Marie-France Delisle | University of British Columbia (original) (raw)

Papers by Marie-France Delisle

Journal SOGC, Sep 1, 1996

Abstract Spontaneous uterine rupture is a rare but life-threatening event. Usually, this complica... more Abstract Spontaneous uterine rupture is a rare but life-threatening event. Usually, this complication is associated with such risk factors as previous injury of the uterine wall. We report a case of spontaneous rupture of an unscarred uterus in the absence of classical risk factors, and review the literature with respect to the possible aetiologies of this condition. We conclude that the differential diagnosis of atypical abdominal pain in pregnancy should include spontaneous uterine rupture, even in the absence of classical risk factors.

Journal of Maternal-fetal & Neonatal Medicine, Dec 1, 2001

Lung cancer diagnosed in pregnancy is rare. The number of reported cases has been escalating in r... more Lung cancer diagnosed in pregnancy is rare. The number of reported cases has been escalating in recent years, probably reflecting the increasing number of women of reproductive age who smoke. This review presents three cases of lung cancer in pregnancy with different manifestations and outcomes, with a review of the literature. Physicians should have a low threshold using different diagnostic tools for investigating unusual symptoms during pregnancy without fear for fetal safety. Once diagnosed, lung cancer represents a major ethical and medical dilemma. The optimal management of lung cancer in pregnancy is not known, because of the rarity of the cases reported during pregnancy and insufficient follow-up data.

Fetal Diagnosis and Therapy, 2004

Objectives: To evaluate whether the cephalic index (CI) in trisomy 21 (T21) and trisomy 18 (T18) ... more Objectives: To evaluate whether the cephalic index (CI) in trisomy 21 (T21) and trisomy 18 (T18) fetuses is different from that in euploid fetuses, and if so, is this difference of clinical utility. Methods: Retrospective. Over an 18-month period, patients attending a single centre for routine advanced maternal age amniocentesis were recruited for a prospective study of ultrasound soft markers of aneuploidy. This prospective database was searched for cases with the following criteria: (1) occipitofrontal diameters (OFD) measured at least twice; (2) gestational age between 98 and 126 days either by ultrasound-confirmed menstrual dates or early second- trimester biometry; (3) no major central nervous system abnormalities detected on prenatal ultrasound, and (4) normal fetal karyotype. This constituted the control group. The study group consisted of all cases of prenatally diagnosed T18 and T21 identified in the same time period with criterion 2 as above. The fetuses in the study group had the OFD measured in a blinded fashion from the biparietal diameter images. CI (= mean biparietal diameter/mean OFD) was calculated for all fetuses. Pearson coefficient and regression analysis were used to determine independence of CI to gestational age in the control group. Standard descriptive statistics were used to describe interval data and two-tailed t test was used to compare means between the study and control groups. ROC curves were constructed to evaluate the clinical efficacy of CI for T18 and T21. Results: Five hundred and ninety-seven fetuses were available for analysis. There were 551 fetuses in the control group and 46 in the study group. Within the study group, there were 30 T21 and 16 T18 fetuses. Within the control group, CI was independent of gestational age (R = 0.026, p = 0.922). Mean CI for the control group was 0.802 (SD 0.040) and this was not statistical different from either the T21 group (mean 0.816, SD 0.042, p = 0.067) or the T18 group (mean 0.792, SD 0.057, p = 0.491). Area under the ROC curves was determined for both T18 and T21 and both had poor results (0.545 and 0.598, respectively). When CI was evaluated in the control group according to the two main ethnic groups in the study, there was a trend towards a statistical difference (p = 0.046) between the fetuses of Oriental and Caucasian mothers. Conclusions:In this retrospective study, CI was not found to be statistically different between the study and control groups. Although a trend towards significance was seen with T21, this difference is not clinically useful. There may be interethnic differences in the CI between fetuses. CI is not useful for aneuploidy screening by ultrasound.

