M V Senat

Publications (80)173.1 Total impact

• Article: A series of 238 Cytomegalovirus primary infections during pregnancy: description and outcome.

  O Picone, C Vauloup-Fellous, A G Cordier, S Guitton, M V Senat, F Fuchs, J M Ayoubi, L Grangeot Keros, A Benachi
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  ABSTRACT: OBJECTIVE: To analyze the outcome of maternal primary CMV infection. METHODS: Retrospective analysis of a cohort of 238 patients with maternal primary CMV infection detected at routine screening. The cases were managed with serial ultrasound (US) scans and amniocentesis was performed in 36.1% of cases. All prenatal results were confirmed at birth. RESULTS: The average age was 31.9 [18-44] years. Patients were symptomatic in 21% of cases. The rate of intrauterine transmission was 24.9%, and it was 8.8%, 19%, 30.6%, 34.1% and 40% in the preconceptional period, the periconceptional period, the first, second and third trimester of pregnancy, respectively (P = 0.025). There was a significantly higher risk of US abnormalities when maternal infection occurred during the preconceptional or periconceptional period and the first trimester compared with later (p < 0.001). Because of US abnormalities, pregnancy was terminated in 18 cases at the parents' request. Three infected newborns were symptomatic; all three cases were suspected at US before birth. We did not observe any symptomatic fetal infection when maternal infection occurred after 14 weeks of gestation. 5.5% of clinically asymptomatic cases developed hearing loss. CONCLUSION: The rate of materno fetal transmission is linearly correlated to the gestational age at infection. No severe case of congenital infection was observed if maternal infection occurred after 14 weeks of gestation. © 2013 John Wiley & Sons, Ltd.
  Prenatal Diagnosis 04/2013; · 2.11 Impact Factor
• Article: [Could we perform quality second trimester ultrasound among obese pregnant women?]

  F Fuchs, A Voulgaropoulos, M Houllier, M-V Senat
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  ABSTRACT: OBJECTIVE: To compare the quality of second trimester ultrasound images and their anatomical quality scores among obese women and those with a normal body mass index (BMI). MATERIALS AND METHODS: This prospective study, which took place from 2009 to 2011, included every obese pregnant woman (prepregnancy BMI greater than 30 kg/m(2)) who had an ultrasound examination at 20 to 24 weeks in our hospital and a control group with a normal BMI (20-24.9kg/m(2)) who had the same examination. A single operator evaluated the quality of all images, reviewing the standardized ultrasound planes - three biometric and six anatomical - required by French guidelines and scoring the quality of the six anatomical images. Each image was assessed according to 4-6 criteria, each worth one point. We sought excellent quality, defined as the frequency of maximum points for a given image. RESULTS: The obese group included 223 women and the control group 60. The completion rate for each image was at least 95 % in the control group and 90 % in the obese group, except for diaphragm and right outflow tract images. Overall, the excellence rate varied from 35 % to 92 % in the normal BMI group and 18 % to 58 % in the obese group and was significantly lower in the latter for all images except abdominal circumference (P=0.26) and the spine (P=0.06). Anatomical quality scores were also significantly lower in the obese group (22.3 vs. 27.2 ; P=0.001). CONCLUSION: Image quality and global anatomical scores in second trimester ultrasound scans were significantly lower among obese than normal-weight women.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 01/2013; · 0.42 Impact Factor
• Article: Recherche médicale et Internet

