861 results on '"Y. Ville"'
Search Results
202. [Pregnancy after renal transplantation. 27 patients and review of the literature]
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Y, Ville, H, Fernandez, D, Edouard, and R, Frydman
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Adult ,Fetal Growth Retardation ,Cesarean Section ,Pregnancy Outcome ,Prognosis ,Kidney Transplantation ,Pregnancy Complications ,Obstetric Labor, Premature ,Pregnancy ,Risk Factors ,Azathioprine ,Hypertension ,Cyclosporine ,Birth Weight ,Humans ,Prednisone ,Drug Therapy, Combination ,Female ,France ,Follow-Up Studies - Abstract
We report the course and outcome of 30 pregnancies in 27 renal transplant patients between 1970 and 1988. Delay between transplantation and pregnancy was 7.3 +/- 4.8 years. There were 1 twin pregnancy and 3 successive pregnancies. Immunosuppressive regime was prednisone and azathioprine in 28 cases and cyclosporine in 2. Hypertension (33%), preterm delivery (74%) and premature rupture of the membranes (33%) were the main complication encountered. The cesarean section rate was 73%, mainly because of these complications. Twenty-seven patients delivered of 31 healthy children. There was no congenital anomaly. Mean birth weight was 2.640 +/- 645 g. In utero growth retardation occurred in 7 cases (23%). Pregnancy after renal transplantation is of good prognosis for both the mother and child but the course of pregnancy can be complicated by hypertension, preterm birth and growth retardation.
- Published
- 1992
203. [Pregnancy after hepatic transplantation. 17 pregnancies]
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Y, Ville, H, Fernandez, D, Samuel, H, Bismuth, and R, Frydman
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Adult ,Adolescent ,Cesarean Section ,Pregnancy Outcome ,Cyclosporins ,Genetic Counseling ,Liver Transplantation ,Abortion, Spontaneous ,Pregnancy Complications ,Adrenal Cortex Hormones ,Pregnancy ,Risk Factors ,Azathioprine ,Hypertension ,Birth Weight ,Humans ,Drug Therapy, Combination ,Female ,France ,Abortion, Therapeutic ,Follow-Up Studies - Abstract
The number of orthotopic liver transplantations (OLT) is increasing and longterm survival is improving. More women recipients may choose to become pregnant. We report a one-center experience with the course and outcome of 17 pregnancies in 17 liver transplant out of 675 OLT since 1985. 10 women delivered of 10 healthy infants at 38 +/- 1.5 week's gestation. There was no preterm delivery and the mean birth weight was 2.990 +/- 370 g, birth weight was adequate for gestational age in any case. Four cesarean sections were performed for obstetrical indications. No congenital anomalies occurred in the children. Hypertension occurred in 2 out of twelve patients and appeared as the main complication to deal with. There was one case with graft function impairment at 37 weeks' gestation. One uncomplicated pregnancy is ongoing at 29 weeks' gestation. There were 4 spontaneous and 2 therapeutic abortions for impaired liver function. Pregnancy is successful in a large proportion of these patients but must be planned and managed as high-risk situations by an obstetrician and a specialist of the liver transplant. Pregnancy should be advised against in patients with poor liver function or active viral infection; a 12 months interval from OLT to pregnancy is since to be the minimal requirement. Post-transplant immunosuppressive therapy consisted of azathioprine, corticosteroids and ciclosporin A, and was maintained throughout pregnancy. Genetic counselling should be provided when the primary liver disease is inherited. This being said, as shown by the results of our study and those reported in the literature, pregnancy is not only feasible but also successful in a large proportion of OLT recipients.
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- 1992
204. F66Learning ultrasound-guided invasive procedures in fetal medicine: the learning curve with an automated system
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J. Nizard and Y. Ville
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,education ,Hand technique ,Obstetrics and Gynecology ,General Medicine ,Ultrasound guided ,Surgery ,Reproductive Medicine ,Learning curve ,medicine ,Radiology, Nuclear Medicine and imaging ,Sampling (medicine) ,Medical physics ,business ,Guidance system ,Fetal medicine - Abstract
Background Learning ultrasound-guided invasive procedures in fetal medicine can be done either on training models or directly on patients. Amniocenteses, cordocentesis, and chorionic villous sampling are associated with more complications at the beginning of the learning curve. It is therefore essential to optimise the teaching and reduce the length of the learning curve. We studied the learning curves of 8 inexperienced registrars in ObGyn with and without the use of a new electronic guidance system. Method 8 medical students performed 100 invasive procedures (cordocentesis) using a specially designed training model. Four students used the ultrasound-assisted free hand technique and four students used the same technique but assisted by the electronic guidance system. We studied the overall duration of the procedure and the proportion of this time the student is in control of the needle (the entire needle is visualised on the ultrasound screen). Results The new electronic guidance system reduces the learning curve of ultrasound-assisted invasive procedures on training models, but increases the length of the procedure. Conclusion The new electronic guidance system can help teaching junior doctors in ultrasound-assisted invasive procedures in fetal medicine.
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- 2000
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205. Depistage integre de la trisomie 21 au premier trimestre
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Y. Ville and L. Salomon
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Radiological and Ultrasound Technology ,Radiology, Nuclear Medicine and imaging - Abstract
Objectifs Connaitre la technique de la mesure de la clarte nucale. Connaitre les principes du calcul de risque integre au premier trimestre. Comprendre le contenu d’un programme d’EPP specifique de l’echo-graphie du premier trimestre. Messages a retenir La mesure de la clarte nucale est mesurable entre 44 et 85 mm de longueur cranio-caudale. la plus grande mesure de la CN parmi des mesures bien faites est retenue pour le depistage. Une auto-evaluation du cliche peut etre realisee par l’application du score de Hermann. La mediane des mesures de CN doit etre suivie pour chaque operateur. Resume Le fœtus doit etre dans une position sagittale stricte et en position neutre. La taille du cliche doit etre d’au moins 75% de celle de l’ecran, le faisceau ultrasonore doit etre dirige perpendiculairement a la nuque fœtale. Le fœtus doit etre eloigne de l’amnios. le calcul integre prend en compte l’âge de la femme enceinte, la mesure de la clarte nucale en mm et 1/10 de mm, et les resultats exprimes en MoM du dosage de la fraction libre de la beta-hCg et de la PAPPA. La base d’une EPP sur l’echographie du 1er trimestre inclut au minimum l’evaluation interne et externe de la qualite de cliches utilises dans la pratique clinique et le suivi des distributions des mesures de clarte nucale.
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- 2009
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206. [Fertility after extra-uterine pregnancy in Africa. Follow-up of a cohort of 145 patients over 5 years]
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Y, Ville, M, Leruez, E, Glowaczower, and H, Fernandez
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Adult ,Time Factors ,Prognosis ,Pelvis ,Pregnancy, Ectopic ,Cohort Studies ,Fertility ,Pregnancy ,Recurrence ,Humans ,Female ,Gabon ,Infertility, Female ,Fallopian Tubes ,Follow-Up Studies - Abstract
Gabon has one of the lowest fertility rates in Central Africa (116 children per 1,000 women); and ectopic pregnancy occurs in 1 per 62.5 live births. We have studied fertility following ectopic pregnancy with a 5 years follow-up in a cohort of 145 women treated for an ectopic pregnancy in the general hospital of Franceville, Gabon. 17% of these women had an intra uterine pregnancy, 10% had a repeat ectopic pregnancy and 73% were infertile 5 years after the ectopic pregnancy. We compared the fertile group and the infertile group after ectopic pregnancy: the main factors for fertility were the fertility of these women before the ectopic pregnancy and the staging of the Fallopian tube and pelvic cavity. Pelvic adhesions following pelvic inflammatory diseases were correlated with infertility. The main causative agent of infertility after ectopic pregnancy were sexual transmitted diseases and their sequelae and late diagnosis.
