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  1. Article ; Online: Automated Insulin Delivery during Pregnancy Complicated by Type 1 Diabetes.

    Vivanti, Alexandre J / Benachi, Alexandra / Voican, Adela

    The New England journal of medicine

    2024  Volume 390, Issue 2, Page(s) 183

    MeSH term(s) Pregnancy ; Female ; Humans ; Insulin/therapeutic use ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/drug therapy
    Chemical Substances Insulin
    Language English
    Publishing date 2024-01-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2313410
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  2. Article ; Online: Stillbirths due to placental COVID infection associated with chronic histiocytic intervillositis do not recur in subsequent pregnancies.

    Cornish, Emily F / van der Meeren, Lotte E / van der Hoorn, Marie-Louise P / Schoenmakers, Sam / Vivanti, Alexandre J / Benachi, Alexandra / Whitten, Melissa / Hignett, Stephanie / McDonnell, Thomas / Williams, David J

    The Journal of infection

    2024  Volume 88, Issue 2, Page(s) 215–217

    MeSH term(s) Pregnancy ; Female ; Humans ; Placenta ; Stillbirth ; COVID-19
    Language English
    Publishing date 2024-01-11
    Publishing country England
    Document type Letter
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2024.01.001
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  3. Article ; Online: Performance of cell-free DNA testing for common fetal trisomies in triplet pregnancies.

    Zakaria, Hoda / Kleinfinger, Pascale / Lohmann, Laurence / Costa, Jean-Marc / Tsatsaris, Vassilis / Salomon, Laurent J / Jouannic, Jean-Marie / Rosenblatt, Jonathan / Demain, Adèle / Benachi, Alexandra / El Khattabi, Laïla / Vivanti, Alexandre J

    Prenatal diagnosis

    2024  

    Abstract: Objective: In singleton pregnancies, the use of cell-free DNA (cfDNA) analysis as a screening test for common fetal trisomies has spread worldwide though we still lack sufficient data for its use in triplet pregnancies. The objective of this study is to ...

    Abstract Objective: In singleton pregnancies, the use of cell-free DNA (cfDNA) analysis as a screening test for common fetal trisomies has spread worldwide though we still lack sufficient data for its use in triplet pregnancies. The objective of this study is to assess the performance of cfDNA testing in detecting fetal aneuploidies in triplet pregnancies as a first-tier test.
    Method: We performed a retrospective cohort study including data from pregnant women with a triplet pregnancy who underwent cfDNA testing between May 1, 2017, and January 15, 2020. cfDNA was obtained by massive parallel sequencing (VeriSeq NIPT solution; Illumina®). The objectives of the study were to assess the diagnostic performance of cfDNA testing for trisomy 21 (T21) (primary outcome), trisomy 18 (T18) and 13 (secondary outcomes).
    Results: During the study period, cfDNA testing was performed in 255 women with triplet pregnancy, of which 165 (64.7%) had a neonatal outcome available. Three tests were positive for T21, one of which was confirmed by an antenatal karyotype, and the other was confirmed at birth. The third case did not undergo an invasive procedure and was not confirmed at birth (false positive). In one case, cfDNA testing was positive for T18 and was confirmed by an antenatal karyotype. There were no cases of trisomy 13 in the cohort. The no-call rate was 2.4% at first sampling. Fifty-eight (22.7%) women had embryo reduction, which in 40 (69%) of whom was performed after the cfDNA test result.
    Conclusion: cfDNA testing could be offered as primary screening for main fetal aneuploidies in triplet pregnancies after provision of appropriate patient information.
    Language English
    Publishing date 2024-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 82031-3
    ISSN 1097-0223 ; 0197-3851
    ISSN (online) 1097-0223
    ISSN 0197-3851
    DOI 10.1002/pd.6548
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  4. Article ; Online: Cesarean delivery and neonatal SARS-CoV-2 infections: beware of hasty shortcuts.

