire sur une cohorte de 42 femmes au premier trimestre (étude HOPE). A des fins de dépistage précoce, c'est l'écho-angiographie Doppler 3D qui a été évaluée sur une cohorte de 2200 femmes (étude SPIRIT).Les résultats de ce travail confirment l'existence d'une perfusion placentaire précoce qui confirme la remise en cause de l'ensemble des hypothèses physiopathologiques de la prééclampsie et du retard de croissance intra-utérin jusqu'ici formulées. L'impact de l'hémodynamique maternelle est par ailleurs soulevé, ce qui permet d'envisager une nouvelle approche à la fois diagnostique et thérapeutique.L'écho-angiographie Doppler 3D et l'échographie de contraste sont deux techniques d'imagerie fonctionnelle innovantes qui ont été mises à profit pour mieux comprendre les mécanismes physiopathologiques et envisager un dépistage individuel des pathologies placentaires.

Published
2022

27. Training in Obstetric Ultrasound Biometry

Author

Donadono, Vera, primary, Ambroise Grandjean, Gaëlle, additional, Stegen, Marie‐Louise, additional, Collin, Adeline, additional, Bertholdt, Charline, additional, Casagrandi, Davide, additional, Morel, Olivier, additional, and Napolitano, Raffaele, additional

Published
2022
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32. Performance of antenatal imaging to predict placenta accreta spectrum degree of severity

Author

Morel, Olivier, van Beekhuizen, Heleen J., Braun, Thorsten, Collins, Sally, Pateisky, Petra, Calda, Pavel, Henrich, Wolfgang, Al Naimi, Ammar, Norgaardt, Lone Nikoline, Chalubinski, Kinga M., Sentilhes, Loic, Tutschek, Boris, Schwickert, Alexander, Stefanovic, Vedran, Bertholdt, Charline, International Society for Placenta accreta spectrum (IS-PAS), Gynecological Oncology, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital Area, Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Berlin Institute of Health (BIH), University of Oxford [Oxford], Medizinische Universität Wien = Medical University of Vienna, First Faculty of Medicine Charles University [Prague], Goethe-Universität Frankfurt am Main, Copenhagen University Hospital, CHU Bordeaux [Bordeaux], and Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf]

Subjects
medicine.medical_specialty, Multivariate analysis, Databases, Factual, Placenta accreta, severity, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Placenta Accreta, Imaging data, Sensitivity and Specificity, Severity of Illness Index, Ultrasonography, Prenatal, Cohort Studies, 03 medical and health sciences, placenta accreta spectrum, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Pregnancy, Original Research Articles, Prenatal Diagnosis, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, 030212 general & internal medicine, Original Research Article, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, ultrasound, Ultrasound, Obstetrics and Gynecology, Magnetic resonance imaging, General Medicine, Odds ratio, medicine.disease, Magnetic Resonance Imaging, Confidence interval, United States, 3. Good health, Europe, abnormal invasive placenta, Female, Radiology, Ultrasonography, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction In cases of placenta accreta spectrum, a precise antenatal diagnosis of the suspected degree of invasion is essential for the planning of individual management strategies at delivery. The aim of this work was to evaluate the respective performances of ultrasonography and magnetic resonance imaging for the antenatal assessment of the severity of placenta accreta spectrum disorders included in the database. The secondary objective was to identify descriptors related to the severity of placenta accreta spectrum disorders. Material and methods All the cases included in the database for which antenatal imaging data were available were analyzed. The rates of occurrence of each ultrasound and magnetic resonance imaging descriptor were reported and compared between the Group “Accreta‐Increta” (FIGO grades 1 & 2) and the Group “Percreta” (FIGO grade 3). Results Antenatal imaging data were available for 347 women (347/442, 78.5%), of which 105 were included in the Group “Accreta – Increta” (105/347, 30.2%) and 213 (213/347, 61.4%) in the Group “Percreta”. Magnetic resonance imaging was performed in addition to ultrasound in 135 women (135/347, 38.9%). After adjustment for all ultrasound descriptors in multivariate analysis, only the presence of a bladder wall interruption was associated with a significant higher risk of percreta (Odds ratio 3.23, Confidence interval 1.33–7.79). No magnetic resonance imaging sign was significantly correlated with the degree of severity. Conclusions The performance of ultrasound and magnetic resonance imaging to discriminate mild from severe placenta accreta spectrum disorders is very poor. To date, the benefit of additional magnetic resonance imaging has not been demonstrated.

Published
2021

33. A multicenter observational survey of management strategies in 442 pregnancies with suspected placenta accreta spectrum

Author

Beekhuizen, Heleen, Stefanovic, Vedran, Schwickert, Alexander, Henrich, Wolfgang, Fox, Karin, Mhallem Gziri, Mina, Sentilhes, Loïc, Gronbeck, Lene, Chantraine, Frederic, Morel, Oliver, Bertholdt, Charline, Braun, Thorsten, Rijken, Marcus, Duvekot, Johannes, Calda, Pavel, Chalubinski, Kinga, Collins, Sally, Martinelli, Pasquale, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, PETIT, Philippe, Ropacka, Mariola, Tikkanen, Minna, Tutschek, Boris, Weichert, Alexander, Weizsäcker, Katharina von, Erasmus University Medical Center [Rotterdam] (Erasmus MC), University of Helsinki, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Baylor College of Medecine, Cliniques Universitaires Saint-Luc [Bruxelles], CHU Bordeaux [Bordeaux], University of Copenhagen = Københavns Universitet (KU), Centre Hospitalier Universitaire de Liège (CHU-Liège), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), University Medical Center [Utrecht], UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'obstétrique, Obstetrics and Gynaecology, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Helsinki University Hospital Area, Gynecological Oncology, and Obstetrics & Gynecology

