Y Ville

Université René Descartes - Paris 5, Lutetia Parisorum, Île-de-France, France

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Publications (572)1859.94 Total impact

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    ABSTRACT: Évaluer les résultats du dépistage de la trisomie 21 par le risque combiné du 1er trimestre (tel qu’il a été défini par l’arrêté du 23 juin 2009) dans la structure Prima facie.
    No preview · Article · Dec 2015 · Gynécologie Obstétrique & Fertilité

  • No preview · Article · Dec 2015
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    ABSTRACT: Background: Evaluation of trainee's ability in obstetrical ultrasound is a time-consuming process, which requires involving patients as volunteers. With the use of obstetrical ultrasound simulators, virtual reality could help assessing competency and evaluating trainees in this field. Objective: To test the validity of an obstetrical ultrasound simulator as a tool for evaluating trainees following structured training by comparing scores obtained on obstetrical ultrasound simulator to those obtained on volunteers, and by assessing correlations between scores of images and of dexterity given by two blinded examiners. Study design: Trainees, taking the 2013 French national exam for the practice of Obstetrical Ultrasound were asked to obtain standardized ultrasound planes both on volunteer pregnant women and on obstetrical ultrasound simulator. These planes included measurements of biparietal diameter, abdominal circumference, femur length, as well as reference planes for cardiac 4-chamber and outflow tracts, kidneys, stomach/diaphragm, spine and face. Images were stored and evaluated subsequently by two national examiners who scored each picture according to previously established quality criteria. Dexterity was also evaluated and subjectively scored between 0 and 10. The Raghunathan's modification of Pearson, Filon's z, Spearman's rank correlation and Anova tests were used to assess correlations between the scores by the two examiners, scores of dexterity and also to compare the final scores between the 2 different methods. Results: We evaluated 29 trainees. The mean dexterity scores in simulation (6.5+/-2.0) and real examination (5.9+/-2.3) were comparable (P = 0.31). Scores with obstetrical ultrasound simulator were significantly higher than those obtained on volunteers (P = 0.027). Nevertheless, there was a good correlation between scores of the 2 examiners judging on simulation (R = 0.888) and on volunteers (R = 0.873), (P = 0.81). Conclusions: Obstetrical ultrasound simulator is as good a method as volunteer-based examination for evaluating practical skills in trainees following structured training in obstetrical ultrasound. The threshold for success/failure should however be adapted, as candidates obtain higher scores on the simulator. Advantages of the obstetrical ultrasound simulator include absence of location and time constraints without the need to involve volunteers or to interfere with the running of ultrasound clinics. However obstetrical ultrasound simulator still lacks the ability to evaluate the trainees' ability to interact with patients.
    No preview · Article · Nov 2015 · American journal of obstetrics and gynecology
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    ABSTRACT: Background: Suprasellar arachnoid cysts (SAC) represent between 9% and 21% of pediatric arachnoid cysts. Recent improvements in magnetic resonance imaging, as well as increasing prenatal diagnosis, have allowed more precise knowledge and follow-up. Objective: To describe a novel classification of SAC. Methods: We present 35 cases of SAC treated between 1996 and 2014. Patient records and imaging studies were reviewed retrospectively to assess symptomatology, radiological findings, treatment, and long-term follow-up. Results: Fourteen SAC were diagnosed prenatally (39%). We observed 15 (43%) cases presenting hydrocephalus (SAC-1) removing Liliequist membrane downward. Lower forms (SAC-2) with free third ventricle were observed in 11 (31%) cases. Asymmetrical forms (SAC-3) with Sylvian or temporal extension were seen in the 9 (26%) remaining patients. Twenty-three (66%) patients were treated by ventriculocisternostomy, 3 (8.5%) by shunt surgery, and 3 (8.5%) by craniotomy. Six (17%) patients had no surgery, including 5 cases (14%) that had prenatal diagnosis. Outcomes were initially favorable in 26 cases (87%). Eight (22%) patients had endocrine abnormalities at the end of the follow-up, 3 (8.5%) had developmental delay, and 6 (17%) had minor neuropsychological disturbances. Conclusion: SAC are heterogeneous entities. SAC-1 may come from an expansion of the diencephalic leaf of the Liliequist membrane. SAC-2 show a dilatation of the interpeduncular cistern and correspond to a defect of the mesencephalic leaf of the Liliequist membrane. SAC-3 correspond to the asymmetrical forms expanding to other subarachnoid spaces. Surgical treatment is not always necessary. The recognition of the different subtypes will allow choosing the best treatment option. Abbreviations: CSF, cerebrospinal fluidMRI, magnetic resonance imagingSAC, suprasellar arachnoid cystsVC, ventriculostomyVCC, ventriculocystocisternostomy.
    No preview · Article · Oct 2015 · Neurosurgery
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    M. Hermann · J. Bernard · Y. Ville · L.J. Salomon

