C Huissoud

Stem Cell And Brain Research Institute, Lyons, Rhône-Alpes, France

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Publications (74)168.95 Total impact

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    ABSTRACT: Evaluate the incidence of perinatal mortality and evaluate the percentage of non optimal care management of fatal pregnancies between 2005 and 2011 in the Rhone-Alpes region in France, by the use of the Aurore network. Evaluate the development of morbi-mortality revues (MMR) in this region.
    Journal de gynecologie, obstetrique et biologie de la reproduction. 07/2014;
  • Ultrasound in Obstetrics and Gynecology 06/2014; · 3.56 Impact Factor
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    ABSTRACT: to test the hypothesis that placental fetal thrombotic vasculopathy (FTV) is associated with obstetric complications and predisposes the child to unfavorable outcomes.
    Placenta 05/2014; · 3.12 Impact Factor
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    ABSTRACT: Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement OBJECTIVE: To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits STUDY DESIGN: Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Intervention: Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. Main outcome measures: The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (p<0.001). Since 2010, the quarterly rate of severe PPH has not exceeded the upper control limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%.
    European journal of obstetrics, gynecology, and reproductive biology 04/2014; · 1.97 Impact Factor
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    ABSTRACT: Objective Demonstrate the feasibility of high-intensity focused ultrasound (HIFU) applied to the placental unit using a toroidal-shaped transducer within an ex-vivo model.Materials and methodsA toroidal HIFU transducer working at 2.5 MHz and composed of 32 ring-shaped emitters was used. An ultrasound imaging probe was placed in the center of the HIFU transducer. First, the attenuation coefficient of human placentae was measured and integrated in a numerical model for simulating HIFU lesions. Second ex-vivo experiments were performed using acoustic parameters from this preliminary study. An animal abdominal wall simulating the maternal wall was used. Single and juxtaposition of HIFU lesions were performed and studied on sonograms and macroscopically.ResultsAttenuation coefficients of 12 human placentae were measured and ranged from 0.07 to 0.10 Np.cm−1.MHz−1 according to the gestational age (17 to 40 weeks). Thirty-three human placentae (from 17 to 40 weeks) were included and exposed to HIFU. 25 single HIFU lesions were obtained, with an average diameter and depth of 7.1 ± 3.2 mm, and 8.2 ± 3.1mm respectively. Eight placentae were used for juxtaposing 6 HIFU lesions. The average diameter of these HIFU lesions was 23 ± 5 mm and the average depth was 11 ± 5 mm. The average thickness of the abdominal wall was 10.5 ± 1.8 mm. No lesions or damage were observed in intervening tissues.Conclusion This study demonstrates the feasibility, the reproducibility, the harmlessness and the effectiveness of HIFU applied to the placental unit within an ex-vivo model.
    Ultrasound in Obstetrics and Gynecology 04/2014; · 3.56 Impact Factor
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    ABSTRACT: Major nonprimate-primate differences in corticogenesis include the dimensions, precursor lineages, and developmental timing of the germinal zones (GZs). microRNAs (miRNAs) of laser-dissected GZ compartments and cortical plate (CP) from embryonic E80 macaque visual cortex were deep sequenced. The CP and the GZ including ventricular zone (VZ) and outer and inner subcompartments of the outer subventricular zone (OSVZ) in area 17 displayed unique miRNA profiles. miRNAs present in primate, but absent in rodent, contributed disproportionately to the differential expression between GZ subregions. Prominent among the validated targets of these miRNAs were cell-cycle and neurogenesis regulators. Coevolution between the emergent miRNAs and their targets suggested that novel miRNAs became integrated into ancient gene circuitry to exert additional control over proliferation. We conclude that multiple cell-cycle regulatory events contribute to the emergence of primate-specific cortical features, including the OSVZ, generated enlarged supragranular layers, largely responsible for the increased primate cortex computational abilities.