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- 1991
207. [Limb-girdle dystrophy and pregnancy: a case report]
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Y, Ville, J P, Barbet, A, Pompidou, and M, Tournaire
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Adult ,Pregnancy Complications ,Cesarean Section ,Pregnancy ,Biopsy ,Myometrium ,Humans ,Female ,Dystocia ,Immunohistochemistry ,Muscular Dystrophies - Abstract
A case of pregnancy with Limb-girdle dystrophy is presented. The course of pregnancy remained uncomplicated, the patient has been delivered at 42 week's gestation by cesarean section, performed for dystocia and fetal distress. Histological and immunohistochemical examinations of the myometrium were unable to show its involvement in the muscular disease. The influence of the muscular disease and the route of delivery for such patients are discussed.
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- 1991
208. Fetal medicine: Intrauterine fetal demise following laser treatment in twin‐to‐twin transfusion syndrome
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Cavicchioni, O, primary, Yamamoto, M, additional, Robyr, R, additional, and Takahashi, Y Ville, Y, additional
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- 2006
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209. Pourquoi une EPP en echographie du 1er trimestre
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Y. Ville
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Radiological and Ultrasound Technology ,Radiology, Nuclear Medicine and imaging - Published
- 2007
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210. OC38: Estimated fetal weight by two operators improves identification of small-for-gestational age fetuses
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M. Rahmati, Y. Ville, and J. Nizard
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Crown-rump length ,Small for gestational age fetus ,medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,Fetal weight ,Reproductive Medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,Identification (biology) ,business - Published
- 2007
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211. OC167: Assessment of the Sylvian fissure operculization (SFO) at between 22 and 32 weeks of gestation: a subjective approach (part I)
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E. Quarello, J. Stirnemann, L. Guibaud, and Y. Ville
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Reproductive Medicine ,Radiological and Ultrasound Technology ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2007
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212. David Lewin
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Y. Ville
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Reproductive Medicine ,Obstetrics and Gynecology ,General Medicine - Published
- 2007
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213. Delivery through an undiagnosed major placenta praevia: good outcome for mother and baby
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Miren J. Turner, A. Ikomi, Y. Ville, K. O. Oyelese, and I. T. Manyonda
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medicine.medical_specialty ,Vaginal delivery ,business.industry ,Uterus ,Obstetrics and Gynecology ,medicine.disease ,Surgery ,Uterine atony ,medicine.anatomical_structure ,Placenta ,medicine ,Rupture of membranes ,Vaginal bleeding ,Uterine cavity ,medicine.symptom ,business ,Cervix - Abstract
Case report A 23-year-old woman, para 1 1 1, had induction of labour at 39 weeks’ gestation for severe symphyseal pain. A transabdominal ultrasound scan at 22 weeks’ gestation showed a posterior and low-lying placenta. At 35 weeks, a repeat trans-abdominal scan localised the placenta anteriorly and high, with its lower edge 5 8 cm from the internal cervical os. At induction, the fetus presented as a vertex, with two® fths of the head palpable abdominally. The cervix was 2 cm long, closed, posterior, and soft, with the presenting part 2 cm above the ischial spines. Prostaglandin gel (2 mg) was inserted into the posterior fornix, and repeated 4 hours later. The cardiotocograph was normal. After 3 hours, the cervix was fully effaced, 3 cm dilated, and arti® cial rupture of membranes was performed, yielding heavily bloodstained liquor . Following this, a small amount of vaginal bleeding was noted, but as the uterus was soft and non-tender, the cardiotocograph remained normal, and labour progressed rapidly to full dilatation and vaginal delivery of a live infant 3 hours later, no further action was taken. Apgar scores were 9 and 10 at 1 and 5 minutes respectively. Immediately following delivery, she passed about 1 litre of fresh clots per vaginam. She was given syntometrine intravenously, an oxytocin infusion commenced, and the placenta was delivered by controlled cord traction. However, brisk bleeding continued, and her uterus was explored under anaesthesia. The uterine cavity was empty, and there were no vaginal or cervical tears to account for the bleeding. The uterine atony following exploration was managed by bimanual massage, intravenous oxytocin and intramuscular carboprost. She was transfused with four units of blood and two units of fresh frozen plasma. The bleeding soon subsided, and the rest of the post-delivery period was uncomplicated. Examination of the placenta revealed intact membranes and a large centrally located hole in the body of the placenta through which the fetus presumably delivered (Figure 1). Subsequent pathological examination con® rmed intact membranes, and a defect in the placental body completely surrounded by villous tissue, without communication between the defect and the membranes.
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- 1998
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214. [Untitled]
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Y. Ville
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Fetus ,medicine.medical_specialty ,Acoustics and Ultrasonics ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Cerebral malformations ,Biophysics ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prenatal diagnosis ,business - Published
- 2006
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215. Mesure de la microcirculation placentaire en IRM fonctionnelle sur un modele murin
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Nathalie Siauve, L.-J. Salomon, Olivier Clément, Y. Ville, F. Taillieu, and C.A. Cuénod
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Radiological and Ultrasound Technology ,Radiology, Nuclear Medicine and imaging - Abstract
Objectifs Mesure de la microcirculation placentaire murine par IRM. Materiels et methodes Quarante-huit souris gestantes ont ete imagees par une sequence monocoupe double echo avec 2 protocoles d’injection : monophasique (double) et biphasique (quadruple dose clinique). Les intensites de signal (IS) etaient mesurees dans le ventricule gauche maternel, les placentas et les fœtus. Une correction de l’effet T2* etait appliquee sur la fonction d’entree, a l’aide de la sequence double echo, pour obtenir une IS uniquement dependante du Tl. Les IS, converties en concentrations, etaient analysees par un modele tricompartimental. Des parametres microcirculatoires etaient calcules a partir des constantes de transfert. Les concentrations arterielles finales mesurees par IRM etaient comparees a celles obtenues par spectrophotometrie. Resultats Les parametres microcirculatoires obtenus avec les 2 protocoles etaient identiques : flux placentaire : 3,03E-02 mL/sec/ml, coefficient permeabilite surface du compartiment placentaire maternel au placentaire fœtal : 16,4E-04 sec -1 et du compartiment placentaire fœtal au placentaire maternel : 6E-04 sec -1 , flux ombilical : 7E-05 mL/sec/ml et fraction volumique du compartiment sanguin placentaire maternel : 36,5 %. Les concentrations arterielles en IRM n’etaient pas significativement differentes de celles obtenues en spectrophotometrie. Conclusion La microcirculation placentaire peut etre mesuree in vivo, a l’aide de fortes doses de Gd et d’une sequence double echo.