  X. Deffieux, E. Faivre, M. V. Senat, A. C. Donnadieu, C. Trichot, H. Fernandez
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  ABSTRACT: IntroductionLe réseau Internet, compte tenu de son récent développement, de sa pénétrance et de la masse d’informations recensées, va devenir progressivement le moyen de conception et de réalisation de la recherche pour les étudiants et les professionnels, et ce sans concurrence. Matériel et méthodesCette revue de la littérature rapporte les moyens d’utilisation d’Internet pour mener une recherche médicale. Nous en discutons les avantages ainsi que les limites actuelles. RésultatsDepuis quelques années, Internet a prouvé qu’il était le moyen le plus puissant et prometteur pour la recherche bibliographique. PubMed et les autres moteurs de recherche aident les investigateurs en leur faisant gagner un temps précieux et leur donnent accès à des sources d’informations jusqu’à il y a peu inaccessibles. Il existe ainsi de multiples bases de données en ligne recensant les revues indexées et proposant des résumés (abstracts) ainsi que des manuscrits complets (full-text articles). L’utilisation d’Internet a longtemps été limitée à cette fonction de base de données. Toutefois, il permet aussi aux chercheurs de différentes nations travaillant sur un même sujet de partager facilement leurs expériences afin de faire avancer plus rapidement les idées et connaissances. Enfin, Internet simplifie toutes les étapes d’un projet de recherche médicale: obtention d’un financement, recrutement des sujets, analyse statistique, rédaction et soumission du manuscrit final. ConclusionInternet simplifie toutes les étapes d’élaboration et de réalisation d’un projet de recherche médicale. IntroductionThe internet, due to the recent upsurge in its penetration and the plethora of information available, has the potential for unparalleled impact on the way research can be conducted in the future by medical students and professionals alike. Materials and methodsIn the current review article, we discuss the methods, merits and drawbacks of using the Internet further for medical research. ResultsSince the past few years, the Internet has proved to be the most promising and powerful tool to review existing literature. PubMed and others engine searches help investigators to not only save time but also gives them access to resources that were unavailable in the past. Various databases online archive indexed journals, providing abstracts or full-text articles. The utility of the Internet has by far been restricted to providing a database of information. However, it also advocates the communication amongst researchers working on similar issues that can provide gateways to more meaningful international interactions and exchange of ideas and intelligence. Furthermore, the Internet can be used to simplify almost any stage of a medical research project: grant earning, data collection, recruiting subjects, statistical analysis, writing and submission of the final manuscript. ConclusionInternet can be used to simplify almost any stage of a medical research project.
  Pelvi-périnéologie 04/2012; 4(3):213-217. · 0.07 Impact Factor
• Article: [Institutional review board of the French college of obstetricians and gynecologists (CEROG).].

  X Deffieux, C Vayssiere, E Azria, R Porcher, O Parant, J Clavier, J Guibert, A Benachi, V Houfflin-Debarge, J-M Jouannic, [......], R Rouzier, A Benbassa, P Collinet, J-P Ayel, B Jacquetin, P Morice, L Boubli, M-V Senat, L Brunet, G Levy
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  ABSTRACT: To report the rules and the activity of the institutional review board of the French college of obstetricians and gynecologists (Comité d'éthique de la recherche en obstétrique et gynécologie [CEROG]) created in 2008. The submission requirements are also described. Retrospective study. The Ethical Review Committee [institutional review board of the French college of obstetricians and gynecologists (CNGOF)] CEROG have examined 65 project studies in 2008. The median number of submitted studies was 5.5 per month (IQR: 3.75-6.25). The origins of the submission were as follows: tertiary care university hospitals (n=63, 97 %), Inserm (n=1), INRA (n=1). Researches were found to be in conformity with the French laws and regulations, to conform to generally accepted scientific principles and medical research ethical standards in 44 cases (68 %). In 13 cases (20 %), the study has been forwarded to the Persons Protection Committee (PPC) since it concerned biomedical research or "usual care research" (soin courant). In six cases (9 %), the investigators have not responded to IRB suggestions. In two cases (3 %), the information form has been judged unsatisfactory. The CEROG is the first national IRB in obstetrics and gynecology. This new committee clarifies IRB submission procedure in France concerning non-interventional studies in the field of obstetrics and gynecology.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 09/2010; 39(5):401-8. · 0.42 Impact Factor
• Article: [Fetomaternal hemorrhage caused by intraplacental choriocarcinoma].

  C Touboul, E Faivre, C Boithias, A-E Mass, M-V Senat, H Fernandez, X Deffieux
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  ABSTRACT: A male infant was born at 41 weeks' gestation to a 34-year-old primiparous woman after an uneventful pregnancy. Physical examination showed extreme paleness. Fetal hemoglobin was 7.6g/dl and Kleihauher exam revealed fetomaternal hemorrhage. Pathology revealed in situ intraplacental choriocarcinoma. Serum human chorionic gonadotrophin level was undetectable 1 month after the delivery both in woman and in newborn. We suggest that a pathological examination of the placenta should be performed in any case of fetomaternal hemorrhage in order to avoid misdiagnosis of intraplacental choriocarcinoma.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 04/2010; 39(2):156-8. · 0.42 Impact Factor
• Article: Using Z-scores to compare biometry data obtained during prenatal ultrasound screening by midwives and physicians.

