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Cordier AG, Zerbib E, Favier A, Dabi Y, Daraï E. Value of Non-Coding RNA Expression in Biofluids to Identify Patients at Low Risk of Pathologies Associated with Pregnancy. Diagnostics (Basel) 2024; 14:729. [PMID: 38611642 PMCID: PMC11011513 DOI: 10.3390/diagnostics14070729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Pregnancy-related complications (PRC) impact maternal and fetal morbidity and mortality and place a huge burden on healthcare systems. Thus, effective diagnostic screening strategies are crucial. Currently, national and international guidelines define patients at low risk of PRC exclusively based on their history, thus excluding the possibility of identifying patients with de novo risk (patients without a history of disease), which represents most women. In this setting, previous studies have underlined the potential contribution of non-coding RNAs (ncRNAs) to detect patients at risk of PRC. However, placenta biopsies or cord blood samples are required, which are not simple procedures. Our review explores the potential of ncRNAs in biofluids (fluids that are excreted, secreted, or developed because of a physiological or pathological process) as biomarkers for identifying patients with low-risk pregnancies. Beyond the regulatory roles of ncRNAs in placental development and vascular remodeling, we investigated their specific expressions in biofluids to determine favorable pregnancy outcomes as well as the most frequent pathologies of pregnant women. We report distinct ncRNA panels associated with PRC based on omics technologies and subsequently define patients at low risk. We present a comprehensive analysis of ncRNA expression in biofluids, including those using next-generation sequencing, shedding light on their predictive value in clinical practice. In conclusion, this paper underscores the emerging significance of ncRNAs in biofluids as promising biomarkers for risk stratification in PRC. The investigation of ncRNA expression patterns and their potential clinical applications is of diagnostic, prognostic, and theragnostic value and paves the way for innovative approaches to improve prenatal care and maternal and fetal outcomes.
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Affiliation(s)
| | - Elie Zerbib
- Department of Obstetrics and Reproductive Medicine, Sorbonne University, Hôpital Tenon, 4 Rue de la Chine, 75020 Paris, France; (A.-G.C.); (Y.D.)
| | | | | | - Emile Daraï
- Department of Obstetrics and Reproductive Medicine, Sorbonne University, Hôpital Tenon, 4 Rue de la Chine, 75020 Paris, France; (A.-G.C.); (Y.D.)
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Vivanti AJ, Couffignal C, Sibiude J, Cordier AG, Tsatsaris V, Rozenberg F, Launay O, Benachi A, De Luca D, Ancel PY, Marcault E, Ville Y, Carrara J, Luton D, Dommergues M, Borie C, Kayem G, Lecomte L, Leruez-Ville M, Périllaud-Dubois C, Biran V, Manchon P, Picone O, Vauloup-Fellous C. Maternal and neonatal outcomes of French prospective multicenter cohort study COVIPREG during the first two COVID-19 waves. J Gynecol Obstet Hum Reprod 2024; 53:102764. [PMID: 38492667 DOI: 10.1016/j.jogoh.2024.102764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND SARS-CoV-2 infection on pregnant women was the subject of many questions since the COVID-19 pandemic. METHODS We aim to assess maternal and neonatal outcomes of SARS-CoV-2 infection contracted during 2nd and 3rd trimesters of pregnancy during the first two COVID-19 waves across a prospective French multicenter cohort study. Patients were included between April 2020 and January 2021 in 10 maternity hospitals in Paris area with two groups (i) pregnant women with a positive SARS-CoV-2 nasopharyngeal RT-PCR between [14WG; 37WG[(symptomatic infection), (ii) pregnant women with a negative serology (or equivocal) at delivery and without a positive SARS-CoV-2 nasopharyngeal RT-PCR at any time during pregnancy (G2 group) MAIN FINDINGS: 2410 pregnant women were included, of whom 310 had a positive SARS-CoV-2 nasopharyngeal RT-PCR and 217 between [14WG; 37WG[. Most infections occurred between 28 and 37 weeks of gestation (56 %). Most patients could be managed as outpatients, while 23 % had to be hospitalized. Among women with a positive RT-PCR, multiparous women were over-represented (OR = 2.45[1.52;3.87]); were more likely to deliver before 37 weeks of gestation (OR = 2.19[1.44;3.24]) and overall cesarean deliveries were significantly increased (OR = 1.53[1.09;2.13]). CONCLUSIONS This study highlights the maternal, obstetrical, and neonatal burden associated with SARS-CoV-2 infections during the first two pandemic waves before availability of vaccines. TRIAL REGISTRATION NCT04355234 (registration date: 21/04/2020).
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Affiliation(s)
- Alexandre J Vivanti
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, F-92140 Clamart, Université Paris-Saclay, Gif-sur-Yvette France; Groupe de Recherche sur les Infections Pendant la Grossesse (GRIG), Paris, France
| | - Camille Couffignal
- Université de Paris, F-75006 Paris, France; IAME U1137, Inserm, Université Paris Cité, Paris, France
| | - Jeanne Sibiude
- IAME U1137, Inserm, Université Paris Cité, Paris, France; Maternité, AP-HP, Hôpital Louis Mourier, F-75007 Paris, France
| | - Anne-Gael Cordier
- Groupe de Recherche sur les Infections Pendant la Grossesse (GRIG), Paris, France; Université Paris-Saclay, 91190 Gif-sur-Yvette, France; Maternité, AP-HP, Hôpital Bicêtre, F-94270 Le Kremlin-Bicêtre, France
| | - Vassilis Tsatsaris
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Cochin Port Royal, F-75007 Paris, France
| | - Flore Rozenberg
- Laboratoire de Virologie, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Odile Launay
- CIC vaccinologie, AP-HP, FHU PREMA, Hôpital Cochin, F-75014 Paris, France
| | - Alexandra Benachi
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, F-92140 Clamart, Université Paris-Saclay, Gif-sur-Yvette France
| | - Daniele De Luca
- Réanimation néonatale, AP-HP, Hôpital Antoine Béclère, F-92140 Clamart, France
| | - Pierre-Yves Ancel
- Unité de recherche clinique, CIC-Mère enfant, AP-HP, FHU PREMA, Hôpital Cochin, F-75014 Paris, France
| | - Estelle Marcault
- Unité de recherche clinique PNVS, AP-HP, Hôpital Bichat, F-75018 Paris, France
| | - Yves Ville
- Maternité, AP-HP, Hôpital Necker, F-75007 Paris, France
| | - Julie Carrara
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, F-92140 Clamart, Université Paris-Saclay, Gif-sur-Yvette France
| | | | - Marc Dommergues
- Sorbonne Université, F-75006 Paris, France; Maternité, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - Constance Borie
- Maternité, AP-HP, Hôpital Robert Debré, F-75019 Paris, France
| | - Gilles Kayem
- Maternité, AP-HP, Hôpital Trousseau, F-75012 Paris, France
| | - Laurence Lecomte
- Unité de recherche clinique, CIC-Mère enfant, AP-HP, FHU PREMA, Hôpital Cochin, F-75014 Paris, France
| | | | - Claire Périllaud-Dubois
- IAME U1137, Inserm, Université Paris Cité, Paris, France; Université Paris-Saclay, INSERM U1193, 94804 Villejuif, France
| | - Valérie Biran
- Réanimation néonatale, AP-HP, Hôpital Robert Debré, F-75019 Paris, France
| | | | - Olivier Picone
- Groupe de Recherche sur les Infections Pendant la Grossesse (GRIG), Paris, France; IAME U1137, Inserm, Université Paris Cité, Paris, France; Maternité, AP-HP, Hôpital Louis Mourier, F-75007 Paris, France
| | - Christelle Vauloup-Fellous
- Groupe de Recherche sur les Infections Pendant la Grossesse (GRIG), Paris, France; Université Paris-Saclay, INSERM U1193, 94804 Villejuif, France; Laboratoire de Virologie, AP-HP, Hôpital Paul-Brousse, F-94804 Villejuif, France.
