G. Chêne - Academia.edu (original) (raw)
Papers by G. Chêne
![Research paper thumbnail of [First-trimester cystic hygroma: prenatal diagnosis and fetal outcome]](https://a.academia-assets.com/images/blank-paper.jpg)
](Journal de gynécologie, obstétrique et biologie de la reproduction, 2014
To describe the ultrasonographic (US) and fetal karyotyping data of fetuses with cystic hygroma d... more To describe the ultrasonographic (US) and fetal karyotyping data of fetuses with cystic hygroma diagnosed in the first trimester. Maternal and fetal data of 69 consecutive fetal cystic hygroma were analysed between 2002 and 2009. The mean size of the cystic hygroma was 6.3 mm ± 2.4 mm. US abnormalities were present in 54% of cases (37/69) (essentially hydrops fetalis in 45%), with an unfavourable prognosis (P=0.006). Chromosomal abnormalities were present in 53% of cases (36/68) (including 44% of Down syndrome). The rate of unfavourable outcome of pregnancy was 71% of cases (49/69) and was associated with the oldest mothers (P=0.011). In the chromosomally normal pregnancies, there were 59% (19/32) fetus with no apparently abnormalities. Among these 19 children, 13 have been followed up until an average age of 5 years and a half, the infant development was strictly normal. The current results suggest to look for the poor prognosis data: nuchal thickness superior to 6 to 6,5 mm, prese...
![Research paper thumbnail of [Computerized cardiotocography and short-term variation in management of obstetric cholestasis: a useful tool?]](https://attachments.academia-assets.com/43856812/thumbnails/1.jpg)
](Journal de gynécologie, obstétrique et biologie de la reproduction, 2011
To evaluate active management of obstetric cholestasis by comparing correlation between bile acid... more To evaluate active management of obstetric cholestasis by comparing correlation between bile acid concentrations and computerized cardiotocography (Short-term variation [STV]). Retrospective analytic study about 51 obstetric cholestasis between January 2001 and August 2009. Demographic characteristics, bile acid concentrations and STV data were recorded since diagnosis to pregnancy with evaluation of fetal outcome. There were no statistical correlation between bile acid concentrations, STV data and fetal outcome. Patients with cholestasis diagnosed in second trimester delivered 12 days earlier than cholestasis diagnosed in third trimester (p=0.0012). Delivery before 37 weeks was found in 37.2% of cases. There were no perinatal deaths. Sixty percent had a recurrent obstetric cholestasis. Further works are necessary to study the exact pathogeny of obstetric cholestasis in order to determinate the best surveillance.
Immuno-analyse & Biologie Spécialisée, 2009
Objective. -To evaluate the new TOXO IgG II Access ® test (Beckman Coulter). Materials and method... more Objective. -To evaluate the new TOXO IgG II Access ® test (Beckman Coulter). Materials and methods. -A comparative study of the TOXO IgG I and II Access ® , Axsym ® and Vidas ® tests was done on 406 consecutive samples. The western Blot (LDBIO TOXO II IgG ® ) was done as a reference technique in case of intertechnique discordance.
![Research paper thumbnail of La parturition de Lucy, chemin vers l'extinction ? | [Lucy's parturition, a way towards extinction?]](https://attachments.academia-assets.com/43856777/thumbnails/1.jpg)
](![Research paper thumbnail of [Failed forceps extraction: risk factors and maternal and neonatal morbidity]](https://attachments.academia-assets.com/43856809/thumbnails/1.jpg)
](Journal de gynécologie, obstétrique et biologie de la reproduction, 2012
To evaluate risk factors associated with failed forceps delivery and to compare the maternal and ... more To evaluate risk factors associated with failed forceps delivery and to compare the maternal and neonatal morbidity. In this retrospective case-control study, all failed forceps delivery cases were analyzed from January 2005 to June 2008 and were compared to a successful forceps delivery cohort. The rate of failed forceps extraction was 4.4% (40/918). Specific risk factors were extraction above a fœtal station of S+2 (OR=43.03; IC 95%: 3.8-475.41), occipito-posterior position (OR=34.64; IC 95%: 4.08-293.5), and biparietal diameter higher than 95mm (OR=10.74; IC 95%: 1.4-82.41). Maternal and neonatal morbidity was few in both groups. Diagnosis of presentation level and variety of presentation are necessary before instrumental extraction. A "trial of forceps" should be performed with caution in a setting where a caesarean delivery could follow. Vacuum extraction could be interesting in case of occipito-posterior position.
