Olivier Irion's research while affiliated with University of Geneva and other places

Publications (228)

Article
(Int J Obstet Anesth. 2020;41:83–103) Both epidural (EP) and combined spinal-epidural (CSE) techniques are used to establish effective labor analgesia. Over time, the latter has gained popularity due to faster onset of pain relief and superior sacral nerve coverage. The addition of opioids in neuraxial labor analgesia allows for lower concentration...
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Background: Studies report an increased risk of maternal and fetal adverse side effects when combined spinal-epidural, rather than standard epidural, analgesia is provided for labour and delivery. Intrathecal opioids used with local anaesthetic in combined spinal-epidural analgesia may be a cause. It is not known whether this is due to the additio...
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Background: Migrant mothers in developed countries often experience more complicated pregnancy outcomes and less fewer women access preventive gynecology services. To enlighten health care providers to potential barriers, the objective of this paper is to explore barriers to reproductive health services in Geneva described by migrant women from a...
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Preeclampsia is associated with increased cardiovascular and renal risk. The aim of this prospective cohort study was to characterize the early postpartum blood pressure (BP) profile after preeclampsia. We enrolled 115 women with preeclampsia and 41 women with a normal pregnancy in a prospective cohort study. At 6 to 12 week postpartum, we assessed...
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Out-of-hospital delivery is rare in Switzerland and it accounted for 2,5 % of all the births in 2015. In Switzerland, out-of-hospital childbirth is not subject to any official regulations. It takes place mainly in midwifery units (1,6 %) and at home (0,9 %), by independent midwifes. One in six women needs to be transferred to a hospital because of...
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Background According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insur...
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Objective: To evaluate the reliability of a four-level triage scale for obstetrics and gynaecology emergencies and to explore the factors associated with an optimal triage. Design: Thirty clinical vignettes presenting the most frequent indications for obstetrics and gynaecology emergency consultations were evaluated twice using a computerised si...
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Introduction: Reproductive health (RH) disparities have been described between migrants and the Swiss population. The study COMIRES (COmmunity MIgrant RESearch) aims to understand barriers to RH services for migrant women and the role of the community using a community-participatory approach. Methods: Between July 2014 and June 2015, 13 focus group...
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Obstetric medicine is a specialty that addresses maternal health and medical complications during pregnancy. This emerging specialty responds to the increasing need for specialized intervention in cases of high risk pregnancies, at a time when pregnancies can occur at more advanced ages and where advances in therapeutics now allow to consider pregn...
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Background: Comparing microbiologic and inflammatory markers of periodontitis with those of preterm birth (PTB). Methods: Secondary analysis of a prior prospective case-control study done at the Geneva University Hospitals. Cases were women delivering at 22-34 6/7 weeks (early PTB, n=30) and controls were women delivering at ≥ 37 weeks (term delive...
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The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the...
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Introduction: Migrant women in Switzerland have poorer reproductive health (RH) outcomes than Swiss-women. The study COMIRES (COmmunity MIgrant RESearch) based at the Department of Obstetrics and Gynaecology, University Hospital of Geneva, aims to understand barriers to RH services for migrant women and the role of the community. Methods: Between J...
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Objectives: To evaluate the number of misoprostol tablets needed to obtain a Bishop score (BS) ≥ 6 or a significant cervical change (≥2 points in BS) during cervical ripening. Methods: Retrospective study of women with term singleton pregnancies and a BS < 6 taking oral misoprostol (20 μg first 2 doses followed by 40 μg every 2 h) for cervical ripe...
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To evaluate the percentage of women with female genital mutilation/cutting who request postpartum reinfibulation, and to assess outcomes after specific care and counseling. A retrospective review was undertaken of consecutive medical files of immigrant women with FGM/C who attended a center in Geneva, Switzerland, between April 1, 2010, and Januar...
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Background: Choice of delivery route after previous cesarean delivery can be difficult because both trial of labor after cesarean delivery and elective repeat cesarean delivery are associated with risks. The major risk that is associated with trial of labor after cesarean delivery is uterine rupture that requires emergency laparotomy. Objective:...
Chapter
Background: Women with a suspected large-for-dates fetus or a fetus with suspected macrosomia (birthweight greater than 4000 g) are at risk of operative birth or caesarean section. The baby is also at increased risk of shoulder dystocia and trauma, in particular fractures and brachial plexus injury. Induction of labour may reduce these risks by de...