    Neuron 02/2014; · 15.77 Impact Factor
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    ABSTRACT: Echogenic bowel (EB) represents 1 % of pregnancy and is a risk factor of fetal pathology (infection, cystic fibrosis, aneuploidy). The aim of our study was to determine the fetuses' outcomes with isolated EB. This is a retrospective study of all patients who presented singleton gestations with a fetal isolated echogenic bowel between 2004 and 2011 in two prenatal diagnosis centers. Search of aneuploidy, infection and cystic fibrosis was systematically proposed as well as an ultrasound monitoring. On 109 fetus addressed for isolate echogenic bowel five had other signs associated and 74 had a real isolated echogenic bowel (without dilatation, calcification, intrauterine growth restriction). In 30 cases, the EB was not found. Eighty-five percent of the patients had in the first trimester a screening for trisomy 21. None fetus with isolated EB had trisomy, infection or cystic fibrosis. One fetus died in utero and one newborn died of a metabolic disease without digestive repercussions. The risk of trisomy 21 and the risk to have a serious disease appear low for the fetus with EB. It does not seem necessary to propose a systematic amniocentesis in case of isolated echogenic bowel.
    Gynécologie Obstétrique & Fertilité 02/2014; · 0.55 Impact Factor
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    ABSTRACT: Objective Echogenic bowel (EB) represents 1 % of pregnancy and is a risk factor of fetal pathology (infection, cystic fibrosis, aneuploidy). The aim of our study was to determine the fetuses’ outcomes with isolated EB. Patients and methods This is a retrospective study of all patients who presented singleton gestations with a fetal isolated echogenic bowel between 2004 and 2011 in two prenatal diagnosis centers. Search of aneuploidy, infection and cystic fibrosis was systematically proposed as well as an ultrasound monitoring. Results On 109 fetus addressed for isolate echogenic bowel five had other signs associated and 74 had a real isolated echogenic bowel (without dilatation, calcification, intrauterine growth restriction). In 30 cases, the EB was not found. Eighty-five percent of the patients had in the first trimester a screening for trisomy 21. None fetus with isolated EB had trisomy, infection or cystic fibrosis. One fetus died in utero and one newborn died of a metabolic disease without digestive repercussions. Discussion and conclusion The risk of trisomy 21 and the risk to have a serious disease appear low for the fetus with EB. It does not seem necessary to propose a systematic amniocentesis in case of isolated echogenic bowel.
    Gynécologie Obstétrique & Fertilité 01/2014; · 0.55 Impact Factor
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    ABSTRACT: Objective To identify women who had measles while being pregnant during the 2011 epidemic peak in Lyon, France, and to document maternal characteristics and fetal outcomes. Methods In a retrospective survey, women who had measles while being pregnant between January and December 2011 were identified from the records of the Laboratory of Virology, Hospices Civils de Lyon. Epidemiologic data, clinical characteristics, and measles outcomes were assessed. Results In total, 11 pregnant women and 2 women who had just delivered were hospitalized with measles infection in Lyon. The most severe maternal complication was pneumonia, which occurred in 4 women (30.8%). Other maternal complications included fever (11 women; 84.6%) and elevated liver enzymes (2/6 women; 33.3%). All women delivered healthy newborns. Post-exposure prophylaxis using human polyvalent immunoglobulin was initiated for three newborns whose mothers acquired measles in the immediate postpartum period. None of these newborns subsequently acquired measles, although breastfeeding was maintained. Conclusion Although measles infections during pregnancy can have a deleterious effect on both mother and child, in many cases hospitalization is not required. Unnecessary admission should be avoided given the high risk of transmission of measles in an obstetrics ward.
