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Saint-Sauveur-en-Rue, France

Quarello E.,Unite Dechographie de Diagnostic Prenatal | Quarello E.,Institute Of Medecine Of La Reproduction | Quarello E.,Center Europeen Of Recherche En Imagerie Medicale Cerimed | Lacoste R.,French National Center for Scientific Research | And 3 more authors.
Gynecologie Obstetrique Fertilite | Year: 2015

Objectives. - To evaluate tissue characteristics of the placenta by transabdominal ShearWave Elastography in pregnant baboon. Materials and method. - For 9 months (03/2013-12/2013) two operators (EQ, GG) performed ultrasound of the placenta during pregnancy pregnant baboons station partner primatology project. The identification of the placenta was performed previously in 2D ultrasound. The elastography method was then activated. Three measurements were carried out by operator for each placenta. The intraclass correlation coefficients within and between observers were calculated for the objective assessment (elastography) of placental maturity. Results. - During the study period, 21 pregnant baboons were included and ultrasounds were performed between 1 and 3 times each. The measurements have been carried out by two operators in 100% of cases. The intra- and inter-observer ICC for single values are respectively 0.657 - 95% CI (0.548 to 0.752) and 0.458 - 95% CI (0.167 to 0.675). The intra- and inter-observer ICC for average values are respectively 0.852 - 95% CI (0.784 to 0.901) and 0.628 - 95% CI (0.286 to 0.806). Conclusion. - The study by transabdominal ShearWave Elastography of placenta's pregnant baboons is possible. The intra- and inter-operator reproducibility of this method is good using the average of three measurements. The objective study via elastography ShearWave of the degree of placental maturity seems not yet be used in clinical practice. Studies of larger cohorts are needed. © 2015 Elsevier Masson SAS.

Quarello E.,Unite Dechographie de Diagnostic Prenatal | Quarello E.,Institute Of Medecine Of La Reproduction | Quarello E.,Aix - Marseille University | Lacoste R.,French National Center for Scientific Research | And 4 more authors.
Prenatal Diagnosis | Year: 2015

Objectives: The purpose of this study was to assess the feasibility and reproducibility of transabdominal ShearWaveTM elastography of fetal organs in pregnant baboons. Materials and methods: Fetal ultrasounds of all pregnant baboons in a single primate research center were performed prospectively during 9months. The visualization of fetal targeted organs (liver, proximal and distal lungs, brain white matter and periventricular gray matter) was initially performed using 2D ultrasound, and then elastography mode was activated. For each organ, three measurements were carried out by two operators. Intra-observer and inter-observer intra-class correlation coefficients (ICC) were calculated. Results: During the study period (03/2013-12/2013), 21 pregnant baboons (21 fetuses) were included. One to three ultrasound scans were performed for each fetus. The measurements were feasible by the two operators in all cases. The intra-observer and inter-observer ICC were 0.654, 95% CI (0.606 to 0.699) and 0.645, 95% CI (0.553 to 0.721) respectively. Conclusion: Transabdominal ShearWaveTM Elastography of fetal organs can be achieved in pregnant baboons. The intra-observer and inter-observer reproducibility is correct but vary according to the targeted organs. © 2015 John Wiley & Sons, Ltd.

Quarello E.,Unite dEchographies Obstetricales | Quarello E.,Institute Of Medecine Of La Reproduction | Saada J.,University Paris - Sud | Desbriere R.,Unite dEchographies Obstetricales | And 3 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2011

The prenatal diagnosis of esophageal atresia is challenging. The length of the defect of the esophageal atretic portion is one of the parameters affecting outcome and prenatal evaluation of this length has not, to our knowledge, been described previously. We report on seven fetuses assessed prospectively which were suspected to have esophageal atresia. Targeted ultrasound examination of both fetal cervical and thoracic structures was performed in each case in order to assess prenatally the atretic portion. The length of the defect was assessed both directly, by visualizing the interruption of the hyperechoic lines representing the walls of the esophagus in a mid-sagittal view (n = 4), and indirectly, by means of the 'tracheal print' (n = 5). Both methods were used in three cases. Prenatal results were compared with postnatal or postmortem findings. The prenatal diagnosis of esophageal atresia was made correctly in six of the seven cases and in all of these there was concordance between prenatal and postnatal estimates of the esophageal defect lengths. Direct or indirect sonographic assessment of the esophagus in cases of suspected prenatal esophageal atresia improves the specificity of its diagnosis and aids prenatal evaluation. © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

Quarello E.,Unite dEchographies Obstetricales | Quarello E.,Institute Of Medecine Of La Reproduction | Molho M.,Center Hospitalier Intercommunal Of Poissy St Germain | Garel C.,Service de Radiologie Pediatrique | And 6 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2014