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Background Many medical research projects encounter difficulties. The objective of this study was to assess the self-reported frequency of difficulties encountered by medical researchers while conducting research and to identify factors associated with their occurrence. Methods The authors conducted a cross-sectional survey in 2010 among principal...
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Objective: Recommendations in Switzerland on screening for gestational diabetes endorse the International Association of Diabetes in Pregnancy Study Group consensus. As universal testing is time consuming and glucose loading is unpleasant, the recommendations include a simplification, not performing the glucose loading in women with fasting glycae...
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Background: Cytomegalovirus (CMV) is the most frequent cause of congenital infection and commonly associated with sensorineural deficit. At present, there is neither prophylaxis nor treatment during pregnancy. The objective of this study was to evaluate the level of awareness regarding CMV infection and its consequences in women delivering at the U...
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Objective: Threatened preterm labor (tPTL) is a complication of pregnancy. Identification of women and clinical definition differs between countries. This study investigated differences in tPTL and effectiveness of vaginal progesterone to prevent preterm birth (PTB) between two countries. Methods: Secondary analysis of a randomized controlled tr...
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The presence of uterine contractions and a short cervix at less than 37 weeks of gestation (preterm labor) is an important risk factor for a preterm birth. Currently, there is not treatment able to reduce the risk of preterm birth in this high risk group of women. Vaginal progesterone has been shown to be effective in reducing the risk of preterm b...
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Objective: To study the obstetric outcomes of women attending a specialized clinic for women with female genital mutilation (FGM). Methods: The medical charts of women with FGM who consecutively attended a specialized clinic between 2010 and 2012 were reviewed retrospectively. The present study focused on women attending for obstetric reasons. T...
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The increasing rate of caesarean delivery is a worldwide concern. A major contributor to this evolution has been a concomitantly decline in vaginal birth after caesarean, because of the risk of intrapartum uterine rupture, which is a rare but potentially catastrophic complication of a trial of labour after caesarean (TOLAC). On the other hand, elec...
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Key Clinical Message Nontherapeutic female genital modifications can cause short‐ and long‐term consequences. Caregivers should promote women's self knowledge on genitals' anatomy and physiology, and psychophysical and sexual health. They should also inform on possible negative consequences of vulvar nontherapeutic alterations requested and avoid t...
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Macrosomia can increase risk of operative vaginal delivery, perineal trauma, shoulder dystocia, and other neonatal morbidities. To reduce these risks, patients can either elect for cesarean delivery or induction of labor that will prevent further fetal growth. In regard to the latter strategy, previous studies have reported increased risk of cesare...
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Preeclampsia is a pregnancy-related syndrome, which still represents one of the major causes of maternal-fetal mortality and morbidity. Diagnosis can be made difficult due to the complexity of the disorder and its wide spectrum of clinical manifestations. In order to provide an efficient diagnostic tool to the clinician, medical societies regularly...
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Macrosomic fetuses are at increased risk of shoulder dystocia. We aimed to compare induction of labour with expectant management for large-for-date fetuses for prevention of shoulder dystocia and other neonatal and maternal morbidity associated with macrosomia. We did this pragmatic, randomised controlled trial between Oct 1, 2002, and Jan 1, 2009,...
Article
Objective: To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. Design: Multicentre, randomised, double-blind, placebo-controlled trial. Setting: Twenty-nine centres in Switzerland and Argentina. Population: A total of 385 women with preterm labour (24(0/7) to 33...
Article
Objective To investigate missed opportunities for diagnosing female genital mutilation (FGM) at an obstetrics and gynecology (OB/GYN) department in Switzerland. Methods In a retrospective study, we included 129 consecutive women with FGM who attended the FGM outpatient clinic at the Department of Gynecology and Obstetrics at the University Hospita...
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Objective: To evaluate the efficacy of the hands and knees position during the first stage of labour to facilitate the rotation of the fetal head to the occiput anterior position. Design: Randomised controlled trial. Setting: Geneva University Hospitals, Switzerland. Population: A total of 439 women with a fetus in the occiput posterior posi...
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Tocolysis is an important treatment in the improvement of outcome in preterm labor and preterm birth, provided that its use follows clear evidence-based recommendations. In this expert opinion, the most recent evidence about efficacy and side effects of different tocolytics is being reviewed and evidence-based recommendation about diagnosis and tre...
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Glucose-regulated protein 78 (GRP78) is an endoplasmic reticulum (ER) molecular chaperone that belongs to the heat shock protein 70 family. GRP78 is also present on the cell surface membrane of trophoblastic cells, where it is associated with invasive or fusion properties of these cells. Impaired mechanism of GRP78 relocation from ER to the cell su...