    Vivanti, Alexandre J / De Luca, Daniele / Benachi, Alexandra

    American journal of obstetrics and gynecology

    2022  Volume 228, Issue 3, Page(s) 358

    MeSH term(s) Pregnancy ; Female ; Infant, Newborn ; Humans ; COVID-19 ; SARS-CoV-2 ; Cesarean Section ; Pregnancy Outcome ; Pregnancy Complications, Infectious/epidemiology ; Infectious Disease Transmission, Vertical
    Language English
    Publishing date 2022-10-25
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2022.10.019
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  5. Article ; Online: Management and survival of foetuses with trisomy 18 in a French retrospective cohort.

    Bouzaglou, Ana / Dumery, Gregoire / Letourneau, Alexandra / Benachi, Alexandra / Vivanti, Alexandre J / Cordier, Anne-Gael

    Journal of gynecology obstetrics and human reproduction

    2023  Volume 52, Issue 4, Page(s) 102565

    Abstract: Objectives: The main objective of this study was to evaluate parents' current demands following the announcement of trisomy 18 and maternal risks.: Material and methods: A single-centre retrospective study was performed in the Paris Saclay Foetal ... ...

    Abstract Objectives: The main objective of this study was to evaluate parents' current demands following the announcement of trisomy 18 and maternal risks.
    Material and methods: A single-centre retrospective study was performed in the Paris Saclay Foetal Medicine Department from 2018 to 2021. All patients followed up in the department who had cytogenetic confirmation of trisomy 18 were included.
    Results: 89 patients were recruited. The most common malformations at ultrasound examination were cardiac or brain abnormalities, distal arthrogryposis as well as severe intrauterine growth retardation. 29% of foetuses with trisomy 18 had more than three malformations. 77.5% of patients requested medical termination of pregnancy. Among the 19 patients who chose to continue their pregnancy, 10 (52.6%) presented with obstetrical complications, of which 7 (41.2%) experienced stillbirth; five babies were born alive with no survival at 6 months.
    Conclusion: In France, in the case of foetal trisomy 18, most women request termination of pregnancy. In the post-natal period, the management of a newborn with trisomy 18 is oriented towards palliative care. The mother's risk of obstetrical complications should be part of counselling. Follow-up, support and safety should be the goal of management of these patients, regardless of the patient's choice.
    MeSH term(s) Pregnancy ; Infant ; Infant, Newborn ; Humans ; Female ; Retrospective Studies ; Trisomy 18 Syndrome ; Trisomy ; Prenatal Care ; Fetus
    Language English
    Publishing date 2023-03-01
    Publishing country France
    Document type Journal Article
    ISSN 2468-7847
    ISSN (online) 2468-7847
    DOI 10.1016/j.jogoh.2023.102565
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  6. Article ; Online: Trial of labour versus elective caesarean delivery for estimated large for gestational age foetuses after prior caesarean delivery: a multicenter retrospective study.

    Chamagne, Matthieu / Richard, Maêva Bôle / Vallee, Alexandre / Tahiri, Jellila / Renevier, Bruno / Dahlhoff, Sandra / Garcia, Diane / Vivanti, Alexandre / Ayoubi, Jean Marc

    BMC pregnancy and childbirth

    2023  Volume 23, Issue 1, Page(s) 388

    Abstract: Background: Lower rates of successful trial of labor after cesarean (TOLAC) in association with fetal macrosomia were previously reported. This study aimed to compare TOLAC to elective caesarean delivery (CD) in women with estimated fetal weight large ... ...