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Dütemeyer V, Schaible T, Badr DA, Cordier AG, Weis M, Perez-Ortiz A, Carriere D, Cannie MM, Vuckovic A, Persico N, Cavallaro G, Benachi A, Jani JC. Fetoscopic endoluminal tracheal occlusion vs expectant management for fetuses with severe left-sided congenital diaphragmatic hernia. Am J Obstet Gynecol MFM 2024; 6:101248. [PMID: 38070678 DOI: 10.1016/j.ajogmf.2023.101248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/14/2023] [Accepted: 12/02/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND The treatment of fetuses with a congenital diaphragmatic hernia is challenging, but there is evidence that fetoscopic endoluminal tracheal occlusion has a benefit over expectant care. In addition, standardization and expertism have a great impact on survival and are probably crucial in centers that rely on expectant management with extracorporeal membrane oxygenation after birth. OBJECTIVE This study aimed to examine the survival and morbidity rates of fetuses with a severe isolated left-sided congenital diaphragmatic hernia who underwent fetoscopic endoluminal tracheal occlusion vs expectant management in high-volume centers. STUDY DESIGN This was a multicenter, retrospective study that included all consecutive fetuses with severe isolated left-sided congenital diaphragmatic hernia who were expectantly managed in a German center or who underwent fetoscopic endoluminal tracheal occlusion in 3 other European centers (Belgium, France, and Italy). Severe congenital diaphragmatic hernia was defined as having an observed to expected total fetal lung volume ≤35% with intrathoracic position of the liver diagnosed with magnetic resonance imaging. All magnetic resonance images were centralized, and lung volumes were measured by 2 experienced operators who were blinded to the pre- and postnatal data. Multiple logistic regression analyses were performed to examine the effect of the management strategy in the 2 groups on the short- and long-term outcomes. RESULTS A total of 147 patients who were managed expectantly and 47 patients who underwent fetoscopic endoluminal tracheal occlusion were analyzed. Fetuses who were managed expectantly had lower observed to expected total fetal lung volumes (20.6%±7.5% vs 23.7%±6.8%; P=.013), higher gestational age at delivery (median weeks of gestation, 37.4; interquartile range, 36.6-38.00 vs 35.1; interquartile range, 33.1-37.2; P<.001), and more frequent use of extracorporeal membrane oxygenation (55.8% vs 4.3%; P<.001) than the fetuses who underwent fetoscopic endoluminal tracheal occlusion. The survival rates at discharge and at 2 years of age in the expectant management group were higher than the survival rates of the fetoscopic endoluminal tracheal occlusion group (74.3% vs 44.7%; P=.001 and 72.8% vs 42.5%; P=.001, respectively). After adjustment for maternal age, gestational age at birth, observed to expected total fetal lung volume, and birth weight Z-score, the odds ratios were 4.65 (95% confidence interval, 1.9-11.9; P=.001) and 4.37 (95% confidence interval, 1.8-11.0; P=.001), respectively. CONCLUSION Fetuses with a severe isolated left-sided congenital diaphragmatic hernia had a higher survival rate when treated in an experienced center in Germany with antenatal expectant management and frequent use of extracorporeal membrane oxygenation during the postnatal period than fetuses who were treated with fetoscopic endoluminal tracheal occlusion in 3 centers in Belgium, France, and Italy.
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Affiliation(s)
- Vivien Dütemeyer
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium (Drs Dütemeyer, Badr, and Jani); Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany (Drs Dütemeyer)
| | - Thomas Schaible
- Department of Neonatology, Universitätsklinikum Mannheim, Mannheim, Germany (Drs Schaible and Perez-Ortiz)
| | - Dominique A Badr
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium (Drs Dütemeyer, Badr, and Jani)
| | - Anne-Gael Cordier
- Department of Obstetrics and Gynecology, Hospital Antoine Béclère, Université Paris Saclay, Clamart, France (Drs Cordier and Benachi)
| | - Meike Weis
- Department of Radiology, Universitätsklinikum Mannheim, Mannheim, Germany (Dr Weis)
| | - Alba Perez-Ortiz
- Department of Neonatology, Universitätsklinikum Mannheim, Mannheim, Germany (Drs Schaible and Perez-Ortiz)
| | - Diane Carriere
- Service de Réanimation Pédiatrique, Hôpital Bicêtre- AP-HP, Université Paris Saclay, Le Kremlin Bicêtre, France (Dr Carriere)
| | - Mieke M Cannie
- Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium (Dr Cannie)
| | - Aline Vuckovic
- Neonatal Intensive Care Unit, Queen Fabiola Children's Hospital-ULB, Brussels, Belgium (Dr Vuckovic)
| | - Nicola Persico
- Fetal Medicine and Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (Dr Persico); Department of Clinical Science and Community Health, University of Milan, Milan, Italy (Dr Persico)
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (Dr Cavallaro)
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology, Hospital Antoine Béclère, Université Paris Saclay, Clamart, France (Drs Cordier and Benachi)
| | - Jacques C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium (Drs Dütemeyer, Badr, and Jani).
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Imauven O, Quesnel C, De Garnier des Garets J, Cordier AG. [Postpartum stress-induced Tako-tsubo cardiomyopathy in 34-year-old woman]. Gynecol Obstet Fertil Senol 2023; 51:538-539. [PMID: 37442435 DOI: 10.1016/j.gofs.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Olivier Imauven
- Sorbonne université, GRC 29, AP-HP, DMU DREAM, service d'anésthesie-réanimation et médecine périopératoire Rive Droite-hôpital Tenon, 100, rue Lauriston, 75016, Paris, France.
| | - Christophe Quesnel
- Sorbonne université, GRC 29, AP-HP, DMU DREAM, service d'anésthesie-réanimation et médecine périopératoire Rive Droite-hôpital Tenon, 100, rue Lauriston, 75016, Paris, France
| | - Juliette De Garnier des Garets
- Sorbonne université, AP-HP, DMU ORIGYNE, service de gynécologie-obstétrique et biologie de la reproduction, hôpital Tenon, Paris, France
| | - Anne-Gael Cordier
- Sorbonne université, AP-HP, DMU ORIGYNE, service de gynécologie-obstétrique et biologie de la reproduction, hôpital Tenon, Paris, France
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Horn-Oudshoorn EJJ, Russo FM, Deprest JA, Kipfmueller F, Geipel A, Schaible T, Rafat N, Cordier AG, Benachi A, Abbasi N, Chiu PPL, de Boode WP, Sikkel E, Peters NCJ, Hansen BE, Reiss IKM, DeKoninck PLJ. Survival in very preterm infants with congenital diaphragmatic hernia and association with prenatal imaging markers: A retrospective cohort study. BJOG 2023; 130:1403-1411. [PMID: 37069727 DOI: 10.1111/1471-0528.17497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVES To describe the outcomes of preterm born infants with congenital diaphragmatic hernia (CDH; ≤32.0 weeks of gestation) and the associations between prenatal imaging markers and survival. DESIGN Retrospective cohort study. SETTING Multicentre study in large referral centres. POPULATION Infants with an isolated unilateral CDH, live born at 32.0 weeks or less of gestation, between January 2009 and January 2020. METHODS Neonatal outcomes were evaluated for infants that were expectantly managed during pregnancy and infants that underwent fetoscopic endoluminal tracheal occlusion (FETO) therapy, separately. We evaluated the association between prenatal imaging markers and survival to discharge. Prenatal imaging markers included observed to expected lung-to-head ratio (o/e LHR), side of the defect, liver position, stomach position grade, and observed to expected total fetal lung volume (o/e TFLV). MAIN OUTCOME MEASURE Survival to discharge. RESULTS We included 53 infants born at 30+4 (interquartile range 29+1 -31+2 ) weeks. Survival in fetuses expectantly managed during pregnancy was 48% (13/27) in left-sided CDH and 33% (2/6) in right-sided CDH. Survival in fetuses that underwent FETO therapy was 50% (6/12) in left-sided CDH and 25% (2/8) in right-sided CDH. The o/e LHR at baseline was positively associated with survival in cases expectantly managed during pregnancy (odds ratio [OR] 1.20, 95% CI 1.07-1.42, p < 0.01), but not in cases that received FETO therapy (OR 1.01, 95% CI 0.88-1.15, p = 0.87). Stomach position grade (p = 0.03) and o/e TFLV were associated with survival (p = 0.02); liver position was not (p = 0.13). CONCLUSIONS In infants with CDH born at or before 32 weeks of gestation, prenatal imaging markers of disease severity were associated with postnatal survival.
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Affiliation(s)
- Emily J J Horn-Oudshoorn
- Division of Neonatology, Department of Paediatrics, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Francesca M Russo
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - Jan A Deprest
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - Florian Kipfmueller
- Department of Neonatology and Paediatric Critical Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Annegret Geipel
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Thomas Schaible
- Department of Neonatology, University Hospital Mannheim, Mannheim, Germany
| | - Neysan Rafat
- Department of Neonatology, University Hospital Mannheim, Mannheim, Germany
| | - Anne-Gael Cordier
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
- Department of Obstetrics and Gynaecology, Hospital Antoine Béclère, University Paris-Saclay, Clamart, France
| | - Alexandra Benachi
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
- Department of Obstetrics and Gynaecology, Hospital Antoine Béclère, University Paris-Saclay, Clamart, France
| | - Nimrah Abbasi
- Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Priscilla P L Chiu
- Division of General and Thoracic Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Willem P de Boode
- Department of Neonatology, Radboud University Medical Centre, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Esther Sikkel
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Nina C J Peters
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Bettina E Hansen
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - Irwin K M Reiss
- Division of Neonatology, Department of Paediatrics, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Philip L J DeKoninck
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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Bouzaglou A, Dumery G, Letourneau A, Benachi A, Vivanti AJ, Cordier AG. Management and survival of foetuses with trisomy 18 in a French retrospective cohort. J Gynecol Obstet Hum Reprod 2023; 52:102565. [PMID: 36863687 DOI: 10.1016/j.jogoh.2023.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/15/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The main objective of this study was to evaluate parents' current demands following the announcement of trisomy 18 and maternal risks. MATERIAL AND METHODS A single-centre retrospective study was performed in the Paris Saclay Foetal Medicine Department from 2018 to 2021. All patients followed up in the department who had cytogenetic confirmation of trisomy 18 were included. RESULTS 89 patients were recruited. The most common malformations at ultrasound examination were cardiac or brain abnormalities, distal arthrogryposis as well as severe intrauterine growth retardation. 29% of foetuses with trisomy 18 had more than three malformations. 77.5% of patients requested medical termination of pregnancy. Among the 19 patients who chose to continue their pregnancy, 10 (52.6%) presented with obstetrical complications, of which 7 (41.2%) experienced stillbirth; five babies were born alive with no survival at 6 months. CONCLUSION In France, in the case of foetal trisomy 18, most women request termination of pregnancy. In the post-natal period, the management of a newborn with trisomy 18 is oriented towards palliative care. The mother's risk of obstetrical complications should be part of counselling. Follow-up, support and safety should be the goal of management of these patients, regardless of the patient's choice.