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Unintended pregnancies reflect an unmet need for family planning, and are part of health disparities. Using the only database to inquire about pregnancy intention among women in Switzerland, this study examined the relationship between immigrant documentation and unintended pregnancy (UP). Among pregnant women presenting to a Swiss hospital, we com...
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Obstetrical emergencies may represent extremely critical situations with potential dramatic maternal and neonatal consequences. These situations should be managed by an effective and experienced multidisciplinary staff. Simulation allows a regular and repeated practice of these situations with no risk to patient safety and the possibility to analys...
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This study investigated the association between anxiety experienced by the mother, a request for analgesia, and the level of pain at maternity hospital admission in early labour. Anxiety levels were measured by the State-Trait Anxiety Inventory and pain was assessed using a Visual Analogue Scale. Anxiety and Visual Analogue Scale scores were compar...
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Cardiovascular diseases are the principal cause of death in women in developed countries and are importantly promoted by hypertension. The salt sensitivity of blood pressure (BP) is considered as an important cardiovascular risk factor at any BP level. Preeclampsia is a hypertensive disorder of pregnancy that arises as a risk factor for cardiovascu...
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Obstetric work generates important subjective and objective mental stress and is perceived as a physically demanding activity by obstetricians. The aim of this study was to quantify physical and mental stress levels in obstetricians at work and during leisure activities to investigate their association with overall physical activity levels and prof...
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Objective: To assess the effectiveness of hypnosis to reduce pain and facilitate external cephalic version (ECV). Design: Cohort study. Setting: Geneva University Hospitals, Switzerland. Participants: 63 women attempting ECV under hypnosis from 2010 to 2011 were compared with 122 women who received standard care from 2005 through 2008. Inte...
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To the Editor: I read with interest the article by Scherrer et al.1 This research was largely advertised in a Swiss television show, 36.9, on April 4, 2012.2 In this show, it was clearly evident that …
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Intraoperative radiotherapy (IORT) has been shown to be as effective as traditional radiotherapy in the management of early stage breast cancer. IORT is performed in a single session and consists in a single irradiation in the tumorectomy cavity. Medically assisted procreation does not seem to favor neither gynecological nor non-gynecological cance...
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This study determined whether anti-Mullerian hormone (AMH) concentration influences the time necessary to conceive a live-born child - effective time to pregnancy (eTTP) - in a population of women who conceived naturally. This is an observational study of 87 women with a planned spontaneous pregnancy resulting in a live birth. eTTP was assessed ret...
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Objectives: To evaluate the efficacy and acceptability of external cephalic version (ECV). Materials and method: From 2004 to 2008, 212 pregnant women between 34-37 weeks of gestation with fetus in breech presentation were included in a randomized clinical trial and 125 externals cephalic versions were studied. Results: A success rate of 37.6%...
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Objectives: The aims of this study were to gain a better understanding of the motivations of pregnant women utilizing moxibustion for breech presentation and to measure the impact of research results on these patients' treatment decisions regarding this alternative medicine technique. Design: The study involved a statistical analysis of two self...
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Objective: Oral iron substitution has shown to be insufficient for treatment of severe iron deficiency anemia in pregnancy. Ferric carboxymaltose is a new intravenous (i.v.) iron formulation promising to be more effective and as safe as iron sucrose. We aimed to assess side effects and tolerance of ferric carboxymaltose compared to i.v. iron sucro...
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Preeclampsia is a specific pregnancy disorder which could be due, at least in part, to impaired invasion of trophoblastic cells. Since matrix metalloproteinases (MMPs) are the predominant proteases involved in trophoblastic invasion, we investigated and compared expression of MMP-1, 2, 7, 9 and 12 of cytotrophoblastic cells (CTB) purified from pree...
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Glucose-regulated protein 78 (GRP78) is highly expressed in first trimester cytrophoblastic cells (CTBs), especially in syncytiotrophoblast (STB). However, the role of GRP78 in these cells has never been investigated. In this study, we have examined the role of GRP78 in trophoblast fusion using the Bewo choriocarcinoma cell line as a model of cytot...
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Severe hypertension is a common complication in pregnancy-associated hypertensive disorders and there is no clear consensus on which first-line antihypertensive drug to use in this setting. To determine the efficacy and safety of four antihypertensive drugs (two intravenous and two oral) in pregnant women with severe hypertension. Pilot prospective...