    Abstract Background: Lower rates of successful trial of labor after cesarean (TOLAC) in association with fetal macrosomia were previously reported. This study aimed to compare TOLAC to elective caesarean delivery (CD) in women with estimated fetal weight large for gestational age (eLGA) and a prior CD. Primary outcome was to analyse the mode of delivery in case of TOLAC. Secondary outcome was to compare maternal and foetal morbidity.
    Methods: We conducted a retrospective, descriptive, multicentric, cohort study in five maternity units between January and December 2020. Inclusion criteria were: women with a single prior CD and eLGA or neonatal weight > 90th percentile with singleton pregnancy and gestational age ≥ 37 weeks.
    Main outcome measures: rate of vaginal delivery, maternal and fetal morbidity including: shoulder dystocia, neonatal hospitalization, fetal trauma, neonatal acidosis, uterine rupture, 3
    Results: Four hundred forty women met inclusion criteria, including 235 (53.4%) eLGA. 170 (72.3%) had a TOLAC (study group) and 65 (27.7%) an elective CD (control). 117 (68.82%) TOLAC had a vaginal delivery. No significant differences were found between the two groups in the rates of: postpartum haemorrhage, transfusion, Apgar score, neonatal hospitalization, and foetal trauma. Cord lactate was higher in the case of TOLAC (3.2 vs 2.2, p < 0.001). Median fetal weight was 3815 g (3597-4085) vs. 3865 g (3659-4168): p = 0.068 in the study vs. controls group respectively.
    Conclusion: TOLAC for eLGA fetuses is legitimate because there is no difference in maternal-fetal morbidity, and the CD rate is acceptable.
    MeSH term(s) Infant, Newborn ; Female ; Pregnancy ; Humans ; Infant ; Trial of Labor ; Retrospective Studies ; Gestational Age ; Cohort Studies ; Fetal Weight ; Vaginal Birth after Cesarean ; Cesarean Section/adverse effects ; Postpartum Hemorrhage ; Fetus
    Language English
    Publishing date 2023-05-26
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2059869-5
    ISSN 1471-2393 ; 1471-2393
    ISSN (online) 1471-2393
    ISSN 1471-2393
    DOI 10.1186/s12884-023-05688-1
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  7. Article ; Online: The association between vein-to-vein anastomoses and birth weight discordance in relation to placental sharing in monochorionic twin placentas.

    Couck, Isabel / Cauwberghs, Brent / Van Aelst, Maïté / Vivanti, Alexandre Joseph / Deprest, Jan / Lewi, Liesbeth

    Placenta

    2022  Volume 118, Page(s) 16–19

    Abstract: Introduction: This study aims to examine the association between the presence and size of a vein-to-vein (VV) anastomosis and birth weight discordance relative to placental discordance in monochorionic diamniotic twin pregnancies.: Methods: Placentas ...

    Abstract Introduction: This study aims to examine the association between the presence and size of a vein-to-vein (VV) anastomosis and birth weight discordance relative to placental discordance in monochorionic diamniotic twin pregnancies.
    Methods: Placentas of two previous prospective studies were included in this retrospective analysis. After injection with color dye, we measured the placental surface of each twin and VV, artery-to-artery (AA), and artery-to-vein (AV) anastomoses on a digital photograph. We calculated the birth weight ratio (BWR), placental ratio (PR), and birth weight ratio/placenta ratio (BWR/PR), as well as total AV size and net AV transfusion. Placental characteristics were compared between placentas with and without VV anastomoses. We performed univariate analyses to assess the following predictors for BWR/PR: VV size, AA size, total AV size, and net AV transfusion. Multivariate analysis was then performed, including the variables significant in univariate analysis.
    Results: We analyzed 247 placentas: 58 (23%) with VV anastomoses and 189 without (77%). The BWR and PR were higher in the group with VV. In contrast, BWR/PR was lower in the group with VV anastomoses than in those without. The size of AA anastomoses was larger in placentas with VV anastomoses than in those without. In univariate analysis, VV size and AA size were significantly associated with BWR/PR. However, in multivariate regression, only VV size remained significantly associated with the BWR/PR.
    Discussion: VV anastomoses are associated with a decreased birth weight discordance relative to the placental sharing discordance, independent of the AA anastomoses.
    MeSH term(s) Adult ; Birth Weight ; Female ; Humans ; Placenta/blood supply ; Pregnancy ; Pregnancy, Twin ; Retrospective Studies ; Twinning, Monozygotic
    Language English
    Publishing date 2022-01-02
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603951-0
    ISSN 1532-3102 ; 0143-4004
    ISSN (online) 1532-3102
    ISSN 0143-4004
    DOI 10.1016/j.placenta.2021.12.023
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  8. Article ; Online: Systematic review and synthesis of stillbirths and late miscarriages following SARS-CoV-2 infections.