Subjects
medicine.medical_specialty, Placenta accreta, medicine.medical_treatment, Obstetric Surgical Procedures, Prenatal diagnosis, Hemorrhage, Placenta Accreta, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Conservative Treatment, Hysterectomy, 03 medical and health sciences, placenta accreta spectrum, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Pregnancy, Placenta, Original Research Articles, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, 030212 general & internal medicine, Original Research Article, ComputingMilieux_MISCELLANEOUS, Patient Care Team, Laparotomy, 030219 obstetrics & reproductive medicine, cesarean section, business.industry, Obstetrics, Vaginal delivery, Obstetrics and Gynecology, Gestational age, Abortion, Induced, General Medicine, medicine.disease, 3. Good health, Placenta previa, abnormal invasive placenta, medicine.anatomical_structure, postpartum hemorrhage, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

INTRODUCTION: Management options for women with placenta accreta spectrum (PAS) comprise termination of pregnancy before the viable gestational age, leaving the placenta in situ for subsequent reabsorption of the placenta or delayed hysterectomy, manual removal of placenta after vaginal delivery or during cesarean section, focal resection of the affected uterine wall, and peripartum hysterectomy. The aim of this observational study was to describe actual clinical management and outcomes in PAS in a large international cohort. MATERIAL AND METHODS: Data from women in 15 referral centers of the International Society of PAS (IS-PAS) were analyzed and correlated with the clinical classification of the IS-PAS: From Grade 1 (no PAS) to Grade 6 (invasion into pelvic organs other than the bladder). PAS was usually diagnosed antenatally and the operators performing ultrasound rated the likelihood of PAS on a Likert scale of 1 to 10. RESULTS: In total, 442 women were registered in the database. No maternal deaths occurred. Mean blood loss was 2600 mL (range 150-20 000 mL). Placenta previa was present in 375 (84.8%) women and there was a history of a previous cesarean in 329 (74.4%) women. The PAS likelihood score was strongly correlated with the PAS grade (P

Published
2021

35. Developing a database for multicenter evaluation of placenta accreta spectrum

Author

Braun, Thorsten, Beekhuizen, Heleen J. Van, Morlando, Maddalena, Morel, Olivier, Stefanovic, Vedran, Al Naimi, Ammar, Bertholdt, Charline, Calda, Pavel, Chalubinski, Kinga M, Pateisky, Petra, Chantraine, Fredric, Petit, Philippe, Collins, Sally, Duvekot, Johannes J, Fox, Karin, Gronbeck, Lene, Henrich, Wolfgang, Nonnenmacher, Andreas, Schwickert, Alexander, Martinelli, Pasquale, Mhallem Gziri, Mina, Paavonen, Jorma, Tikkanen, Minna, Rijken, Marcus, Ropacka, Mariola, Strindfors, Gita, Weichert, Alexander, Weizsäcker, Katharina Von, International Society For Placenta Accreta Spectrum (IS‐PAS), Freie Universität Berlin, Humboldt-Universität zu Berlin, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Università degli studi della Campania 'Luigi Vanvitelli', Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), University of Helsinki, First Faculty of Medicine Charles University [Prague], Medizinische Universität Wien = Medical University of Vienna, Centre Hospitalier Universitaire de Liège (CHU-Liège), University of Oxford [Oxford], John Radcliffe Hospital [Oxford University Hospital], Baylor College of Medicine (BCM), Baylor University, Copenhagen University Hospital, Università degli studi di Napoli Federico II, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Poznan University of Medical Sciences [Poland] (PUMS), Obstetrics and Gynaecology, Gynecological Oncology, Obstetrics & Gynecology, Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Braun, Thorsten, van Beekhuizen, Heleen J, Morlando, Maddalena, Morel, Olivier, and Stefanovic, Vedran

Subjects
Societies, Scientific, Databases, Factual, Placenta accreta, online database, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Placenta Accreta, computer.software_genre, Imaging data, 03 medical and health sciences, placenta accreta spectrum, 0302 clinical medicine, Pregnancy, abnormally invasive placenta, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, Data collection, case reporting form, Database, business.industry, Online database, Obstetrics and Gynecology, General Medicine, medicine.disease, Current analysis, 3. Good health, Female, business, computer, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Human
Abstract

Studies of rare, but complex clinical conditions require multicenter cooperation. The International Society for Placenta accreta spectrum (IS-PAS) have established a secure web-based database to analyze pregnancies complicated by PAS. By repeated in-person meetings of the IS-PAS, a core dataset was established. Then, a custom-made, secure online database, capable of receiving strictly anonymized patient-related textual and imaging data and allowing statistical queries was designed, tested, amended and implemented. Between 2008 and 2019, 14 IS-PAS centers across Europe and one center in the USA contributed data for all their PAS cases, containing pregnancy data for a total of 442 pregnant women. Data were analyzed by a designated data analysis sub-group of the IS-PAS. Center characteristics are presented. Based on experiences with previous versions, our new online database now allows an all-encompassing data collection. It has shown its usefulness in the current analysis project.

Published
2021
Full Text
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36. A multicenter observational survey of management strategies in 442 pregnancies with suspected placenta accreta spectrum.