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Affiliation(s)
- Ana Bouzaglou
- Department of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-nés, Hôpital Bicêtre, AP-HP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Gregoire Dumery
- Department of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-nés, Hôpital Bicêtre, AP-HP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Alexandra Letourneau
- Department of Obstetrics and Gynecology DMU Santé des Femmes et des Nouveau-nés, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, Clamart, France
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology DMU Santé des Femmes et des Nouveau-nés, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, Clamart, France
| | - Alexandre J Vivanti
- Department of Obstetrics and Gynecology DMU Santé des Femmes et des Nouveau-nés, Hôpital Antoine Béclère, AP-HP, Université Paris Saclay, Clamart, France
| | - Anne-Gael Cordier
- Department of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-nés, Hôpital Bicêtre, AP-HP, Université Paris Saclay, Le Kremlin Bicêtre, France; Department of Obstetrics and Gynecology, DMU ORIGYNE, Hôpital Tenon, Sorbonne Université, Paris, France.
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Picone O, Vivanti AJ, Sibiude J, Cordier AG, Alessandrini V, Kayem G, Borie C, Luton D, Manchon P, Couffignal C, Vauloup Fellous C. SARS-COV-2 excretion and maternal-fetal transmission: Virological data of French prospective multi-center cohort study COVIPREG during the first wave. J Gynecol Obstet Hum Reprod 2023; 52:102547. [PMID: 36796640 PMCID: PMC9928608 DOI: 10.1016/j.jogoh.2023.102547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Olivier Picone
- IAME U1137, Inserm, Université Paris Cité; AP-HP.Nord Université Paris Cité, Site Hôpital Louis Mourier, Service de Gynécologie Obstétrique, Colombes, France; Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France.
| | - Alexandre J Vivanti
- Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France; Division of Obstetrics and Gynecology, Antoine Béclère Hospital, Paris Saclay University Hospitals, APHP, Clamart, France
| | - Jeanne Sibiude
- IAME U1137, Inserm, Université Paris Cité; AP-HP.Nord Université Paris Cité, Site Hôpital Louis Mourier, Service de Gynécologie Obstétrique, Colombes, France; Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France
| | - Anne-Gael Cordier
- Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France; Bicêtre Hospital, Department of Gynecology and Obstetrics, Paris Saclay University, Le Kremlin Bicêtre, France
| | - Vivien Alessandrini
- Université Paris Cité, Division of Obstetrics and Gynecology, Hôpital Cochin-Port-Royal, Paris
| | - Gilles Kayem
- Université de Paris, CRESS, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, DHU Risks in Pregnancy, Paris, France; Department of Obstetrics and Gynecology, Trousseau Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Constance Borie
- Division of Obstetrics and Gynecology, Antoine Béclère Hospital, Paris Saclay University Hospitals, APHP, Clamart, France; Université de Paris, F-75006 Paris, France; Maternité, AP-HP, Hôpital Robert Debré, F-75019 Paris, France
| | - Dominique Luton
- Division of Obstetrics and Gynecology, Antoine Béclère Hospital, Paris Saclay University Hospitals, APHP, Clamart, France; Maternité, AP-HP, Hôpital Robert Debré, F-75019 Paris, France; Maternité, AP-HP, Hôpital Bichat, F-75018 Paris, France
| | - Pauline Manchon
- AP-HP.Nord Université Paris Cité Site Hôpital Bichat, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Paris, France
| | - Camille Couffignal
- AP-HP.Nord Université Paris Cité Site Hôpital Bichat, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Paris, France; IAME U1137, Inserm, Université Paris Cité
| | - Christelle Vauloup Fellous
- Virology Department, Paul Brousse Hospital, AP-HP, Inserm U 1193, Université Paris Saclay, Villejuif, France; Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France
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- Virology Department, Paul Brousse Hospital, AP-HP, Inserm U 1193, Université Paris Saclay, Villejuif, France; Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France
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8
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Dabi Y, Bouaziz J, Burke Y, Nicolas-Boluda A, Cordier AG, Chayo J, Cohen SB. Outcome of subsequent pregnancies post uterine rupture in previous delivery: A case series, a review, and recommendations for appropriate management. Int J Gynaecol Obstet 2023; 161:204-217. [PMID: 36087068 DOI: 10.1002/ijgo.14445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/20/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To provide clinicians with concrete solutions on the best management of and counseling for patients in a subsequent pregnancy following uterine rupture. METHODS A retrospective analysis of patients treated between 2005 and 2020 at Sheba Medical Center was conducted. All patients who had undergone a complete uterine rupture and subsequently had a full-term pregnancy were included. A literature review was conducted using Pubmed database and including previously published literature reviews. RESULTS Fifteen patients with subsequent pregnancies following uterine rupture were included in our cohort. Mean interval between rupture and subsequent pregnancy was 3.8 years (range 2.2-6.9 years). One patient had repeat uterine rupture of less than 2 cm at 36+5 weeksof pregnancy. A total of 17 studies were selected in this literature review, including a total of 774 pregnancies in 635 patients. The risk of repeated uterine rupture was 8.0% (62/774), ranging from 0% to 37.5%. Overall, the risk of maternal death was of 0.6% (4/635), with only four cases reported in three studies. CONCLUSION The risk of recurrence after uterine rupture is significant but should not prevent patients from conceiving.
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Affiliation(s)
- Yohann Dabi
- PointGyn-Gynecologic and Obstetrics Department, Paris, France.,Department of Research, One Clinic, Paris, France
| | - Jerome Bouaziz
- PointGyn-Gynecologic and Obstetrics Department, Paris, France.,Department of Research, One Clinic, Paris, France
| | - Yechiel Burke
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Alba Nicolas-Boluda
- PointGyn-Gynecologic and Obstetrics Department, Paris, France.,Department of Research, One Clinic, Paris, France
| | - Anne-Gael Cordier
- Sorbonne University, Department of Obstetrics and Gynecology, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Jennifer Chayo
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Shlomo B Cohen
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
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9
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Boisson M, Cordier AG, Martinovic J, Receveur A, Mouka A, Diot R, Egoroff C, Esnault G, Drévillon L, Benachi A, Tachdjian G, Tosca L. Copy number variations analysis in a cohort of 47 fetuses and newborns with congenital diaphragmatic hernia. Prenat Diagn 2022; 42:1627-1635. [PMID: 36403094 PMCID: PMC10100393 DOI: 10.1002/pd.6268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/31/2022] [Accepted: 11/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The congenital diaphragmatic hernia (CDH), characterized by malformation of the diaphragm and lung hypoplasia, is a common and severe birth defect that affects around 1 in 4000 live births. However, the etiology of most cases of CDH remains unclear. The aim of this study was to perform a retrospective analysis of copy number variations (CNVs) using a high-resolution array comparative genomic hybridization (array-CGH) in a cohort of fetuses and newborns with CDH. METHODS Forty seven fetuses and newborns with either isolated or syndromic CDH were analyzed by oligonucleotide-based array-CGH Agilent 180K technique. RESULTS A mean of 10.2 CNVs was detected by proband with a total number of 480 CNVs identified based on five categories: benign, likely benign, of uncertain signification, likely pathogenic, and pathogenic. Diagnostic performance was estimated at 19.15% (i.e., likely pathogenic and pathogenic CNVs) for both CDH types. We identified 11 potential candidate genes: COL25A1, DSEL, EYA1, FLNA, MECOM, NRXN1, RARB, SPATA13, TJP2, XIRP2, and ZFPM2. CONCLUSION We suggest that COL25A1, DSEL, EYA1, FLNA, MECOM, NRXN1, RARB, SPATA13, TJP2, XIRP2, and ZFPM2 genes may be related to CDH occurrence. Thus, this study provides a possibility for new methods of a positive diagnosis.