    Alcover, Noemi / Regiroli, Giulia / Benachi, Alexandra / Vauloup-Fellous, Christelle / Vivanti, Alexandre J / De Luca, Daniele

    American journal of obstetrics and gynecology

    2023  Volume 229, Issue 2, Page(s) 118–128

    Abstract: Objective: This study aimed to describe the characteristics of fetal demise after SARS-CoV-2 infections and clarify whether it is associated with clinical severity, placental lesions, or malformations or due to actual fetal infections.: Data sources: ...

    Abstract Objective: This study aimed to describe the characteristics of fetal demise after SARS-CoV-2 infections and clarify whether it is associated with clinical severity, placental lesions, or malformations or due to actual fetal infections.
    Data sources: PubMed and Web of Science databases were searched between December 1, 2019, and April 30, 2022.
    Study eligibility criteria: Cohort, cross-sectional, and case-control studies and case series or case reports describing stillbirths or late miscarriages (ie, pregnancy loss occurring between 14 and 22 weeks of gestation, before and after the onset of labor) from mothers with SARS-CoV-2 infection during pregnancy (demonstrated by at least 1 positive real-time reverse transcription-polymerase chain reaction from nasopharyngeal swabs and/or SARS-CoV-2 placental infection). No language restriction was applied; cases with other causes possibly explaining the fetal demise were excluded.
    Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis Of Observational Studies in Epidemiology guidelines were followed. The quality of the case series and case reports was evaluated using the specific Mayo Clinic Evidence-Based Practice Center tool. Maternal and clinical fetal data and placental and fetal virology and histology findings were collected. Data were summarized with descriptive statistics using the World Health Organization criteria to classify disease severity and fetal-neonatal infections.
    Results: Data from 184 mothers and 190 fetuses were analyzed. No clear link to maternal clinical severity or fetal malformation was evident. Approximately 78% of fetal demise cases occurred during the second and third trimesters of pregnancy, approximately 6 to 13 days after the diagnosis of SARS-CoV-2 infection or the onset of symptoms. Most placentas (88%) were positive for SARS-CoV-2 or presented the histologic features of placentitis (massive fibrin deposition and chronic intervillositis) previously observed in transplacentally transmitted infections (85%-91%). Of note, 11 fetuses (5.8%) had a confirmed in utero transmitted SARS-CoV-2 infection, and 114 fetuses (60%) had a possible in utero transmitted SARS-CoV-2 infection.
    Conclusion: The synthesis of available data showed that fetal demise generally occurs a few days after the infection with histologic placental inflammatory lesions associated with transplacental SARS-CoV-2 transmission and eventually causing placental insufficiency.
    MeSH term(s) Female ; Humans ; Infant, Newborn ; Pregnancy ; Abortion, Spontaneous/epidemiology ; COVID-19 ; Cross-Sectional Studies ; Fetal Death/etiology ; Infectious Disease Transmission, Vertical ; Placenta/pathology ; Pregnancy Complications, Infectious/diagnosis ; SARS-CoV-2 ; Stillbirth/epidemiology
    Language English
    Publishing date 2023-01-24
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2023.01.019
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  9. Article ; Online: Perinatal outcomes between immediate vs deferred selective termination in dichorionic twin pregnancies with fetal congenital anomalies: a French multicenter study.