Clinica Chimica Acta, Mar 1, 1972

The best known foetoprotein is alphafetaglobulin (AFG). The highest levels are in the blood betwe... more The best known foetoprotein is alphafetaglobulin (AFG). The highest levels are in the blood between weeks 10-12 of intrauterine life. The concentration decreases until birth and disappears within 2-3 weeks. The alphaglobulin concentrations of 134 infants were determined at birth. 47 infants were full-term (between 38-42 weeks), 68 were premature (before 38 weeks), and 19 were small-for-date. The level decreases progressively in a nonlinear pattern during the last trimester of gestation. The level decreases rapidly after birth, regardless of the maturity of the infant. The test was not a biochemical indicator of maturation because of individual variations in alphafetoglobulin concentration with both increasing gestational age and birth weight.

Journal of obstetrics and gynaecology Canada, Mar 1, 2006

Objective: This study was conducted to evaluate the usefulness of testing for fetal fibronectin (... more Objective: This study was conducted to evaluate the usefulness of testing for fetal fibronectin (fFN) to rule out the diagnosis of preterm labour in symptomatic patients in a Canadian setting. Methods: This was a prospective, blinded clinical evaluation of fFN testing in women presenting with threatened preterm labour at between 24 and 34 weeks' gestation at two Canadian tertiary care centres. Results: Of the 149 women tested, 32 had a positive fFN test. In the total patient population, 10.1% delivered within seven days of testing, and 18.2% delivered prior to 34 weeks. A negative fFN result was associated with a 97.4% likelihood of delivering more than seven days after testing and with a 91.4% chance of delivering after 34 weeks. Conclusion: The fFN test appears to provide useful information in the risk assessment of Canadian women presenting with symptoms compatible with preterm labour. A negative test has a high predictive value for delivering more than seven days after presentation. Résumé Objectif : La présente étude a été menée en vue d'évaluer l'utilité du test visant la fibronectine foetale (FNf) pour écarter le diagnostic de travail préterme chez les patientes symptomatiques, en milieu canadien. Méthodes : Il s'agissait d'une évaluation clinique prospective et à l'aveugle du test FNf chez les femmes présentant une menace de travail préterme entre la 24 e et la 34 e semaine de gestation, au sein de deux centres de soins tertiaires canadiens. Résultats : Des 149 femmes soumises au test FNf, 32 ont obtenu des résultats positifs. Au sein de la population totale de patientes, 10,1 % des femmes ont accouché dans les sept jours suivant l'administration du test et 18,2 % des femmes ont accouché avant la 34 e semaine de gestation. L'obtention de résultats négatifs au test FNf a été associée à une probabilité d'accoucher plus de sept jours à la suite de l'administration du test de l'ordre de 97,4 %, ainsi qu'à une probabilité d'accoucher après la 34 e semaine de gestation de l'ordre de 91,4 %. Conclusion : Le test FNf semble offrir des renseignements utiles pour l'évaluation du risque chez les Canadiennes qui présentent des symptômes compatibles avec le travail préterme. L'obtention d'un test négatif compte une valeur prédictive élevée en ce qui concerne l'accouchement plus de sept jours à la suite de l'administration du test.

Journal of obstetrics and gynaecology Canada, Nov 1, 2007

To review the teratogenesis associated with pre-existing and gestational diabetes, to provide gui... more To review the teratogenesis associated with pre-existing and gestational diabetes, to provide guidelines to optimize prevention and diagnosis of fetal abnormalities in women with diabetes, and to identify areas specific to fetal abnormalities and diabetes requiring further research. Pre-conception counselling, pre-conception and first trimester folic acid supplementation, and glycemic control. Increased awareness of fetal abnormalities associated with pre-existing and gestational diabetes. The Cochrane Library and Medline were searched for English-language articles, published from 1990 to February 2005, relating to pre-existing and gestational diabetes and fetal abnormalities. Search terms included pregnancy, diabetes mellitus, pre-existing diabetes, type 1 diabetes, type 2 diabetes, insulin dependent diabetes, gestational diabetes, impaired glucose tolerance, congenital anomalies, malformations, and stillbirth. Additional publications were identified from the bibliographies of these articles as well as the Science Citation Index. All study types were reviewed. Randomized controlled trials were considered evidence of the highest quality, followed by cohort studies. Key studies and supporting data for each recommendation are summarized with evaluative comments and referenced. The evidence collected was reviewed by the Genetics and Maternal Fetal Medicine Committees of the Society of Obstetricians and Gynaecologists of Canada (SOGC) and quantified using the criteria and classifications of the Canadian Task Force on Preventive Health Care. VALIDATION: These guidelines have been reviewed by the Genetics Committee and the Maternal Fetal Medicine Committee of the SOGC. Final approval has been given by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. The Society of Obstetricians and Gynaecologists of Canada.