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- 2005
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216. Formation initiale et continue
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Y. Ville
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Radiological and Ultrasound Technology ,Radiology, Nuclear Medicine and imaging - Published
- 2005
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217. P09.13: The impact of laser therapy on fetal growth discordance in twin-to-twin transfusion syndrome
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S. J. Laurent, M. Yamamoto, Y. Ville, Y. Takahashi, and Renato Augusto Moreira de Sá
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Twin-to-twin transfusion syndrome ,medicine.disease ,Surgery ,Reproductive Medicine ,Laser therapy ,medicine ,Fetal growth ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2005
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218. OC18.08: Intertwin venous flow imbalance in twin-twin transfusion syndrome (TTTS)
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F. Huard, Y. Takahashi, Y. Ville, M. Yamamoto, and J. P. Bernard
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medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Internal medicine ,Cardiology ,medicine ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Venous flow ,Twin Twin Transfusion Syndrome - Published
- 2005
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219. P06.12: Changes in urine production using three dimensional ultrasound in twin-to-twin transfusion syndrome treated by laser
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M. Yamamoto, R. Moreira de Sa, Y. Takahashi, and Y. Ville
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medicine.medical_specialty ,Three dimensional ultrasound ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Laser ,Twin-to-twin transfusion syndrome ,medicine.disease ,law.invention ,Urine production ,Reproductive Medicine ,law ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2005
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220. P09.14: Analysis of fetal growth following laser therapy in twin-to-twin transfusion syndrome
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M. Yamamoto, Y. Takahashi, Renato Augusto Moreira de Sá, Y. Ville, and L. J. Salomon
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,Twin-to-twin transfusion syndrome ,medicine.disease ,Reproductive Medicine ,Laser therapy ,Fetal growth ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2005
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221. IRM fonctionnelle placentaire : etude de la perfusion et de la permeabilite du placenta murin
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C. Vayssettes, Olivier Clément, L.-J. Salomon, D. Balvay, C.A. Cuénod, Alain Luciani, Nathalie Siauve, Y. Ville, and Guy Frija
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Radiological and Ultrasound Technology ,Radiology, Nuclear Medicine and imaging - Abstract
Objectifs L’etude de la microcirculation par IRM fonctionnelle (IRMf) est rendue possible grâce au developpement d’agents de contraste de biodistribution differente et aux progres de l’imagerie rapide. L’evaluation de la fonction placentaire in vivo est actuellement difficile mais pourrait etre realisee par IRMf. Le but de cette etude etait de realiser un modele murin d’etude fonctionnelle placentaire par IRM. Materiels et methodes Des souris Balb/c gestantes ont ete etudiees avec une sequence IRM Fast SPGR, ponderee en T1 apres injection d’un agent de contraste traditionnel (gadolinium-Dota / Dotarem®) ou macromoleculaire experimental (P792 / Vistarem®). Les intensites de signal du ventricule gauche (fonction d’entree), des placentas et des fœtus etaient mesurees sur chaque image puis converties en concentration d’agent de contraste. Un modele compartimental a ete realise pour etudier les parametres de perfusion et de permeabilite a l’aide du logiciel SAAM. Des images parametriques ont ete realisees pour preciser la physiologie placentaire. Resultats Quarante trois souris ont ete utilisees pour construire ce modele. Les parametres de perfusion ont ete obtenus grâce a l’analyse compartimentale de 32 series de donnees. La perfusion du placenta in vivo a ete mesuree a 110 ml/min/100 grammes de tissu placentaire. Il n’etait pas detecte de passage transplacentaire d’agent de contraste. Les images parametriques ont permis d’illustrer la physiologie placentaire. Conclusion L’evaluation de la perfusion placentaire chez la souris est possible par IRM fonctionnelle. Ce type de technique permet d’etudier la physiologie placentaire in vivo et pourrait etre utile dans l’etude des dysfonctionnements placentaires chez l’animal et chez l’Homme.
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- 2004
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222. Prolapsus de la femme jeune : étude des facteurs de risque
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Y. Ville, G. Bader, and Arnaud Fauconnier
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Reproductive Medicine ,business.industry ,Obstetrics and Gynecology ,Medicine ,General Medicine ,business - Published
- 2003
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223. OC241: Treatment of twin-to-twin-transfusion syndrome. The end of a long-standing misunderstanding
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Y. Ville
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Pediatrics ,medicine.medical_specialty ,Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,business ,Twin-to-twin transfusion syndrome ,medicine.disease - Published
- 2003
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224. P203: Perfusion and permeability assessments in mice placenta using dynamic magnetic resonance imaging (MRI) contrast media. A feasibility study
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Guy Frija, Y. Ville, Laurent Salomon, Catherine Vayssettes, Nathalie Siauve, Charles-André Cuénod, and Olivier Clément
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Magnetic resonance imaging ,General Medicine ,Nuclear magnetic resonance ,medicine.anatomical_structure ,Reproductive Medicine ,Permeability (electromagnetism) ,Placenta ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Perfusion - Published
- 2003
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225. F72Visualization of anal sphincter disruptions with transperineal three-dimensional ultrasound following vaginal delivery in primiparous women
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P. Rozenberg, G. Bader, and Y. Ville
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Episiotomy ,medicine.medical_specialty ,Three dimensional ultrasound ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Vaginal delivery ,Birth weight ,medicine.medical_treatment ,Obstetrics and Gynecology ,General Medicine ,Surgery ,Perineum ,medicine.anatomical_structure ,Reproductive Medicine ,Medicine ,Sphincter ,Radiology, Nuclear Medicine and imaging ,3D ultrasound ,business ,Anal sphincter - Abstract
Objective To visualize the anal sphincter disruptions following vaginal delivery in primiparous women using 3D ultrasound to correlate damage to obstetrical factors. Methods We have studied prospectively 150 consecutive primiparous women. Axial and sagittal images of the anal sphincter were performed 48 h after vaginal delivery using a 7.5-MHz convex transducer placed on the perineum (Voluson 530 D Kretz) and repeated in the 30 women with anal sphincter disruption at a median of six months post natally. Obstetrical characteristics were analysed in all cases. Results Anal sphincter defect and its location were detected in 30 women (20%). None of the 24 women (16%) who underwent cesarean section had a sphincter disruption even in the 10 women delivered by cesarean section in labor. Head circumference, birth weight, maternal age, the duration of each stage of labor and the duration of active pushing were not significantly related to anal sphincter disruptions after vaginal delivery. Instrumental delivery, epidural analgesia and posterolateral episiotomy were associated with a sphincter defect but the only single independent factor related to the development of sphincter defects was instrumental delivery. The 3D sonography revealed sphincter injuries in 70% of the cases in the forceps delivery group (7 of 10), 13.3% of the cases in the vacuum delivery group (2 of 15) and 9.9% of the cases in the normal vaginal delivery group (10 of 101). 12 women (8%) had anal incontinence of faecal urgency when studied two months after vaginal delivery. The anal function was not altered after cesarean section. Conclusions Transperineal 3D ultrasound of the anal sphincter is a reliable method for evaluating the anal sphincter. It is quickly performed and well tolerated by patients. Besides forceps delivery, commonly measured delivery variables are not useful predictors of latent anal sphincter injury.
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- 2000
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226. WS07-02Treatment for TTS should be done within a trial
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Y. Ville
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medicine.medical_specialty ,Pediatrics ,Radiological and Ultrasound Technology ,business.industry ,Laser treatment ,Neurological morbidity ,Obstetrics and Gynecology ,Large series ,General Medicine ,law.invention ,Neonatal morbidity ,Reproductive Medicine ,Laser therapy ,Randomized controlled trial ,law ,Overall survival ,medicine ,Radiology, Nuclear Medicine and imaging ,Intensive care medicine ,business ,Survival rate - Abstract
Over a year I invited you here to participate to the rct for treating twin-to-twin transfusion syndrome (TTS). Are there any data available to reconsider this? The answer is clearly no, on the contrary. Indeed large series on amniodrainage or laser therapy have become available. With serial amniodrainage overall survival for both twins is 49% or 71% where at least one baby survive. In cases where one fetus dies in utero, 20% of the survivors die, and in another 20% they have severe neurological morbidity. Laser treatment has now a survival rate of 54% for both twins and 81% for at least one survivor. Neurological morbidity seems to be less than 10%. Has this larger experience contributed to solve the question whether one or the other therapy is better? No, it only underscores that our estimate of the number of patients needed in a rct was right: 10% difference in survival rate and 15% for severe neonatal morbidity. All new data, all new studies are an urgent call for randomisation. If not, both patients and their obstetricians will continue to argue based on unsubstantiated views. Further case series will not bring any critically new element. Results Over 45 patients have now been included, all but a few in France. If we would extrapolate the number of patients randomised at our centre, only three other groups would have to recruit at the same pace to reach the 142 patients needed by the end of next year. Discussion There are many arguments to try to finish the study within a few years. It avoids the obvious bias due to improvements of perinatal resuscitation. It would keep high motivation amongst referring clinicians. I would dare to say more: at this point it has become unethical not to randomise cases with TTTS. Not laser, neither amniodrainage have become established yet as the best treatment and there is no room for empirical new techniques until the trial is completed.