    Soussan, Stanley / Egloff, Charles / Peyronnet, Violaine / Winer, Norbert / Weingertner, Anne-Sophie / Rault, Emmanuel / Fuchs, Florent / Quibel, Thibault / Bourgon, Nicolas / Vivanti, Alexandre J / Rosenblatt, Jonathan / Ponzio-Klijanienko, Alice / Dap, Matthieu / Mandelbrot, Laurent / Picone, Olivier

    American journal of obstetrics & gynecology MFM

    2024  , Page(s) 101363

    Abstract: Background: Because selective termination (ST) for discordant dichorionic twin anomalies carries a risk of pregnancy loss, deferring the procedure until the third trimester can be considered in settings where it is legal.: Objective: To determine ... ...

    Abstract Background: Because selective termination (ST) for discordant dichorionic twin anomalies carries a risk of pregnancy loss, deferring the procedure until the third trimester can be considered in settings where it is legal.
    Objective: To determine whether perinatal outcomes were more favorable following deferred rather than immediate ST.
    Study design: A French multicenter retrospective study from 2012 to 2023 on dichorionic twin pregnancies with ST for fetal conditions which were diagnosed before 24 WG. Pregnancies with additional risk factors for late miscarriage were excluded. We defined two groups according to the intention to perform ST within 2 weeks after the diagnosis of the severe fetal anomaly was established (immediate ST) or to wait until the third trimester (deferred ST). The primary outcome was perinatal survival at 28 days of life. Secondary outcomes were pregnancy losses before 24 WG and preterm delivery.
    Results: Of 390 pregnancies, 258 were in the immediate ST group and 132 in deferred ST group. Baseline characteristics were similar in both groups. Overall survival of the healthy co-twin was 93.8% (242/258) in the immediate ST group vs 100% (132/132) in the deferred ST group (p<0.01). Preterm birth < 37 weeks' gestation was lower in the immediate than in the deferred ST group (66.7% vs 20.2%, p<0.01); preterm birth < 28 WG and < 32 WG did not differ significantly (respectively 1.7% vs 0.8%, p=0.66 and 8.26% vs 11.4%, p=0.36). In the deferred ST group, an emergency procedure was performed in 11.3% (15/132) because of threatened preterm labor, of which 3.7% (5/132) for imminent delivery.
    Conclusion: Overall survival after ST was high regardless of the gestational age at which the procedure was performed. Postponing ST until the third trimester seems to improve survival, while immediate ST reduces the risk of preterm delivery. Furthermore, deferred ST requires an expert center capable of performing the ST procedure on an emergency basis if required.
    Language English
    Publishing date 2024-04-02
    Publishing country United States
    Document type Journal Article
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2024.101363
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  10. Article: Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study.

    Soued, Mickaël / Vivanti, Alexandre J / Smiljkovski, Daniel / Deffieux, Xavier / Benachi, Alexandra / Le Gouez, Agnès / Mercier, Frédéric J

    Journal of clinical medicine

    2020  Volume 10, Issue 1

    Abstract: Invasive therapies (surgery or radiological embolization) are used to control severe post-partum hemorrhage. The intra-uterine tamponade balloon is a potential alternative, well documented after vaginal delivery. However, available data on its use after ... ...

    Abstract Invasive therapies (surgery or radiological embolization) are used to control severe post-partum hemorrhage. The intra-uterine tamponade balloon is a potential alternative, well documented after vaginal delivery. However, available data on its use after cesarean delivery remain scarce. This study assessed the efficacy of the intra-uterine tamponade balloon during post-partum hemorrhage in a cesarean delivery setting. Using a retrospective impact design, post-partum hemorrhage-related outcomes before ("pre-balloon" period) versus after implementation of intra-uterine tamponade balloon ("post-balloon" period) were compared. All women with post-partum hemorrhage requiring potent uterotonic treatment with prostaglandins after cesarean delivery over a 9-year period were eligible. The primary outcome was the rate of invasive procedure (conservative surgery, radiological embolization and/or hysterectomy).
    Language English
    Publishing date 2020-12-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm10010081
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