Author

UCL - (SLuc) Service d'obstétrique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, van Beekhuizen, Heleen J, Stefanovic, Vedran, Schwickert, Alexander, Henrich, Wolfgang, Fox, Karin A, Mhallem Gziri, Mina, Sentilhes, Loïc, Gronbeck, Lene, Chantraine, Frederic, Morel, Oliver, Bertholdt, Charline, Braun, Thorsten, Rijken, Marcus J, Duvekot, Johannes J, International Society of Placenta Accreta Spectrum (IS-PAS) group, UCL - (SLuc) Service d'obstétrique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, van Beekhuizen, Heleen J, Stefanovic, Vedran, Schwickert, Alexander, Henrich, Wolfgang, Fox, Karin A, Mhallem Gziri, Mina, Sentilhes, Loïc, Gronbeck, Lene, Chantraine, Frederic, Morel, Oliver, Bertholdt, Charline, Braun, Thorsten, Rijken, Marcus J, Duvekot, Johannes J, and International Society of Placenta Accreta Spectrum (IS-PAS) group

Abstract

INTRODUCTION: Management options for women with placenta accreta spectrum (PAS) comprise termination of pregnancy before the viable gestational age, leaving the placenta in situ for subsequent reabsorption of the placenta or delayed hysterectomy, manual removal of placenta after vaginal delivery or during cesarean section, focal resection of the affected uterine wall, and peripartum hysterectomy. The aim of this observational study was to describe actual clinical management and outcomes in PAS in a large international cohort. MATERIAL AND METHODS: Data from women in 15 referral centers of the International Society of PAS (IS-PAS) were analyzed and correlated with the clinical classification of the IS-PAS: From Grade 1 (no PAS) to Grade 6 (invasion into pelvic organs other than the bladder). PAS was usually diagnosed antenatally and the operators performing ultrasound rated the likelihood of PAS on a Likert scale of 1 to 10. RESULTS: In total, 442 women were registered in the database. No maternal deaths occurred. Mean blood loss was 2600 mL (range 150-20 000 mL). Placenta previa was present in 375 (84.8%) women and there was a history of a previous cesarean in 329 (74.4%) women. The PAS likelihood score was strongly correlated with the PAS grade (P < .001). The mode of delivery in the majority of women (n = 252, 57.0%) was cesarean hysterectomy, with a repeat laparotomy in 20 (7.9%) due to complications. In 48 women (10.8%), the placenta was intentionally left in situ, of those, 20 (41.7%) had a delayed hysterectomy. In 26 women (5.9%), focal resection was performed. Termination of pregnancy was performed in 9 (2.0%), of whom 5 had fetal abnormalities. The placenta could be removed in 90 women (20.4%) at cesarean, and in 17 (3.9%) after vaginal delivery indicating mild or no PAS. In 34 women (7.7%) with an antenatal diagnosis of PAS, the placenta spontaneously separated (false positives). We found lower blood loss (P < .002) in 2018-2019 compared with 2009-2017, sug

Published
2021

37. Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum: A multinational database study.

Author

UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'obstétrique, Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M, Pateisky, Petra, Chalubinski, Kinga M, Nonnenmacher, Andreas, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Van Beekhuizen, Heleen J, Collins, Sally L, International Society for Placenta Accreta Spectrum (IS-PAS), UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'obstétrique, Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M, Pateisky, Petra, Chalubinski, Kinga M, Nonnenmacher, Andreas, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Van Beekhuizen, Heleen J, Collins, Sally L, and International Society for Placenta Accreta Spectrum (IS-PAS)

Abstract

Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve maternal outcomes; however, the benefits must be weighed against the risk of iatrogenic prematurity. The aim of this study is to investigate the rates of emergency delivery seen for antenatally suspected PAS and compare the resulting outcomes in the 15 referral centers of the International Society for PAS (IS-PAS). Fifteen centers provided cases between 2008 and 2019. The women included were divided into two groups according to whether they had a planned or an emergency cesarean delivery. Delivery was defined as "planned" when performed at a time and date to suit the team. All the remaining cases were classified as "emergency". Maternal characteristics and neonatal outcomes were compared between the two groups according to gestation at delivery. In all, 356 women were included. Of these, 239 (67%) underwent a planned delivery and 117 (33%) an emergency delivery. Vaginal bleeding was the indication for emergency delivery in 41 of the 117 women (41%). There were no significant differences in terms of blood loss, transfusion rates or major maternal morbidity between planned and emergency deliveries. However, the rate of maternal intensive therapy unit admission was increased with emergency delivery (45% vs 33%, P = .02). Antepartum hemorrhage was the only independent predictor of emergency delivery (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency delivery due to vaginal bleeding was more frequent with false-positive cases (antenatally suspected but not confirmed as PAS at delivery) and the milder grades of PAS (accreta/increta). The rate of infants experiencing any major neonatal morbidity was 25% at 34 to 36 weeks and 19% at >36 weeks. Emergency delivery in centers of excellence did not increase blood loss, transfusion rates or maternal morbidity. The single greatest risk factor for emergency delivery

Published
2021

38. Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum:A multinational database study

Author

Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M., Pateisky, Petra, Chalubinski, Kinga M., Nonnenmacher, Andreas, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Van Beekhuizen, Heleen J., Collins, Sally L., Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M., Pateisky, Petra, Chalubinski, Kinga M., Nonnenmacher, Andreas, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Van Beekhuizen, Heleen J., and Collins, Sally L.

Abstract

Introduction: Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve maternal outcomes; however, the benefits must be weighed against the risk of iatrogenic prematurity. The aim of this study is to investigate the rates of emergency delivery seen for antenatally suspected PAS and compare the resulting outcomes in the 15 referral centers of the International Society for PAS (IS-PAS). Material and methods: Fifteen centers provided cases between 2008 and 2019. The women included were divided into two groups according to whether they had a planned or an emergency cesarean delivery. Delivery was defined as “planned” when performed at a time and date to suit the team. All the remaining cases were classified as “emergency”. Maternal characteristics and neonatal outcomes were compared between the two groups according to gestation at delivery. Results: In all, 356 women were included. Of these, 239 (67%) underwent a planned delivery and 117 (33%) an emergency delivery. Vaginal bleeding was the indication for emergency delivery in 41 of the 117 women (41%). There were no significant differences in terms of blood loss, transfusion rates or major maternal morbidity between planned and emergency deliveries. However, the rate of maternal intensive therapy unit admission was increased with emergency delivery (45% vs 33%, P =.02). Antepartum hemorrhage was the only independent predictor of emergency delivery (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency delivery due to vaginal bleeding was more frequent with false-positive cases (antenatally suspected but not confirmed as PAS at delivery) and the milder grades of PAS (accreta/increta). The rate of infants experiencing any major neonatal morbidity was 25% at 34+1 to 36+0 weeks and 19% at >36+0 weeks. Conclusions: Emergency delivery in centers of excellence did not increase blood lo