Joubert syndrome and related disorders (JSRD) are characterized by absence or underdevelopment of the cerebellar vermis and a malformed brainstem. This family of disorders is a member of an emerging class of diseases called ciliopathies. We describe the abnormal features of the brain, particularly the fourth ventricle, in seven fetuses affected by JSRD. In three cases abnormality of the fourth ventricle was isolated and in four cases there were associated malformations. The molar tooth sign (MTS) was always present and visible on two-dimensional ultrasound and, when performed, on three-dimensional ultrasound and magnetic resonance imaging. The fourth ventricle was always abnormal, in both axial and sagittal views, presenting pathognomonic deformities. It is important to identify JSRD, preferably prenatally or at least postnatally, due to its high risk of recurrence of about 25%. A detailed prenatal assessment of the fourth ventricle in several views may help to achieve this goal. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Courbiere B.,Obstetrics | Courbiere B.,Aix - Marseille University | Courbiere B.,French National Center for Scientific Research | Decanter C.,Lille University Hospital Center | And 12 more authors.
Human Reproduction | Year: 2013

STUDY QUESTIONWhat are the outcomes of French emergency IVF procedures involving embryo freezing for fertility preservation before gonadotoxic treatment?SUMMARY ANSWERPregnancy rates after emergency IVF, cryopreservation of embryos, storage, thawing and embryo transfer (embryo transfer), in the specific context of the preservation of female fertility, seem to be similar to those reported for infertile couples undergoing ART.STUDY DESIGN, SIZE, DURATIONA French retrospective multicentre cohort study initiated by the GRECOT network - the French Study Group for Ovarian and Testicular Cryopreservation. We sent an e-mail survey to the 97 French centres performing the assisted reproduction technique in 2011, asking whether the centre performed emergency IVF and requesting information about the patients' characteristics, indications, IVF cycles and laboratory and follow-up data. The response rate was 53.6% (52/97).PARTICIPANTS/MATERIALS, SETTING, METHODSFourteen French centres reported that they performed emergency IVF (56 cycles in total) before gonadotoxic treatment, between 1999 and July 2011, in 52 patients.MAIN RESULTS AND THE ROLE OF CHANCEThe patients had a mean age of 28.9 ± 4.3 years, and a median length of relationship of 3 years (1 month-15 years). Emergency IVF was indicated for haematological cancer (42%), brain tumour (23%), sarcoma (3.8%), mesothelioma (n = 1) and bowel cancer (n = 1). Gynaecological problems accounted for 17% of indications. In 7.7% of cases, emergency IVF was performed for autoimmune diseases. Among the 52 patients concerned, 28% (n = 14) had undergone previous courses of chemotherapy before beginning controlled ovarian stimulation (COS). The initiation of gonadotoxic treatment had to be delayed in 34% of the patients (n = 19). In total, 56 cycles were initiated. The mean duration of stimulation was 11.2 ± 2.5 days, with a mean peak estradiol concentration on the day on which ovulation was triggered of 1640 ± 1028 pg/ml. Three cycles were cancelled due to ovarian hyperstimulation syndrome (n = 1), poor response (n = 1) and treatment error (n = 1). A mean of 8.2 ± 4.8 oocytes were retrieved, with 6.1 ± 4.2 mature oocytes and 4.4 ± 3.3 pronuclear-stage embryos per cycle. The mean number of embryos frozen per cycle was 4.2 ± 3.1. During follow-up, three patients died from the consequences of their disease. For the 49 surviving patients, 22.5% of the couples concerned (n = 11) requested embryo replacement. A total of 33 embryos were thawed with a post-thawing survival rate of 76%. Embryo replacement was finally performed for 10 couples with a total of 25 embryos transferred, leading to one biochemical pregnancy, one miscarriage and three live births. Clinical pregnancy rate and live birth per couple who wanted a pregnancy after cancer were, respectively, 36% (95% CI = 10.9-69.2%) and 27% (95% CI = 6.0-61%).LIMITATIONS, REASONS FOR CAUTIONThe overall response rate for clinics was 53.6%. Therefore, it is not only that patients may not have been included, but also that those that were included were biased towards the University sector with a response rate of 83% (25/30) for a small number of patients.WIDER IMPLICATIONS OF THE FINDINGSAccording to literature, malignant disease is a risk factor for a poor response to COS. However, patients having emergency IVF before gonadotoxic treatment have a reasonable chance of pregnancy after embryo replacement. Embryo freezing is a valuable approach that should be included among the strategies used to preserve fertility. © The Author 2013. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.

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