Obstetric Anesthesia Digest, Dec 1, 2009

Journal of obstetrics and gynaecology Canada, Apr 1, 2009

Prise en charge du méconium à la naissance Résumé Objectif : Fournir aux cliniciens des directive... more Prise en charge du méconium à la naissance Résumé Objectif : Fournir aux cliniciens des directives fondées sur les meilleures données disponibles quant à l'aspiration au périnée pour les enfants nés en présence de liquide amniotique teinté de méconium. Résultats : Des recherches ont été menées dans la base de données Medline afin d'en tirer les articles, publiés en anglais entre 2000 et 2008, portant sur la prise en charge du méconium à la naissance. Valeurs : La recommandation a été formulée conformément aux lignes directrices élaborées par le Groupe d'étude canadien sur les soins de santé préventifs. Recommandation Il est recommandé que les établissements adoptent une politique indiquant que le fait de ne pas procéder à l'aspiration est aussi sûr que la tenue systématique d'une aspiration au périnée pour les enfants nés en présence de liquide amniotique teinté de méconium. (IA)

Journal of Ultrasound in Medicine, Aug 1, 1998

ransvaginal ultrasonography is an excellent diagnostic tool in gynecology. The technique is safe ... more ransvaginal ultrasonography is an excellent diagnostic tool in gynecology. The technique is safe and painless, is widely available, and has a high degree of acceptability to patients. It offers an effective noninvasive method to assess structural and functional changes in the uterus and ovaries and also allows the evaluation of ET. 1,2 Recent studies have been performed that discuss and analyze different characteristics of the endometrial wall. Fleischer and coworkers 3 have shown excellent agreement between the measurements of the ET obtained by TVS and those taken directly in fresh, unfixed pathologic specimens. Furthermore, several recent studies also have demonstrated a correlation between ET and histopathologic findings. 4-6 For the last decade, TVS has been used increasingly to assess changes in endometrial structure. 2,7 Measurement of the ET is being used to exclude pathologic conditions of the endometrium. 5,8,9 TVS measurement of ET as a diagnostic tool has not been evaluated extensively with regard to its reliability or reproducibility. Despite this, many clinical decisions are based on a single ET measurement. Wolman and colleagues studied interobserver variability in a small number of patients 10 ; the present study, however,