  P Capmas, L J Salomon, O Picone, F Fuchs, R Frydman, M V Senat
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  ABSTRACT: To compare retrospectively the distribution of foetal biometry data as measured by midwives and physicians during second and third trimester screening of an unselected population of pregnant women. Standard measurements of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were performed by four midwives and ten physicians at 20 to 24 weeks of gestation and at 30 to 34 weeks of gestation as part of routine ultrasound examinations over a 26-month period (Jan. 2005-Mar. 2007). All measurements were converted into Z-scores using different prediction equations. The reference chart best fitting our practice was determined for each fetal parameter (French College of Sonographers for BPD, Chitty et al. for HC and FL, Snidjers and Nicolaides for AC). The means and SDs of the Z-score distributions for data collected by midwives and physicians were compared using Student's t-test for means and the Fisher-Snedecor test for SDs. We retrieved 1566 and 1631 measurements made by midwives and physicians respectively between 20 and 24 weeks of gestation, and 1710 and 1578 measurements made by midwives and physicians respectively between 30 and 34 weeks of gestation. Mean values recorded by midwives were significantly closer to 0 (p < 0.05) for many foetal parameters. SD values were also significantly lower and were below 1. In this study, midwives have a greater tendency than physicians to normalize biometry data. Such normalization may hamper the sensitivity of routine ultrasound screening for abnormal foetal growth.
  Prenatal Diagnosis 12/2009; 30(1):40-2. · 2.11 Impact Factor
• Article: Clinical application of fetal urine production rate in unexplained polyhydramnios.

  C Touboul, O Picone, J M Levaillant, C Boithias, R Frydman, M Boulvain, M V Senat
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  ABSTRACT: To evaluate the clinical use of hourly fetal urine production rate (HFUPR) in polyhydramnios. This was a retrospective review of 33 singleton pregnancies with polyhydramnios, 30 of them unexplained and three due to gastrointestinal atresia. HFUPR was estimated using three-dimensional ultrasound and was compared with recently established nomograms. Abnormal midterm outcome, defined as diagnosis or persistence of pathology after the neonatal period until the age of 2 years, was analyzed according to prenatal HFUPR measurements and other polyhydramnios characteristics. Seventeen of the 30 fetuses with unexplained polyhydramnios had an HFUPR above the 95(th) centile, and five (29.4%) of them developed midterm disorders. None of the 13 with normal HFUPR developed midterm disorders. The HFUPR was 1.9 (SD, 0.7) multiples of the median (MoM) in fetuses with an adverse childhood outcome and 1.4 (SD, 1.2) in fetuses with normal childhood outcome (P = 0.34). In the three fetuses with gastrointestinal atresia, the HFUPR was significantly lower than in those with unexplained polyhydramnios (P = 0.003). HFUPR was associated with the mechanism of polyhydramnios but failed to help in the prognosis of unexplained polyhydramnios because of lack of power. Children with prenatal unexplained polyhydramnios and HFUPR above the 95(th) centile should nevertheless receive detailed pediatric follow-up.
  Ultrasound in Obstetrics and Gynecology 11/2009; 34(5):521-5. · 3.01 Impact Factor
• Article: [Pandemic influenza A H1N1 2009 flu during pregnancy: Epidemiology, diagnosis and management].

  O Picone, O Ami, C Vauloup-Fellous, V Martinez, M Guillet, C Dupont-Bernabé, A-C Donnadieu, C Trichot, M-V Senat, H Fernandez, R Frydman
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  ABSTRACT: Pandemic influenza A H1N1 2009 is a benign disease when infecting healthy adults, but it can lead to severe consequences in pregnant woman, for the fetus or its mother. The incidence of the disease is increasing strongly, and health authorities estimate that one third of the world population might be infected before the end of the winter. Diagnosis of infection with influenza virus H1N1 is suspected when a patient presents with the association of symptoms of the respiratory tract like sore throat, cough, or dyspnea, with general signs like fever, myalgias, or exhaustion. Diagnosis confirmation is obtained with nasopharyngeal swab and virus detection with molecular biology. This flu can lead to severe consequences for the pregnant woman and fetus. For this reason, it is advisable to treat pregnant women systematically by oseltamivir or zanamivir, and to treat preventively the pregnant woman in case of close contact with a suspected or confirmed infected person. Even if the management of influenza A H1N1 2009 infection during pregnancy relies on family physicians and gynecologists, every physician having in charge such cases should regularly update his knowledge regarding the evolution of the recommendations for the pandemic.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 10/2009; 38(8):615-28. · 0.42 Impact Factor
• Article: First-trimester nuchal abnormalities secondary to dehydrated hereditary stomatocytosis.

  O Ami, O Picone, L Garçon, C Castel, C Guitton, J Delaunay, R Frydman, M V Senat
  Prenatal Diagnosis 09/2009; 29(11):1071-4. · 2.11 Impact Factor
• Article: Imaging of the fetal bony pelvis by computed tomography in a case of bladder exstrophy.

