Y Ville

Assistance Publique – Hôpitaux de Paris, Lutetia Parisorum, Île-de-France, France

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Publications (556)1692.87 Total impact

  • G.E. Chalouhi · V. Bernardi · Y. Ville
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    ABSTRACT: Simulation and virtual reality have spread in various field of medicine, from anesthesiology to surgery and emergency care. In all medical fields, simulation offers the possibility of making errors without experiencing negative patient outcomes. Additionally, the negative emotions generated by failures or errors are critical to the medical learning process but are experienced more constructively in the context of simulation than in real life.Ultrasound is the primary method of imaging in obstetrics and gynecology and has become an essential part of practice. To date, ultrasound simulators have been mainly used to teach basic skills in cardiac ultrasound within emergency and internal care units. In the field of obstetrics and gynecology ultrasound, simulators have appeared at the beginning of this century and have led to only few studies. This field is developing and could bring several benefits into teaching, training and evaluation of ultrasound competency. We reviewed the existing literature to provide with an overview of the state of the art in the use of simulation in ultrasound in obstetrics and gynecology.
    Ultrasound in Obstetrics and Gynecology 10/2014; DOI:10.1002/uog.14707 · 3.14 Impact Factor
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    ABSTRACT: Objectives To determine the incidence of chromosomal abnormalities, syndromic association and fetal defects associated with second trimester fetal growth restriction (FGR) in a tertiary referral center. Patients and methods Retrospective review of all cases referred between 14 and 27 weeks with an abdominal circumference (AC) < 5th centile between 2008 and 2012. Multiple pregnancies were excluded. Medical records were retrieved to look for the presence of associated malformations, aneuploidy and outcomes. Results A total of 8626 fetuses had ultrasonographic examination between 14 and 27 weeks. Of these, there were 239 cases (2.8%) with evidence of FGR as based on AC measurement. Thirty-seven fetuses had an abnormal karyotype or an identified syndromic association (15%). The most common chromosomal defect was Trisomy 18 (10 cases, 4,2%), 67 had at least one associated morphological abnormality without aneuploidy or syndromic association (28%). Most common associated abnormalities were relative short femur (5%), omphalocele (5%) and gastroschisis (4%). Last 135 cases were isolated fetal growth retardation (5%). Maternal age was higher (33 yr ± 5 yr versus 31 yr ± 5.6 yr, p < 0.01) and the z-score for the AC lower (2.5 ± 1 versus 2.15 ± 0.6) in the group with abnormal karyotype or syndromic association than in the group without associated malformation. Amniotic fluid was more often increased in the group with an abnormal karyotype or associated malformation (14% and 17%) than in the group without malformations (0%, p < 0.01). Discussion and conclusion This study describes abnormalities and outcomes associated with second trimester fetal growth retardation in a large population of patients. Our results suggest that the absence of associated malformation, degree of growth restriction, maternal age and the amniotic fluid index may help in the prenatal management and counseling of this high risk population.
    Gynécologie Obstétrique & Fertilité 09/2014; 42(9). DOI:10.1016/j.gyobfe.2014.07.002 · 0.58 Impact Factor
  • Ultrasound in Obstetrics and Gynecology 09/2014; 44(S1). DOI:10.1002/uog.13416 · 3.14 Impact Factor
  • L. Joyeux · G.E. Chalouhi · Y. Ville · E. Sapin
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    ABSTRACT: Open spina bifida or myelomeningocele (MMC) is a frequent congenital abnormality (450 cases per year in France) associated with high morbidity. Immediate postnatal surgery is aimed at covering the exposed spinal cord, preventing infection, treating hydrocephalus with a ventricular shunt. MMC surgical techniques haven’t achieved any major progress in the past decades. Numerous experimental and clinical studies have demonstrated the MMC “two-hit” hypothetic pathogenesis: a primary embryonic congenital abnormality of the nervous system due to a failure in the closure of the developing neural tube, followed by secondary damages of spinal cord and nerves caused by long-term exposure to amniotic fluid. This malformation frequently develops cranial consequences, i.e. hydrocephalus and Chiari II malformation, due to leakage of cerebrospinal fluid. After 30 years of research, a randomized trial published in February 2011 proved open maternal-fetal surgery (OMFS) for MMC to be a real therapeutic option. Comparing prenatal to postnatal surgery, it confirmed better outcomes of MMC children after a follow up of 2.5 years: enhancement of lower limb motor function, decrease of the degree of hindbrain herniation associated with the Chiari II malformation and the need for shunting. At 5 years of age, MMC children operated prenatally seems to have better neurocognitive, motor and bladder-sphincter outcomes than those operated postnatally. However, risks of OMFS exist: prematurity for the fetus and a double hysterotomy at approximately 3-month interval for the mother. Nowadays, it seems crucial to inform parents of MMC patients about OMFS and to offer it in France. Future research will improve our understanding of MMC pathophysiology and evaluate long-term outcomes of OMFS. Tomorrow's prenatal surgery will be less invasive and more premature using endoscopic, robotic or percutaneous techniques. Beforehand, Achilles’ heel of maternal-fetal surgery, i.e. preterm premature rupture of membranes, preterm labor and preterm birth, must be solved.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 06/2014; DOI:10.1016/j.jgyn.2014.01.014 · 0.62 Impact Factor
  • S. Seshadri · Y. Ville · U. Ram · I Suresh · M. Essaoui · A. Ibrahim
    BJOG An International Journal of Obstetrics & Gynaecology 04/2014; 121:24-25. · 3.86 Impact Factor
  • L Joyeux · G E Chalouhi · Y Ville · E Sapin