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Affiliation(s)
- Marie Boisson
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Anne-Gael Cordier
- Service de Gynécologie Obstétrique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France.,Centre de Référence Maladie Rare Hernie de Coupole Diaphragmatique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Jelena Martinovic
- Unité de Fœtopathologie, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Aline Receveur
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Aurélie Mouka
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France.,Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Laboratoire de Développement des Gonades, UMRE008 Stabilité Génétique Cellules Souches et Radiations, Commissariat à l'Energie Atomique et aux Énergies Alternatives, Fontenay-aux-Roses, France
| | - Romain Diot
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Catherine Egoroff
- Unité de Fœtopathologie, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Geoffroy Esnault
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France
| | - Loïc Drévillon
- Centre Hospitalier Universitaire de Caen Normandie, Caen, France
| | - Alexandra Benachi
- Service de Gynécologie Obstétrique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France.,Centre de Référence Maladie Rare Hernie de Coupole Diaphragmatique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France.,Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Gérard Tachdjian
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France.,Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Laboratoire de Développement des Gonades, UMRE008 Stabilité Génétique Cellules Souches et Radiations, Commissariat à l'Energie Atomique et aux Énergies Alternatives, Fontenay-aux-Roses, France
| | - Lucie Tosca
- Service d'Histologie, Embryologie et Cytogénomique, AP-HP. Université Paris Saclay, Hôpital Antoine Béclère, Clamart, France.,Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Laboratoire de Développement des Gonades, UMRE008 Stabilité Génétique Cellules Souches et Radiations, Commissariat à l'Energie Atomique et aux Énergies Alternatives, Fontenay-aux-Roses, France
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10
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Huré M, Peyronnet V, Sibiude J, Cazenave MG, Anselem O, Luton D, Vauloup-Fellous C, Deruelle P, Cordier AG, Benachi A, Mandelbrot L, Couffignal C, Pauphilet V, Vivanti AJ, Picone O. [SARS-Cov-2 vaccine's acceptance among pregnant women-A cross-sectional survey]. Gynecol Obstet Fertil Senol 2022; 50:712-720. [PMID: 35914734 PMCID: PMC9335352 DOI: 10.1016/j.gofs.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE SARS-CoV-2 is more likely to cause severe cases in pregnant women. They were part of the priority groups since April 2021 to benefit from SARS-CoV-2 vaccination before its extent to general population. This contribution aims to evaluate, in the postpartum period, the achievement of COVID-19 vaccination and factors associated in women during their pregnancy. MATERIAL AND METHOD Multicenter cross-sectional survey study conducted from September to December 2021 with online self-questionnaire. All postpartum patients hospitalized in one of the 6 participating maternity hospitals were invited to answer. The questionnaire asked patients about their demographic characteristics, vaccination modalities, vaccine tolerance, and their general perception of vaccination. RESULTS Of the 371 women who responded, the vaccination rate was 65.7% (IC95% [60.8-70.4]), whom 98.8% entirely during pregnancy. Associated factors with vaccination during pregnancy were older age, higher socio-professional category, and prior information provided by health professionals. Factors that appear to motivate vaccination were personal protection and protection of the newborn. Finally, main factors negatively influencing the vaccination process were the fear of vaccine side effects and the negative perception of vaccines in general. DISCUSSION Acceptability and information about the vaccine by health professionals is in constant improvement. Information campaigns should be continued to improve the acceptability of vaccination, in light of the accumulating data.
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Affiliation(s)
- M Huré
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Louis-Mourier, service de gynécologie obstétrique, Colombes, France; Université Paris Cité, France
| | - V Peyronnet
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Louis-Mourier, service de gynécologie obstétrique, Colombes, France
| | - J Sibiude
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Louis-Mourier, service de gynécologie obstétrique, Colombes, France; Université Paris Cité, France; Inserm, IAME, 75018 Paris, France; FHU PREMA, Paris, France
| | - M G Cazenave
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Louis-Mourier, service de gynécologie obstétrique, Colombes, France
| | - O Anselem
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Bichat, département de recherche clinique, biostatistiques et épidémiologie, 75018 Paris, France; Maternité Port-Royal, hôpital Cochin, AP-HP, centre-université de Paris, Paris, France
| | - D Luton
- Université Paris Cité, France; FHU PREMA, Paris, France; Service de gynécologie-obstétrique, université Paris Cité, FHU prématurité, hôpital Bichat, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, Paris, France
| | - C Vauloup-Fellous
- Groupe de recherche sur les infections pendant la grossesse (GRIG), Vélizy, France; Hôpital universitaire, AP-HP, département de virologie, département de biologie génétique et PUI, université Paris Saclay, Villejuif, France; Inserm U1193, université Paris Saclay, Villejuif, France
| | - P Deruelle
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - A G Cordier
- Université Paris Cité, France; Département de gynécologie et obstétrique, DMU santé des femmes et des nouveau-nés, hôpital Antoine-Béclère, université Paris Saclay, AP-HP, France
| | - A Benachi
- Département de gynécologie et obstétrique, DMU santé des femmes et des nouveau-nés, hôpital Antoine-Béclère, université Paris Saclay, AP-HP, France
| | - L Mandelbrot
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Louis-Mourier, service de gynécologie obstétrique, Colombes, France; Université Paris Cité, France; Inserm, IAME, 75018 Paris, France; FHU PREMA, Paris, France
| | - C Couffignal
- Université Paris Cité, France; Inserm, IAME, 75018 Paris, France; Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Bichat, département de recherche clinique, biostatistiques et épidémiologie, 75018 Paris, France
| | - V Pauphilet
- Université Paris Cité, France; Maternité hôpital Robert-Debré, AP-HP, France
| | - A J Vivanti
- Département de gynécologie et obstétrique, DMU santé des femmes et des nouveau-nés, hôpital Antoine-Béclère, université Paris Saclay, AP-HP, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), Vélizy, France
| | - O Picone
- Assistance publique-Hôpitaux de Paris, AP-HP Nord, hôpital Louis-Mourier, service de gynécologie obstétrique, Colombes, France; Université Paris Cité, France; Inserm, IAME, 75018 Paris, France; FHU PREMA, Paris, France; Groupe de recherche sur les infections pendant la grossesse (GRIG), Vélizy, France.
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11
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Cordier AG, Laup L, Letourneau A, Le Sache N, Fouquet V, Senat MV, Perrotin F, Rosenblatt J, Sananes N, Jouannic JM, Benoist G, Jani JC, Benachi A. Prenatal stomach position predicts gastrointestinal morbidity at 2 years in fetuses with left-sided congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2021; 57:959-967. [PMID: 32462707 DOI: 10.1002/uog.22086] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/02/2020] [Accepted: 05/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The long-term morbidity associated with isolated left-sided congenital diaphragmatic hernia (CDH) has been described previously. However, antenatal criteria impacting gastrointestinal morbidity (GIM) are not yet defined. The objective of this study was to evaluate the effect of fetal stomach position on the risk of GIM at 2 years of age in children with left-sided CDH. METHODS This was a retrospective, observational multicenter cohort study of data obtained from January 2010 to January 2014, that included patients whose fetus had isolated left-sided CDH, with or without fetal endoscopic tracheal occlusion (FETO). Prenatal maternal, fetal and pediatric data were collected. Fetal stomach position was evaluated a posteriori by two observers, using ultrasound images at the level of the four-chamber view of the heart that had been obtained to calculate the observed-to-expected lung-area-to-head-circumference ratio (O/E-LHR). Fetal stomach position was graded as follows: Grade 1, stomach not visualized; Grade 2, stomach visualized anteriorly, next to the apex of the heart, with no structure in between the stomach and the sternum; Grade 3, stomach visualized alongside the left ventricle of the heart, and abdominal structures anteriorly; or Grade 4, as Grade 3 but with stomach posterior to the level of the atrioventricular heart valves. The primary outcome was GIM at 2 years of age, assessed in a composite manner, including the occurrence of gastroesophageal reflux disease, need for gastrostomy, duration of parenteral and enteral nutrition and persistence of oral aversion. Regression analysis was performed in order to investigate the effect of O/E-LHR, stomach position and FETO on various GIM outcome variables. RESULTS Forty-seven patients with fetal left-sided CDH were included in the analysis. Thirteen (27.7%) infants did not meet the criterion of exclusive oral feeding at 2 years of age. Fetal stomach position grade was associated significantly and independently with the duration of parenteral nutrition (odds ratio (OR), 19.86; P = 0.031) and persistence of oral aversion at 2 years (OR, 3.40; P = 0.006). On multivariate analysis, O/E-LHR was predictive of the need for prosthetic patch repair, but not for GIM. FETO did not seem to affect the risk of GIM at 2 years. CONCLUSION In isolated left-sided CDH, fetal stomach position is the only factor that is predictive of GIM at 2 years of age. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A G Cordier