  M Mabille, J De Laveaucoupet, M-V Senat, O Picone, J-M Levaillant, A E Mas, D Musset
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  ABSTRACT: We describe the findings on computed tomography (CT) in a prenatally diagnosed case of bladder exstrophy, and compare them with the findings on two- and three-dimensional sonography. The CT data of the affected fetus were compared with the CT findings of 14 fetuses with normal bony pelvises. The CT images showed differences in the structure of the bony pelvis in the case of bladder exstrophy, with a wide gap between the iliopubic and ischiopubic rami and a widening of the iliac bones. CT scanning was useful in confirming the sonographic diagnosis of bladder exstrophy, and it may also be helpful for planning early surgery following delivery.
  Ultrasound in Obstetrics and Gynecology 07/2009; 33(6):716-9. · 3.01 Impact Factor
• Article: Beckwith-Wiedemann syndrome in association with posterior hypoplasia of the cerebellar vermis.

  C Bui, O Picone, A E Mas, J M Levaillant, O Ami, I Netchine, R Frydman, M V Senat
  Prenatal Diagnosis 07/2009; 29(9):906-7. · 2.11 Impact Factor
• Article: Prenatal diagnosis of a spontaneous dural sinus thrombosis.

  G Legendre, O Picone, J M Levaillant, J Delavaucoupet, A Ozanne, R Frydman, M V Senat
  Prenatal Diagnosis 06/2009; 29(8):808-13. · 2.11 Impact Factor
• Article: A 2-year study on cytomegalovirus infection during pregnancy in a French hospital.

  O Picone, C Vauloup-Fellous, A-G Cordier, I Parent Du Châtelet, M-V Senat, R Frydman, L Grangeot-Keros
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  ABSTRACT: To evaluate the proportion of pregnant women agreeing to cytomegalovirus (CMV) serologic screening. To collect data on CMV infection during pregnancy. Prospective study. During two years, all pregnant women were informed on CMV infection. If the patient agreed, serological testing was performed around 12 weeks of gestation (WG) and, if negative, redone around 36 WG. Four thousand two hundred and eighty-seven pregnant women followed from 12 weeks to delivery. If the first CMV serologic test was negative, detailed hygiene information was given to the parents. Diagnosis of primary infection was based on the detection of CMV-G, CMV-M and low CMV-G avidity index. When maternal infection was confirmed, diagnosis of CMV congenital infection was done in the newborns by urine culture within the three days following birth. Crude infection-rate data consisted of the number of CMV infection cases and person-time units for both exposed to hygiene CMV information (12 to 36 WG) and unexposed pregnant women (first 12 WG). Rate of CMV seropositive and seronegative women. Rate of women agreeing for screening. Rate of primary infection. Rate of seroconversion. Number of CMV-infected newborns. Among the 4287 women followed, 3792 were either seronegative or with an unknown immune status. 96.7% out of them agreed for screening. 53.2% were initially CMV-specific IgG negative. Primary infection was detected in nine women between 0 and 12 WG (0.46%) and seroconversion was diagnosed in five women between 12 and 36 WG (0.26%) (mid P = 0.02, 95% CI [1.07-13.6]). If clear information on CMV infection during pregnancy is given, patients frequently agree to screening. The rate of seroconversion after information, observed in this study, is low after counselling.
  BJOG An International Journal of Obstetrics & Gynaecology 06/2009; 116(6):818-23. · 3.41 Impact Factor
• Article: [Management of antenatal fetal abdominal tumors. Clues for the diagnosis of a congenital mesoblastic nephroma].

  C Boithias, H Martelli, K-D Destot-Vong, F Dugelay, S Branchereau, M Fabre, M-V Senat, P Boileau, R Frydman, O Picone
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  ABSTRACT: The prenatal diagnosis of abdominal mass poses the problem of its origin. Renal tumors are rarer than neuroblastoma but they are most often congenital mesoblastic nephroma. The congenital mesoblastic nephroma has a good forecast in spite of a sonographic impressive aspect. MRI can help to locate tumor but cannot tell difference between the different kinds of renal tumor. Prenatal forecast is especially linked with hydramnios and hydrops fetalis. Histolological study of the tumor is important for the prognosis. Two morphological subtypes are currently distinguished: the classic type with a good forecast and the atypical or cellular type. Distant metastases have been related only to the cellular form but especially in infants aged more than 3 months and never in the newborns. The diagnosis of the tumor does not change the mode of delivery except in case of an important volume. Complications are searched during the first days of life: hypertension, hypercalcemia, vomiting, hyperreninemia. Radical nephrectomy is performed after the end of the first week. In case of a classic form, the healing is always obtained. In case of cellular form, distant metastases are searched. In any rate, the follow-up is recommended until the end of the growth.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 05/2009; 38(4):277-85. · 0.42 Impact Factor
• Article: Prenatal diagnosis of a patent urachus cyst with the use of 2D, 3D, 4D ultrasound and fetal magnetic resonance imaging.

