0000000000402256
AUTHOR
Didier Riethmuller
Benefits of Direct Colposcopic Vision for Optimal LLETZ Procedure: A Prospective Multicenter Study.
International audience; Objective The aim of the study was to assess whether direct colposcopic ă vision (DCV) of the cervix during large loop excision of the ă transformation zone (LLETZ) is associated with a decrease in the volume ă and dimensions of specimens or affects margin status at histology. ă Materials and Methods A prospective multicenter observational study of ă 216 women who underwent LLETZ for grades 2 and 3 cervical ă intraepithelial neoplasia was conducted. The volume and dimensions ă (circumference, length, and thickness) of the surgical specimens were ă measured before fixation. Data were compared according to the use of ă colposcopy during LLETZ. The following 3 groups we…
Multiple pregnancies and air pollution in moderately polluted cities: Is there an association between air pollution and fetal growth?
Background: Multiple pregnancies (where more than one fetus develops simultaneously in the womb) are systematically excluded from studies of the impact of air pollution on pregnancy outcomes. This study aims to analyze, in a population of multiple pregnancies, the relationship between fetal growth restriction (FGR), small for gestational age (SGA) and exposure to air pollution in moderately polluted cities. Methods: All women with multiple pregnancies living in the city of Besançon or in the urban area of Dijon and who delivered at a university hospital between 2005 and 2009 were included. FGR and SGA were obtained from medical records. Outdoor residential nitrogen dioxide (NO2) exposure wa…
Changes in Maternal Blood Inflammatory Markers As a Predictor Of Chorioamnionitis: A Prospective Multicenter Study
Problem To evaluate the inflammatory pattern in maternal circulation from women with preterm premature rupture of membranes (PPROM) considering the occurrence of histologically confirmed chorioamnionitis (HCA). Method of study A prospective study was conducted in 121 women with PPROM between 24 and 34 + 0 weeks of gestation. Association between white blood cells (WBC) count, plasma CRP, IL-6, MCP-1 and IP-10 levels, and HCA was assessed. Results The rate of HCA was 44.7% (54/121). During the 5 days preceding delivery, median CRP, WBC, and IL-6 levels were significantly higher in the HCA than in no-HCA group (P < 0.001). Variations in IL-6, IP-10 levels, during the 24–72 hr before delivery, …
Does low to moderate environmental exposure to noise and air pollution influence preterm delivery in medium-sized cities?
International audience; Background: Preterm birth (PB) is an important predictor of childhood morbidity and educational performance. Beyond the known risk factors, environmental factors, such as air pollution and noise, have been implicated in PB. In urban areas, these pollutants coexist. Very few studies have examined the effects of multi-exposure on the pregnancy duration. The objective of this study was to analyse the relationship between PB and environmental chronic multi-exposure to noise and air pollution in medium-sized cities.Methods: A case-control study was conducted among women living in the city of Besançon (121 671 inhabitants) or in the urban unit of Dijon (243 936 inhabitants…
Satisfaction des soins obstétricaux : élaboration et validation d’une échelle de mesure de la qualité des soins
Resume Objectif Elaborer et valider une echelle de mesure subjective et multidimensionnelle pour l’evaluation de la satisfaction des soins obstetricaux (SSO) lors du travail, l’accouchement et deux heures post-partum, qui soit adaptee a la culture francophone. Patientes et methodes Quarante entretiens semi-directifs aupres de patientes lors des 48 heures post-partum et 4 entretiens aupres des soignants ont ete mis en place pour etablir le questionnaire. Apres une etude de faisabilite sur 40 patientes, la validite psychometrique du questionnaire a ete evaluee en calculant le coefficient de Cronbach pour la fiabilite du questionnaire chez 432 patientes. Resultats L’analyse du contenu thematiq…
Vulnerability during pregnancy in an urban environment : do environmental and individual risk factors cumulate?
International audience; Apart from demographic, socio-economic, behavioral, nutritional and medico-obstetrical factors, environmental factors have been suggested to be associated with adverse pregnancy outcomes, such as preterm birth, low birth weight or hypertensive disorders. According to a recent review of the literature, there is some suggestive evidence of adverse associations with environmental noise especially for low birth weight. However, the way these individual and environmental vulnerabilities combine has been scarcely studied. The objective of this study was to describe the accumulation of individual, socio-economics, medical and environmental vulnerability markers and to asses…
Exposition environnementale au bruit et à la pollution de l'air au cours de la grossesse avec comorbidités associées
L’objectif était d’analyser le lien entre l’exposition environnementale au bruit et à la pollution de l’air en milieu urbain et la prématurité chez les femmes dont le risque d’accouchement prématuré était augmenté par la présence d’une ou plusieurs comorbidités. Méthode. Une étude cas-témoins a été conduite sur les grossesses uniques accompagnées d’au moins une comorbidité. Les accouchements ont eu au CHU de Besançon ou de Dijon entre 2005 et 2009. Le niveau sonore de nuit (Lnight en façade du bâtiment d’habitation) et la concentration en dioxyde d’azote (NO2) dans les 50 m autour de l’habitation ont été modélisés à l’adresse déclarée au moment de l’accouchement. Une régression logistique c…
Very preterm birth: who has access to antenatal corticosteroid therapy?
International audience; We describe the administration of antenatal corticosteroid therapy (ACT) for liveborn very preterm neonates in a population-based study. A total of 790 very preterm neonates (between 24 and 31 full weeks of gestation) were included in this regionally defined population of very preterm neonates in France. The main outcome measure was non-access to ACT. Data were analysed using logistic and polytomous models to control for neonatal and sociodemographic characteristics, mechanisms of very preterm birth and neonatal network organisation. As compared with level III, births in levels I-II maternity units were closely related to non-access to ACT (60.1% vs. 8.8%), but not t…