Publications by authors named "Christophe Vayssiere"

Background: Population-based data are needed to reliably assess the impact of SARS-CoV-2 infection during pregnancy.

Objectives: To estimate the population-based incidence of SARS-CoV-2 infection and its severe forms in the obstetric population, identify risk factors of severe SARS-CoV-2 infection (severe COVID-19) and describe delivery, maternal and neonatal outcomes by disease severity, using a definition of severity based on organ dysfunction.

Methods: A prospective population-based study conducted over the three first pandemic waves between March 2020 and April 2021 in 281 maternity hospitals in six French regions included all women with SARS-CoV-2 infection during pregnancy or within 7 days post-partum, whether symptomatic or not, hospitalised or not.

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Unlabelled: ST analysis during labour requires the classification of CTG traces in order to help clinical decisions. The usual STAN classification is based on the FIGO 1987 classification, modified in 2007. New STAN guidelines adapted to physiology-based interpretation have been proposed in 2022.

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Article Synopsis
  • The study aimed to determine whether a more restrictive threshold for aspirin prophylaxis (risk >1/70) would effectively identify high-risk nulliparous women for pre-eclampsia compared to the usual threshold (risk >1/100).
  • Conducted at the University Hospital of Toulouse, the study observed two cohorts: one before the screening (2014-2016) and one after implementing the FMF screening and aspirin treatment (2017-2018).
  • Results showed no significant difference in pre-eclampsia rates (1.7% vs. 1.3%) between the two groups, indicating that using the more restrictive threshold did not lead to a decrease in pre-eclampsia with premature delivery
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Introduction: The use of different growth charts can lead to confusion in discussions between professionals. There are obstetric charts (of fetal growth) and neonatal charts (of measurements at birth and of postnatal growth). These charts can be descriptive (derived from an unselected population) or prescriptive (derived from of a population at low risk and with optimal conditions for growth).

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To evaluate the predictive value of the sFlt-1/PlGF ratio for the prediction of preeclampsia in women with preexisting diabetes mellitus. This is a monocentric retrospective observational study conducted between January 2018 and December 2020. All singleton pregnancies with preexisting diabetes mellitus, who had a dosage of the sFlt-1/PlGF ratio between 30 and 34 + 6 weeks of gestation were included.

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Substandard or disrespectful care during labour should be of serious concern for healthcare professionals, as it can affect one of the most important events in a woman's life. Substandard care refers to the use of interventions that are not considered best-practice, to the inadequate execution of interventions, to situations where best-practice interventions are withheld from patients, or there is lack of adequate informed consent. Disrespectful care refers to forms of verbal and non-verbal communication that affect patients' dignity, individuality, privacy, intimacy, or personal beliefs.

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Background: Induction of labour (IOL) is common practice and different methods carry different effectiveness and safety profiles.

Objectives: To compare the effectiveness, and maternal and perinatal safety outcomes of IOL with vaginal misoprostol versus vaginal dinoprostone using individual participant data from randomised clinical trials.

Search Strategy: The following databases were searched from inception to March 2023: CINAHL Plus, ClinicalTrials.

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Objective: To assess which fetal growth charts best describe intrauterine growth in France defined as the ability to classify 10% of fetuses below the 10th percentile (small for gestational age [SGA]) and above the 90th percentile (large for gestational age [LGA]) in the second and third trimesters.

Methods: We analyzed five studies on fetal ultrasound measurements using three French data sources. Two studies used second and third trimester ultrasound data from a nationwide birth cohort in 2011 (the ELFE study, N = 13 197 and N = 7747); one study used third trimester ultrasound data from on a nationwide cross-sectional study (the 2016 French National Perinatal Survey, N = 9940); and the last two studies were from the "Flash study" 2014 which prospectively collected ultrasound data from routine visits in the second and third trimesters (N = 4858 and N = 3522).

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In high-resource countries, adverse perinatal outcomes are currently rare in term, non-malformed fetuses, undergoing labor, but they remain a leading cause of medico-legal dispute. Precise terminology is important to describe situations related to inadequate fetal oxygenation in labor, to ensure appropriate communication between healthcare professionals and adequate transmission of information to parents. This position statement provides consensus definitions from European perinatologists and midwives regarding the most appropriate terminology to describe situations related to inadequate fetal oxygenation in labor: suspected fetal hypoxia, severe newborn acidemia, newborn metabolic acidosis, and hypoxic-ischemic encephalopathy.

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In cervical cancer screening programs, the detection of high-risk human papillomavirus (HR-HPV) is now widely implemented on physician-collected samples and has expanded to include self-collected samples. The use of a cellularity control (CC) is needed to reduce false-negative HPV results. An external mRNA CC for the HPV APTIMA® assay was assessed for its analytical performance and the results were compared with both cervix cytobrush samples taken by physicians and self-collected vaginal samples from 148 women.

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Objective: To describe maternal and fetal outcomes of pregnancies after 42 years and to compare maternal and fetal morbidities according to the conception mode; comparing pregnancies obtained spontaneously and those resulting from assisted reproductive technology (ART).