![Research paper thumbnail of [Anthropometric analysis of obstetrical pelvis from Neolithic area: obstetrical consequences. Preliminary study]](https://attachments.academia-assets.com/43856806/thumbnails/1.jpg)
](Gynécologie, obstétrique & fertilité, 2011
To study female pelves from Neolithic area (5000 years AD) in order to better understand the evol... more To study female pelves from Neolithic area (5000 years AD) in order to better understand the evolution of obstetrical mecanisms. The fossil material comprised 73 Homo sapiens pelves: we reconstructed all the 20 adult female bony pelves. We realised the shape and morphometric analysis of the pelvic cavity. Changes in pelvic neolithic morphology were compared with pelvic modern morphology. The pelves of prehistoric female were similar in shape with modern female. However, they differ in relative dimensions (transversal diameter of the pelvis inlet: respectively 118 mm vs 125 mm, p=0.02). Reconstructions based on Neolithic hominin fossils suggest that obstetrical mechanisms were probably common to Neolithic and modern humans: childbirth would probably require social adaptations and risks of perinatal and obstetric complications were undoubtedly high. However, the differences in morphometric analysis could suggest a change of human pelvis and raise the question of the evolution in obste...
![Research paper thumbnail of [Shoulder dystocia: a ten-year descriptive study in a level-III maternity unit]](https://attachments.academia-assets.com/43856808/thumbnails/1.jpg)
](Gynécologie, obstétrique & fertilité, 2009
Shoulder dystocia is one of the most dreadful complications of vaginal deliveries. The aim of thi... more Shoulder dystocia is one of the most dreadful complications of vaginal deliveries. The aim of this observational study was to evaluate risk factors of dystocia, maternal and neonatal complications and recurrent risk factors. Sixty-six cases of shoulder dystocia occurring between January 1998 and August 2008 in our university hospital were identified. Demographic data, labor management, management of the shoulder dystocia and neonatal outcome were recorded. The incidence of shoulder dystocia was 0.3%. Multiparity, weight gain greater than 12 kg, and post-term delivery were more present in our study group. McRoberts' manoeuver and symphyseal pressure were first realised. Brachial plexus injuries affected 9% of neonates with skeletal fractures in 7.5% of cases. Maternal morbidity was evaluated at about 8%. Twenty per cent had a recurrent shoulder dystocia. Shoulder dystocia is an obstetric emergency which requires a prompt management of trained personnel. Despite the difficulty of ...
American Journal of Epidemiology, 2001
and the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine After initiation of a treatment for ... more and the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine After initiation of a treatment for human immunodeficiency virus type 1 infection containing a protease inhibitor, immune restoration associated with increases in CD4-positive (CD4+) T lymphocyte count may be delayed. In a sample of patients who had been prescribed protease inhibitors for the first time, the authors tested to see whether there was a minimal duration of CD4+ cell count increase before the increase had an impact on the occurrence of opportunistic infections. The evolution (difference between time t and baseline) of CD4+ cell count was modeled using a mixed effects linear model. Changes in CD4+ count estimated by this model were then included as time-dependent covariates in a proportional hazards model. Finally, the authors tested for the existence of a CD4+ change × time interaction. The authors used a sample of 553 French patients first prescribed protease inhibitors in 1996 and followed for a median of 16 months. During the first 120 days, there was no association between CD4+ change and the rate of opportunistic infections. After 120 days, each 50cell/mm 3 increase in CD4+ count was associated with a 60% (95% confidence interval: 45, 72) reduction in the incidence of opportunistic infections. These results, based on modeling of CD4+ cell response, at least indirectly reinforce the concept of a delayed but possible immune recovery with the use of protease inhibitors. The findings support the potential for interruption of certain types of prophylaxis against opportunistic infections under reasonable conditions of duration of antiretroviral therapy and sustained CD4+ cell response. Am J Epidemiol 2001;153:386-93. acquired immunodeficiency syndrome; antiviral agents; CD4-positive T-lymphocytes; cell count; immune system; immunity; opportunistic infections; protease inhibitors
Gynécologie Obstétrique & Fertilité, 2009
Reçu le 7 juin 2008 ; accepté le 16 décembre 2008 Disponible sur Internet le 5 février 2009 Résum... more Reçu le 7 juin 2008 ; accepté le 16 décembre 2008 Disponible sur Internet le 5 février 2009 Résumé Objectif.-Unemégavessie au premier trimestre de la grossesse est définie par un diamètre vésical longitudinal supérieur ou égal à 7 mm. L'objectif de cette étude est de décrire cette pathologie foetale rare qui pose le problème du diagnostic étiologique et du pronostic à un terme aussi précoce. Patientes et méthodes.-Entre janvier 2003 et décembre 2008, nous avons recensé 12 cas de mégavessie adressées à notre centre pluridisciplinaire de diagnostic anténatal au CHU de Saint-É tienne. Résultats.-Deux cas ont spontanément régressé et un cas s'est avéré être un diagnostic différentiel. La prise en charge proposée par l'équipe a été une interruption médicale de grossesse dans tous les autres cas devant une évolution rapidement progressive (six cas) ou des anomalies de caryotype (deux trisomies 18 et une trisomie 21). Discussion et conclusion.-L'évaluation morphologique précoce échographique ainsi que la surveillance rapprochée sont fondamentales pour, d'une part, porter le diagnostic de mégavessie et, d'autre part, orienter le diagnostic étiologique. Le caryotype est toujours recommandé. Le pronostic global apparaît cependant sombre. # 2008 Elsevier Masson SAS. Tous droits réservés.
