
Philippe KadhelUniversity of French West Indies - University Hospital Center of Guadeloupe · Gynecology and Obstetrics
Philippe Kadhel
MD, PhD
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Publications (88)
Background:
Chlordecone is a highly persistent organochlorine insecticide that was intensively used in banana fields in the French West Indies, resulting in a widespread contamination. Neurotoxicity of acute exposures in adults is well recognized, and empirical data suggests that prenatal exposure affects visual and fine motor developments during...
Background:Chlordecone is a highly persistent organochlorine insecticide that was intensively used in banana fields in the French West Indies, therefore resulting in a widespread contamination of soils, water sources and foodstuff. Neurotoxicity of acute exposures in adults is well recognized, and empirical data suggests that prenatal exposure affe...
Background
Exposure to persistent environmental organic pollutants may contribute to the development of obesity among children. Chlordecone is a persistent organochlorine insecticide with estrogenic properties that was used in the French West Indies (1973–1993) and is still present in the soil and the water and food consumed by the local population...
Background
Chlordecone is an endocrine-disrupting chemical with well recognized estrogenic and progestagenic properties. This organochlorine insecticide was extensively used in the French West Indies from 1973 to 1993 to control the banana root borer. Due to its poor degradation in the environment, permanently polluted soil is responsible for the c...
Background
In the French Territories in the Americas (FTA), the risk of birth defects possibly associated with Zika virus (ZIKV) infection was 7.0% (95%CI: 5.0 to 9.5) among foetuses/infants of 546 women with symptomatic RT-PCR confirmed ZIKV infection during pregnancy. Many of these defects were isolated measurement-based microcephaly (i.e. withou...
Chlordecone was used intensively as an insecticide in the French West Indies. Because of its high persistence, the resulting contamination of food and water has led to chronic exposure of the general population as evidenced by its presence in the blood of people of Guadeloupe, in particular in pregnant women and newborns, and in maternal breast mil...
Chlordecone is an organochlorine pesticide that was extensively used to control the banana root borer population in the French West Indies until 1993. Its persistence in soil has led to widespread pollution of the environment, and human beings, including pregnant women, are still exposed to this chemical. High levels of exposure to chlordecone duri...
Desert dust transported from the Sahara to the Caribbean generates peak exposures to particulate matter ≤ 10 μm (PM10). We investigated the impact of dust episodes on severe small for gestational-age births in Guadeloupe. The study sample consisted of 911 pregnant women enrolled in the Timoun mother-child cohort. Desert dust exposure was assessed t...
Recent evidence suggests that prenatal exposure to chlordecone, a persistent organochlorine pesticide that was used intensively in the French West Indies, affects infant neurodevelopment. The aim of the present study was to evaluate the association between prenatal and postnatal chlordecone exposures on visual contrast sensitivity in 285 children a...
Background:
Uterine leiomyoma has been reported to be a worse problematic disease for African American than Caucasian women in the US. Data are almost non-existent for other populations of African ancestry. Our aim was to investigate the hypothesis of an equivalent influence of ethnicity on uterine leiomyomas for women of a French African-Caribbea...
Background
In the French Territories in the Americas (FTA), the risk of birth defects possibly associated with Zika virus (ZIKV) infection was estimated at 7% among fetuses/infants in a cohort of 546 women who developed a symptomatic RT-PCR confirmed ZIKV infection during pregnancy (NEJM 2018;378:985–94). There was no concomitant prospective cohort...
Introduction
Dans les Territoires Français d’Amérique (TFA), le risque d’anomalies congénitales associées à une infection à virus Zika (ZIKV) a été estimé à 7 % des enfants/fœtus dans une cohorte de 546 femmes ayant présenté une infection symptomatique à ZIKV confirmée par RT-PCR (NEJM 2018 ;378 :985). Comme nous ne disposions pas de cohorte de fem...
Objectives
Large amounts of mineral dust are transported from their African sources in the Saharan-Sahel region to the Caribbean Sea, generating peak exposures to particulate matter ≤10 µm (PM 10 ). This study aimed to investigate the impact of Saharan dust episodes on preterm births in the Guadeloupe archipelago.
Methods
The study population cons...
( N Engl J Med 2018;378:985–994)
It is well recognized that Zika virus (ZIKV) infection during pregnancy can cause severe birth defects. Fortunately, the presence of centralized maternal care facilities in French territories in the Americas (French Guiana, Guadeloupe, and Martinique) allowed for enhanced surveillance of all pregnancies during the 2...