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- 2000
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227. F93Feasibility of the second trimester fetal ultrasound examination in an unselected population at 18, 20 or 22 weeks of pregnancy: a randomized trial
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P. Schwärzler and Y. Ville
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Pregnancy ,Fetus ,Pediatrics ,medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,Ultrasound ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,law.invention ,Reproductive Medicine ,Randomized controlled trial ,law ,Second trimester ,Unselected population ,medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2000
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228. P15Cervical cerclage: comparison of two techniques by transvaginal ultrasound
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Y. Ville, A. Gillet, and P. Rozenberg
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medicine.medical_specialty ,Radiological and Ultrasound Technology ,business.industry ,medicine.medical_treatment ,Ultrasound ,Significant difference ,Obstetrics and Gynecology ,General Medicine ,External os ,Surgery ,law.invention ,medicine.anatomical_structure ,Transvaginal ultrasound ,Reproductive Medicine ,Randomized controlled trial ,Suture (anatomy) ,law ,medicine ,Radiology, Nuclear Medicine and imaging ,Cervical cerclage ,business ,Cervix - Abstract
Background Cervical cerclage can be performed using either the MacDonald technique or following an anterior colpotomy (Shirodkar technique). A randomized study comparing the two techniques would be impossible to run since 1900 patients would have to be included in each arm. Objective To evaluate the benefit of performing a colpotomy prior to putting a cervical suture, by measuring the distance between the stitch and the external os. Design and methods Retrospective case-control study (January 1997–January 1999). All patients having had cervical cerclage after anterior colpotomy and giving birth in our Institution were the study group. Each case was matched with the next patient giving birth in our Institution after having had a MacDonald cerclage. The indication was left to the surgeon's decision and each surgeon used only one technique. Obstetrical characteristics were recorded and ultrasound measurement of the cervix was performed within 8 days following the procedure. Results During the study period, there were 15 cases in each group. There was no significant difference between the two groups in the obstetrical outcome. Cervical length was 36.6 mm and 35.4 mm, and the distance between the stitch and the external os was 16.1 mm and 13.5 mm in the Shirodkar and the MacDonald groups, respectively. Conclusion Anterior colpotomy did increase the distance between the stitch and the external os by only 2.6 mm and does not seem to offer any clinical benefit.
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- 2000
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229. Fetal Therapy. Invasive and transplacental Edited by Nicholas M. Fisk and Kenneth J. Moise Jr Published by Cambridge University Press,1997 ISBN 0-521-461-33-2
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Y. Ville
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Reproductive Medicine ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,Transplacental ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Theology ,business ,Fetal therapy - Published
- 1997
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230. FEATURES OF THE CONGENITAL CMV INFECTION IN THE UNBORN AND NEWBORN INFANT.
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G BENOIST and Y VILLE
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CYTOMEGALOVIRUSES , *VIRUS diseases , *GENETIC disorders , *HERPESVIRUSES , *INFECTION - Abstract
Cytomegalovirus (CMV) is the most frequent cause of congenital viral infection,1with a prevalence of 0.5 to 1% of all live births, and the leading infectious cause of sensorineural deafness and mental retardation.1As other Herpesviridae, CMV fetal infection can develop following both primary and recurrent maternal infection. Vertical transmission rate is around 30% following primary infection and 2 to 3% following recurrent infection.2Effects on the unborn as well as on the newborn are widely variable. It is estimated that only 5 to 10% of infected newborns have symptoms at birth, whereas around 90% of congenitally infected infants are asymptomatic although 5?15% of these infants will develop some degree of sensorineural hearing loss.3 [ABSTRACT FROM AUTHOR]
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- 2007
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231. Evidence of a high proportion of premature unbalanced separation of sister chromatids in the first polar bodies of women of advanced age.
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F. Vialard, C. Petit, M. Bergere, D. Molina Gomes, V. Martel-Petit, R. Lombroso, Y. Ville, H. Gerard, and J. Selva
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MATERNAL age ,ANEUPLOIDY ,OVUM ,REPRODUCTIVE technology - Abstract
BACKGROUND: Maternal ageing is the only aetiological factor unequivocally linked to aneuploidy. Two mechanisms seem to explain these abnormalities in oocytes: non-disjunction and premature unbalanced separation of sister chromatids (PSSC). Previous studies of unfertilized oocytes argue for a major role of PSSC in the aetiology of aneuploidy for women of advanced age, but in vitro ageing of the oocytes could influence the results. METHODS: Owing to the high prevalence of aneuploidy in women of advanced age, chromosomal screening of the first polar body just before ICSI was offered to women (from 38 years of age) included in an assisted reproduction programme. RESULTS: Among 141 oocytes from 29 women (mean age 40 years and 2 months), 43 (30.5%) were abnormal. Sixty-five abnormalities were found and PSSC was involved in 80% of cases. CONCLUSION: These results are in accordance with previous studies and confirm, in ‘fresh’ oocytes, the major role of PSSC in the aetiology of aneuploidy in women of advanced age. [ABSTRACT FROM AUTHOR]
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- 2006
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232. LATE TERMINATION OF PREGNANCY FOR FETAL ANOMALY.
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Y VILLE and AS CABARET
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- 2005
233. Fetal karyotyping after 28 weeks of gestation for late ultrasound findings in a low risk population.
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C. L. Drummond, D. Molina Gomes, M. V. Senat, F. Audibert, A. Dorion, and Y. Ville
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To analyze the indications and the results of invasive testing for fetal karyotyping for ultrasound abnormality in the third trimester of pregnancy, when first- and second-trimester screening tests were negative. Retrospective study of 171 consecutive pregnancies that underwent invasive testing after 28 weeks of gestation in 2 institutions between January 1999 and December 2001. Forty-one patients did not have any form of screening for fetal aneuploidy beforehand. One hundred and thirty of them had a normal first-trimester scan and a low risk of fetal aneuploidy by nuchal translucency and/or maternal serum screening and were included in the statistical analysis. Mean maternal age, gestational age at diagnosis and at invasive testing were 30.5 years; 29.3 weeks and 32.5 weeks respectively. Amniocentesis and fetal blood sampling were performed in 97 and 33 cases respectively. The most frequent indications for invasive testing in the third trimester were major fetal malformations (51%) and intrauterine growth restriction (19%) detected on routine second- or third-trimester ultrasound examination. Ultrasound markers of aneuploidy and polyhydramnios accounted for 17 and 11% of the indications respectively. Fetal karyotype was normal in 121/130 cases. A gene mutation was found in one case. The karyotype was abnormal in nine cases, including seven cases of aneuploidy (one Turner syndrome, three trisomy 18, and three trisomy 21) and two cases of structural chromosomal abnormalities (46,XX, del 4 p16.1 and 46,XX, dup1). One hundred cases resulted in the delivery of a normal baby. Thirty cases led to termination of pregnancy or intrauterine death due to major fetal malformations (N = 25), abnormal karyotype in six of these, and severe IUGR (N = 5) with normal karyotype. Fetal US markers of aneuploidy and isolated polyhydramnios were associated with a favorable outcome in all cases. A significant increase in the risk of chromosomal anomaly was seen when two or more anomalies were found, rising from 2% with one anomaly to 21% when two or more anomalies were present. In low risk patients, fetal karyotyping in the third trimester may be justified when the diagnosis of fetal malformation is made in the third trimester of pregnancy. Two or more anomalies increase the risk of fetal aneuploidy even with a negative-screening test in the first and second trimester of pregnancy. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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- 2003
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234. Fetal intraventricular haemorrhage and maternal warfarin
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D.P. Vasey, M.J. Shearer, K. H. Nicolaides, E. Jenkins, M. Layton, H. Hemley, and Y. Ville
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medicine.medical_specialty ,Fetus ,business.industry ,Internal medicine ,Cardiology ,Warfarin ,Medicine ,General Medicine ,business ,medicine.drug - Published
- 1993
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235. MIGRAINE AND INTRAVENOUS INJECTIONS OF HYPERTONIC SALT SOLUTIONS
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y Ville and J. F. Buvat
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chemistry.chemical_classification ,Psychiatry and Mental health ,Migraine ,chemistry ,business.industry ,Anesthesia ,Medicine ,Salt (chemistry) ,Tonicity ,business ,medicine.disease - Published
- 1938
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236. Cytokines and chemokines in follicular fluids and potential of the corresponding embryo: the role of granulocyte colony-stimulating factor.
