Publications (3) View all
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Article: Effects of environmental tobacco smoke on the pulmonary circulation in the ovine fetus.
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ABSTRACT: Epidemiologic studies have highlighted an association between maternal smoking and persistent pulmonary hypertension of the newborn infant. However, the impact of exposure to tobacco smoke on the perinatal pulmonary circulation is currently unknown. The purpose of this study was to assess the pulmonary vascular effects of environmental tobacco smoke in the fetus. We performed surgery on 16 fetal lambs and placed catheters in the main pulmonary artery, aorta, and left atrium to measure pressures. An ultrasonic blood flow transducer was placed around the left pulmonary artery to measure blood flow. The ewes were exposed to tobacco smoke for 2 hours. In another set of experiments, the pulmonary vascular response to increased fetal O(2) tension has been assessed after 2 hours of tobacco smoke inhalation or not (control group). Exposure to tobacco smoke decreased pulmonary blood flow by 30% and elevated pulmonary vascular resistance by 40%. The vasodilator response to increased O(2) tension was blunted after smoke inhalation compared with control animals. Smoke inhalation was associated with a decrease in fetal PaO(2) and SaO(2). Exposure to environmental tobacco smoke in pregnant ewes impairs both basal tone and vascular reactivity of the fetal lung.American journal of obstetrics and gynecology 02/2011; 204(5):450.e8-450.e14. · 3.28 Impact Factor -
Article: [Morbidity and mortality of patients with preeclampsia or HELLP syndrome transferred in intensive care].
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ABSTRACT: During pregnancy, the two leading causes of admission in intensive care are preeclampsia and obstetric haemorrhage. However, there are few studies about preeclamptic patients admitted in intensive care. Our purpose was to determine the outcome of pregnancies with preeclampsia and/or HELLP syndrome admitted in intensive care. We performed a retrospective study between March 1996 and April 2005 in a level III maternity. 533 patients were managed with preeclampsia and/or HELLP syndrome during this period. We compared patients admitted in intensive care with patients who did not require admission in intensive care. Sixty six patients (12,4%) with preeclampsia and/or HELLP were admitted in intensive care. Severe HELLP syndrome, eclampsia, neurological troubles and acute pulmonary oedema were the four leading causes of admission. The mean duration of admission was 3, 2+/-2,9 days. Mean age of the patients (28, 2+/-5,8 vs. 29,0+/-5,8 years, NS) and number of primiparous (71, 2% vs 66,6%, NS) were similar between the two groups. The mean gestational age of delivery was reduced when patients were needed admission in intensive care (29,8+/-3,9 weeks of gestation versus 32,5+/-4,4, p<0,001). 77, 3% of babies survived in the intensive care group compared with 90,4% in the other group (p<0,01). The short-term outcome of patients admitted in intensive care for preeclampsia or HELLP syndrome is generally good. However, neonatal morbidity and mortality remained important when women needed management in intensive care.La Presse Médicale 01/2009; 38(6):872-80. · 0.67 Impact Factor -
Article: [Liver hernia. Prognosis and report of 11 cases].
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ABSTRACT: Exclusive hepatocele is defined as a hernia containing in majority the liver with possibly some intestinal loops. This study was undertaken to evaluate neonatal morbidity and mortality in this series of exclusive hepatoceles. We reviewed 11 cases of exclusive hepatoceles with delivery at the hospital Jeanne-de-Flandre in the CHRU of Lille, in France. The mean gestational age of diagnosis was 14.5+/-3.4 weeks of gestation. Karyotype determination was performed in 100% of cases: it was abnormal in one case of 11. One termination of pregnancy was performed because of trisomy 13. The mean gestational age at delivery was 38+/-1.8 weeks of gestation. Cesarean deliveries were performed in nine cases. Morbidity was important with: one case of fetal growth retardation on total hepatocele, three cases of severe respiratory distress, two cases of severe digestive complications. The mean length of stay was 42.8 days. The mean length of parenteral feeding was 14.4 days. Postnatal mortality concerned one child, which died because of a severe respiratory distress due to pulmonary hypoplasia. In this series, morbidity is thus important, making of exclusive hepatoceles a full entity among the omphaloceles. The multidisciplinary take care is more complex but conceivable.Journal de Gynécologie Obstétrique et Biologie de la Reproduction 07/2008; 37(4):379-84. · 0.42 Impact Factor