Published
2021

39. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS):A multinational database study

Author

Schwickert, Alexander, van Beekhuizen, Heleen J., Bertholdt, Charline, Fox, Karin A., Kayem, Gilles, Morel, Olivier, Rijken, Marcus J., Stefanovic, Vedran, Strindfors, Gita, Weichert, Alexander, Weizsaecker, Katharina, Braun, Thorsten, Calda, Pavel, Chalubinski, Kinga M., Chantraine, Frederic, Collins, Sally, Duvekot, Johannes J., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Mhallem Gziri, Mina, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, Petit, Philippe, Ropacka, Mariola, Tikkanen, Minna, Schwickert, Alexander, van Beekhuizen, Heleen J., Bertholdt, Charline, Fox, Karin A., Kayem, Gilles, Morel, Olivier, Rijken, Marcus J., Stefanovic, Vedran, Strindfors, Gita, Weichert, Alexander, Weizsaecker, Katharina, Braun, Thorsten, Calda, Pavel, Chalubinski, Kinga M., Chantraine, Frederic, Collins, Sally, Duvekot, Johannes J., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Mhallem Gziri, Mina, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, Petit, Philippe, Ropacka, Mariola, and Tikkanen, Minna

Abstract

Introduction: Placenta accreta spectrum (PAS) carries a high burden of adverse maternal outcomes, especially significant blood loss, which can be life-threatening. Different management strategies have been proposed but the association of clinical risk factors and surgical management options during cesarean delivery with high blood loss is not clear. Material and methods: In this international multicenter study, 338 women with PAS undergoing cesarean delivery were included. Fourteen European and one non-European center (USA) provided cases treated retrospectively between 2008 and 2014 and prospectively from 2014 to 2019. Peripartum blood loss was estimated visually and/or by weighing and measuring of volume. Participants were grouped based on blood loss above or below the 75th percentile (>3500 ml) and the 90th percentile (>5500 ml). Results: Placenta percreta was found in 58% of cases. Median blood loss was 2000 ml (range: 150-20 000 ml). Unplanned hysterectomy was associated with an increased risk of blood loss >3500 ml when compared with planned hysterectomy (adjusted OR [aOR] 3.7 [1.5-9.4], p = 0.01). Focal resection was associated with blood loss comparable to that of planned hysterectomy (crude OR 0.7 [0.2–2.1], p = 0.49). Blood loss >3500 ml was less common in patients undergoing successful conservative management (placenta left in situ, aOR 0.1 [0.0–0.6], p = 0.02) but was more common in patients who required delayed hysterectomy (aOR 6.5 [1.7–24.4], p = 0.001). Arterial occlusion methods (uterine or iliac artery ligation, embolization or intravascular balloons), application of uterotonic medication or tranexamic acid showed no significant effect on blood loss >3500 ml. Patients delivered by surgeons without experience in PAS were more likely to experience blood loss >3500 ml (aOR 3.0 [1.4–6.4], p = 0.01). Conclusions: In pregnant women with PAS, the likelihood of blood loss >3500 ml was reduced in planned vs unplanned cesarean deliver

Published
2021

40. A multicenter observational survey of management strategies in 442 pregnancies with suspected placenta accreta spectrum

Author

van Beekhuizen, Heleen J., Stefanovic, Vedran, Schwickert, Alexander, Henrich, Wolfgang, Fox, Karin A., MHallem Gziri, Mina, Sentilhes, Loïc, Gronbeck, Lene, Chantraine, Frederic, Morel, Oliver, Bertholdt, Charline, Braun, Thorsten, Rijken, Marcus J., Duvekot, Johannes J., van Beekhuizen, Heleen J., Stefanovic, Vedran, Schwickert, Alexander, Henrich, Wolfgang, Fox, Karin A., MHallem Gziri, Mina, Sentilhes, Loïc, Gronbeck, Lene, Chantraine, Frederic, Morel, Oliver, Bertholdt, Charline, Braun, Thorsten, Rijken, Marcus J., and Duvekot, Johannes J.

Abstract

INTRODUCTION: Management options for women with placenta accreta spectrum (PAS) comprise termination of pregnancy before the viable gestational age, leaving the placenta in situ for subsequent reabsorption of the placenta or delayed hysterectomy, manual removal of placenta after vaginal delivery or during cesarean section, focal resection of the affected uterine wall, and peripartum hysterectomy. The aim of this observational study was to describe actual clinical management and outcomes in PAS in a large international cohort. MATERIAL AND METHODS: Data from women in 15 referral centers of the International Society of PAS (IS-PAS) were analyzed and correlated with the clinical classification of the IS-PAS: From Grade 1 (no PAS) to Grade 6 (invasion into pelvic organs other than the bladder). PAS was usually diagnosed antenatally and the operators performing ultrasound rated the likelihood of PAS on a Likert scale of 1 to 10. RESULTS: In total, 442 women were registered in the database. No maternal deaths occurred. Mean blood loss was 2600 mL (range 150-20 000 mL). Placenta previa was present in 375 (84.8%) women and there was a history of a previous cesarean in 329 (74.4%) women. The PAS likelihood score was strongly correlated with the PAS grade (P < .001). The mode of delivery in the majority of women (n = 252, 57.0%) was cesarean hysterectomy, with a repeat laparotomy in 20 (7.9%) due to complications. In 48 women (10.8%), the placenta was intentionally left in situ, of those, 20 (41.7%) had a delayed hysterectomy. In 26 women (5.9%), focal resection was performed. Termination of pregnancy was performed in 9 (2.0%), of whom 5 had fetal abnormalities. The placenta could be removed in 90 women (20.4%) at cesarean, and in 17 (3.9%) after vaginal delivery indicating mild or no PAS. In 34 women (7.7%) with an antenatal diagnosis of PAS, the placenta spontaneously separated (false positives). We found lower blood loss (P < .002) in 2018-2019 compared with 2009

