American journal of obstetrics and gynecology, Jan 9, 2015
We performed an Individual Participant Data (IPD) meta-analysis to calculate the recurrence risk ... more We performed an Individual Participant Data (IPD) meta-analysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. We performed an electronic literature search for cohort studies that reported on women suffering from HDP and who had a subsequent pregnancy. The principal investigators were contacted, informed and requested for their original study data. The obtained data were merged to form one combined database. The results will be presented as % with 95% confidence interval (CI) and odds ratios (OR) with 95% CI. Out of 94 eligible cohort studies, we obtained IPD of 22 studies, including a total of 99,415 women. Pooled data of 64 studies using published data (IPD where available) showed a recurrence rate of 18.1% (N=152,213, 95% CI: 17.9 - 18.3). In the 22 studies included in our IPD, the recurrence rate of a HDP was 20.7% (95%CI: 20.4 - 20.9). Recurrence manifested as preeclampsia (PE) in 13.8% (95%CI: ...
BJOG: An International Journal of Obstetrics & Gynaecology, 2021
ObjectiveTo describe and compare the characteristics of women with placenta accreta spectrum (PAS... more ObjectiveTo describe and compare the characteristics of women with placenta accreta spectrum (PAS) and their pregnancy outcomes according to the presence of placenta praevia and a prior caesarean section.DesignProspective population‐based study.SettingAll 176 maternity hospitals of eight French regions.PopulationTwo hundred and forty‐nine women with PAS, from a source population of 520 114 deliveries.MethodsWomen with PAS were classified into two risk‐profile groups, with or without the high‐risk combination of placenta praevia (or an anterior low‐lying placenta) and at least one prior caesarean. These two groups were described and compared.Main outcome measuresPopulation‐based incidence of PAS, characteristics of women, pregnancies, deliveries and pregnancy outcomes.ResultsThe PAS population‐based incidence was 4.8/10 000 (95% CI 4.2–5.4/10 000). After exclusion of women lost to follow up from the analysis, the group with placenta praevia and a prior caesarean included 115 (48%) wo...
Background:One of the 3 features of obstetrical antiphospholipid syndrome (APS) is severe preecla... more Background:One of the 3 features of obstetrical antiphospholipid syndrome (APS) is severe preeclampsia (PE). Its time of occurrence, the associated risk of thromboses and systemic lupus erythematosus (SLE) have not been reported yet.Objectives:We analyzed severe PE in a series of women with APS.Methods:We retrospectively collected data of female patients from 5 French internal medicine and 1 Italian rheumatology units. Inclusion criteria were: a severe PE/eclampsia(1), that occurred before 34 weeks of gestation (WG) in patients who met the APS classification criteria(2).Results:40 patients were enrolled (Table 1). Because of known APS/positive aPL/previous obstetrical complications, 23(57.5%) patients were treated during the index PE: 4 with low dose aspirin (LDA), 4 with low molecular weight heparin (LMWH), and 15 with a combination of both. 7 patients were also treated with hydroxychloroquine, 8 with corticosteroids and 3 with immunosuppressants. 17(42.5%) patients received no tre...
Introduction Les facteurs predictifs de complications neonatales chez les femmes ayant un syndrom... more Introduction Les facteurs predictifs de complications neonatales chez les femmes ayant un syndrome des antiphospholipides (SAPL) restent controverses et n’ont pas ete etudies dans le contexte francais. La principale etude disponible est l’etude americaine prospective PROMISSE [1] qui met en evidence 19 % de complications neonatales au cours de 144 grossesses de patientes porteuses d’une biologie APL. Nous rapportons les premiers resultats obtenus dans le cadre de l’etude du GR2. Patients et methodes Les criteres d’inclusion etaient : – une grossesse evolutive a 12 semaines d’amenorrhee (SA) incluse dans l’etude prospective observationnelle du GR2 ; – anterieure a mai 2018 ; – chez une patiente ayant un SAPL [2] . Les criteres d’exclusion etaient une proteinurie > 1 g/g, une creatinine > 100 μmol/L et la gemellarite. Une grossesse par patiente etait analysee (la premiere repondant aux criteres en cas d’inclusions multiples). Le critere de jugement principal (CJP) etait composit...