Background: Chlordecone (Kepome) is an organochlorine insecticide that was intensively used in banana fields in the French West Indies, therefore resulting in a widespread contamination of soils, water sources and foodstuff. Despite its proven neurotoxicity at acute exposures, data on its potential neurotoxicity at low exposures in human population...
Background:
The risk of congenital neurologic defects related to Zika virus (ZIKV) infection has ranged from 6 to 42% in various reports. The aim of this study was to estimate this risk among pregnant women with symptomatic ZIKV infection in French territories in the Americas.
Methods:
From March 2016 through November 2016, we enrolled in this p...
Background:
Mass breast cancer screening is offered to French women between the ages of 50 and 74. In the French overseas department of Guadeloupe, where the population is of mostly African ancestry, a low age at diagnosis of breast cancer has been reported, as for African-Americans. This raises the question of whether breast cancer is more aggres...
The unexpected diagnosis of a leiomyosarcoma from a surgical specimen of a presumed leiomyoma is rare, but with deleterious consequences, especially if morcellation techniques are used. There are currently no effective methods for such a preoperative diagnosis. Ulipristal acetate has demonstrated efficacy for the preoperative treatment of leiomyoma...
Background:
Geographical disparities in breast cancer incidence and outcomes are reported worldwide. Women of African descent show lower incidence, higher mortality rates and earlier age of onset. We analyzed data from the cancer registry of Guadeloupe for the period 2008-2013.
Methods:
We describe breast cancer characteristics by molecular subt...
The seasonal patterns of conceptions and births differ between geographic areas. Several potential determinants of this variation have been identified, including biological, environmental and behavioral elements, but festive events are rarely mentioned. We investigated the possible association between the carnival and seasonal fertility variations...
Parameter Estimates for conceptions in the University Hospital of Guadeloupe (French West Indies): 2007–2010.
a Estimates and standard errors from a binomial negative regression model, adjusted to mean weekly temperature, mean weekly precipitation and mean weekly hours of sunshine.
(DOCX)
Parameter Estimates for births in Guadeloupe (French West Indies): 2000–2011.
a Estimates and standard errors from a binomial negative regression model, adjusted to mean weekly temperature, mean weekly precipitation and mean weekly hours of sunshine.
(DOCX)
Daily meteorological parameters during the carnival period in Guadeloupe (French West Indies): 2000–2011.
a Data were provided by Météo-France services. b For differences in means (Student’s t test).
(DOC)
Patients frequently ask about the cause of their breast cancer. To answer, physicians refer to breast cancer risk factors based on medical reports. We aim to assess these risk factors for the point of view of survivors, a point of view which seems to differ from that of medical references. We ran a survey with open- and closed-ended questionnaires...
Background:
Chlordecone is a persistent organochlorine insecticide with well-defined estrogenic properties. It was intensively used in the French West Indies until 1993 to control the banana root borer. Because of the long-term contamination of soils and water, the population is currently exposed to chlordecone through food consumption. Chlordecon...
Aim:
The global increase in the rate of cesarean sections (CS) is currently an issue. We aimed to assess the rate of CS locally and to identify cases in which this procedure may have been avoidable.
Methods:
In this prospective consecutive series, we analyzed the 478 CS carried out in our unit in 2009. We analyzed the characteristics of each cas...
The intensive use of chlordecone (an organochlorine insecticide) in the French West Indies until 1993 resulted in a long-term soil and water contamination. Chlordecone has known hormonal properties and exposure through contaminated food during critical periods of development (gestation and early infancy) may affect growth.
We aimed to assess the im...
Chlordecone (Kepone) is an organochlorine insecticide that has been used as insecticide and fungicide. In the French West Indies, Guadeloupe and Martinique, it was intensively applied to banana fields from 1973 to 1993 to control root borers. This pesticide undergoes no significant biotic or abiotic degradation in the environment and is still prese...
Perinatal exposure to endocrine-disrupting chemicals may affect thyroid hormones homeostasis and impair brain development. Chlordecone, an organochlorine insecticide widely used in the French West Indies has known estrogenic and progestin properties, but no data is available, human or animal, on its action on thyroid hormone system.
Our aim was to...
Purpose:
Vaginal cesarean section is a uterine incision technique derived from Dührssen's incision, with which it is sometimes confused. We report here our experience over 10 years with this technique, with the aim of defining the situations in which it is potentially useful.
Methods:
We retrospectively analyzed 24 cases of vaginal cesarean sect...
The objective of this retrospective study is to compare two types of antimicrobial management used to treat premature rupture of membranes in pregnancy. This study evaluates both duration and the type of antibiotic therapy used for treatment.