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To evaluate a previously described score to predict the risk of cesarean delivery after induction of labor. We conducted a multicenter prospective study among women at 36 weeks of gestation or more undergoing induction of labor in the maternity units of Geneva, Switzerland, and Novi Sad, Serbia. Before induction, we calculated the risk score for ce...
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Keywords: GRP78 Hydatidiform moles Immunohistochemistry p53 MMP-2 qPCR Objective. Hydatidiform moles, subdivided into partial moles (PM) and complete moles (CM), are abnor-mal pregnancies with a disturbed invasive behavior. We had previously shown that MMP-2 and p53 proteins are overexpressed in CM versus PM, and that in primary cytotrophoblasts p5...
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Objective: Prospective case-control study assessing the association between maternal periodontitis according to the recently issued USA and European consensus definitions and early preterm delivery (<35 weeks gestation). Cases were women delivering between 22 and 34(6/7) weeks of gestation (n = 84) and controls were women delivering at term (≥37 we...
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Antenatal maternal administration of corticosteroids has been shown to reduce morbidity and mortality rates in preterm delivery. Threatened spontaneous or medically indicated preterm delivery for maternal or fetal indications between 24 and 34 weeks of gestation with unknown fetal lung maturity status are indications for antenatal corticosteroid ad...
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During implantation, human trophoblastic cells have to proliferate, migrate and invade pregnant uterus. A natural product of cruciferous vegetables, 3,3'-diindolylmethane (DIM), is known to induce some stress response genes (such as glucose-regulated protein 78 kDa (GRP78)) and to have anti-invasive and pro-apoptotic effects on tumor cells. Therefo...
Article
Preeclampsia (PE) is a pathology of pregnancy which represents the main cause of maternal and perinatal morbidity and mortality. Defective placentation is the first event of this pathology. The purpose of this study was to identify the proteins secreted by cytotrophoblastic cells (CTB) using proteomic approach that are associated with PE. Compariso...
Article
Hydatidiform moles, subdivided into partial moles (PM) and complete moles (CM), are abnormal pregnancies with a disturbed invasive behavior. We had previously shown that MMP-2 and p53 proteins are overexpressed in CM versus PM, and that in primary cytotrophoblasts p53 protein is stabilized by complexing to the 78kDa glucose-regulated protein (GRP78...
Article
Full-text available
Preeclampsia (PE) is a pathology of pregnancy which represents the main cause of maternal and perinatal morbidity and mortality. Defective placentation is the first event of this pathology. The purpose of this study was to identify the proteins secreted by cytotrophoblastic cells (CTB) using proteomic approach that are associated with PE. Compariso...
Article
Background: Mechanical methods were the first methods developed to ripen the cervix and induce labour. During recent decades they have been substituted by pharmacological methods. Potential advantages of mechanical methods, compared with pharmacological methods, may include simplicity of preservation, lower cost and reduction of the side effects....
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Full-text available
Preeclampsia (PE) is a pathology of pregnancy which represents the main cause of maternal and perinatal morbidity and mortality. Defective placentation is the first event of this pathology. The purpose of this study was to identify the proteins secreted by cytotrophoblastic cells (CTB) using proteomic approach that are associated with PE. Compariso...
Article
Because of the lack of screening methods, ovarian cancer remains one of the major causes of mortality in gynecological oncology. Prevention by salpingectomy, based on a concept about the origin of serous carcinoma, may be proven effective in the future. Regarding cervical cancer, screening methods are improving and the benefit of HPV-HR testing has...
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Die ersten Empfehlungen zur Betreuung von Frühgeborenen an der Grenze der Lebensfähigkeit in der Schweiz wurden im Jahre 2002 veröffentlicht1). Als Grundlage dienten damals unter anderem Empfehlungen europäischer2), 3) und kanadischer Fachgruppen4), sowie die relevanten edizinischethischen Richtlinien der Schweizerischen Akademie der Medizinischen...
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Umbilical cord blood (UCB) is a source of hematopoietic stem cells that initially was used exclusively for the hematopoietic reconstitution of pediatric patients. It is now suggested for use for adults as well, a fact that increases the pressure to obtain units with high cellularity. Therefore, the optimization of UCB processing is a priority. The...
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Clin Microbiol Infect 2011; 17: 1786–1791 Group B streptococcus (GBS) is a leading cause of infectious neonatal morbidity and mortality. Timely and accurate identification of colonized mothers is imperative so that antibioprophylaxis can be implemented during labour to reduce the risk of neonatal sepsis. We planned our study to analyse the diagnost...