Introduction Le risque de thrombose (0,05 a 0,2 %) et d’hemorragie severe au cours de la grossess... more Introduction Le risque de thrombose (0,05 a 0,2 %) et d’hemorragie severe au cours de la grossesse et du post-partum (autour de 1 % dans le post-partum [1] ) peut etre exacerbe en presence d’un syndrome des antiphospholipides (SAPL). Nous rapportons les premiers resultats obtenus dans le cadre de l’etude du GR2. Patients et methodes Les criteres d’inclusion etaient : –une grossesse evolutive a 12 semaines d’amenorrhee (SA) incluse dans l’etude prospective observationnelle du GR2 ; –anterieure a mai 2018 ; –chez une patiente ayant un SAPL [2] . Les criteres d’exclusion etaient une proteinurie > 1 g/g, une creatinine > 100 μmol/L et la gemellarite. Une grossesse par patiente etait analysee (la premiere repondant aux criteres en cas d’inclusions multiples). Les evenements thrombotiques et hemorragiques survenus entre l’inclusion pour grossesse et jusqu’a 3 mois post-partum ont ete etudies. Une hemorragie severe etait definie par une hemorragie associee a une hospitalisation en re...
BJOG : an international journal of obstetrics and gynaecology, Jan 12, 2018
Poor maternal mental health is an important contributor to maternal mortality, which remains a gl... more Poor maternal mental health is an important contributor to maternal mortality, which remains a global health priority as expressed in the sustainable development goals. Although underreported and neglected, psychiatric disorders in pregnant women or following childbirth have been shown to increase the risk of death from obstetric and medical conditions in pregnancy and puerperium as well as suicide up to one year postpartum (1,2). Therefore, increased attention to maternal mental health is needed. Many maternal suicides are preventable. This article is protected by copyright. All rights reserved.
American journal of obstetrics and gynecology, Jan 9, 2015
We performed an Individual Participant Data (IPD) meta-analysis to calculate the recurrence risk ... more We performed an Individual Participant Data (IPD) meta-analysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. We performed an electronic literature search for cohort studies that reported on women suffering from HDP and who had a subsequent pregnancy. The principal investigators were contacted, informed and requested for their original study data. The obtained data were merged to form one combined database. The results will be presented as % with 95% confidence interval (CI) and odds ratios (OR) with 95% CI. Out of 94 eligible cohort studies, we obtained IPD of 22 studies, including a total of 99,415 women. Pooled data of 64 studies using published data (IPD where available) showed a recurrence rate of 18.1% (N=152,213, 95% CI: 17.9 - 18.3). In the 22 studies included in our IPD, the recurrence rate of a HDP was 20.7% (95%CI: 20.4 - 20.9). Recurrence manifested as preeclampsia (PE) in 13.8% (95%CI: ...
BJOG: An International Journal of Obstetrics & Gynaecology, 2021
ObjectiveTo describe and compare the characteristics of women with placenta accreta spectrum (PAS... more ObjectiveTo describe and compare the characteristics of women with placenta accreta spectrum (PAS) and their pregnancy outcomes according to the presence of placenta praevia and a prior caesarean section.DesignProspective population‐based study.SettingAll 176 maternity hospitals of eight French regions.PopulationTwo hundred and forty‐nine women with PAS, from a source population of 520 114 deliveries.MethodsWomen with PAS were classified into two risk‐profile groups, with or without the high‐risk combination of placenta praevia (or an anterior low‐lying placenta) and at least one prior caesarean. These two groups were described and compared.Main outcome measuresPopulation‐based incidence of PAS, characteristics of women, pregnancies, deliveries and pregnancy outcomes.ResultsThe PAS population‐based incidence was 4.8/10 000 (95% CI 4.2–5.4/10 000). After exclusion of women lost to follow up from the analysis, the group with placenta praevia and a prior caesarean included 115 (48%) wo...