Journal de gynécologie, obstétrique et biologie de la reproduction, 2014
To describe the ultrasonographic (US) and fetal karyotyping data of fetuses with cystic hygroma d... more To describe the ultrasonographic (US) and fetal karyotyping data of fetuses with cystic hygroma diagnosed in the first trimester. Maternal and fetal data of 69 consecutive fetal cystic hygroma were analysed between 2002 and 2009. The mean size of the cystic hygroma was 6.3 mm ± 2.4 mm. US abnormalities were present in 54% of cases (37/69) (essentially hydrops fetalis in 45%), with an unfavourable prognosis (P=0.006). Chromosomal abnormalities were present in 53% of cases (36/68) (including 44% of Down syndrome). The rate of unfavourable outcome of pregnancy was 71% of cases (49/69) and was associated with the oldest mothers (P=0.011). In the chromosomally normal pregnancies, there were 59% (19/32) fetus with no apparently abnormalities. Among these 19 children, 13 have been followed up until an average age of 5 years and a half, the infant development was strictly normal. The current results suggest to look for the poor prognosis data: nuchal thickness superior to 6 to 6,5 mm, prese...
Journal de gynécologie, obstétrique et biologie de la reproduction, 2011
To evaluate active management of obstetric cholestasis by comparing correlation between bile acid... more To evaluate active management of obstetric cholestasis by comparing correlation between bile acid concentrations and computerized cardiotocography (Short-term variation [STV]). Retrospective analytic study about 51 obstetric cholestasis between January 2001 and August 2009. Demographic characteristics, bile acid concentrations and STV data were recorded since diagnosis to pregnancy with evaluation of fetal outcome. There were no statistical correlation between bile acid concentrations, STV data and fetal outcome. Patients with cholestasis diagnosed in second trimester delivered 12 days earlier than cholestasis diagnosed in third trimester (p=0.0012). Delivery before 37 weeks was found in 37.2% of cases. There were no perinatal deaths. Sixty percent had a recurrent obstetric cholestasis. Further works are necessary to study the exact pathogeny of obstetric cholestasis in order to determinate the best surveillance.
Immuno-analyse & Biologie Spécialisée, 2009
Objective. -To evaluate the new TOXO IgG II Access ® test (Beckman Coulter). Materials and method... more Objective. -To evaluate the new TOXO IgG II Access ® test (Beckman Coulter). Materials and methods. -A comparative study of the TOXO IgG I and II Access ® , Axsym ® and Vidas ® tests was done on 406 consecutive samples. The western Blot (LDBIO TOXO II IgG ® ) was done as a reference technique in case of intertechnique discordance.
Journal de gynécologie, obstétrique et biologie de la reproduction, 2012
To evaluate risk factors associated with failed forceps delivery and to compare the maternal and ... more To evaluate risk factors associated with failed forceps delivery and to compare the maternal and neonatal morbidity. In this retrospective case-control study, all failed forceps delivery cases were analyzed from January 2005 to June 2008 and were compared to a successful forceps delivery cohort. The rate of failed forceps extraction was 4.4% (40/918). Specific risk factors were extraction above a fœtal station of S+2 (OR=43.03; IC 95%: 3.8-475.41), occipito-posterior position (OR=34.64; IC 95%: 4.08-293.5), and biparietal diameter higher than 95mm (OR=10.74; IC 95%: 1.4-82.41). Maternal and neonatal morbidity was few in both groups. Diagnosis of presentation level and variety of presentation are necessary before instrumental extraction. A "trial of forceps" should be performed with caution in a setting where a caesarean delivery could follow. Vacuum extraction could be interesting in case of occipito-posterior position.