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    ABSTRACT: Open spina bifida or myelomeningocele (MMC) is a frequent congenital abnormality (450 cases per year in France) associated with high morbidity. Immediate postnatal surgery is aimed at covering the exposed spinal cord, preventing infection, treating hydrocephalus with a ventricular shunt. MMC surgical techniques haven't achieved any major progress in the past decades. Numerous experimental and clinical studies have demonstrated the MMC "two-hit" hypothetic pathogenesis: a primary embryonic congenital abnormality of the nervous system due to a failure in the closure of the developing neural tube, followed by secondary damages of spinal cord and nerves caused by long-term exposure to amniotic fluid. This malformation frequently develops cranial consequences, i.e. hydrocephalus and Chiari II malformation, due to leakage of cerebrospinal fluid. After 30 years of research, a randomized trial published in February 2011 proved open maternal-fetal surgery (OMFS) for MMC to be a real therapeutic option. Comparing prenatal to postnatal surgery, it confirmed better outcomes of MMC children after a follow up of 2.5 years: enhancement of lower limb motor function, decrease of the degree of hindbrain herniation associated with the Chiari II malformation and the need for shunting. At 5 years of age, MMC children operated prenatally seems to have better neurocognitive, motor and bladder-sphincter outcomes than those operated postnatally. However, risks of OMFS exist: prematurity for the fetus and a double hysterotomy at approximately 3-month interval for the mother. Nowadays, it seems crucial to inform parents of MMC patients about OMFS and to offer it in France. Future research will improve our understanding of MMC pathophysiology and evaluate long-term outcomes of OMFS. Tomorrow's prenatal surgery will be less invasive and more premature using endoscopic, robotic or percutaneous techniques. Beforehand, Achilles' heel of maternal-fetal surgery, i.e. preterm premature rupture of membranes, preterm labor and preterm birth, must be solved.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 02/2014; · 0.62 Impact Factor
  • Y. Ville · L.J. Salomon · N. Fries
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 12/2013; 43(1). DOI:10.1016/j.jgyn.2013.10.013 · 0.62 Impact Factor
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    ABSTRACT: Objective Previous studies have recommended that several repeat measurements of nuchal translucency (NT) be obtained to optimize sensitivity of the screening process. However, truncation is applied within the risk calculation for small NT measurements; therefore, repeating NT measurements in the lower range may be unnecessary. The aim of this study was to determine the optimal number of NT measurements and whether this is dependent on the initial value obtained. Methods We simulated the expected distribution of sets of five repeat NT measurements and their corresponding likelihood ratios (LR) for a variety of crown–rump length (CRL) values at 11–14 weeks' gestation, based on the published mixture model for first-trimester NT measurements and on published data regarding NT measurement variability. The ratio between LR obtained from the highest and the initial measurement in each set were computed, with a ratio of 1 indicating that repeat measurements would have no effect on risk estimation. We calculated NT cut-offs below which a change in estimated LR would occur in fewer than 10% of cases if repeat measurements were obtained, and we tested this approach on a real first-trimester screening dataset. ResultsThe simulations performed indicated that repeating NT measurements when the first NT obtained ranged between ≤ 0.9 and ≤ 1.6 mm at CRLs of 45 and 84 mm, respectively, is not useful. When applied to a real dataset, our approach allowed avoiding repetition of measurements in 47/165 cases (28%). Conclusions Although there is some variability in NT measurements, repeat assessment is not useful to optimize screening performance for the smallest NT measurements due to lower truncation limits that are applied in risk calculation. Our study provides NT cut-off values, in relation to CRL, below which it appears that there is no need to repeat measurements once a good quality image has been obtained. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
    Ultrasound in Obstetrics and Gynecology 12/2013; 42(6). DOI:10.1002/uog.12482 · 3.14 Impact Factor
  • Journal of Minimally Invasive Gynecology 11/2013; 20(6):S165. DOI:10.1016/j.jmig.2013.08.554 · 1.58 Impact Factor
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    ABSTRACT: Objective To determine whether a standard complete fetal anatomical survey, as recommended for ultrasound examination guidelines, is feasible using a standardized magnetic resonance imaging (MRI) protocol. Methods Based on guidelines for ultrasound examination, we created a specific MRI protocol for fetal anatomical survey. This protocol was then tested prospectively in 100 women undergoing fetal MRI examination for various specific indications at a median gestational age of 30 weeks. The feasibility of using MRI to perform the fetal anatomical survey was analyzed by two reviewers (A and B) based on 26 predefined anatomical criteria, yielding a score ranging from 0 to 26 (26 meaning successful complete anatomical study). Reproducibility was analyzed using percentage agreement and modified kappa statistics. ResultsThe mean score for the standardized MRI anatomical survey was 24.6 (SD, 1.4; range, 15–26) for Reviewer A and 24.2 (SD, 1.7; range, 15–26) for Reviewer B (P = 0.1). Twenty-two, two and two criteria could be assessed in > 95%, 80–95% and 95%, 80–95% and
    Ultrasound in Obstetrics and Gynecology 11/2013; 42(5). DOI:10.1002/uog.12415 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12897 · 3.14 Impact Factor
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    ABSTRACT: To study the course and outcome of fetuses with congenital atrioventricular block (AVB) in a single centre. Retrospective analysis of cases diagnosed prenatally with 2nd and 3rd degree AVB. The clinical characteristics and outcome of fetal AVB were evaluated including in utero treatment. 62 cases were studied. AVB was associated with a congenital heart defect (CHD-AVB) in 17 cases (27%) whereas it was isolated (i-AVB) in 45 (73%), 42 of which were associated with maternal antibodies. There were 9 (52.9%) live births in the CHD-AVB group, 5 of which (55%) resulted in infant deaths. In the i-AVB group there were 40/45 (88.9%) live births and 1/40 (2.5%) infant death; 36 (90%) babies required a permanent pacemaker (PM). The only factor predictive of postnatal death was the presence of CHD (5/9 vs 1/39, OR 48.7 [3.6; 1457.7], p < 0.001). Nineteen fetuses (40.5%) with i-AVB received steroids in utero. No difference in outcome was found between the AVB treated in utero versus the no-treatment group in terms of permanent PM placement, postnatal death or development of dilated cardiomyopathy CONCLUSION: The most important prognostic factor for congenital AVB is the association with CHD. In utero treatment remains questionable. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12744 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.13079 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12896 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12695 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12865 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12709 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12898 · 3.14 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.12673 · 3.14 Impact Factor
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    J. Nizard · S. Haberman · R. Gonen · Y. Ville · Y. Paltieli
    Ultrasound in Obstetrics and Gynecology 10/2013; 42(s1). DOI:10.1002/uog.13104 · 3.14 Impact Factor