Published
2021

41. Birth experience during COVID-19 confinement (CONFINE): protocol for a multicentre prospective study

Author

Bertholdt, Charline, Epstein, Jonathan, Banasiak, Claire, Ligier, Fabienne, Dahlhoff, Sandra, Olieric, Marie France, Mottet, Nicolas, Beaumont, Marine, Morel, Olivier, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC), Université de Lorraine (UL), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and BIRKER, Juliette

Subjects
Time Factors, Physical Distancing, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Depression, Postpartum, Stress Disorders, Post-Traumatic, Pregnancy, Surveys and Questionnaires, Obstetrics and Gynaecology, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Prospective Studies, Psychiatric Status Rating Scales, maternal medicine, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Postpartum Period, Parturition, COVID-19, General Medicine, Research Design, depression & mood disorders, Female, France, adult psychiatry, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction The absence of companionship during childbirth is known to be responsible for negative emotional birth experience, which can increase the risk of postpartum depression and post-traumatic stress disorder. The context of COVID-19 epidemic and the related confinement could increase the rate of negative experience and mental disorders. The main objective is to compare, in immediate post partum, the maternal sense of control during childbirth between a group of women who gave birth during confinement (‘confinement’ group) versus a group of women who gave birth after confinement but in the context of epidemic (‘epidemic’ group) versus a group of control women (‘control’ group; excluding confinement and epidemic context). Methods and analysis This is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 927 women in a period of 16 months. Women will be recruited immediately in post partum during three different periods constituting the three groups: ‘confinement’; ‘epidemic’ and ‘control’ group. The maternal sense of control will be evaluated by the Labour Agentry Scale questionnaire completed immediately in post partum. Postnatal depression (Edinburgh Postnatal Depression Scale), post-traumatic stress disorder (Impact of Event Scale—Revised) and breast feeding (evaluative statement) will be evaluated at 2 months post partum. Ethics and dissemination The study was approved by the French Ethics Committee, the CPP (Comité de Protection des Personnes) SUD OUEST ET OUTRE-MER IV on 16th of April 2020 with reference number CPP2020-04-040. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences. Trial registration number NCT04348929.

Published
2020

42. Management of persistent occiput posterior position: The added value of manual rotation.

Author

Bertholdt, Charline, Piffer, Alexandre, Pol, Hélène, Morel, Olivier, and Guerby, Paul

Subjects
*SPHINCTERS, *DELIVERY (Obstetrics), *ANUS, *ROTATIONAL motion, *EPISIOTOMY, *PREGNANCY
Abstract

Objective: To evaluate the delivery rate in the occiput posterior position according to the result of manual rotation performed in the case of persistent occiput posterior position. Secondary objectives were perinatal outcomes. Methods: This was a prospective cohort study conducted in two French tertiary care units. All women with a singleton pregnancy after 37 weeks of gestation with a fetus in persistent occiput posterior position and an attempt of manual rotation were included. The main outcome was the occiput position at delivery. The secondary outcomes were duration of labor, mode of delivery, and perineal tears. Two groups were compared according to the result of manual rotation. Results: In total, 460 women were included, with a manual rotation success of 62.4%. The success was significantly associated with a decrease in occiput posterior position at vaginal delivery (1.4% vs 57.2%, P < 0.0001), cesarean (0.7% vs 17.9%, P < 0.0001), operative vaginal delivery (40.1% vs 78%, P < 0.0001), episiotomy (40.1% vs 54.9%, P < 0.0001), and obstetric anal sphincter injury (3.1% vs 8.7%, P = 0.008) compared with a failure. Conclusion: An attempt of manual rotation in the case of persistent occiput posterior position is associated with decreased rates of occiput posterior position at delivery, operative delivery, and anal sphincter injuries. [ABSTRACT FROM AUTHOR]

Published
2022
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43. Rapport d’Experts et Recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse – texte court

Author

Grangé, Gilles, Berlin, Ivan, Bretelle, Florence, Bertholdt, Charline, Berveiller, Paul, Blanc, Julie, Diguisto, Caroline, Dochez, Vincent, Garabedian, Charles, Guerby, Paul, Koch, Antoine, Lous, Maela Le, Perdriolle-Galet, Estelle, Peyronnet, Violaine, Emmanuel, Rault, Torchin, Héloise, Legendre, Guillaume, Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Maternité Régionale Adolphe Pinard [Nancy], Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre hospitalier universitaire de Nantes (CHU Nantes), Environnement périnatal et croissance - EA 4489 (EPS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Strasbourg, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Louis Mourier - AP-HP [Colombes], Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de pharmacologie médicale [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Environnement périnatal et croissance, Université de Lille, Droit et Santé, CHU Toulouse [Toulouse], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
Essais cliniques, Nicotine, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Études observationnelles, Tabagisme, Sevrage tabagique, Déterminants, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Tabagisme passif, Épidémiologie, traitement substitutif nicotinique, Grossesse, Facteurs de risque, Allaitement maternel, Revue de la littérature, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Revue systématique, Prédicteurs, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Méta-analyse, Comportements, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Interventions, Post-partum
Abstract

International audience; Objectives - To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy. Methods - Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest). Results - "Counseling", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child's development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression. Conclusions - Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.