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N. Lédée, R. Lombroso, L. Lombardelli, J. Selva, S. Dubanchet, G. Chaouat, F. Frankenne, J.M. Foidart, E. Maggi, S. Romagnani, Y. Ville, and M.-P. Piccinni
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GRANULOCYTE-colony stimulating factor ,CEREBROSPINAL fluid ,CYTOKINES ,IMMUNOREGULATION - Abstract
: BACKGROUND The cytokine/chemokine levels of individual follicular fluids (FFs) were measured to determine whether a biomarker could be linked to the developmental potential of the derived embryo. : METHODS Fluid was collected from 132 individual FFs that were the source of oocytes subsequently fertilized and transferred. In each, a bead-based multiplex sandwich immunoassay (Luminex) was used to measure 28 cytokines and chemokines simultaneously. : RESULTS Significantly higher levels of interleukin (IL-2) and interferon (IFN-γ) were detected in FF for embryos that underwent early cleavage. IL-12 was significantly higher in FF corresponding to highly fragmented embryos and the chemokine CCL5 was significantly higher in FF related to the best quality (Top) embryos. The level of granulocyte colony-stimulating factor (G-CSF) in individual FF samples was correlated with the implantation potential of the corresponding embryo. The area under the receiver operating characteristics curve, which distinguished the embryos that definitely led to delivery from those that did not, was 0.84 (0.75–0.90) (P = 0.0001) for FF G-CSF. FF G-CSF was significantly lower in patients older than 36 years compared with those <30-year old. When the FF G-CSF was 20 pg/ml or higher, the ratio between Top and non-Top embryos was significantly higher than for the group with FF G-CSF below 20 pg/ml (45 versus 20.45%, P = 0.007). : CONCLUSIONS Individual FF composition is related to the development of the corresponding in vitro generated embryo and its potential of implantation. Individual FF G-CSF may provide a non-invasive biomarker of implantation that needs to be evaluated together with in vitro observation to select the oocyte, and hence the embryo, to transfer. [ABSTRACT FROM AUTHOR]
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- 2008
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237. ISUOG Practice Guidelines (updated): role of ultrasound in twin pregnancy.
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Khalil A, Sotiriadis A, Baschat A, Bhide A, Gratacós E, Hecher K, Lewi L, Salomon LJ, Thilaganathan B, and Ville Y
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- 2025
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238. Quantification of maternal and fetal valaciclovir exposure in a pharmacokinetic study of cytomegalovirus-infected pregnant women treated to prevent vertical transmission.
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Faure-Bardon V, Bouazza N, Benaboud S, Foissac F, Rouillon S, Froelicher-Bournaud L, Leruez-Ville M, Guilleminot T, Lui G, Tréluyer JM, and Ville Y
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Background: In cases of maternal primary infection with cytomegalovirus (CMV-MPI) maternal treatment with oral valaciclovir 8 g/day has been shown to reduce the risk of fetal infection. The pharmacological profile of this high dosage during pregnancy is not yet known., Objectives: To quantify maternal-fetal exposure to valaciclovir 8 g/day in a population pharmacokinetic (popPK) study., Methods: Between October 2019 and April 2023, pregnant women referred for CMV-MPI were offered to participate following: (i) CMV-MPI <14 weeks of gestation; (ii) acceptance of valaciclovir 8 g/day; and (iii) consent for amniocentesis. Amniotic fluid was tested for (i) CMV PCR for prenatal diagnosis; and (ii) dosage of aciclovir concentration (the active form of valaciclovir). Maternal serum levels of aciclovir were also measured. Aciclovir assays in both compartments were used for popPK analysis. Pharmacokinetics were described using non-linear mixed-effect modelling., Results: We prospectively included 119 women with their 122 fetuses. CMV-MPI occurred at a median of 3.0 (range: -12; + 14) weeks of gestation. CMV-infected pregnant women were treated at a median of 12.3 (range: 4.6-21.4) weeks of gestation for a median duration of 35 days (range: 7-90 days). Median pharmacokinetic parameters (Cmin, Cmax and AUC0-24) were all successfully defined in both maternal blood and amniotic fluid compartments. No differences in aciclovir exposure were observed between infected (n = 12, 9.8%) and non-infected fetuses. Simulations showed that after a last maternal dose, aciclovir concentration would be undetectable in the amniotic fluid after 43-47 h., Conclusions: In this popPK study, maternal and fetal pharmacokinetics were established using in vivo data. The results provide a better understanding of how this fetal therapy works., (© The Author(s) 2025. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2025
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239. Foetal achondroplasia: Prenatal diagnosis, outcome and perspectives.
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Vallin AL, Grévent D, Bessières B, Salomon LJ, Legeai-Mallet L, Cormier-Daire V, Baujat G, Ville Y, and Faure-Bardon V
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Background: Achondroplasia, due to a specific pathogenic variant in FGFR3, is the most common viable skeletal dysplasia and the diagnosis is mostly done in the prenatal period. Since 2021, the use of Vosoritide, a specific treatment for achondroplasia, validated in phase 3 placebo-controlled trials, has been recommended to significantly increase the height of children and infants. In the light of these new therapeutic prospects, a complete understanding of the pathophysiology of skeletal damages occurring from foetal life is required., Objectives: To describe foetal imaging and the antenatal and postnatal management of pregnancies complicated by a diagnosis of foetal achondroplasia., Methods: A retrospective and descriptive study, including all pregnant women with a prenatal diagnosis of achondroplasia, was conducted in the prenatal unit of Necker Hospital (Paris, France) between 2009 and 2022. Maternal and obstetric characteristics and foetal imaging (ultrasound and bone CT) were collected. Pregnancy outcomes, paediatric follow-up in the case of live births, and post-mortem examination (PME) data in the case of termination of pregnancy were reported. In addition, we have prospectively developed a specific research protocol using foetal brain MRI to assess the anatomy of the foramen magnum, following the same approach currently recommended in the postnatal period., Results: 29 cases of achondroplasia were included. Median gestational age at referral was 31
+2 weeks', about 1 week after the suspected diagnosis on routine ultrasound. Shortening of the femoral length and of all the other long bones, macrocephaly, facial abnormalities, increased metaphyseal-diaphyseal angle and tapering of the proximal femoral bone were the five most prevalent ultrasound signs. Foetal diagnosis was done by the identification of the foetal FGFR3 mutation and/or by CT scans (n = 15) where specific abnormalities of the long bones, platyspondyly and abnormal profile have been described in 100 % of cases. PME revealed: i) on external examinations (n = 7) that all fetuses had very short long bones, moderate platyspondyly, small iliac wings with internal spines, macrocrania, and narrow thorax, ii) on internal examination (n = 5) all had severe abnormalities in the growth plate and particularities in the temporal cortex and hippocampal region. One foetal MRI was performed at 33 weeks' and revealed tight stenosis of the foramen magnum and compression of the spinal cord. Of the live-born infants for whom follow-up was known (n = 6), 2/6 (including the case who had a foetal MRI) required neurosurgical intervention in the first few months of life for spinal cord compression due to severe stenosis of the foramen magnum., Conclusion: A complete mapping of the skeletal features present in foetuses with achondroplasia is reported here, providing a better understanding of the pathophysiology of this condition. New tools such as foetal MRI, to assess the risk of postnatal severe neurological complications, could help improve the care pathway of the affected neonates., Competing Interests: Declaration of competing interest The authors have no competing interests inside this work to declare, (Copyright © 2024. Published by Elsevier Masson SAS.)- Published
- 2024
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240. Long-term urological and nephrological outcomes after in-utero incision of obstructive duplex-system ureterocele.