    Preview · Article · Sep 2015 · Ultrasound in Obstetrics and Gynecology

  • No preview · Article · Sep 2015 · Journal of Clinical Virology
  • 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.
    No preview · Article · Oct 2014 · Ultrasound in Obstetrics and Gynecology
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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.
    No preview · Article · Sep 2014 · Gynécologie Obstétrique & Fertilité

  • No preview · Article · Sep 2014 · Ultrasound in Obstetrics and Gynecology
  • 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.
    No preview · Article · Jun 2014 · Journal de Gynécologie Obstétrique et Biologie de la Reproduction
  • S. Seshadri · Y. Ville · U. Ram · I Suresh · M. Essaoui · A. Ibrahim

    No preview · Article · Apr 2014 · BJOG An International Journal of Obstetrics & Gynaecology
  • 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.
    No preview · Article · Feb 2014 · Journal de Gynécologie Obstétrique et Biologie de la Reproduction
  • Y. Ville · L.J. Salomon · N. Fries

    No preview · Article · Dec 2013 · Journal de Gynécologie Obstétrique et Biologie de la Reproduction
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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.
    No preview · Article · Dec 2013 · Ultrasound in Obstetrics and Gynecology
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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
    No preview · Article · Nov 2013 · Ultrasound in Obstetrics and Gynecology

  • No preview · Article · Nov 2013 · Journal of Minimally Invasive Gynecology
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    Full-text · Article · Oct 2013 · Ultrasound in Obstetrics and Gynecology
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    Full-text · Article · Oct 2013 · Ultrasound in Obstetrics and Gynecology
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    Preview · Article · Oct 2013 · Ultrasound in Obstetrics and Gynecology
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    Full-text · Article · Oct 2013 · Ultrasound in Obstetrics and Gynecology

Publication Stats

6k Citations
1,859.94 Total Impact Points

Institutions

  • 2008-2015
    • Université René Descartes - Paris 5
      • Faculty of medicine
      Lutetia Parisorum, Île-de-France, France
  • 2010-2013
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-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
  • 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
  • 1999
    • Royal Brompton and Harefield NHS Foundation Trust
      Harefield, England, United Kingdom
  • 1995-1999
    • The Fetal Medicine Foundation
      Londinium, England, United Kingdom
    • Asklepios Klinik Barmbek
      Hamburg, Hamburg, Germany
  • 1998
    • George Eliot Hospital NHS Trust
      Nuneaton, England, United Kingdom
    • St George Hospital
      Sydney, New South Wales, Australia
  • 1992-1998
    • Hôpital Antoine-Béclère – Hôpitaux universitaires Paris-Sud
      Clamart, Île-de-France, France
    • The Peninsula College of Medicine and Dentistry
      Plymouth, England, United Kingdom
  • 1994-1996
    • King's College London
      • • School of Medicine
      • • Division of Asthma, Allergy and Lung Biology
      Londinium, England, United Kingdom
  • 1992-1996
    • International Centre of Medical Research of Franceville
      Franceville, Haut-Ogooué, Gabon
  • 1994-1995
    • King's College Hospital NHS Foundation Trust
      • Department of Obstetrics and Gynaecology
      Londinium, England, United Kingdom