Methods: This retrospective cohort study was conducted in a level 3 maternity hospital. This study covered all women, aged 42 years or older, who gave birth between January 1, 2014 and December 31, 2019.

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Few reports of laser coagulation for foetal bronchopulmonary sequestration (BPS), a rare congenital malformation characterised by the absence of tracheobronchial connection and the presence of a systemic feeding artery, have been published. Additionally, very few of them focus also on the postnatal management, with results limited and controversial. Postnatal treatment of residual malformation remains debated, hence the need to share our experience of a combined pre- and postnatal approach to complicated extra-lobar BPS.

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Objective: Preterm birth, defined as birth before 37 weeks of gestation, is a leading cause of perinatal and infant mortality throughout the world. Preterm birth is also associated with long-term neurological disabilities and other significant health issues in children. A short cervix in the second trimester has been noted to be one of the strongest predictors of subsequent spontaneous preterm birth in both singleton and multiple pregnancies.

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Article Synopsis
  • The study investigates the effects of intrauterine balloon tamponade when used along with second-line uterotonics versus after the failure of second-line treatment in managing severe postpartum hemorrhage for women who had vaginal deliveries.
  • Conducted across 18 hospitals with 403 participants, it focuses on women with postpartum hemorrhage that did not respond to first-line treatment (oxytocin) and required additional intervention.
  • The primary outcome measured was the need for blood transfusions or excessive blood loss, with secondary outcomes including the frequency of significant blood loss, transfusions, invasive procedures, and ICU transfers.
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Background: Recent observational studies reported a high rate of suboptimal use of antenatal corticosteroids (too anticipated or retrospectively not indicated) for women at risk of preterm delivery despite a recommended use within 7 days before delivery.

Objective: This study aimed to elaborate a nomogram aiming at optimizing the timing of administration of antenatal corticosteroids in case of threatened preterm labor, asymptomatic short cervix, or uterine contractions.

Study Design: This was an observational retrospective study conducted in a tertiary hospital.

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Introduction: Periodontal diseases (gingivitis and periodontitis) are chronic non-communicable inflammatory diseases. The risk of developing gingivitis and periodontitis increases during pregnancy. Also, periodontitis increases the risk of developing adverse pregnancy outcomes such as preterm birth and preeclampsia.

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Background: About 1.3 million pregnant women lived with HIV and were eligible to receive antiretroviral therapy (ART) worldwide in 2021. The World Health Organization recommends protease inhibitors (PI)-based regimen as second or third-line during pregnancy.

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Objective: To assess whether standardised longitudinal reporting of growth monitoring information improves antenatal detection of infants who are small for gestational age (SGA), compared with usual care.

Design: Cluster-randomised controlled trial.

Setting: Sixteen French level-3 units in 2018-2019.

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Objective: To assess the association between marked variability in fetal heart rate (FHR) and neonatal acidosis.

Design: Bicentric prospective cohort study.

Setting: From January 2019 to December 2019, in two French tertiary care maternity units.

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Article Synopsis
  • This clinical trial aimed to determine if daily low-dose aspirin could lower the risks of preeclampsia and fetal growth restriction in first-time pregnant women identified as high risk through early ultrasound screenings.
  • Conducted in France, the study involved over 1,100 participants who were randomly assigned to either take low-dose aspirin or a placebo from early pregnancy until the 34th week.
  • Results showed no significant difference in the rates of preeclampsia or low birth weight between the aspirin and placebo groups, leading to the conclusion that low-dose aspirin does not provide benefits for these outcomes in the targeted population.
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Objective: To evaluate the risk of spontaneous preterm birth on subsequent pregnancies after second stage cesarean section.

Methods: This is a retrospective cohort study. Women were included if they had their two consecutive births in Toulouse University Hospital in the study period.

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Objective: The magnitude and direction of effects on pregnancy outcomes of the lockdown imposed during COVID-19 have been uncertain and debated. Therefore, we aimed to quantify delivery and perinatal outcomes during the first nationwide lockdown due to the COVID-19 pandemic compared with the same durations of time for the pre- and post-lockdown periods.

Study Design: This was a retrospective cohort study of six university hospital maternity units distributed across France, each of which serves as the obstetric care referral unit within its respective perinatal network.

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Article Synopsis
  • Twin pregnancies are increasing around the world, but they often lead to early births, which can cause health problems for babies.
  • The study aimed to find out if using a special device called the Arabin pessary could help improve the health of babies in twin pregnancies where the mother has a short cervix.
  • Researchers compared the effects of the pessary with regular care in 308 pregnancies to see if it reduced serious health issues or deaths for newborns.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause severe placental lesions leading rapidly to intrauterine fetal death (IUFD). From August 2020 to September 2021, in the pathology department of Toulouse Oncopole, we analyzed 50 placentas from COVID-19-positive unvaccinated mothers. The purpose of our study is to describe the clinicopathological characteristics of these placental damages and to understand the pathophysiology.

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