Recent studies suggest that a Mediterranean dietary pattern during pregnancy may influence pregnancy outcomes. The aim of this study was to evaluate the effect of adherence to a Mediterranean diet (MD) during pregnancy on fetal growth restriction (FGR) and preterm delivery (PTD) in a French Caribbean island where the population is largely of Africa...
Objective
The objective of this retrospective study is to compare two types of antimicrobial management used to treat premature rupture of membranes in pregnancy. This study evaluates both duration and the type of antibiotic therapy used for treatment.
Patients and methods
The antimicrobials used to treat premature rupture of membranes include a f...
Few studies have explored the consequences of environmental exposure to organochlorine pesticides for gestational hypertension (GH), preeclampsia (PE) and gestational diabetes mellitus (GDM). Chlordecone is a persistent organochlorine pesticide that was used intensively, and almost exclusively, in the French West Indies until 1993. We investigated...
Based on US national cancer registry data, age differences at breast cancer diagnosis have been reported between African-American women and European-American women. Such differences between populations of African and European ancestry have not been studied in other countries at a nationwide level. Here, we report and compare descriptive nationwide...
Persistent organic pollutants have not been conclusively associated with length of gestation or with preterm birth. Chlordecone
is an organochlorine pesticide that has been extensively used to control the banana root borer population in the French West
Indies. Data from the Timoun Mother–Child Cohort Study conducted in Guadeloupe between 2004 and 2...
Objectives
Medical tools to determine the imminence of unplanned out-of-hospital birth have not been validated. The main goal of this study was to analyze assessments of the imminence of these deliveries, by methods such as the Manilas score and the need to push.
Patients and methods
All calls made to the Emergency Medical Aid Service in Guadeloup...
Previous studies have been limited in reporting the association between chocolate consumption, measured by interviewer-administered questionnaire or serum theobromine, a biomarker for cocoa, and risk of preeclampsia, and have showed somewhat conflicting results.
A systematic review of observational and experimental studies will be carried out. We w...
In France, contraception is available for everybody; however, the number of abortion does not decrease, especially among young people. The aim of our study is to analyze, in the Guadeloupian context, the characteristics of underage people who ask for an abortion.
This retrospective study, analyses sociodemographic and medical characteristics of 129...
Myoma is the most common benign tumor in women of childbearing age, with a high frequency in Afro-Caribbean than in other women. Depending on their number, size and location, myomas are suspected to be a cause of infertility. Conservative treatment by myomectomy is possible for symptomatic patients wishing to preserve their fertility.
The aim of th...
Objectives
In Guadeloupe (French West Indies), fecondity rate of teenagers is higher than in mainland France. The aim of our study was to analyze sociodemographic characteristics and perinatal indicators among underage girls and to compare them to those of a previous study also conducted in our maternity unit in 1993 and 1994.
Materials and method...
Objectives
The aim of this study was to describe the typical profile, and to assess the motivations of women who underwent illegal abortion with misoprostol in Guadeloupe (French West Indies).
Materials and methods
We conducted a 1-year prospective study on women who consulted after failure or complication of an illegal abortion with misoprostol....
Objective
The aim of this study was to assess changes in the ages at which the main stages of reproductive life, including first sexual intercourse in particular, occur in Guadeloupe (French West Indies).Patients and methodsWe conducted a transverse study of three generations of men and women over the age of 20 years. We recorded age at first inter...
OBJECTIVES: In Guadeloupe (French West Indies), fecondity rate of teenagers is higher than in mainland France. The aim of our study was to analyze sociodemographic characteristics and perinatal indicators among underage girls and to compare them to those of a previous study also conducted in our maternity unit in 1993 and 1994. MATERIALS AND METHOD...
Objectives:
Medical tools to determine the imminence of unplanned out-of-hospital birth have not been validated. The main goal of this study was to analyze assessments of the imminence of these deliveries, by methods such as the Manilas score and the need to push.
Patients and methods:
All calls made to the Emergency Medical Aid Service in Guade...
Chlordecone is a persistent organochlorine pesticide that was used in the French West Indies until the early 1990s for banana weevil borer control. Human exposure to this chemical in this area still occurs nowadays due to consumption of contaminated food. Although adverse effects on neurodevelopment, including tremors and memory deficits, have been...
Objective
In France, contraception is available for everybody; however, the number of abortion does not decrease, especially among young people. The aim of our study is to analyze, in the Guadeloupian context, the characteristics of underage people who ask for an abortion.
Methods
This retrospective study, analyses sociodemographic and medical cha...
OBJECTIVES: The aim of this study was to describe the typical profile, and to assess the motivations of women who underwent illegal abortion with misoprostol in Guadeloupe (French West Indies). MATERIALS AND METHODS: We conducted a 1-year prospective study on women who consulted after failure or complication of an illegal abortion with misoprostol....