Published
2020

44. An international registry for emergent pathogens and pregnancy

Author

Alice Panchaud, Guillaume Favre, Leo Pomar, Manon Vouga, Karoline Aebi-Popp, David Baud, Tallarek Ann-Christin, Strizek Brigitte, Hecher Kurt, Böckenhoff Paul, Schrey-Petersen Susanne, Mullins Edward, Bromley Rebecca, Whitehead Clare, Rolnik Daniel, Deprest Jan, Richter Jute, Gomes Luz Adriana, Bohrer Betania, Carvalho Ribeiro-do-Valle Carolina, Garanhani Surita Fernanda, Schuler-Faccini Lavinia, Osorio Wender Maria Celeste, Da Rocha Oppermann Maria Lucia, Moreira de sa Renato Augusto, Quintana Silvana, Sjaus Ana, Rahman Arifa, Hamel-Thibault Audrey, Nash Christopher, Kakkar Fatima, Berger Howard, Boucoiran Isabelle, Pasquier Jean-Charles, Snelgrove John, Zipursky Jonathan, Lacroix Meagan, Whittle Wendy, Fuenzalida Javiera, Carvajal Jorge, Guerra Canales Manuel, Hernandez Olivia, Yin Mingzhu, Chen Xiang, Qi Xiaolong, Sanín Blair José Enrique, Gonzalez Ricardo, Cano Aguilar Africa, Rodriguez Vicente Agueda, Tubau Navarra Albert, Puertas Prieto Alberto, Cano Garcia Alejandra Maria, Carrascal Cumplido Ana, Villalba Yarza Ana, Filloy Lavia Ana Cristina, Fernandez Alonso Ana Maria, Sanchez Vegazo Garcia Angeles, Goncé Anna, Ruano Garcia Antonio, Sanchez Munoz Antonio, Marcos Puig Beatriz, Munoz Abellana Begona, Garrido Luque Belen, Fernandez Fernandez Camino, Larranaga Azcarate Carlos, Baena Luque Carmen, Orizales Lago Carmen Maria, Alvarez Colomo Cristina, Lesmes Heredia Cristina, Ruiz Aguilar Cristina, Ferriols Perez Elena, Pascual Salvador Elena, Carmona Sanchez Encarnacion, Alvarez Silvares Esther, Canedo Carballeira Esther Maria, Moran Antolin Eva, Muelas Parraga Eva Maria, Oviedo Perez Eva Maria, Gonzalez Carvajal Francisco Jesus, Agudo Iène, Ocerin Bengoa Iratxe, Gastaca Abasolo Irene, Cabello de Alba Fernandez Isabel, Alvarez Javier, Duro Gomez Jorge, Atxotegi Jose, Navarrina Martinez José, Ruiz Aragon José, Sainz Bueno José Antonio, Adanez Garcia Jose Manuel, Broullon Molanes José Roman, Wizner de Alva Juan Carlos, Forcen Acebal Laura, Gonzalez Rodriguez Laura, Aceituno Velasco Longinos, Cerrillos Gonzalez Lucas, Trigo Lucas, Diaz Meca Lucia, Parada Millan M Carmen, Molina Oller Magdalena, Dominguez Gonzalez Manuel, Munoz Chapuli Gutierrez Mar, Caridad Ortiz Herrera Maria, Nieves Quesada Fernandez Maria, Suarez Arana Maria, Teulon Gonzalez Maria, Zafra Bailera Maria, Duenas Carazo Maria Begona, Gonzalez Macias Maria Carmen, Pilar Guadix Martin Maria del, Barbancho Lopez Maria del Carmen, Medina Mallen Maria del Carmen, Pardo Pumar Maria Isabel, Gimeno Gimeno Maria Joaquina, Nunez Valera Maria José, Pelegay Escartin Maria José, Camacho Caro Marta, Garcia Sanchez Marta, Meca Casbas Marta Ruth, Fraca Padilla Mercedes, Ramirez Gomez Mercedes, Catalina Coello Monica, Cruz Lemini Monica, Perez Perez Noelia, Nieto Velasco Olga, Alomar Mateu Onofre, Martinez Perez Oscar, Vaquerizo Ruiz Oscar, Barrio Fernández Pablo Guillermo del, Monteliu Gonzalez Pilar, Prats Rodriguez Pilar, Vivaracho Terrer Porfirio, Gonzales Seoane Raquel, Jimenez Velazquez Raquel, Alvarez Fernandez Rebeca, Lopez Perez Rocio, Ostos Serna Rosa Maria, Redondo Aguilar Rosario, Bernardo Vega Rut, Cano Sandra, Mateos Lopez Silvia, Fernandez Garcia Susana, Soldevilla Perez Susana, Manrique Gomez Tania, Munoz Carmona Vitor, Ko Albert I, Johnson Anthony, Nielsen Saines Karin, Cambou Mary, Grechukhina Olga, Neupane Sahara, Reddy Uma, Shah Zubin, Breton Bénédicte, Garabedian Charles, Bertholdt Charline, Poncelet Christophe, Subtil Damien, Musso Didier, Henry Estelle, Plantefeve Gaetan, Ducarme Guillaume, Pelerin Helene, Dimet Jerome, Cottin Judith, Stiremann Julien, Lambert Véronique, Hcini Najeh, Salomon Laurent, Sentilhes Loïc, Giral Marylene, Mottet Nicolas, Morel Olivier, Rozenberg Patrick, Lucie Sedille, Quibel Thibaud, Karagianni Vasiliki, Equy Véronique, Ville Yves, Carles Gabriel, Ruehl Ina, Cleary Brian, Malone Fergal, Higgins Mary, Geary Michael, Hadar Eran, Malinger Gustavo, Sela Hen, Krajden Haratz Karina, Maymon Ron, Yogev Yariv, De Luca Carmen, De Santis Marco, Rosso Telefono, Atallah David, Boguziene Emilija, Germes Pina Fernando, Van den Akker Thomas, Gil-Guevara Enrique, Marchena Jeannette, Ventura Walter, Pereira Alcides, Ayres de Campos Diogo, Charepe Nadia, Viana Pinto Pedro, Ntasumbumuyange Diomede, Rulisa Stephen, Panchaud Alice, Radan Anda-Petronela, Papadia Andrea, Bloch Andrea, Feki Anis, Muller Brochut Anne-Claude, Toussaint