Gynécologie, obstétrique & fertilité, 2011
To study female pelves from Neolithic area (5000 years AD) in order to better understand the evol... more To study female pelves from Neolithic area (5000 years AD) in order to better understand the evolution of obstetrical mecanisms. The fossil material comprised 73 Homo sapiens pelves: we reconstructed all the 20 adult female bony pelves. We realised the shape and morphometric analysis of the pelvic cavity. Changes in pelvic neolithic morphology were compared with pelvic modern morphology. The pelves of prehistoric female were similar in shape with modern female. However, they differ in relative dimensions (transversal diameter of the pelvis inlet: respectively 118 mm vs 125 mm, p=0.02). Reconstructions based on Neolithic hominin fossils suggest that obstetrical mechanisms were probably common to Neolithic and modern humans: childbirth would probably require social adaptations and risks of perinatal and obstetric complications were undoubtedly high. However, the differences in morphometric analysis could suggest a change of human pelvis and raise the question of the evolution in obste...
Gynécologie, obstétrique & fertilité, 2009
Shoulder dystocia is one of the most dreadful complications of vaginal deliveries. The aim of thi... more Shoulder dystocia is one of the most dreadful complications of vaginal deliveries. The aim of this observational study was to evaluate risk factors of dystocia, maternal and neonatal complications and recurrent risk factors. Sixty-six cases of shoulder dystocia occurring between January 1998 and August 2008 in our university hospital were identified. Demographic data, labor management, management of the shoulder dystocia and neonatal outcome were recorded. The incidence of shoulder dystocia was 0.3%. Multiparity, weight gain greater than 12 kg, and post-term delivery were more present in our study group. McRoberts' manoeuver and symphyseal pressure were first realised. Brachial plexus injuries affected 9% of neonates with skeletal fractures in 7.5% of cases. Maternal morbidity was evaluated at about 8%. Twenty per cent had a recurrent shoulder dystocia. Shoulder dystocia is an obstetric emergency which requires a prompt management of trained personnel. Despite the difficulty of ...
American Journal of Epidemiology, 2001
and the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine After initiation of a treatment for ... more and the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine After initiation of a treatment for human immunodeficiency virus type 1 infection containing a protease inhibitor, immune restoration associated with increases in CD4-positive (CD4+) T lymphocyte count may be delayed. In a sample of patients who had been prescribed protease inhibitors for the first time, the authors tested to see whether there was a minimal duration of CD4+ cell count increase before the increase had an impact on the occurrence of opportunistic infections. The evolution (difference between time t and baseline) of CD4+ cell count was modeled using a mixed effects linear model. Changes in CD4+ count estimated by this model were then included as time-dependent covariates in a proportional hazards model. Finally, the authors tested for the existence of a CD4+ change × time interaction. The authors used a sample of 553 French patients first prescribed protease inhibitors in 1996 and followed for a median of 16 months. During the first 120 days, there was no association between CD4+ change and the rate of opportunistic infections. After 120 days, each 50cell/mm 3 increase in CD4+ count was associated with a 60% (95% confidence interval: 45, 72) reduction in the incidence of opportunistic infections. These results, based on modeling of CD4+ cell response, at least indirectly reinforce the concept of a delayed but possible immune recovery with the use of protease inhibitors. The findings support the potential for interruption of certain types of prophylaxis against opportunistic infections under reasonable conditions of duration of antiretroviral therapy and sustained CD4+ cell response. Am J Epidemiol 2001;153:386-93. acquired immunodeficiency syndrome; antiviral agents; CD4-positive T-lymphocytes; cell count; immune system; immunity; opportunistic infections; protease inhibitors
Gynécologie Obstétrique & Fertilité, 2009
Reçu le 7 juin 2008 ; accepté le 16 décembre 2008 Disponible sur Internet le 5 février 2009 Résum... more Reçu le 7 juin 2008 ; accepté le 16 décembre 2008 Disponible sur Internet le 5 février 2009 Résumé Objectif.-Unemégavessie au premier trimestre de la grossesse est définie par un diamètre vésical longitudinal supérieur ou égal à 7 mm. L'objectif de cette étude est de décrire cette pathologie foetale rare qui pose le problème du diagnostic étiologique et du pronostic à un terme aussi précoce. Patientes et méthodes.-Entre janvier 2003 et décembre 2008, nous avons recensé 12 cas de mégavessie adressées à notre centre pluridisciplinaire de diagnostic anténatal au CHU de Saint-É tienne. Résultats.-Deux cas ont spontanément régressé et un cas s'est avéré être un diagnostic différentiel. La prise en charge proposée par l'équipe a été une interruption médicale de grossesse dans tous les autres cas devant une évolution rapidement progressive (six cas) ou des anomalies de caryotype (deux trisomies 18 et une trisomie 21). Discussion et conclusion.-L'évaluation morphologique précoce échographique ainsi que la surveillance rapprochée sont fondamentales pour, d'une part, porter le diagnostic de mégavessie et, d'autre part, orienter le diagnostic étiologique. Le caryotype est toujours recommandé. Le pronostic global apparaît cependant sombre. # 2008 Elsevier Masson SAS. Tous droits réservés.