  F Fuchs, O Picone, J M Levaillant, M Mabille, A E Mas, R Frydman, M V Senat
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  ABSTRACT: Patent urachus cyst is a rare umbilical anomaly, which is poorly detected prenatally and frequently confounded with pseudo bladder exstrophy or omphalocele. A 27-year-old woman was referred to our prenatal diagnosis centre at 18 weeks of gestation after diagnosis of a megabladder and 2 umbilical cord cysts. Subsequent 2D, 3D and 4D ultrasound examinations and fetal magnetic resonance imaging (MRI) revealed a typical umbilical cyst and an extra-abdominal cyst, communicating with the vertex of the fetal bladder through a small channel that increased in size when the fetus voided urine. Termination of pregnancy occured at 31 weeks because of associated cerebral septal agenesis, and autopsy confirmed the prenatal diagnosis of urachus cyst. Few cases of urachus cyst diagnosed prenatally are reported in literature, but none were associated with other extra-abdominal disorders and none used 3D, 4D and fetal MRI. Our case illustrated the efficiency in prenatal diagnosis of 3D and 4D ultrasound examinations. This could help pediatrician surgeons to explain to a couple about neonatal surgical repair and plastic reconstruction in the prenatal period.
  Fetal Diagnosis and Therapy 12/2008; 24(4):444-7. · 1.05 Impact Factor
• Article: Prenatal features of a fetal frontal hemangioma assessed by 3D ultrasound and color Doppler imaging.

  P Capmas, J M Levaillant, R Frydman, M V Senat, O Picone
  Prenatal Diagnosis 12/2008; 28(11):1077-9. · 2.11 Impact Factor
• Article: [Cervical cerclage in 2008].

  F Fuchs, M-V Senat, A Gervaise, X Deffieux, E Faivre, R Frydman, H Fernandez
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  ABSTRACT: Cervical cerclage is a common surgical technique that has been used for more than 50 years to prevent preterm deliveries and in the management of a threatened second trimester loss. However, it remains one of the most controversial interventions in obstetrics and this is probably due to difficulties in diagnosing cervical insufficiency, which is based on a history of recurrent second trimester loss or early preterm delivery following painless cervical dilatation in the absence of contractions or bleeding. This article reviews in 2008 the current literature regarding the efficacy of elective cerclage, ultrasound-indicated cerclage, emergency cerclage, and cervico-isthmic cerclage for singletons and multiple pregnancies.
  Gynécologie Obstétrique & Fertilité 11/2008; 36(11):1074-83. · 0.52 Impact Factor
• Article: Prenatal diagnosis of a rare skeletal dysplasia by ultrasound and scan tomography: atelosteogenesis III (AO III). Correlation with autopsy.

  A G Cordier, M Mabille, A L Delezoide, G Chambon, R Frydman, M V Senat, O Picone
  Prenatal Diagnosis 10/2008; 28(10):975-7. · 2.11 Impact Factor
• Article: Maternal varicella infection during pregnancy in a vaccinated patient.

  O Picone, C Vauloup-Fellous, M V Senat, R Frydman, L Grangeot-Keros
  Prenatal Diagnosis 10/2008; 28(10):971-2. · 2.11 Impact Factor
• Article: [Teaching physician-patient relationship using role-play in obstetrics and gynecology].

  X Deffieux, E Faivre, R Frydman, M-V Senat
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  ABSTRACT: The aim of this study was to report our experience concerning a role-playing approach for the teaching of physician-patient relationship. The role-playing two-day course was designed to be highly interactive for a small group (ten participants). Opinions were gathered by an anonymous structured questionnaire (ten questions) completed by the participants and focused on their view of the play role and the physician-patient relationship. The opinions of the participants were highly positive; all appreciated the courses. The strong emotional involvement was considered beneficial for all of them, sharing emotional aspects of the profession, and usefulness in clarifying opinions on the physician-patient relationship. The positive opinions recorded during this experience suggest the benefit of implementing non-conventional educational approaches, such as role-play, to highlight the relative importance of physician-patient relationship in obstetrics and gynecology.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 06/2008; 37(3):291-8. · 0.42 Impact Factor