Journal of obstetrics and gynaecology Canada, Jul 1, 2004

Background: Vesicouterine fistula is a rare complication of Caesarean delivery. This is the third... more Background: Vesicouterine fistula is a rare complication of Caesarean delivery. This is the third known report of vesicouterine fistula diagnosed during pregnancy. Case: Linda (pseudonym), a 28-year-old woman in her second pregnancy, having had a Caesarean delivery in her first pregnancy, was admitted to the delivery unit with possible preterm ruptured membranes at 23 weeks' gestation. She also complained of a fluid-filled sac bulging from her introitus during her admission assessment. Diagnosis of premature rupture of membranes was confirmed by a positive nitrazine paper test and appearance of ferning during microscopic evaluation of vaginal fluid. Cystoscopy, performed 3 days after admission, demonstrated ballooning of amnion into the bladder. At 24 weeks' gestation, the woman had a precipitous vaginal breech delivery. Two months later, the fistula was successfully repaired through a transabdominal route. Conclusion: Although uncommon in pregnancy, vesicouterine fistula should be considered in women who present with urinary incontinence or recurrent urinary tract infections after a lower transverse Caesarean section. Evaluation in pregnancy is usually limited to cystoscopy. Treatment is usually surgical and is often delayed until 2 to 3 months following delivery. Resume Contexte : La fistule vesico-uterine est une complication rare de I'accouchement par cesarienne. La presente constitue Ie troisieme signalement connu d'un diagnostic de fistule vesicouterine etabli au cours d'une grossesse. Cas : A la 23" semaine de gestation, Linda (pseudonyme), femme de 28 ans vivant sa deuxieme grossesse et ayant vecu un accouchement par cesarienne lors de sa premiere grossesse, a ete admise it I'unite d'accouchement en raison d'une possible rupture prematuree des membranes. Au cours de son evaluation d'admission, Linda s'est egalement plaint de la saillie d'un sac rempli de flu ide au travers de son ostium vaginae. Le diagnostic de rupture prematuree des membranes a ete

Obstetrics & Gynecology, Nov 1, 1999

To quantify the association of prenatally diagnosed atrioventricular septal defect with Down synd... more To quantify the association of prenatally diagnosed atrioventricular septal defect with Down syndrome and to evaluate its impact on obstetric and neonatal outcomes. Methods: Charts of 42 cases of atrioventricular septal defect diagnosed by fetal echocardiography from July 1985 to July 1997 were reviewed for prenatal history and outcome data (pregnancy outcome, pathologic confirmation, postnatal echocardiographic findings, and neonatal outcome). Statistical analysis was done using Fisher exact test and odds ratios. Results: The mean gestational age at diagnosis was 26 weeks. Four cases could not be confirmed antenatally on repeat echocardiograms and were excluded. Reasons for referral of the remaining 38 fetuses included an abnormal four-chamber view in 76%. Twenty-two fetuses (58%) had abnormal karyotypes: 19 trisomy 21, one trisomy 18, one trisomy 13, and one mosaicism. The cardiac lesions were isolated in 20 fetuses (53%). After excluding cases of termination, ten of 12 fetuses (83%) with Down syndrome survived, compared with seven of 13 (54%) with normal karyotypes (P ‫؍‬ ‫؍‬ ‫؍‬ .125). The odds of trisomy 21 were 16 times higher (95% confidence interval 3.0, 85.3) in fetuses with isolated cardiac lesions compared with those with associated cardiac anomalies. Conclusion: Prenatal diagnosis of atrioventricular septal defect was associated with a 58% risk of aneuploidy (mainly trisomy 21). Down syndrome fetuses with this cardiac anomaly appeared to have a better survival rate than fetuses with normal karyotypes. Our sample did not have enough power to show a statistically significant difference. When an isolated atrioventricular septal defect was diagnosed prenatally, the odds of trisomy 21 were significantly higher than when other associated cardiac lesions were diagnosed. This information should be considered in prenatal counseling for atrioventricular septal defect.

American Journal of Perinatology, 2002

Factor V Leiden (FVL) is a newly discovered genetic mutation that impairs one of the body&amp... more Factor V Leiden (FVL) is a newly discovered genetic mutation that impairs one of the body&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s naturally occurring anticoagulation systems. The result is resistance to activated protein C and a predisposition to thrombosis. FVL is the most common cause of primary and recurrent venous thromboembolism in the pregnant and nonpregnant state. The FVL gene is common in the general population and transmitted in an autosomal dominant fashion. When FVL is combined with the prothrombotic state of pregnancy, the result is an increased propensity to manifest a number of pregnancy complications. These include recurrent pregnancy loss and stillbirth, severe and early-onset preeclampsia, placental abruption and possibly, intrauterine growth restriction. It remains unknown whether thromboprophylaxis is effective in ameliorating these pregnancy complications. The current literature and management recommendations are highlighted in this article.