Arnaud, Eggel-Hort Béatrice, Martinez de Tejada Begoña, Frey Tirri Brigitte, Weber Brigitte, Blume Carolin, Monod Cécile, Kahlert Christian, Voekt Cora, Surbek Daniel, Baud David, Bassler Dirk, Mueller Doris, Prentl Elke Barbara, Gerber Eva, Rothe Friederike, Eric Giannoni, Favre Guillaume, Hoesli Irene, Mathis Jérôme, Lepigeon Karine, Aebi-Popp Karoline, Pomar Leo, Schäffer Leonhard, Raio Luigi, Vouga Manon, Huesler Charles Margaret, Rossier Marie-Claude, Hodel Markus, Kaufmann Martin, Gavillet Mathilde, Boulvain Michel, Todesco Bernasconi Monya, Bickle Myriam, Ochsenbein Kölble Nicole, Jarrah Omar, Kanellos Panagiotis, Brasier Lutz Pascale, Capoccia Brugger Romina, Heldstab Sandra, Heldstab Sandra Andrea, Rouiller Cornu Sylvie, Fischer Tina, Winterfeld Ursula, Lambelet Valentine, Rieder Wawrzyniec, Greub Gilbert, Gengler Carole, Patel Rena C, Huespe Miguel Angel, Nieto-Calvache Albaro José, COVI-Preg group, Ann-Christin, T., Brigitte, S., Kurt, H., Paul, B., Susanne, S.P., Edward, M., Rebecca, B., Clare, W., Daniel, R., Jan, D., Jute, R., Adriana, G.L., Betania, B., Carolina, C.R., Fernanda, G.S., Lavinia, S.F., Maria Celeste, O.W., Maria Lucia, DRO, Renato Augusto, M.S., Silvana, Q., Ana, S., Arifa, R., Audrey, H.T., Christopher, N., Fatima, K., Howard, B., Isabelle, B., Jean-Charles, P., John, S., Jonathan, Z., Meagan, L., Wendy, W., Javiera, F., Jorge, C., Manuel, G.C., Olivia, H., Mingzhu, Y., Xiang, C., Xiaolong, Q., José Enrique, S.B., Ricardo, G., Africa, C.A., Agueda, R.V., Albert, T.N., Alberto, P.P., Alejandra Maria, C.G., Ana, C.C., Ana, V.Y., Ana Cristina, F.L., Ana Maria, F.A., Angeles, SVG, Anna, G., Antonio, R.G., Antonio, S.M., Beatriz, M.P., Begona, M.A., Belen, G.L., Camino, F.F., Carlos, L.A., Carmen, B.L., Carmen Maria, O.L., Cristina, A.C., Cristina, L.H., Cristina, R.A., Elena, F.P., Elena, P.S., Encarnacion, C.S., Esther, A.S., Esther Maria, C.C., Eva, M.A., Eva Maria, M.P., Eva Maria, O.P., Francisco Jesus, G.C., Iène, A., Iratxe, O.B., Irene, G.A., Isabel, CAF, Javier, A., Jorge, D.G., Jose, A., José, N.M., José, R.A., José Antonio, S.B., Jose Manuel, A.G., José Roman, B.M., Juan Carlos, W.A., Laura, F.A., Laura, G.R., Longinos, A.V., Lucas, C.G., Lucas, T., Lucia, D.M., M Carmen, P.M., Magdalena, M.O., Manuel, D.G., Mar, MCG, Maria, COH, Maria, NQF, Maria, S.A., Maria, T.G., Maria, Z.B., Maria Begona, D.C., Maria Carmen, G.M., Maria Del, PGM, Maria Del Carmen, B.L., Maria Del Carmen, M.M., Maria Isabel, P.P., Maria Joaquina, G.G., Maria José, N.V., Maria José, P.E., Marta, C.C., Marta, G.S., Marta Ruth, M.C., Mercedes, F.P., Mercedes, R.G., Monica, C.C., Monica, C.L., Noelia, P.P., Olga, N.V., Onofre, A.M., Oscar, M.P., Oscar, V.R., Pablo Guillermo Del, B.F., Pilar, M.G., Pilar, P.R., Porfirio, V.T., Raquel, G.S., Raquel, J.V., Rebeca, A.F., Rocio, L.P., Rosa Maria, O.S., Rosario, R.A., Rut, B.V., Sandra, C., Silvia, M.L., Susana, F.G., Susana, S.P., Tania, M.G., Vitor, M.C., Albert I, K., Anthony, J., Karin, N.S., Mary, C., Olga, G., Sahara, N., Uma, R., Zubin, S., Bénédicte, B., Charles, G., Charline, B., Christophe, P., Damien, S., Didier, M., Estelle, H., Gaetan, P., Guillaume, D., Helene, P., Jerome, D., Judith, C., Julien, S., Véronique, L., Najeh, H., Laurent, S., Loïc, S., Marylene, G., Nicolas, M., Olivier, M., Patrick, R., Sedille, L., Thibaud, Q., Vasiliki, K., Véronique, E., Yves, V., Gabriel, C., Ina, R., Brian, C., Fergal, M., Mary, H., Michael, G., Eran, H., Gustavo, M., Hen, S., Karina, K.H., Ron, M., Yariv, Y., Carmen, L., Marco, S., Telefono, R., David, A., Emilija, B., Fernando, G.P., Thomas, VDA, Enrique, G.G., Jeannette, M., Walter, V., Alcides, P., Diogo, A.C., Nadia, C., Pedro, V.P., Diomede, N., Stephen, R., Alice, P., Anda-Petronela, R., Andrea, P., Andrea, B., Anis, F., Anne-Claude, M.B., Arnaud, T., Béatrice, E.H., Begoña, M.T., Brigitte, F.T., Brigitte, W., Carolin, B., Cécile, M., Christian, K., Cora, V., Daniel, S., David, B., Dirk, B., Doris, M., Elke Barbara, P., Eva, G., Friederike, R., Giannoni, E., Guillaume, F., Irene, H., Jérôme, M., Karine, L., Karoline, A.P., Leo, P., Leonhard, S., Luigi, R., Manon, V., Margaret, H.C., Marie-Claude, R., Markus, H., Martin, K., Mathilde, G., Michel, B., Monya, T.B., Myriam, B., Nicole, O.K., Omar, J., Panagiotis, K., Pascale, B.L., Romina, C.B., Sandra, H., Sandra Andrea, H., Sylvie, R.C., Tina, F., Ursula, W., Valentine, L., Wawrzyniec, R., Gilbert, G., Carole, G., Rena C, P., Miguel Angel, H., and Albaro José, N.C.