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Vinit N, Heidet L, Taghavi K, Salomon LJ, Ville Y, and Blanc T
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- 2024
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241. Growth velocity of fetal sacrococcygeal teratoma as predictor of perinatal morbidity and mortality: multicenter study.
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Vinit N, Benachi A, Rosenblatt J, Jouannic JM, Rousseau V, Bonnard A, Irtan S, Fouquet V, Ville Y, Khen-Dunlop N, Lapillonne A, Jais JP, Beaudoin S, Salomon LJ, and Sarnacki S
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- Humans, Female, Pregnancy, Retrospective Studies, Infant, Newborn, Adult, Pregnancy Outcome, Fetal Death etiology, Perinatal Mortality, Perinatal Death, Fetal Diseases diagnostic imaging, Fetal Diseases mortality, Teratoma diagnostic imaging, Teratoma embryology, Teratoma mortality, Sacrococcygeal Region diagnostic imaging, Sacrococcygeal Region embryology, Ultrasonography, Prenatal, Gestational Age
- Abstract
Objective: To identify prenatal predictors of poor perinatal outcome in fetuses with isolated sacrococcygeal teratoma (SCT)., Methods: This was a retrospective study of fetuses with isolated (non-syndromic) SCT managed at one of five pediatric surgery and/or fetal medicine centers between January 2007 and December 2017. The primary outcome was the occurrence of poor perinatal outcome, defined as prenatal death (including termination), or neonatal death or severe compromise (hemorrhagic shock). Data regarding prenatal diagnosis (sonographic features both at referral and at the last ultrasound examination before pregnancy outcome, assessment of SCT growth velocity), perinatal complications and outcome, and neonatal course were analyzed to determine prenatal SCT characteristics associated with adverse perinatal outcome., Results: Fifty-five fetuses were included, diagnosed with isolated SCT at a median gestational age of 22 (interquartile range, 18-23) weeks. There was a poor perinatal outcome in 31% (n = 17) of these cases, including intrauterine fetal demise (4%, n = 2), pregnancy termination (13%, n = 7) and neonatal severe compromise (15%, n = 8), leading to neonatal death in five cases. The overall survival rate after prenatal diagnosis of isolated SCT was 75% (n = 41 of 55). Earlier gestational age at diagnosis (P = 0.02), large tumor volume at referral (P < 0.001), presence of one or more hemodynamic complications (P = 0.02), fast tumor growth velocity (P < 0.001) and high tumor grade (highest tumor grade ≥ 3) (P = 0.049) were associated with poor perinatal outcome on univariate analysis. On stepwise logistic regression analysis, tumor growth velocity was the only remaining independent factor associated with poor perinatal outcome (odds ratio (OR) (per 1-mm/week increase), 1.48 (95% CI, 1.22-1.97), P = 0.001). The best predictive cut-off of tumor growth velocity for poor perinatal outcome was 7 mm/week (OR, 25.7 (95% CI, 5.6-191.3), P < 0.001), yielding a sensitivity of 88% and a specificity of 77%., Conclusions: Approximately 30% of fetuses with a diagnosis of isolated SCT have poor perinatal outcome. Tumor growth velocity ≥ 7 mm/week appears to be an appropriate discriminative cut-off for poor perinatal outcome. These results could help to inform prenatal management and counseling of parents with an affected pregnancy. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology., (© 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.)
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- 2024
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242. In utero treatment of congenital cytomegalovirus infection with valganciclovir: an observational study on safety and effectiveness.
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Bourgon N, Lopez R, Fourgeaud J, Guilleminot T, Bussières L, Magny JF, Ville Y, and Leruez Ville M
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- Humans, Female, Pregnancy, Retrospective Studies, Infant, Newborn, Adult, Treatment Outcome, Cytomegalovirus drug effects, Ganciclovir analogs & derivatives, Ganciclovir therapeutic use, Ganciclovir adverse effects, Infectious Disease Transmission, Vertical prevention & control, Valganciclovir therapeutic use, Valganciclovir administration & dosage, Valganciclovir adverse effects, Cytomegalovirus Infections drug therapy, Cytomegalovirus Infections congenital, Antiviral Agents therapeutic use, Antiviral Agents adverse effects, Antiviral Agents administration & dosage, Pregnancy Complications, Infectious drug therapy, Pregnancy Complications, Infectious virology
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Background: The treatment of congenital cytomegalovirus (CMV) infection is usually administered to neonates after birth; however, it can be anticipated during the prenatal period by treating pregnant women in order to reduce the severity of the congenital disease. The most commonly used treatment for CMV during pregnancy is valaciclovir; however, valganciclovir has a higher potency against CMV and is the first choice for neonates with congenital CMV disease., Objectives: We investigated neonatal and maternal safety of tertiary prevention in infected fetuses showing ultrasound features of infection using valganciclovir., Methods: Retrospective cohort study of pregnant women and their symptomatic infected fetuses taking valganciclovir, 3 × 450 mg per day. All fetuses presented at least one prenatal feature on ultrasound. We assessed fetal/neonatal and maternal safety, as well as neonatal efficacy of treatment. The main outcome was neutropenia. Secondary outcomes included other haematological side effects, symptoms at birth and neonatal CMV-PCR was positive., Results: Seventeen women with singleton pregnancies received valganciclovir from a median (IQR) of 27.1 (26.0-30.3) to 11.6 (6.5-12.9) weeks of gestation. No neonatal neutropenia was reported. One pregnancy was terminated for severe features. Three newborns (18%) were asymptomatic at birth, including one with negative CMV-PCR from blood and saliva. CMV-PCR was positive for 12/13 symptomatic newborns, with a median (IQR) log10 viral load of 3.36 (3.30-4.20), 4.03 (1.75-4.27) and 3.04 (0.00-3.40) log10 copies/mL in blood, urine and saliva, respectively., Conclusions: Tertiary prevention by valganciclovir appears to be well tolerated for both fetus and mother. However, more extensive trials accompanied by long-term follow-up are needed., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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243. Postnatal outcome following fetal aortic valvuloplasty for critical aortic stenosis.
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Corroenne R, Meot M, Salomon LJ, Szezepanski I, Baghdadi H, Stos B, Levy M, Le Bidois J, Laux D, Gaudin R, Raisky O, Ville Y, Bonnet D, Stirnemann J, and Malekzadeh-Milani S
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- Humans, Female, Retrospective Studies, Pregnancy, Infant, Newborn, Treatment Outcome, Aortic Valve diagnostic imaging, Aortic Valve surgery, Aortic Valve embryology, Fetal Diseases therapy, Fetal Diseases surgery, Aortic Valve Stenosis surgery, Aortic Valve Stenosis embryology, Aortic Valve Stenosis diagnostic imaging, Balloon Valvuloplasty methods, Gestational Age, Ultrasonography, Prenatal
- Abstract
Objective: To report our experience of fetal aortic valvuloplasty (FAV) for critical aortic stenosis (AS), with a focus on the postnatal evolution of the patients., Methods: This was a retrospective study including all fetuses with critical AS which underwent FAV in a single center between January 2011 and June 2022. FAV was performed under ultrasound guidance. Technical success was based upon balloon inflation across the aortic valve and improvement of the antegrade aortic flow across the aortic valve. At birth, a biventricular circulation (BVC) strategy was decided assuming the left ventricular (LV) systolic and diastolic function would ensure the systemic circulation., Results: Sixty-three FAV procedures were performed in 58 fetuses, at a median (range) gestational age of 26.2 (20.3-32.2) weeks. The procedure was technically successful in 50/58 (86.2%) fetuses. There were 11/58 (19.0%) cases of in-utero demise and 9/58 (15.5%) terminations of pregnancy. No patient was liveborn after an unsuccessful procedure. Thirty-eight (65.5%) infants were liveborn, at a median (range) gestational age of 38.1 (29.0-40.6) weeks, of whom 21 (55.3%) required prostaglandin treatment. Twenty-eight of the 38 (73.7%) liveborn children (48.3% of the study population) entered the BVC pathway at birth. Among them, 20 (71.4%) required an aortic valvuloplasty procedure at birth (11 (55.0%) percutaneous balloon, nine (45.0%) surgical) and eight (28.6%) did not require any treatment at birth, but, of these, five (62.5%) underwent surgical valvuloplasty between day 26 and day 1200 of age. Eleven (39.3%) of the infants with BVC at birth required a second intervention and four (14.3%) of them required a third intervention. Two (7.1%) infants who entered the BVC pathway at birth underwent conversion to univentricular circulation (UVC). None of the surviving children with BVC developed pulmonary hypertension. The overall survival rate in those with BVC at birth was 22/28 (78.6%) at a median (range) follow-up of 23.3 (2.0-112.6) months. Ten of the 58 (17.2%) patients had UVC at birth. Among these, six (60.0%) received compassionate care from birth and four (40.0%) underwent surgery. Three of the 10 patients who had UVC at birth were still alive at the latest follow-up assessment, at a median (range) gestational age of 24.3 (8.3-48.7) months., Conclusions: FAV for critical AS led to increase of antegrade aortic flow in 86.2% of fetuses, with BVC being achieved in 48.3% (73.7% of the liveborn cases). Among patients with BVC at birth, the rate of reintervention was high, but 78.6% of these children were alive at the latest evaluation. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology., (© 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.)