    International Journal of Gynecology & Obstetrics. 01/2014;
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    ABSTRACT: Objective to test the hypothesis that placental fetal thrombotic vasculopathy (FTV) is associated with obstetric complications and predisposes the child to unfavorable outcomes. Methods 54 placentas with FTV lesions and 100 placentas without FTV lesions were collected over a 5-year period at the Croix-Rousse pathology department. Clinical findings including maternal, fetal, neonatal condition and pediatric outcome up to three years were collected for each case and control observation. The statistical analyses were assessed with Wald’s chi-square derived from conditional logistic regression modeling. Results FTV was associated with a significantly higher frequency of obstetric complications: (pregnancy-induced hypertension(OR 3.620, CI 1.563-8.385), preeclampsia(OR 3.674, CI 1.500-8.998), emergency delivery procedures(OR 3.727, CI 1.477-9.403), cesarean sections (OR 2.684, CI 1.016-7.088)), poor fetal condition (intrauterine growth restriction(IUGR)(OR 5.440, CI 2.007-14.748), nonreassuring fetal heart tracing(OR 6.062, CI 2.280-16.115), difficulties in immediate ex utero adaptation (OR 3.416, CI 1.087-10.732)) and perinatal or early childhood demise(OR 3.043, CI 1.327-6.978). On pathological examination, FTV was associated with marginal cord insertion (OR3.492, CI 1.350-9.035), cord stricture and hypercoiled cord (OR 3.936, CI 1.209-12.813). Thromboembolic events were significantly more frequent in cases with FTV (OR 2.154, CI 1.032-5.622). Neurological complications within the first 3 years of life were also more frequent in the FTV group compared to the control group, but this association was not statistically significant. Conclusions FTV is associated with maternal complications, pathological findings in the placenta, especially gross cord abnormalities, IUGR, and poor perinatal or early childhood outcome. It may also predispose children to somatic thromboembolic events.
    Placenta 01/2014; · 3.12 Impact Factor
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    ABSTRACT: Objectives Evaluate the incidence of perinatal mortality and evaluate the percentage of non optimal care management of fatal pregnancies between 2005 and 2011 in the Rhone-Alpes region in France, by the use of the Aurore network. Evaluate the development of morbi-mortality revues (MMR) in this region. Methods Retrospective study of perinatal mortality in the Aurore network, from 2005 to 2011. Systematic analysis of care management (adapted, non adapted, non evaluable), of each perinatal death that occurred in the Aurore network, by a multidisciplinary committee during regional MMR. Results The incidence of perinatal mortality has diminished from 2005 to 2011 (8,4‰ vs. 6,4‰, P < 0.07) as well as the percentage of non adapted care management (13% vs. 5,6%, P < 0.001). An underestimation of irregularities in the fetal heart rate was described in 34% of per partum deaths. The percentage of optimal care management was significantly higher when the obstetrician was in the maternity rather than on call at home (P < 0.03) and in type 3 maternities compared to type 1 and 2 maternities (P < 0.04). The attendance of the MMR organized in the AURORE network progressed between 2006 and 2011. Conclusion Since 2005, a decrease in perinatal mortality and in non-adapted care management was observed. More studies are necessary to evaluate the link between the development of MMR in this network and the amelioration of these two indicators.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction. 01/2014;
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    ABSTRACT: The incidence of ovarian tumors diagnosed during pregnancy is between 0.3 and 5.4% (LE2). The most common ovarian tumors diagnosed during pregnancy are functional cysts diagnosed incidentally during the first trimester ultrasound (LE2) and spontaneous regression is often observed. Dermoid cysts and cystadenoma are the most frequent organic benign ovarian tumors diagnosed during pregnancy (LE2). The main complication of presumed benign ovarian tumor (PBOT) during pregnancy is adnexal torsion and is estimated at around 8% (LE2), especially at the end of the first trimester and during the second trimester (LE4). Tumor markers are not reliable during pregnancy to assess the risk of malignancy of ovarian tumor (LE2). Ultrasound remains the gold standard for characterizing an ovarian tumor during pregnancy (LE3), but with a lower specificity for the diagnosis of malignancy. Pelvic MRI is accurate in the diagnosis of ovarian tumors during pregnancy and brings additional information to ultrasound (LE4). Ultrasound-guided aspiration of ovarian tumors is not recommended during pregnancy (grade C). Expectation is recommended in cases of PBOT during pregnancy, which does not enlarge (grade C). Whatever the gestational age, surgery is recommended in patients with symptoms suggesting an adnexal torsion (grade C). Laparoscopy is possible during the first and second trimester of pregnancy for the management of symptomatic PBOT (LE3). The risk of miscarriage following surgery (laparoscopy and laparotomy) for ovarian tumor during pregnancy is estimated at 2.8% (LE3). The route of delivery should not be modified by the ovarian tumour, except in case of praevia cyst requiring a cesarean section, a complication or suspicion of malignancy (grade C). Surgical treatment of PBOT may be performed during a cesarean section indicated for another reason. The risk of torsion is increased during the postpartum period (LE4).