- Department of Gynecology and Obstetrics, Antoine Béclère Hospital, Paris-Sud University, Clamart, France
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
| | - L Laup
- Department of Gynecology and Obstetrics, Antoine Béclère Hospital, Paris-Sud University, Clamart, France
| | - A Letourneau
- Department of Gynecology and Obstetrics, Antoine Béclère Hospital, Paris-Sud University, Clamart, France
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
| | - N Le Sache
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
- Department of Neonatal Pediatrics, Bicêtre Hospital, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - V Fouquet
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
- Department of Pediatric Surgery, Bicêtre Hospital, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - M V Senat
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
- Department of Gynecology and Obstetrics, Bicêtre Hospital, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - F Perrotin
- Department of Obstetrics, Gynecology and Fetal Medicine, Regional University Hospital, Francois Rabelais University, Tours, France
| | - J Rosenblatt
- Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, Paris, France
| | - N Sananes
- Department of Maternal-Fetal Medicine, Strasbourg University Hospital, Strasbourg, France
| | - J M Jouannic
- Department of Fetal Medicine, Trousseau Hospital, APHP Sorbonne, Sorbonne University, Paris, France
| | - G Benoist
- Department of Obstetrics and Gynecology, Caen University Hospital, Caen, France
| | - J C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - A Benachi
- Department of Gynecology and Obstetrics, Antoine Béclère Hospital, Paris-Sud University, Clamart, France
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
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12
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Bouchghoul H, Dumery G, Russo FM, Cordier AG, Le Sache N, Debeer A, Decaluwe H, Fouquet V, Senat MV, Deprest J, Benachi A. Optimal gestational age at delivery in isolated left-sided congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2021; 57:968-973. [PMID: 32610372 DOI: 10.1002/uog.22133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/25/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the morbidity and mortality of neonates with left-sided isolated congenital diaphragmatic hernia (CDH) according to gestational age at delivery. METHODS This was a retrospective study of fetuses diagnosed prenatally with isolated left-sided CDH that were delivered in the University Hospitals of Antoine Béclère-Bicêtre and Leuven between 1 January 2010 and 31 December 2018. The Kaplan-Meier method was used to calculate cumulative survival at 28 days after birth according to gestational age at delivery. The association between gestational age at delivery, as a continuous variable, and survival at 28 days was modeled using a fractional polynomial. Adjustment for position of the liver, management center and mode of delivery was performed. The association was also evaluated according to the severity of CDH, as defined by the observed-to-expected lung-to-head ratio (o/e-LHR), which was classified as severe (o/e-LHR < 25%), moderate (o/e-LHR between 25% and 45%) or mild (o/e-LHR > 45%). RESULTS We included 213 fetuses with isolated left-sided CDH, with a median gestational age at delivery of 38 + 2 weeks (interquartile range, 37 + 0 to 39 + 1 weeks). The survival rates at 28 days and at 6 months were 66.7% (142/213) and 64.3% (137/213), respectively. Kaplan-Meier analysis showed a higher survival rate at 28 days for babies delivered between 37 + 0 and 38 + 6 weeks than for those delivered at or after 39 + 0 weeks (log-rank test, P < 0.001). In the subgroup of moderate CDH, the 28-day survival rate was significantly higher in newborns delivered between 37 + 0 and 38 + 6 weeks than in those delivered at or after 39 + 0 weeks (81.5% vs 61.5%; P = 0.03), and this was also the case for survival rate at 6 months. In the subgroup with moderate CDH, 28-day survival significantly increased with advancing gestational age at birth up to about 38-39 weeks (P = 0.005), and significantly decreased from 39 weeks onwards. CONCLUSION Delivery between 37 + 0 and 38 + 6 weeks' gestation is associated with a higher survival rate at 28 days in neonates with isolated left-sided CDH and moderate lung hypoplasia, independently of intrathoracic liver, management center and mode of delivery. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- H Bouchghoul
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, University Paris-Saclay, Le Kremlin-Bicêtre, France
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
| | - G Dumery
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, University Paris-Saclay, Le Kremlin-Bicêtre, France
| | - F M Russo
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - A G Cordier
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Antoine Béclère Hospital, University Paris-Saclay, Clamart, France
| | - N Le Sache
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
- Department of Neonatology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, University Paris-Saclay, Le Kremlin-Bicêtre, France
| | - A Debeer
- Department of Neonatology, University Hospitals Leuven, Leuven, Belgium
| | - H Decaluwe
- Department of Pediatric Surgery, University Hospitals Leuven, Leuven, Belgium
| | - V Fouquet
- Department of Pediatric Surgery, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, University Paris-Saclay, Le Kremlin-Bicêtre, France
| | - M V Senat
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, University Paris-Saclay, Le Kremlin-Bicêtre, France
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
| | - J Deprest
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - A Benachi
- Centre Reference Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
- Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Antoine Béclère Hospital, University Paris-Saclay, Clamart, France
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13
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Kayem G, Lecarpentier E, Deruelle P, Bretelle F, Azria E, Blanc J, Bohec C, Bornes M, Ceccaldi PF, Chalet Y, Chauleur C, Cordier AG, Desbrière R, Doret M, Dreyfus M, Driessen M, Fermaut M, Gallot D, Garabédian C, Huissoud C, Luton D, Morel O, Perrotin F, Picone O, Rozenberg P, Sentilhes L, Sroussi J, Vayssière C, Verspyck E, Vivanti AJ, Winer N, Alessandrini V, Schmitz T. A snapshot of the Covid-19 pandemic among pregnant women in France. J Gynecol Obstet Hum Reprod 2020; 49:101826. [PMID: 32505805 PMCID: PMC7270811 DOI: 10.1016/j.jogoh.2020.101826] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 05/31/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To describe the course over time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in French women from the beginning of the pandemic until mid-April, the risk profile of women with respiratory complications, and short-term pregnancy outcomes. METHODS We collected a case series of pregnant women with COVID-19 in a research network of 33 French maternity units between March 1 and April 14, 2020. All cases of SARS-CoV-2 infection confirmed by a positive result on real-time reverse transcriptase polymerase chain reaction tests of a nasal sample and/or diagnosed by a computed tomography chest scan were included and analyzed. The primary outcome measures were COVID-19 requiring oxygen (oxygen therapy or noninvasive ventilation) and critical COVID-19 (requiring invasive mechanical ventilation or extracorporeal membrane oxygenation, ECMO). Demographic data, baseline comorbidities, and pregnancy outcomes were also collected. RESULTS Active cases of COVID-19 increased exponentially during March 1-31, 2020; the numbers fell during April 1-14, after lockdown was imposed on March 17. The shape of the curve of active critical COVID-19 mirrored that of all active cases. By April 14, among the 617 pregnant women with COVID-19, 93 women (15.1 %; 95 %CI 12.3-18.1) had required oxygen therapy and 35 others (5.7 %; 95 %CI 4.0-7.8) had had a critical form of COVID-19. The severity of the disease was associated with age older than 35 years and obesity, as well as preexisting diabetes, previous preeclampsia, and gestational hypertension or preeclampsia. One woman with critical COVID-19 died (0.2 %; 95 %CI 0-0.9). Among the women who gave birth, rates of preterm birth in women with non-severe, oxygen-requiring, and critical COVID-19 were 13/123 (10.6 %), 14/29 (48.3 %), and 23/29 (79.3 %) before 37 weeks and 3/123 (2.4 %), 4/29 (13.8 %), and 14/29 (48.3 %) before 32 weeks, respectively. One neonate (0.5 %; 95 %CI 0.01-2.9) in the critical group died from prematurity. CONCLUSION COVID-19 can be responsible for significant rates of severe acute, potentially deadly, respiratory distress syndromes. The most vulnerable pregnant women, those with comorbidities, may benefit particularly from prevention measures such as a lockdown.
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Affiliation(s)
- Gilles Kayem
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France.