Subjects
Diagnostic Screening Programs, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Severe Acute Respiratory Syndrome, Communicable Diseases, Emerging, Risk Assessment, Betacoronavirus, Fetus, Pregnancy, Risk Factors, Pandemic, medicine, Humans, Registries, 610 Medicine & health, Intensive care medicine, Pandemics, Zika Virus Infection, Viral Epidemiology, business.industry, Pregnancy Outcome, Betacoronavirus/growth & development, Betacoronavirus/immunology, Communicable Diseases, Emerging/epidemiology, Communicable Diseases, Emerging/prevention & control, Coronavirus Infections/epidemiology, Diagnostic Screening Programs/standards, Female, Interdisciplinary Placement/methods, Pneumonia, Viral/epidemiology, Pregnancy Outcome/epidemiology, Severe Acute Respiratory Syndrome/epidemiology, Zika Virus/immunology, Zika Virus Infection/epidemiology, COVID-19, Zika Virus, General Medicine, medicine.disease, Interdisciplinary Placement, sars-cov-2, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Coronavirus Infections, business
Published
2020

47. Assessment of uteroplacental vascularisation in early first-trimester pregnancy with contrast-enhanced ultrasound and 3D power Doppler angiography: protocol for a prospective, cross-sectional, multicentre and non-randomised open study (“HOPE Study”)

Author

Bertholdt, Charline, primary, Eszto, Marie-Laure, additional, Tournier, Mathilde, additional, Hossu, Gabriela, additional, Mellouki, Naoual, additional, Cherifi, Aboubaker, additional, and Morel, Olivier, additional

Published
2019
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49. Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Author

Collins, Sally L., primary, Alemdar, Bahrin, additional, van Beekhuizen, Heleen J., additional, Bertholdt, Charline, additional, Braun, Thorsten, additional, Calda, Pavel, additional, Delorme, Pierre, additional, Duvekot, Johannes J., additional, Gronbeck, Lene, additional, Kayem, Gilles, additional, Langhoff-Roos, Jens, additional, Marcellin, Louis, additional, Martinelli, Pasquale, additional, Morel, Olivier, additional, Mhallem, Mina, additional, Morlando, Maddalena, additional, Noergaard, Lone N., additional, Nonnenmacher, Andreas, additional, Pateisky, Petra, additional, Petit, Philippe, additional, Rijken, Marcus J., additional, Ropacka-Lesiak, Mariola, additional, Schlembach, Dietmar, additional, Sentilhes, Loïc, additional, Stefanovic, Vedran, additional, Strindfors, Gita, additional, Tutschek, Boris, additional, Vangen, Siri, additional, Weichert, Alexander, additional, Weizsäcker, Katharina, additional, and Chantraine, Frederic, additional

Published
2019
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50. Placenta Imaging Workshop 2018 report: Multiscale and multimodal approaches

Author

Slator, Paddy, primary, Aughwane, Rosalind, additional, Cade, Georgina, additional, Taylor, Daniel, additional, David, Anna L., additional, Lewis, Rohan, additional, Jauniaux, Eric, additional, Desjardins, Adrien, additional, Salomon, Laurent J., additional, Millischer, Anne-Elodie, additional, Tsatsaris, Vassilis, additional, Rutherford, Mary, additional, Johnstone, Edward D., additional, Melbourne, Andrew, additional, Atkinson, David, additional, Baranikumar, Rupanjali, additional, Bertholdt, Charline, additional, Bonet-Carne, Elisenda, additional, Brownbill, Paul, additional, Bruchhage, Muriel, additional, Caulfield, Richard, additional, Chernyavsky, Igor, additional, Chew, Andrew, additional, David, Anna, additional, De Vita, Enrico, additional, Doel, Tom, additional, Erlich, Alexander, additional, Flouri, Dimitra, additional, Guerreri, Michele, additional, Hakim, Matina, additional, Hansen, Ditte, additional, Haq, Makinah, additional, Haris, Parvez, additional, Hillman, Sara, additional, Ho, Alison, additional, Hutter, Jana, additional, Jackson, Laurence, additional, Johnstone, Edward, additional, Kipergil, Esra, additional, Labianco, Silvia, additional, Malamateniou, Christina, additional, Maneas, Efthymios, additional, Monton, Enrique, additional, Morris, David, additional, Nihouarn, Julie, additional, Nye, Gareth, additional, O'Neill, Helen, additional, Thunbo, Mette Østergaard, additional, Palombo, Marco, additional, Peasley, Rachel, additional, Baruteau, Kelly Pegoretti, additional, Mayo, Romina Plitman, additional, Port, Saskia, additional, Salomon, Laurent, additional, Shah, Simon, additional, Slator, Paddy, additional, Soe, Natalia, additional, Soerensen, Anne, additional, Sokolska, Magdalena, additional, Svigilsky, Carla, additional, Tropea, Teresa, additional, Wang, Guotai, additional, and Yassine, Bilal, additional

Published
2019
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