Guadeloupe is the second highest French area for diagnosis and prevalence of HIV infection and AIDS. In October 2009, the French High Health Authority has published guidelines for a more systematic HIV screening. The goal of this study is to identify the limitations in HIV testing prescription by the Guadeloupian prescribers according to these new...
There appears to be an incompressible high rate of preterm births among populations of African origin irrespective of their geographic location. The objective of this study was to assess the risk factors for preterm birth in a French Caribbean population of African descent, offered medical care comparable to that on the French mainland, but present...
Background:
The insecticide chlordecone was extensively used in the French West Indies to control banana root borer. Its persistence in soils has led to the widespread pollution of the environment, and human beings are still exposed to this chemical. Chlordecone has been shown to impair neurological and behavioural functions in rodents when expose...
The possible adverse effects of organochlorine pollutants (OPs) on human fertility are a matter of concern. Direct evaluation of the effects on female fertility was made possible by the advent of in vitro fertilization (IVF). We conducted a systematic review to assess possible associations between OP levels and selected indicators of female fertili...
The aim of the study was to assess whether HIV infection is associated with a higher risk of invasive cervical cancer (ICC).
We conducted a region-wide, population-based observational cohort study of 1232 HIV-infected women over the age of 15 years in Guadeloupe, a French Caribbean archipelago, during the period 1999-2006. The observed numbers of i...
Multiple myeloma, a hematological malignancy generally affecting elderly people, was diagnosed at the beginning of the pregnancy of a 33-year-old woman. We carried out a literature review in order to evaluate the consequences of this cancer on pregnancy and of pregnancy on multiple myeloma, as to determine the specific follow-up required.
A systema...
Chlordecone, an environmentally persistent organochlorine insecticide used intensively in banana culture in the French West Indies until 1993, has permanently polluted soils and contaminated foodstuffs. Consumption of contaminated food is the main source of exposure nowadays. We sought to identify main contributors to blood chlordecone concentratio...
The principal gynaecological cancers (breast, ovary, uterus, and cervix) account for over 40% of cancers found in women worldwide. However, large differences exist, in both their incidence and geographical distribution. The French West Indies, through their location, environment, socio-economic development, lifestyle, nutrition and the origins of t...
The term “endocrine disruptor” is now commonly used in general and scientific language. It refers to chemical substances, of human or natural origin, able to cause harmful effects in humans or animals through their hormonal properties. However, the exact definition of an endocrine disruptor remains a subject of ongoing discussion. Hormonal communic...
There is increasing evidence that reproductive abnormalities are increasing in frequency in both human population and among wild fauna. This increase is probably related to exposure to toxic contaminants in the environment. The use of sentinel species to raise alarms relating to human reproductive health has been strongly recommended. However, no s...
Pregnancy in SCD women, with a major sickle cell syndrome, is a high-risk situation and is associated with raised incidence of maternal and fetal morbidity and mortality, mainly in late pregnancy, during delivery and in the postpartal periods. Pregnancy increases the incidence of sickle cell specific complications such as anaemia, vaso-occlusive cr...
We present in this study the results of a retrospective analysis comparing a group of ongoing triplet pregnancies and a group
of triplet pregnancies reduced to twins. These two groups were managed in the same way between January 1993 and April 1996
in hospital. Mean gestational age at birth was comparable in both groups of patients. Prematurity rat...
Maternal LIF is essential for embryo implantation in mice and it may also be the case in humans. We recently reported that endometrial LIF secretion from infertile women presenting repeated failures of embryonic implantation or unexplained sterility was significantly lower than the secretion of explants from fertile women. We now report on the modu...
Background: infertility is defined as one year of unprotected coitus without conception. By artificial reproductive technology, rate of multiple pregnancy is increased to 35%. This leads to an increase in cesarean section rate, prematurity, perinatal mortality. Materials and methods: This study is designed as retrospective descriptive- analytic. Al...
To compare the perinatal outcome of IVF-ET twin pregnancies to twin pregnancies conceived spontaneously or after ovarian stimulation without IVF-ET.
Retrospective analysis.
Three groups of patients: those who conceived after IVF-ET (n = 72), after ovarian stimulation without IVF-ET (stimulation group, n = 82), or spontaneously (spontaneous group, n...
The authors report a case of pregnancy in a rudimentary horn diagnosed by laparotomy. The location could not be suspected by any clinical sign. This pregnancy stopped at 19 weeks of amenorrhoea. Any attempts of induction of labour failed. Laparotomy was necessary to assess the diagnosis and to allow the resection of the uterine horn. The authors pr...