| | | | - Philippe Deruelle
- Centre Hospitalo-Universitaire de Strasbourg, 67000, Strasbourg, France
| | | | - Elie Azria
- Groupe Hospitalier Saint-Joseph, 75014, Paris, France
| | - Julie Blanc
- Assistance Publique-Hôpitaux de Marseille, 13000, Marseille, France
| | | | - Marie Bornes
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France
| | | | - Yasmine Chalet
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France
| | - Céline Chauleur
- Centre Hospitalo-Universitaire de Saint-Etienne, 42000, Saint-Etienne, France
| | | | | | | | - Michel Dreyfus
- Centre Hospitalo-Universitaire de Caen, 14000, Caen, France
| | | | - Marion Fermaut
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France
| | - Denis Gallot
- Centre Hospitalo-Universitaire Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Charles Garabédian
- Centre Hospitalier Régional Universitaire de Lille, 59000, Lille, France
| | | | | | | | - Franck Perrotin
- Centre Hospitalier Régional Universitaire de Tours, 37000, Tours, France
| | - Olivier Picone
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France
| | | | - Loïc Sentilhes
- Centre Hospitalo-Universitaire de Bordeaux, 33000, Bordeaux, France
| | - Jeremy Sroussi
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France
| | | | - Eric Verspyck
- Centre Hospitalo-Universitaire de Rouen, 76000, Rouen, France
| | | | - Norbert Winer
- Centre Hospitalo-Universitaire de Nantes, 44000, Nantes, France
| | | | - Thomas Schmitz
- Assistance Publique-Hôpitaux de Paris, 75004, Paris, France
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Cordier AG, Bouvier AS, Vibert F, Martinovic J, Couturier-Tarrade A, Lai-Kuen R, Curis E, Fournier T, Benachi A, Peoc'H K, Gil S. Preserved efficiency of sickle cell disease placentas despite altered morphology and function. Placenta 2020; 100:81-88. [PMID: 32871493 DOI: 10.1016/j.placenta.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Pregnant women with sickle cell disease (SCD) are at high risk for sickle cell-related complications, obstetrical complications, and perinatal morbidity. Chronic inflammation and the proangiogenic environment associated with SCD have been associated with endothelial damage. It is unknown whether SCD complications could be associated with placental dysfunction or abnormal placental morphology. Moreover, circulating angiogenic factors in pregnant women with SCD are unexplored. METHODS Clinical records, placental and blood samples were collected at term delivery for 21 pregnant patients with SCD and 19 HbAA pregnant controls with adapted to gestational age birth weight newborns. Histological and stereological analyses and scanning electron microscopy (SEM) of the placenta, and PlGF and sFlt1 measurements in blood were performed. RESULTS In the SCD group, the parenchyma-forming villi of placentas were thinner than in controls, and increased fibrinoid necrosis and an overabundance of syncytial knots were seen. SEM revealed elongated intermediate villous endings with a reduction in the number of terminal villi compared to controls, indicating a significant branching defect in SCD placentas. Finally, SCD patients had an imbalance in the angiogenic ratio of sFlt1/PlGF (p = 0.008) with a drop of PlGF concentrations. DISCUSSION We evidence for the first time both abnormal placenta morphology and altered sFlt1/PlGF ratio in SCD patients, uncorrelated with maintained placental efficiency and fetal growth.
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Affiliation(s)
- Anne-Gael Cordier
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie Obstétrique, Centre hospitalier universitaire Antoine Béclère, Université Paris-Sud, 92140, Clamart, France; Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France; Centre de référence maladies rares. Syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse, Paris, France.
| | - Anne-Sophie Bouvier
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France
| | - Francoise Vibert
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France
| | - Jelena Martinovic
- Assistance Publique-Hôpitaux de Paris, Service de Fœtopathologie, Centre hospitalier universitaire Antoine Béclère, Université Paris-Sud, Clamart, France; INSERM, UMR, 1195, Université Paris Sud, Paris Saclay, France
| | | | - René Lai-Kuen
- Plateau technique Imagerie Cellulaire et Moléculaire (ICM), UMS, 3612, CNRS, US25 INSERM, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, France
| | - Emmanuel Curis
- Service de biostatistiques et informatique médicale, Hôpital Saint-Louis, APHP, Paris, France; Laboratoire de biomathématiques, Faculté de pharmacie, Université Paris Descartes, France
| | - Thierry Fournier
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France
| | - Alexandra Benachi
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie Obstétrique, Centre hospitalier universitaire Antoine Béclère, Université Paris-Sud, 92140, Clamart, France; Centre de référence maladies rares. Syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse, Paris, France
| | - Katell Peoc'H
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; Assistance Publique-Hôpitaux de Paris, Laboratoire de Biochimie Clinique, HUPNVS, Hôpital Beaujon, Clichy and Université de Paris, UFR de Médecine Xavier Bichat, Paris, France
| | - Sophie Gil
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France
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15
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Dütemeyer V, Cordier AG, Cannie MM, Bevilacqua E, Huynh V, Houfflin-Debarge V, Verpillat P, Olivier C, Benachi A, Jani JC. Prenatal prediction of postnatal survival in fetuses with congenital diaphragmatic hernia using MRI: lung volume measurement, signal intensity ratio, and effect of experience. J Matern Fetal Neonatal Med 2020; 35:1036-1044. [PMID: 32212880 DOI: 10.1080/14767058.2020.1740982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To evaluate various signal intensity ratios in isolated congenital diaphragmatic hernia (CDH) and to compare their potential in predicting survival with that of the observed-to-expected (O/E) ratio of total fetal lung volume (TFLV) using magnetic resonance imaging (MRI) measurements. Our second objective was to evaluate the impact of operator's experience in comparing the prediction of postnatal survival by O/E-TFLV.Methods: In 75 conservatively managed CDH fetuses and in 50 who underwent fetoscopic endoluminal tracheal occlusion (FETO), the fetal lung-to-amniotic fluid, lung-to-liver, lung-to-muscle, lung-to-spinal fluid signal intensity ratios, respectively LAFSIR, LLSIR, LMSIR, and LSFSIR, were measured, as was O/E-TFLV. Receiver operating characteristic (ROC) curves were constructed and used to compare the various signal intensity ratios with O/E-TFLV in the prediction of postnatal survival. In 72 MRI lung volumes assessed by the referring radiologists in Paris and Lille and secondarily by our expert radiologist in Brussels (M.M.C.) using the same MRI examinations, ROC curves were constructed and used to compare the value of O/E-TFLV determined by the two centers in the prediction of postnatal survival.Results: In the total cohort of CDH fetuses, O/E-TFLV and LLSIR were predictive of postnatal survival whereas in the conservatively managed group O/E-TFLV, LLSIR, and LMSIR predicted postnatal survival. O/E-TFLV predicted postnatal survival far better than the signal intensity ratios: area under the ROC curve for prediction by O/E-TFLV in the total cohort was 0.866 (p < .001; standard error = 0.031). The area under the ROC curve for prediction of postnatal survival using O/E-TFLV by MRI evaluated at the referral centers was 0.640 (p = 102; standard error = 0.085), and with O/E-TFLV reevaluated by M.M.C., it was 0.872 (p < .001; standard error = 0.061). Pairwise comparison showed a significant difference between the areas under the ROC curves (difference = 0.187, p = .012; standard error = 0.075).Conclusion: In fetuses with CDH with/without FETO, LLSIR was significantly correlated with the prediction of postnatal survival. However, measurement of O/E-TFLV was far better in predicting postnatal outcome. Operator experience in measurement of lung volumes using MRI seem to play a role in the predictive value of the technique.
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Affiliation(s)
- Vivien Dütemeyer
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anne-Gael Cordier
- Department of Gynecology and Obstetrics, Bicêtre Hospital, Paris Sud University, Le Kremlin Bicêtre, France.,Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France
| | - Mieke M Cannie
- Department of Radiology, University Hospital Brugmann, Brussels, Belgium.,Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elisa Bevilacqua
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Vrije Universiteit Brussel, Brussels, Belgium
| | - Van Huynh
- Department of Paediatric Radiology, Bicêtre Hospital, Paris Sud University, Le Kremlin Bicêtre, France
| | | | | | - Camille Olivier
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Vrije Universiteit Brussel, Brussels, Belgium
| | - Alexandra Benachi
- Reference Center for Rare Diseases: Congenital Diaphragmatic Hernia, Clamart, France.,Department of Obstetrics and Gynaecology, Antoine Béclère Hospital, Paris Sud University, Clamart, France
| | - Jacques C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Vrije Universiteit Brussel, Brussels, Belgium
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16
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Abstract
Antenatal ultrasound screening identifies more than 60% of Congenital Diaphragmatic Hernia (CDH) cases and provides the opportunity for in utero referral to a tertiary care center for expert assessment and perinatal management. Prenatal assessment of fetuses with CDH has tremendously improved over the past ten years. The outcome may be predicted prenatally by medical imaging and advanced genetic testing. The combination of lung size and liver position determination by ultrasound measurements and MRI are widely accepted methods to stratify fetuses into groups that correlate not only with neonatal mortality but also with morbidity. Notwithstanding this, prediction of persistent pulmonary hypertension of the newborn still needs to be improved.
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Affiliation(s)
- Anne-Gael Cordier
- Department of Obstetrics and Gynecology, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, 157 rue de la porte de Trivaux, 92140 CLAMART, APHP, Clamart, France; Centre Référence Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France.
| | - Francesca M Russo
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium; Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - Jan Deprest
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium; Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium; Institute for Women's Health, University College London, London, UK
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, 157 rue de la porte de Trivaux, 92140 CLAMART, APHP, Clamart, France; Centre Référence Maladie Rare, Hernie de Coupole Diaphragmatique, Clamart, France
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Russo FM, Cordier AG, De Catte L, Saada J, Benachi A, Deprest J. Proposal for standardized prenatal ultrasound assessment of the fetus with congenital diaphragmatic hernia by the European reference network on rare inherited and congenital anomalies (ERNICA). Prenat Diagn 2018; 38:629-637. [PMID: 29924391 DOI: 10.1002/pd.5297] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/02/2018] [Accepted: 06/08/2018] [Indexed: 12/13/2022]
Abstract
Congenital diaphragmatic hernia is a rare disease associated with high mortality and morbidity. Antenatal ultrasound screening identifies more than 70% of cases, providing the opportunity for in utero referral to a tertiary care center for expert assessment and perinatal management. Additional genetic and morphologic assessment may be used to rule out associated anomalies. In isolated cases, the outcome may be predicted prenatally by medical imaging. The combination of lung size and liver herniation is a widely accepted method to stratify fetuses into groups with an increasing degree of pulmonary hypoplasia and corresponding mortality rates. Ultrasound measurement of the observed to expected lung-to-head ratio (o/e LHR) is most widely used. The o/e LHR is an independent predictor of survival and short-term morbidity. Finally, evaluation of stomach position has recently been introduced as an indirect method to estimate severity of the disease in left-sided defects, as it has been shown to correlate with the proportion of intrathoracic liver. Herein, we propose a protocol for the standardized ultrasound assessment of fetuses with isolated CDH and individualized prediction of neonatal outcome.