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 11/2013; · 0.45 Impact Factor
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    ABSTRACT: Women who are carriers for hemophilia are usually considered as safe carriers. However, they can present hemorragic symptoms associated with low factor VIII or IX levels. During pregancy, factor VIII increases whereas factor IX does not. The peripartum period is at risk of increased bleeding in these women. Here are presented reports of clinical data concerning two hemophilia carriers with low factor VIII or IX (30-40%) during the peripartum period. They received remifentanil and ketamine for labor pain management because of contraindication of epidural and spinal analgesia. Delivery occured quickly but they presented immediate moderate postpartum haemorrage. They did not necessitate blood transfusion. The one with hemophilia A received desmopressin just after delivery and the other one received factor IX when she arrived in delivery room. Blood factor VIII or IX has to be assessed in these women with familial history of hemophilia and bleeding. During pregnancy, factor VIII increases and can be assessed many times during pregnancy expecting a level over 50%. Factor IX does not really increase during pregancy and hemorrage can occur. Epidural and spinal anesthesia seem to be contraindicated as far as recommandations are concerned. Coagulation factor substitution is a mean of increasing factor level before these anaesthesias and can be discussed for each case.
    Annales francaises d'anesthesie et de reanimation 10/2013; · 0.77 Impact Factor
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    ABSTRACT: Long-term ex vivo live imaging combined with unbiased sampling of cycling precursors shows that macaque outer subventricular zone (OSVZ) includes four distinct basal radial glial (bRG) cell morphotypes, bearing apical and/or basal processes in addition to nonpolar intermediate progenitors (IPs). Each of the five precursor types exhibits extensive self-renewal and proliferative capacities as well as the ability to directly generate neurons, albeit with different frequencies. Cell-cycle parameters exhibited an unusual stage-specific regulation with short cell-cycle duration and increased rates of proliferative divisions during supragranular layer production at late corticogenesis. State transition analysis of an extensive clonal database reveals bidirectional transitions between OSVZ precursor types as well as stage-specific differences in their progeny and topology of the lineage relationships. These results explore rodent-primate differences and show that primate cortical neurons are generated through complex lineages by a mosaic of precursors, thereby providing an innovative framework for understanding specific features of primate corticogenesis.
    Neuron 10/2013; 80(2):442-57. · 15.77 Impact Factor
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    ABSTRACT: The laminar location of the cell bodies and terminals of interareal connections determines the hierarchical structural organization of the cortex and has been intensively studied. However, we still have only a rudimentary understanding of the connectional principles of feedforward (FF) and feedback (FB) pathways. Quantitative analysis of retrograde tracers was used to extend the notion that the laminar distribution of neurons interconnecting visual areas provides an index of hierarchical distance (percentage of supragranular labeled neurons (SLN)). We show that: (1) SLN values constrain models of cortical hierarchy, revealing previously unsuspected areal relations; (2) SLN reflects the operation of a combinatorial distance rule acting differentially on sets of connections between areas; (3) Supragranular layers contain highly segregated bottom-up and top-down streams, both of which exhibit point-to-point connectivity. This contrasts with the infragranular layers, which contain diffuse bottom-up and top-down streams; (4) Cell filling of the parent neurons of FF and FB pathways provides further evidence of compartmentalization; (5) FF pathways have higher weights, cross fewer hierarchical levels and are less numerous than FB pathways. Taken together, the present results suggest that cortical hierarchies are built from supra- and infragranular counterstreams. This compartmentalized dual counterstream organization allows point-to-point connectivity in both bottom-up and top-down directions. J. Comp. Neurol., 2013. © 2013 Wiley Periodicals, Inc.