Seminars in Perinatology, Oct 1, 1999

Twenty years after midtrimester genetic amniocentesis was first used, first trimester invasive pr... more Twenty years after midtrimester genetic amniocentesis was first used, first trimester invasive prenatal procedures were introduced. Chorionic villous sampling presents some disadvantages that entitled many centers to look into an alternative for first trimester diagnosis. Early amniocentesis (EA) can be performed effectively, as shown over the years in many observational studies and partially randomized and randomized trials. Recently, a multicenter randomized trial (Canadian Early and Midtrimester Amniocentesis Trial) reported a higher total pregnancy loss, a significant increased incidence of musculoskeletal foot deformities, a significant increased culture failure rate, and an increased postamniocentesis rate of leakage in the EA group compared with midtrimester amniocentesis. These results concerning EA procedures from 11w +~ to 12w +6 should be included in any pre-EA counseling. However, further trials have started to evaluate EA procedures between 13w +~ to 14w +6.

Journal of obstetrics and gynaecology Canada, Feb 1, 2010

Objective: To review the evidence and provide recommendations for the counselling and management ... more Objective: To review the evidence and provide recommendations for the counselling and management of obese parturients. Outcomes: Outcomes evaluated include the impact of maternal obesity on the provision of antenatal and intrapartum care, maternal morbidity and mortality, and perinatal morbidity and mortality. Evidence: Literature was retrieved through searches of Statistics Canada, Medline, and The Cochrane Library on the impact of obesity in pregnancy on antepartum and intrapartum care, maternal morbidity and mortality, obstetrical anaesthesia, and perinatal morbidity and mortality. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to April 2009. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Values: The evidence obtained was reviewed and evaluated by the Maternal Fetal Medicine and Clinical Practice Obstetric Committees of the SOGC under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care. Benefits, Harms, and Costs: Implementation of the recommendations in this guideline should increase recognition of the issues clinicians need to be aware of when managing obese women in pregnancy, improve communication and consultation amongst the obstetrical care team, and encourage federal and provincial agencies to educate Canadians about the values of entering pregnancy with as healthy a weight as possible. Recommendations 1. Periodic health examinations and other appointments for gynaecologic care prior to pregnancy offer ideal opportunities to raise the issue of weight loss before conception. Women should be encouraged to enter pregnancy with a BMI < 30 kg/m 2 , and ideally < 25 kg/m 2. (III-B) 2. BMI should be calculated from pre-pregnancy height and weight. Those with a pre-pregnancy BMI > 30 kg/m 2 are considered obese. This information can be helpful in counselling women about pregnancy risks associated with obesity. (II-2B) 3. Obese pregnant women should receive counselling about weight gain, nutrition, and food choices. (II-2B)

Journal of Maternal-fetal & Neonatal Medicine, 2000

A 30-year-old woman with von Hippel-Lindau disease presented at 30 weeks&amp;amp;amp;#39;... more A 30-year-old woman with von Hippel-Lindau disease presented at 30 weeks&amp;amp;amp;#39; gestation with a symptomatic cerebellar hemangioblastoma. She underwent a craniotomy for complete removal of the tumor. The postoperative period and the remaining of the pregnancy were uneventful. She delivered under epidural anesthesia after induction for postterm.

Journal of obstetrics and gynaecology Canada, Dec 1, 2016

Insuffisance cervicale et cerclage cervical Avis: La présente directive clinique est publiée offi... more Insuffisance cervicale et cerclage cervical Avis: La présente directive clinique est publiée officiellement dans le Journal d'obstétrique et gynécologie du Canada. Par conséquent, la date de parution pourrait ne pas correspondre à la date de publication originale. Aucune modification n'a été apportée au contenu. La présente directive clinique a été rédigée par le comité de médecine foeto-maternelle, analysée par le comité de pratique clinique-obstétrique et approuvée par le comité exécutif et le Conseil de la Société des obstétriciens et gynécologues du Canada.