Publication Stats

5k Citations
1,692.87 Total Impact Points

Institutions

  • 2010–2013
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2008–2013
    • Université René Descartes - Paris 5
      • Faculté de Médecine
      Paris, Ile-de-France, France
  • 2002–2013
    • College of Obstetrics and Gynecology of Leon
      Aquitaine, France
    • University of Innsbruck
      Innsbruck, Tyrol, Austria
  • 2012
    • Hôpital Saint-Vincent-de-Paul – Hôpitaux universitaires Paris Centre
      Lutetia Parisorum, Île-de-France, France
  • 2000–2010
    • Hôpital de Poissy Saint Germain en Laye
      Saint-Germain, Île-de-France, France
    • St. Mary's Hospital (WI, USA)
      Madison, Wisconsin, United States
  • 2003–2009
    • Université de Versailles Saint-Quentin
      Versailles, Île-de-France, France
    • Computational Hydraulics Int.
      Guelph, Ontario, Canada
  • 1997–2002
    • St George's, University of London
      • Medical School
      Londinium, England, United Kingdom
    • University of Southampton
      Southampton, England, United Kingdom
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
  • 1992–2000
    • Hôpital Antoine-Béclère – Hôpitaux universitaires Paris-Sud
      Clamart, Île-de-France, France
    • The Peninsula College of Medicine and Dentistry
      Plymouth, England, United Kingdom
  • 1999
    • Royal Brompton and Harefield NHS Foundation Trust
      Harefield, England, United Kingdom
  • 1998
    • St George Hospital
      Sydney, New South Wales, Australia
    • George Eliot Hospital NHS Trust
      Nuneaton, England, United Kingdom
  • 1994–1998
    • The Fetal Medicine Foundation
      Londinium, England, United Kingdom
    • King's College Hospital NHS Foundation Trust
      • Department of Obstetrics and Gynaecology
      Londinium, England, United Kingdom
  • 1994–1996
    • King's College London
      • Division of Asthma, Allergy and Lung Biology
      Londinium, England, United Kingdom
  • 1993
    • Ipswich Hospital NHS Trust
      Ipswich, England, United Kingdom
  • 1991–1992
    • International Centre of Medical Research of Franceville
      Franceville, Haut-Ogooué, Gabon