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- 2024
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244. Corrigendum to "Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)" [The Lancet Regional Health - Europe 40 (2024) 100892].
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Leruez-Ville M, Chatzakis C, Lilleri D, Blazquez-Gamero D, Alarcon A, Bourgon N, Foulon I, Fourgeaud J, Gonce A, Jones CE, Klapper P, Krom A, Lazzarotto T, Lyall H, Paixao P, Papaevangelou V, Puchhammer E, Sourvinos G, Vallely P, Ville Y, and Vossen A
- Abstract
[This corrects the article DOI: 10.1016/j.lanepe.2024.100892.]., (© 2024 The Author(s).)
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- 2024
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245. Maternal and neonatal outcomes of French prospective multicenter cohort study COVIPREG during the first two COVID-19 waves.
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Vivanti AJ, Couffignal C, Sibiude J, Cordier AG, Tsatsaris V, Rozenberg F, Launay O, Benachi A, De Luca D, Ancel PY, Marcault E, Ville Y, Carrara J, Luton D, Dommergues M, Borie C, Kayem G, Lecomte L, Leruez-Ville M, Périllaud-Dubois C, Biran V, Manchon P, Picone O, and Vauloup-Fellous C
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- Humans, Female, Pregnancy, Adult, Prospective Studies, Infant, Newborn, France epidemiology, Cohort Studies, COVID-19 Nucleic Acid Testing statistics & numerical data, Infectious Disease Transmission, Vertical statistics & numerical data, Infectious Disease Transmission, Vertical prevention & control, Cesarean Section statistics & numerical data, COVID-19 epidemiology, Pregnancy Complications, Infectious epidemiology, Pregnancy Outcome epidemiology, SARS-CoV-2
- Abstract
Background: SARS-CoV-2 infection on pregnant women was the subject of many questions since the COVID-19 pandemic., Methods: We aim to assess maternal and neonatal outcomes of SARS-CoV-2 infection contracted during 2nd and 3rd trimesters of pregnancy during the first two COVID-19 waves across a prospective French multicenter cohort study. Patients were included between April 2020 and January 2021 in 10 maternity hospitals in Paris area with two groups (i) pregnant women with a positive SARS-CoV-2 nasopharyngeal RT-PCR between [14WG; 37WG[(symptomatic infection), (ii) pregnant women with a negative serology (or equivocal) at delivery and without a positive SARS-CoV-2 nasopharyngeal RT-PCR at any time during pregnancy (G2 group) MAIN FINDINGS: 2410 pregnant women were included, of whom 310 had a positive SARS-CoV-2 nasopharyngeal RT-PCR and 217 between [14WG; 37WG[. Most infections occurred between 28 and 37 weeks of gestation (56 %). Most patients could be managed as outpatients, while 23 % had to be hospitalized. Among women with a positive RT-PCR, multiparous women were over-represented (OR = 2.45[1.52;3.87]); were more likely to deliver before 37 weeks of gestation (OR = 2.19[1.44;3.24]) and overall cesarean deliveries were significantly increased (OR = 1.53[1.09;2.13])., Conclusions: This study highlights the maternal, obstetrical, and neonatal burden associated with SARS-CoV-2 infections during the first two pandemic waves before availability of vaccines., Trial Registration: NCT04355234 (registration date: 21/04/2020)., Competing Interests: Declaration of competing interests The authors declare no conflict of interest., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
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- 2024
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246. Neonatal hemodynamics of recipient twins after fetoscopic selective laser coagulation for twin-to-twin transfusion syndrome: An unicist classification.
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Chambon E, Hachem T, Salvador E, Bellanger C, Stirnemann J, Kermorvant-Duchemin E, Tissieres P, Ville Y, and Lapillonne A
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- Humans, Female, Retrospective Studies, Infant, Newborn, Pregnancy, Male, Heart Failure etiology, Heart Failure physiopathology, Fetofetal Transfusion surgery, Fetofetal Transfusion physiopathology, Fetoscopy methods, Laser Coagulation methods, Hemodynamics physiology
- Abstract
To characterize the neonatal hemodynamic profiles in recipients born after twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic selective laser coagulation (FSLC). Retrospective analysis during the first month of life of recipient twins. Of the 480 newborns born during an 11-year period, 138 recipient twins with prenatal FSLC were classified into four groups: no hemodynamic impairment (NoHI, n = 102, 74%), isolated high blood pressure (HighBP, n = 18, 13%), right ventricular outflow tract obstruction (RVOTO, n = 10, 7%), and cardiac failure (CF, n = 8, 6%). The time (median (IQR)) between FSLC and birth was significantly shorter in the HighBP (36 days (23-54)) and CF (44 days (18-54)) groups than in the RVOTO (91 days (68-112)) and NoHi (82 days (62-104)) groups (p < 0.001). Conclusion: Four distinct and well-characterized groups of recipients were identified based on their hemodynamics. High blood pressure and heart failure occurred in approximately 20% of the infants and were associated with a time between laser coagulation and birth of less than 2 months. What is Known: • Twin-to-twin transfusion syndrome (TTTS) is characterized by a hemodynamic imbalance that leads to high fetal and neonatal mortality if left untreated. One-third of recipient twins born without prenatal fetoscopic laser coagulation (FSLC) develop a life-threatening cardiac failure. What is New: • Four distinct groups of recipient twins with prenatal FSLC have been identified based on their hemodynamics. High blood pressure and cardiac failure occurred in 20% of the infants and were associated with an interval between FSLC and birth of less than 2 months., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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247. Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI).
