J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Jun 2003
[Results of prenatal management of fetuses with supraventricular tachycardia. A series of 66 cases].
To describe the prenatal management and outcome of a series of 66 fetuses with supraventricular tachycardia (SVT). ⋯ Group of fetuses with no hydrops: digoxin was used in 32 cases and allowed 26 fetuses to be converted to sinus rhythm (80%). One intra uterine death (IUD) occurred in this group. Hydropic fetuses group: nine fetuses were converted to sinus rhythm using either flecainide (n=7) or amiodarone (n=2) as first line therapy, whilst digoxin alone or in association with sotalol failed to restore sinus rhythm in all cases. After first line therapy, SVT persisted in 10 fetuses. Nine fetuses received amiodarone alone or in association with digoxin as second line therapy, five of whom were converted to sinus rhythm. Among the 18 alive neonates treated by amiodarone in utero, three presented elevated thyroid stimulating hormone at day 3-4 and required thyroid hormonal substitution therapy for 2-6 months with normal outcome.
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J Gynecol Obst Bio R · Apr 2003
Review[Clinical and molecular diagnosis of inherited breast-ovarian cancer].
The aim of this work was to pinpoint familial breast and/or ovarian cancer risk. Clinical cancer genetics include: diagnostic cancer genetics, cancer genetic counseling and management of women at high risk of developing breast and/or ovarian cancer. ⋯ Inherited BC or OC due to a mutation in BRCA1 or BRCA2 are rare in the general population. However, women and men have the right to be informed of the possibilities concerning presymptomatic testing, risk assessment, surveillance, prevention and psychological support with respect to the potential benefits and limitations. Other large prospective studies are needed to validate rapidly the methods of surveillance and prevention in this group at "high risk" in order to adapt them to very large populations. However, predictive medicine should be used with care.
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J Gynecol Obst Bio R · Feb 2003
Review[Smoking, fetal pulmonary development and lung disease in children].
Prenatal exposure to tobacco smoke is associated with a significant increase in respiratory symptoms and a decrease in lung function in children. Epidemiological studies have demonstrated that tobacco smoke exposure represents one of the most important respiratory risk factors in childhood. Nicotine crosses the placenta and activates the nicotinic receptors which are present in a wide range of lung cells during the prenatal period. ⋯ These structural and functional disturbances explain why these infants are more susceptible to respiratory irritants. The alterations in ventilatory control induced by prenatal exposure to nicotine explain the link between tobacco smoke exposure and the sudden infant death syndrome. This underlines the importance of adequate information and preventative measures to decrease this major and avoidable cause of respiratory morbidity and mortality in infants.
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J Gynecol Obst Bio R · Feb 2003
Case Reports[Intrauterine device appendicitis: an exceptional complication].
We report a case of migration of an intrauterine contraceptive device to the appendix. In this patient with a clinical presentation suggestive of appendicitis, transvaginal ultrasonography visualized a device located outside the uterus, near the small bowel. ⋯ A literature review spanning the past years only revealed a few reported cases. Most of the authors recommend removal because of the potential for inflammatory reactions that can cause bowel obstruction and perforation.
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Recruitment, work load and morbidity linked to newborn asphyxia during delivery at term: a study from Pediatric Mobile Intensive Care Units. ⋯ Pediatric MICUs transport the most severely affected neonates. The initial clinical state is critical, and systemic and neurological complications are frequent and severe. Calls to the MICU should be made earlier in order to enable a better impact of new neuroprotective strategies.