Background:One of the 3 features of obstetrical antiphospholipid syndrome (APS) is severe preecla... more Background:One of the 3 features of obstetrical antiphospholipid syndrome (APS) is severe preeclampsia (PE). Its time of occurrence, the associated risk of thromboses and systemic lupus erythematosus (SLE) have not been reported yet.Objectives:We analyzed severe PE in a series of women with APS.Methods:We retrospectively collected data of female patients from 5 French internal medicine and 1 Italian rheumatology units. Inclusion criteria were: a severe PE/eclampsia(1), that occurred before 34 weeks of gestation (WG) in patients who met the APS classification criteria(2).Results:40 patients were enrolled (Table 1). Because of known APS/positive aPL/previous obstetrical complications, 23(57.5%) patients were treated during the index PE: 4 with low dose aspirin (LDA), 4 with low molecular weight heparin (LMWH), and 15 with a combination of both. 7 patients were also treated with hydroxychloroquine, 8 with corticosteroids and 3 with immunosuppressants. 17(42.5%) patients received no tre...
Introduction Les facteurs predictifs de complications neonatales chez les femmes ayant un syndrom... more Introduction Les facteurs predictifs de complications neonatales chez les femmes ayant un syndrome des antiphospholipides (SAPL) restent controverses et n’ont pas ete etudies dans le contexte francais. La principale etude disponible est l’etude americaine prospective PROMISSE [1] qui met en evidence 19 % de complications neonatales au cours de 144 grossesses de patientes porteuses d’une biologie APL. Nous rapportons les premiers resultats obtenus dans le cadre de l’etude du GR2. Patients et methodes Les criteres d’inclusion etaient : – une grossesse evolutive a 12 semaines d’amenorrhee (SA) incluse dans l’etude prospective observationnelle du GR2 ; – anterieure a mai 2018 ; – chez une patiente ayant un SAPL [2] . Les criteres d’exclusion etaient une proteinurie > 1 g/g, une creatinine > 100 μmol/L et la gemellarite. Une grossesse par patiente etait analysee (la premiere repondant aux criteres en cas d’inclusions multiples). Le critere de jugement principal (CJP) etait composit...
Introduction Le risque de thrombose (0,05 a 0,2 %) et d’hemorragie severe au cours de la grossess... more Introduction Le risque de thrombose (0,05 a 0,2 %) et d’hemorragie severe au cours de la grossesse et du post-partum (autour de 1 % dans le post-partum [1] ) peut etre exacerbe en presence d’un syndrome des antiphospholipides (SAPL). Nous rapportons les premiers resultats obtenus dans le cadre de l’etude du GR2. Patients et methodes Les criteres d’inclusion etaient : –une grossesse evolutive a 12 semaines d’amenorrhee (SA) incluse dans l’etude prospective observationnelle du GR2 ; –anterieure a mai 2018 ; –chez une patiente ayant un SAPL [2] . Les criteres d’exclusion etaient une proteinurie > 1 g/g, une creatinine > 100 μmol/L et la gemellarite. Une grossesse par patiente etait analysee (la premiere repondant aux criteres en cas d’inclusions multiples). Les evenements thrombotiques et hemorragiques survenus entre l’inclusion pour grossesse et jusqu’a 3 mois post-partum ont ete etudies. Une hemorragie severe etait definie par une hemorragie associee a une hospitalisation en re...
BJOG : an international journal of obstetrics and gynaecology, Jan 12, 2018
Poor maternal mental health is an important contributor to maternal mortality, which remains a gl... more Poor maternal mental health is an important contributor to maternal mortality, which remains a global health priority as expressed in the sustainable development goals. Although underreported and neglected, psychiatric disorders in pregnant women or following childbirth have been shown to increase the risk of death from obstetric and medical conditions in pregnancy and puerperium as well as suicide up to one year postpartum (1,2). Therefore, increased attention to maternal mental health is needed. Many maternal suicides are preventable. This article is protected by copyright. All rights reserved.
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