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Leruez-Ville M, Chatzakis C, Lilleri D, Blazquez-Gamero D, Alarcon A, Bourgon N, Foulon I, Fourgeaud J, Gonce A, Jones CE, Klapper P, Krom A, Lazzarotto T, Lyall H, Paixao P, Papaevangelou V, Puchhammer E, Sourvinos G, Vallely P, Ville Y, and Vossen A
- Abstract
Congenital cytomegalovirus (cCMV) infection carries a significant burden with a 0.64% global prevalence and a 17-20% chance of serious long-term effects in children. Since the last guidelines, our understanding, particularly regarding primary maternal infections, has improved. A cCMV guidelines group was convened under the patronage of the European Society of Clinical Virology in April 2023 to refine these insights. The quality and validity of selected studies were assessed for potential biases and the GRADE framework was employed to evaluate quality of evidence across key domains. The resulting recommendations address managing cCMV, spanning prevention to postnatal care. Emphasizing early and accurate maternal diagnosis through serological tests enhances risk management and prevention strategies, including using valaciclovir to prevent vertical transmission. The guidelines also strive to refine personalized postnatal care based on risk assessments, ensuring targeted interventions for affected families., Competing Interests: MLV reports receiving support for attending meetings by BioMérieux and Altona outside the submitted work. MLV reports payment made to her institution for presentation/lecture by Diasorin, Abbott Molecular and Roche Diagnostic outside the submitted work. DBG received Grant from the Spanish Ministry of Science and Innovation. ISCIII and Fondos FEDER (EU) outside the submitted work and received Honoraria for lectures from the Medscape, outside the submitted work. JF received honoraria for poster presentation by Abbott GmbH, outside the submitted work. CJ received consulting fees from Moderna, outside the submitted work; Participated on a Data Safety Monitoring Board or Advisory Board of Moderna, outside the submitted work; Is Co-director of the European Congenital CMV Initiative; Her institution received payment for clinical trials by Moderna, outside the submitted work. HL participated on advisory board for the Study of Zidovudine in children with Aicadri-Goutiere Syndrome, outside the submitted work and she is Trustee of European Society For Paediatric Infectious Diseases (ESPID). VP institution received honoraria for lectures from MSD and Pfizer, outside the submitted work and received support for attending a meeting (ESPID 2023) from Pfizer. PV is president and board-member of the European Congenital CMV Initiative. AV is participating in the Advisory Council European Society of Virology. The rest author of the authors declare no conflict of interest., (© 2024 The Author(s).)
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- 2024
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248. Predictors of the Outcome at 2 Years in Neonates With Congenital Cytomegalovirus Infection.
- Author
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Fourgeaud J, Magny JF, Couderc S, Garcia P, Maillotte AM, Benard M, Pinquier D, Minodier P, Astruc D, Patural H, Parat S, Guillois B, Garenne A, Guilleminot T, Parodi M, Bussières L, Ghout I, Ville Y, and Leruez-Ville M
- Subjects
- Infant, Newborn, Child, Humans, Infant, Hearing Tests, Disease Progression, Cytomegalovirus Infections complications, Cytomegalovirus Infections diagnosis, Hearing Loss, Sensorineural diagnosis, Hearing Loss, Deafness
- Abstract
Background: Approximately 20% of neonates with congenital cytomegalovirus (cCMV) develop long-term sequelae. The ability to accurately predict long-term outcomes as early as the neonatal period would help to provide for appropriate parental counseling and treatment indications. With this study, we aimed to identify neonatal predictive markers of cCMV long-term outcomes., Methods: As this study's subjects, we chose neonates diagnosed with cCMV in 13 hospitals throughout France recruited from 2013 to 2017 and evaluated for at least 2 years with thorough clinical, audiology, and imaging evaluations and psychomotor development tests., Results: A total of 253 neonates were included, and 3 were later excluded because of the identification of a genetic disorder. A total of 227 were followed up for 2 years: 187/227 (82%) and 34/227 (15%) were infected after a maternal primary or nonprimary infection, respectively, 91/227 (40%) were symptomatic at birth, and 44/227 (19%) had cCMV sequelae. Maternal primary infection in the first trimester was the strongest prognosis factor (odds ratio = 38.34 [95% confidence interval, 5.02-293], P < .001). A predictive model of no risk of sequelae at 2 years of age according to normal hearing loss at birth, normal cerebral ultrasound, and normal platelet count had 98% specificity, 69% sensitivity, and 0.89 area under the curve (95% confidence interval, 0.83-0.96)., Conclusions: In the studied population, children with normal hearing at birth, normal platelet count at birth, and a normal cranial ultrasound had no risk of neurologic sequelae and a low risk of delayed unilateral sensorineural hearing loss. The use of this model based on readily available neonatal markers should help clinicians establish a personalized care pathway for each cCMV neonate., (Copyright © 2024 by the American Academy of Pediatrics.)
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- 2024
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249. Quantitative fetal MRI with diffusion tensor imaging in cases with 'short' corpus callosum.
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Corroenne R, Grevent D, Mahallati H, Millischer AE, Gauchard G, Bussieres L, Kasprian G, Ville Y, and Salomon LJ
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- Female, Humans, Pregnancy, Magnetic Resonance Imaging, Prenatal Care, Retrospective Studies, Clinical Trials as Topic, Corpus Callosum diagnostic imaging, Diffusion Tensor Imaging
- Abstract
Objectives: It has been suggested previously that the presence of Probst bundles (PB) in cases with a short corpus callosum (SCC) on diffusion tensor imaging (DTI) may help to differentiate between corpus callosal (CC) dysplasia and a variant of normal CC development. The objectives of this study were to compare DTI parameters between cases of SCC vs normal CC and between cases of SCC with PB (SCC-PB+) vs SCC without PB (SCC-PB-)., Methods: This was a retrospective study of patients referred to the Necker Hospital in Paris, France, for magnetic resonance imaging (MRI) evaluation of an apparently isolated SCC detected by sonography between November 2016 and December 2022 (IRB: 00011928). MRI was performed using a 1.5-Tesla Signa system. T2-weighted axial and sagittal sequences of the fetal brain were used to measure the length and thickness of the CC. 16-direction DTI axial brain sequences were performed to identify the presence of PB and to generate quantitative imaging parameters (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) of the entire CC, genu, body and splenium. Cases in which other associated brain abnormalities were detected on MRI were excluded. Cases were matched for fetal gender and gestational age with controls in a 1:3 ratio. Control cases were normal fetuses included in the LUMIERE on the FETUS trial (NCT04142606) that underwent the same DTI evaluation of the brain. Comparisons between SCC and normal CC cases, and between SCC-PB+ and SCC-PB- cases were performed using ANOVA and adjusted for potential confounders using ANCOVA., Results: Twenty-two SCC cases were included and compared with 66 fetuses with a normal CC. In 10/22 (45.5%) cases of SCC, PB were identified. As expected, dimensions of the CC were significantly smaller in SCC compared with normal CC cases (all P < 0.01). In SCC-PB+ vs SCC-PB- cases, FA values were significantly lower in the entire CC (median, 0.21 (range, 0.19-0.24) vs 0.24 (range, 0.22-0.28); P < 0.01), genu (median, 0.21 (range, 0.15-0.29) vs 0.24 (range, 0.17-0.29); P = 0.04), body (median, 0.21 (range, 0.18-0.23) vs 0.23 (range, 0.21-0.27); P = 0.04) and splenium (median, 0.22 (range, 0.16-0.30) vs 0.25 (range, 0.20-0.29); P = 0.03). ADC values were significantly higher in the entire CC, genu and body in SCC-PB+ vs SCC-PB- cases (all P < 0.05). In SCC-PB+ cases, all FA values were significantly lower, and ADC values in the CC body were significantly higher compared with normal CC cases (all P < 0.05). In SCC-PB- cases, there was no significant difference in FA and ADC compared with normal CC cases (all P > 0.05)., Conclusions: Fetal DTI evaluation of the CC showed that FA values were significantly lower and ADC values tended to be significantly higher in SCC-PB+ compared with normal CC cases. This may highlight alterations of the white matter microstructure in SCC-PB+. In contrast, isolated SCC-PB- did not demonstrate significant changes in DTI parameters, strengthening the possibility that this is a normal CC variant. © 2023 International Society of Ultrasound in Obstetrics and Gynecology., (© 2023 International Society of Ultrasound in Obstetrics and Gynecology.)
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- 2024
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250. Prenatal treatment of a vein of Galen malformation by embolization and 1-year follow-up.
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Naggara O, Stirnemann J, Boulouis G, Orbach DB, Grévent D, James S, Boddaert N, Kossorotoff M, Blauwblomme T, and Ville Y
- Subjects
- Pregnancy, Female, Humans, Follow-Up Studies, Veins, Vein of Galen Malformations diagnostic imaging, Vein of Galen Malformations therapy, Embolization, Therapeutic
- Published
- 2024
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