American Journal of Obstetrics and Gynecology, Dec 1, 2001

Journal of Obstetrics and Gynaecology Canada, 2021

Journal of Ultrasound in Medicine, 1998

Journal of Obstetrics and Gynaecology Canada, 2011

Resume Objectif Fournir une directive clinique quant a l’administration prenatale de sulfate de m... more Resume Objectif Fournir une directive clinique quant a l’administration prenatale de sulfate de magnesium (MgSO 4 ) a des fins de neuroprotection foetale pour ce qui est du nouveau-ne issu d’un accouchement preterme. Options L’administration prenatale de MgSO 4 devrait etre envisagee a des fins de neuroprotection foetale en presence d’un accouchement preterme imminent (defini comme une forte probabilite d’accouchement en raison d’un travail actif en presence d’une dilatation cervicale ≥ 4 cm, avec ou sans rupture pretravail des membranes preterme, et/ou un accouchement preterme planifie en raison d’indications foetales ou maternelles) chez une patiente en etant a ≤ 31+6 semaines. Il n’existe aucun autre agent neuroprotecteur foetal connu. Issues Les criteres d’evaluation sont l’incidence de l’infirmite motrice cerebrale (IMC) et le deces neonatal. Resultats La litterature publiee a ete recuperee par l’intermediaire de recherches menees dans PubMed ou Medline, CINAHL et The Cochrane Library, en mai 2010, au moyen d’un vocabulaire controle et de mots cles adequats (« magnesium sulphate », « cerebral palsy », « preterm birth »). Les resultats ont ete restreints aux analyses systematiques, aux essais comparatifs randomises / essais cliniques comparatifs et aux etudes observationnelles pertinentes. Aucune restriction n’a ete imposee en matiere de date ou de langue. Les recherches ont ete mises a jour de facon reguliere et integrees a la directive clinique jusqu’en aout 2010. La litterature grise (non publiee) a ete identifiee par l’intermediaire de recherches menees dans les sites Web d’organismes s’interessant a l’evaluation des technologies dans le domaine de la sante et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et aupres de societes de specialite medicale nationales et internationales. Valeurs La qualite des resultats a ete evaluee au moyen des criteres decrits dans le rapport du Groupe d’etude canadien sur les soins de sante preventifs (Tableau 1). Avantages, desavantages et couts L’administration prenatale de sulfate de magnesium a des fins de neuroprotection foetale attenue le risque de « deces ou d’IMC » (RR, 0,85; IC a 95 %, 0,74 – 0,98; 4 essais, 4 446 nouveau-nes), de « deces ou d’IMC allant de moderee a grave » (RR, 0,85; IC a 95 %, 0,73 – 0,99; 3 essais, 4 250 nouveau-nes), de « toute forme d’IMC » (RR, 0,71; IC a 95 %, 0,55 – 0,91; 4 essais, 4 446 nouveaunes), d’« IMC allant de moderee a grave » (RR, 0,60; IC a 95 %, 0,43 – 0,84; 3 essais, 4 250 nouveau-nes) et de « dysfonction substantielle de la motricite globale » (incapacite de marcher sans aide) (RR, 0,60; IC a 95 %, 0,43 – 0,83; 3 essais, 4 287 nouveau-nes) a l’âge de deux ans. Les resultats etaient concordants d’un essai et d’une meta-analyse a l’autre. Nous n’anticipons aucune hausse significative des couts de sante, puisque les femmes admissibles au traitement prenatal au MgSO 4 seront considerees comme etant sur le point de connaitre un accouchement preterme. Validation La directive clinique nationale australienne a ete publiee en mars 2010 par le Antenatal Magnesium Sulphate for Neuroprotection Guideline Development Panel. L’administration prenatale de MgSO 4 a ete recommandee a des fins de neuroprotection foetale en fonction de la meme posologie que celle qui est recommandee dans la presente directive clinique. Cependant, l’administration de MgSO4 n’a ete recommandee qu’a Commanditaire Instituts de recherche en sante du Canada (IRSC).