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Affiliation(s)
- Francesca Maria Russo
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.,Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - Anne-Gael Cordier
- Department of Obstetrics and Gynecology, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France
| | - Luc De Catte
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.,Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium
| | - Julien Saada
- Centre Référence Maladie Rare: Hernie de Coupole Diaphragmatique, Clamart, France
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.,Centre Référence Maladie Rare: Hernie de Coupole Diaphragmatique, Clamart, France
| | - Jan Deprest
- Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.,Academic Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium.,Institute for Women's Health, University College London, London, UK
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18
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Schmitz T, Korb D, Battie C, Cordier AG, De Carné Carnavalet C, Chauleur C, Equy V, Haddad B, Lemercier D, Poncelet C, Ramos A, Rigonnot L, Goffinet F. 98: Neonatal outcomes according to second twin presentation after vaginal delivery of the first twin. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.10.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Vivanti AJ, Cordier AG, Baujat G, Benachi A. Abnormal pelvic morphology and high cervical length are responsible for high-risk pregnancies in women displaying achondroplasia. Orphanet J Rare Dis 2016; 11:166. [PMID: 27919255 PMCID: PMC5139109 DOI: 10.1186/s13023-016-0529-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 10/21/2016] [Indexed: 11/10/2022] Open
Abstract
Pregnancies of women displaying achondroplasia are at high risk of adverse events. Early sonographic assessment of affected women can indicate an unusually long cervical length. It is the consequence of pathological anatomy of the pelvis. Thus, there is a foreseeable dystocia owing to cephalopelvic disproportion. Furthermore, this situation could also complicate cervical ripening prior to fetal extraction.
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Affiliation(s)
- Alexandre J Vivanti
- Department of Obstetrics and Gynecology and Reproductive Medicine, AP-HP, Antoine Béclère Hospital, Univ Paris-Sud Clamart, Clamart, 92140, France.
| | - Anne-Gael Cordier
- Department of Obstetrics and Gynecology and Reproductive Medicine, AP-HP, Antoine Béclère Hospital, Univ Paris-Sud Clamart, Clamart, 92140, France
| | - Geneviève Baujat
- Département de Génétique et INSERM U781, Université Paris Descartes-Sorbonne Paris Cité, Fondation Imagine, Hôpital Necker-Enfants malades, AP-HP, Paris, France
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology and Reproductive Medicine, AP-HP, Antoine Béclère Hospital, Univ Paris-Sud Clamart, Clamart, 92140, France
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20
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Cordier AG, Fuchs F, Tassin M, Saada J, Letourneau A, Brisset S, Mandelbrot L, Bidat L, Benachi A. Cover Image, Volume 36, Issue 10. Prenat Diagn 2016. [DOI: 10.1002/pd.4744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Cordier AG, Fuchs F, Tassin M, Saada J, Letourneau A, Brisset S, Mandelbrot L, Bidat L, Benachi A. Teaching invasive prenatal procedures: effectiveness of two simple simulators in training. Prenat Diagn 2016; 36:905-910. [DOI: 10.1002/pd.4875] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/29/2016] [Accepted: 07/16/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Anne-Gael Cordier
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP Antoine Béclère Hospital, Univ Paris-Sud; Clamart France
| | - Florent Fuchs
- Department of Obstetrics and Gynaecology; AP-HP, Bicêtre Hospital, Univ Paris-Sud; Kremlin Bicêtre France
| | - Mikael Tassin
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP Antoine Béclère Hospital, Univ Paris-Sud; Clamart France
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP, Louis Mourier Hospital; Colombes France
| | - Julien Saada
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP Antoine Béclère Hospital, Univ Paris-Sud; Clamart France
| | - Alexandra Letourneau
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP Antoine Béclère Hospital, Univ Paris-Sud; Clamart France
| | - Sophie Brisset
- Department of Cytogenetics; AP-HP, Antoine Béclère Hospital, Univ Paris-Sud; Clamart France
| | - Laurent Mandelbrot
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP, Louis Mourier Hospital; Colombes France
| | | | - Alexandra Benachi
- Department of Obstetrics and Gynaecology and Reproductive Medicine; AP-HP Antoine Béclère Hospital, Univ Paris-Sud; Clamart France
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Dobrescu O, Cannie MM, Cordier AG, Rodó C, Fabietti I, Benachi A, Carreras E, Persico N, Hurtado I, Gucciardo L, Jani JC. Prophylactic use of the Arabin cervical pessary in fetuses with severe congenital diaphragmatic hernia treated by fetoscopic endoluminal tracheal occlusion (FETO): preliminary experience. Prenat Diagn 2015; 36:81-7. [DOI: 10.1002/pd.4716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Oana Dobrescu
- Department of Obstetrics and Gynaecology; University Hospital Brugmann, Université Libre de Bruxelles; Brussels Belgium
| | - Mieke M. Cannie
- Department of Radiology; University Hospital Brugmann, Université Libre de Bruxelles; Brussels Belgium
- Department of Radiology; UZ Brussel, Vrije Universiteit Brussel; Brussel Belgium
| | - Anne-Gael Cordier
- Department of Obstetrics, Gynecology and Reproductive Medicine and Centre Maladies Rares: Hernie de Coupole Diaphragmatique; Hôpital Antoine Béclère, APHP, Université Paris Sud; Paris France
| | - Carlota Rodó
- Department of Obstetrics, Gynecology and Reproductive Medicine; Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona; Barcelona Spain
| | - Isabella Fabietti
- Department of Obstetrics and Gynecology ‘L. Mangiagalli’; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Alexandra Benachi
- Department of Obstetrics, Gynecology and Reproductive Medicine and Centre Maladies Rares: Hernie de Coupole Diaphragmatique; Hôpital Antoine Béclère, APHP, Université Paris Sud; Paris France
| | - Elena Carreras
- Department of Obstetrics, Gynecology and Reproductive Medicine; Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona; Barcelona Spain
| | - Nicola Persico
- Department of Obstetrics and Gynecology ‘L. Mangiagalli’; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Ivan Hurtado
- Department of Obstetrics and Gynaecology; University Hospital Brugmann, Université Libre de Bruxelles; Brussels Belgium
| | - Léonardo Gucciardo
- Department of Obstetrics and Gynaecology; University Hospital Brugmann, Université Libre de Bruxelles; Brussels Belgium
- Department of Obstetrics; UZ Brussel, Vrije Universiteit Brussel; Brussel Belgium
| | - Jacques C. Jani
- Department of Obstetrics and Gynaecology; University Hospital Brugmann, Université Libre de Bruxelles; Brussels Belgium
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Carrara J, Delaveaucoupet J, Cordier AG, Vauloup-Fellous C, Senat MV, Ayoubi JM, Benachi A, Picone O. [Detailed in utero ultrasound description of 34 cases of congenital cytomegalovirus infection]. ACTA ACUST UNITED AC 2015; 45:397-406. [PMID: 26096352 DOI: 10.1016/j.jgyn.2015.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 04/16/2015] [Accepted: 04/22/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe precisely prenatal ultrasound features in congenital cytomegalovirus (CMV) infection. MATERIAL AND METHODS We retrospectively evaluated the ultrasound descriptions of cases of congenital CMV infection between 2004 and 2013. RESULTS In 74 congenital CMV infections, related ultrasound abnormalities were reported in 34 cases (45.9%). Abnormalities reported were either cerebral (11 cases), either extracerebral (6 cases), or associated (17 cases). A total of 22/34 cases presented extracerebral features of 11 different sorts of abnormalities, mainly intra-uterine growth retardation (11 cases) and hyperechogenic bowel (10 cases) and 26/34 cases presented cerebral features of 14 different sorts, mainly brain calcifications (12 cases) and occipital horn cavity (12 cases). MRI was performed in 25 cases and have found additional abnormalities in 8 cases. These abnormalities are not specific to CMV infection. However, a frequent finding attracted our attention: the anechogenic cavity located on the extremity of the occipital horn. CONCLUSION A potentially specific sign, inexistent in other fetal pathologies, is an anechogenic cavity located on the extremity of the occipital and/or temporal horn, a germinal region which contains numerous proliferating and differentiating germinal cells. A better understanding of these signs could increase the sensitivity of ultrasound, and clarify the pathophysiology of congenital CMV infection.