    The Journal of Comparative Neurology 08/2013; · 3.66 Impact Factor
  • Ultrasound in Obstetrics and Gynecology 06/2013; · 3.56 Impact Factor
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    ABSTRACT: But Identifier les mécanismes de défense manifestés par les équipes pouvant entraver la prise de décisions, révélés par l’intervention des professionnels en sciences humaines (PSH) lors des revues de morbi-mortalité (RMM) en obstétrique. Matériels et méthodes Application de deux méthodes d’intervention avec des PSH lors de RMM de service, réalisées entre le 1er mars 2009 et le 30 novembre 2010, dans 20 maternités randomisées issues de cinq réseaux de périnatalité : la méthode interactive de résolution de problème ciblant le fonctionnement de l’équipe et la méthode de l’élaboration des pratiques professionnelles centrée sur l’individu. La collecte des données s’est effectuée pendant l’analyse des cas cliniques durant les RMM, par une prise de note par deux PSH en binôme. Les expressions orales des participants aux RMM étaient secondairement retranscrites, analysées et classées par thème. Résultats Cinquante-quatre RMM ont été réalisées. Des mécanismes de défense ont pu être identifiés par l’intervention des PSH lors des RMM : le déni, le pacte dénégatif, le clivage et la surprotection. Ils ont été identifiés par les deux méthodes appliquées d’intervention en sciences humaines, ce qui consolide ces résultats. Cette intervention a engagé les équipes vers une transformation à différents niveaux, notamment en augmentant sa capacité de coopération. Conclusion L’identification des mécanismes de défenses lors des RMM permet aux équipes d’améliorer la communication et la qualité des liens entre les soignants. Cela peut constituer un réel facteur d’amélioration des pratiques. Cependant, des études complémentaires sont nécessaires pour confirmer cette hypothèse.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction. 06/2013; 42(4):383–392.
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    ABSTRACT: Objective The aim of this study was to determine if the method used to expand the hysterotomy during a cesarean section (c-section) could affect maternal blood loss and uterine laceration. Material and Methods Prospective study including 214 c-sections divided into two groups. Hundred and thirty-six were assigned to have blunt expansion of the uterine incision (group 1) and 78 to have sharp expansion by scissors (group 2). Maternal blood loss, change in hemoglobin level, and uterine tears were studied. Results The median blood loss was (IQR) 475 mL (300–700) and 500 mL (300–800) (P = 0.227) in groups 1 and 2 respectively. The decrease in hemoglobin level was 9.5 g/L versus 6 g/L (P = 0.007) in groups 1 and 2. Nine lateral uterine extensions of uterine incision (5.88%) were found in the group 1, three of them were complicated by a wound of the uterine vascular pedicle. One lateral uterine tear with vascular wound was found in the group 2 (1.28%). Conclusion Sharp expansions were associated with a lower shift in hemoglobin level and a trend to more uterine lacerations.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 06/2013; 42(4):366–371. · 0.45 Impact Factor

Publication Stats

386 Citations
168.95 Total Impact Points

Institutions

  • 2012–2014
    • Stem Cell And Brain Research Institute
      Lyons, Rhône-Alpes, France
  • 2009–2014
    • CHU de Lyon - Hôpital de la Croix-Rousse
      • Service de Gynécologie et d'Obstétrique
      Lyons, Rhône-Alpes, France
  • 2008–2014
    • Hospices Civils de Lyon
      Lyons, Rhône-Alpes, France
    • CHU de Lyon - Hôpital Femme-Mère-Enfant
      Lyons, Rhône-Alpes, France
    • French Institute of Health and Medical Research
      • Stem Cell and Brain Research Institute
      Lutetia Parisorum, Île-de-France, France
  • 2013
    • University of Lyon
      Lyons, Rhône-Alpes, France
  • 2005–2013
    • Claude Bernard University Lyon 1
      • Filière de gynécologie-obstétrique
      Villeurbanne, Rhône-Alpes, France