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Affiliation(s)
- J Carrara
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Foch, 40, rue Worth, 92120 Suresnes, France
| | - J Delaveaucoupet
- Service de radiologie, AP-HP, Antoine-Béclère Hospital, 92140 Clamart, France
| | - A G Cordier
- Service de gynécologie-obstétrique, AP-HP, Antoine-Béclère Hospital, 92140 Clamart, France
| | - C Vauloup-Fellous
- Service de microbiologie, hôpital Antoine-Béclère, AP-HP, Inserm U764, université Paris Sud, 92140 Clamart, France
| | - M V Senat
- Service de microbiologie, hôpital Antoine-Béclère, AP-HP, Inserm U764, université Paris Sud, 92140 Clamart, France; Service de gynécologie-obstétrique, hôpital Bicêtre, Assistance publique-hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France; Inserm, Centre de recherche en épidémiologie et santé des populations, U1018, reproduction et développement de l'enfant, Villejuif, France
| | - J M Ayoubi
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Foch, 40, rue Worth, 92120 Suresnes, France; EA2493, UFR des sciences de la santé Simone-Veil, université Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France
| | - A Benachi
- Service de gynécologie-obstétrique, AP-HP, Antoine-Béclère Hospital, 92140 Clamart, France; Service de microbiologie, hôpital Antoine-Béclère, AP-HP, Inserm U764, université Paris Sud, 92140 Clamart, France
| | - O Picone
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Foch, 40, rue Worth, 92120 Suresnes, France; EA2493, UFR des sciences de la santé Simone-Veil, université Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France.
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Benachi A, Cordier AG, Courbebaisse M, Souberbielle JC. Vitamine D et grossesse. Presse Med 2013; 42:1377-82. [DOI: 10.1016/j.lpm.2013.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/10/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022] Open
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Rosefort A, Cordier AG, Kaddioui S, Beaumont B, Baergen R, Benachi A, Martinovic J. Co-occurrence of multifocal chorioangiomatosis and mesenchymal dysplasia in preeclampsia. Pediatr Dev Pathol 2013; 16:206-9. [PMID: 23286309 DOI: 10.2350/12-02-1153-cr.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chorioangioma is the most common benign vascular placental tumor. It is often small and has no clinical significance. Large chorioangiomata are rarer and can lead to fetal or maternal complications. Chorioangiomatosis is even rarer and is defined as a focal or multifocal proliferation of placental capillaries permeating villous tissue. Placental mesenchymal dysplasia (PMD) is characterized by the overgrowth of placental mesenchymal tissue and can be associated with fetal or obstetrical complications. We report a case associated with preeclampsia and intrauterine growth restriction, in which both chorioangiomatosis and PMD were present.
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Affiliation(s)
- Audrey Rosefort
- Department of Obstetrics and Gynecology, Antoine Béclère Hospital, Paris-Sud University, Clamart, France
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Picone O, Vauloup-Fellous C, Cordier AG, Guitton S, Senat MV, Fuchs F, Ayoubi JM, Grangeot Keros L, Benachi A. A series of 238 cytomegalovirus primary infections during pregnancy: description and outcome. Prenat Diagn 2013; 33:751-8. [PMID: 23553686 DOI: 10.1002/pd.4118] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 03/24/2013] [Accepted: 03/25/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To analyze the outcome of maternal primary cytomegalovirus (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, and the first, second and third trimesters 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. A number of clinically asymptomatic cases (5.5%) 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.
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Affiliation(s)
- O Picone
- Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France.
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Cordier AG, Guitton S, Vauloup-Fellous C, Grangeot-Keros L, Ayoubi JM, Benachi A, Picone O. Awareness of cytomegalovirus infection among pregnant women in France. J Clin Virol 2012; 53:332-7. [PMID: 22265828 DOI: 10.1016/j.jcv.2011.12.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 12/29/2011] [Accepted: 12/29/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) is the most frequent cause of congenital virus infection. Approximately 1% of newborns are infected by CMV at birth with severe consequences among 10% of them. Efficacy of hygienic counselling is nowadays established and should be spread. OBJECTIVE To evaluate pregnant women's awareness of cytomegalovirus infection in France. STUDY DESIGN Pregnant women receiving prenatal care, at any moment of their pregnancy, in two different obstetrics clinics with different information policies, were asked to complete a written questionnaire about CMV infection. RESULTS More than half (217/362, 60%) of the pregnant women had heard of congenital CMV infection, and most of them (72%) knew the hygiene measures to use to prevent infection. Nevertheless, most could not correctly identify the symptoms associated with congenital CMV disease. Awareness was associated with hospital's policy concerning CMV infection information, the mother's educational level, parity, and employment in health care. Indeed, when information is supposed to be given (hospital A), 74% (vs 34%) know congenital CMV infection and among them the knowledge is more precise. CONCLUSIONS This study tends to confirm that there is a large gap between knowledge of CMV and the burden of this disease. To bridge this gap, women should receive education about congenital CMV. Hospital-based prenatal education increases awareness and knowledge about CMV and CMV prevention.
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Affiliation(s)
- A G Cordier
- AP-HP, Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, Clamart F-92140, Université Paris-Sud, France
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Jani JC, Cordier AG, Martinovic J, Peralta CF, Senat MV, Segers V, Benachi A. Antenatal ultrasound prediction of pulmonary hypoplasia in congenital diaphragmatic hernia: correlation with pathology. Ultrasound Obstet Gynecol 2011; 38:344-349. [PMID: 21520476 DOI: 10.1002/uog.9031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To examine the relationship between observed to expected (o/e) lung to head circumference ratio (LHR) and lung-to-body weight ratio (LBWR) in fetuses with congenital diaphragmatic hernia (CDH). METHODS All consecutive fetuses with CDH and termination of pregnancy for which a postmortem examination was available, examined at three institutions between 2000 and 2010, were included in the study. Contralateral fetal lung area was measured by two-dimensional ultrasonography using the longest axis method and the o/e-LHR was calculated based on the appropriate normal mean for gestational age (GA). Regression analysis was used to determine the significance of association between the LBWR and the o/e-LHR for left and right-sided cases, and subsequently the predicted LBWR in left-sided CDH was calculated using the regression equation. Regression analysis was used to investigate the effect on the proportional difference between the predicted and observed LBWR of GA at o/e-LHR, time gap between o/e-LHR and LBWR measurement, proportional weight of the ipsilateral compared with total lung weight, presence of associated anomalies and intrathoracic herniation of the liver. RESULTS There were 23 fetuses with left-sided and seven fetuses with right-sided CDH. In left-sided CDH, the LBWR and the o/e-LHR correlated significantly, following the linear equation: LBWR = 0.0043 + (0.0134 × o/e-LHR) (r = 0.52, P = 0.012), but this was not the case for right-sided CDH, for which LBWR followed the equation: LBWR = 0.0107 - (0.0014 × o/e-LHR) (r = 0.08, P = 0.862), where o/e-LHR is expressed as percentage. Regression analysis showed that the proportional difference between predicted and observed LBWR in left-sided CDH was significantly and independently associated with GA at o/e-LHR measurement and proportional weight of ipsilateral vs. total lung weight. CONCLUSION In left-sided CDH, o/e-LHR correlates well with LBWR irrespective of the length of time between o/e-LHR and LBWR measurement, presence of associated anomalies and intrathoracic herniation of the liver. Inconsistencies between the two measurements are mainly attributable to the contribution of the ipsilateral lung to the total lung weight. In right-sided CDH, o/e-LHR does not correlate with LBWR.
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Affiliation(s)
- J C Jani
- Department of Obstetrics and Gynecology, Fetal Medicine and Treatment Units, University Hospital Brugmann, Brussels, Belgium.
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Picone O, Sonigo P, Cordier AG, Vauloup-Fellous C, Benachi A. The in utero
natural history of a cytomegalovirus-related fetal cerebral periventricular halo. Prenat Diagn 2010; 30:1224-5. [DOI: 10.1002/pd.2653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Cordier AG, Mabille M, Delezoide AL, Chambon G, Frydman R, Senat MV, Picone O. Prenatal diagnosis of a rare skeletal dysplasia by ultrasound and scan tomography: atelosteogenesis III (AO III). Correlation with autopsy. Prenat Diagn 2008; 28:975-7. [PMID: 18792994 DOI: 10.1002/pd.2093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A G Cordier
- AP-HP, Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, 157 Rue de la Porte de Trivaux, Clamart, France
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Picone O, Vauloup-Fellous C, Cordier AG, Grangeot-Keros L, Frydman R, Senat MV. Late onset of ultrasound abnormalities in a case of periconceptional congenital cytomegalovirus infection. Ultrasound Obstet Gynecol 2008; 31:481-483. [PMID: 18383478 DOI: 10.1002/uog.5268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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