Resektion der Plazentahaftstelle bei pathologischer Plazentainvasion
CHANTRAINE, Frédéric ; PETIT, Philippe ;
in Der Gynäkologe (2014), 47
Abnormally invasive placenta (AIP) is a rare condition with an increasing incidence. Severe cases, such as placenta percreta, can cause massive peripartal bleeding linked to an elevated maternal morbidity ... [more ▼]
Abnormally invasive placenta (AIP) is a rare condition with an increasing incidence. Severe cases, such as placenta percreta, can cause massive peripartal bleeding linked to an elevated maternal morbidity and even mortality. Prenatal AIP screening using ultra- sound allows referral to a specialized centre in suspected cases in order to optimize the chances for mother and child. Caesarean hys- terectomy or placenta in situ methods are the currently known and recommended management options. This article describes the techniques of elective resection of the placental bed including AIP which allow conserving the uterus and preserving fertility. Furthermore, it seems that morbidity of this technique is lower when compared to the standard treatment options. Whether this is due to a selection of less severe AIP cases for resection or really represents a lower complication rate in cases of resection has to be demonstrated by further prospective studies. [less ▲]Detailed reference viewed: 9 (0 ULg)
Individual decisions in placenta increta and percreta: a case series.
CHANTRAINE, Frédéric ; NISOLLE, Michelle ; PETIT, Philippe et al
in Journal of Perinatal Medicine (2012), 40(3), 265-70
Abstract Objective: Placenta increta or percreta is an uncommon pathology, sometimes associated with high maternal morbidity. Its prevalence increases proportionally to the number of cesarean sections ... [more ▼]
Abstract Objective: Placenta increta or percreta is an uncommon pathology, sometimes associated with high maternal morbidity. Its prevalence increases proportionally to the number of cesarean sections. This study analyzed the changes of our management strategy to devise treatment guidelines for this uncommon disorder. Materials and methodology: Between 2005 and 2011, 10 cases of placenta increta or percreta were managed at our university hospital maternity department. Results: Among the 10 cases, seven were diagnosed prenatally. Two patients were diagnosed early, at 14 and 17 weeks of gestational age, and their pregnancies were terminated. Five had hysterectomies during the intrapartum period, and despite attempted conservative treatment for the two others, hysterectomy proved necessary 2 months postpartum because of intrauterine infections. Seven of the 10 women had hysterectomies. Conclusion: Prenatal diagnosis of placenta increta or percreta is essential to plan the delivery in a competent tertiary care center. The decision to perform a cesarean hysterectomy or leave the placenta in situ for spontaneous delivery is based on the extent of infiltration, the patient's hemodynamic status, and her desire to remain fertile. The high-risk of infection and severe hemorrhage must not be overlooked should conservative treatment be chosen. This situation requires prolonged close monitoring. [less ▲]Detailed reference viewed: 41 (7 ULg)
Prise en charge des pathologies gynécologiques bénignes par chirurgie robotique
BRENEZ, Anne ; PETIT, Philippe ; DECHENNE, Valérie et al
in Gunaïkeia (2012), 17(5), 36-39Detailed reference viewed: 73 (4 ULg)
Lymphadénectomie para-aortique par laparoscopie assistée par robot dans le bilan des cancers du col utérin localement avancés. Étude belge multicentrique.
; GOFFIN, Frédéric ; et al
Poster (2012)Detailed reference viewed: 6 (0 ULg)
Belgian experience of robot assisted laparoscopic para – aortic lymphadenectomy for staging of locally advanced cervical carcinoma. A multicentric study.
; GOFFIN, Frédéric ; et al
Objectives: FIGO clinical staging, imaging techniques sometimes underestimate extension of locally advanced cervical cancer (LACC). The presence of para-aortic lymph node (LN) metastases in LACC ... [more ▼]
Objectives: FIGO clinical staging, imaging techniques sometimes underestimate extension of locally advanced cervical cancer (LACC). The presence of para-aortic lymph node (LN) metastases in LACC identifies patients with poor prognosis. Laparoscopic para-aortic lymphadenectomy is now proposed as a diagnostic tool. Feasibility and safety of robot assisted laparoscopic para-aortic lymphadenectomy has been reported. We collected data from different Belgian centers to assess its oncological safety and complication rate. Study design: Three centers participated in the study. Thirty seven patients with LACC underwent a pre treatment robot assisted laparoscopic para-aortic lymphadenectomy. Data was prospectively collected. Results: The median number of LN collected was 27.5 (1-54) per patient. Five out of 37 patients had para-aortic node metastasis. The false negative rate for PET CT diagnosing para- aortic node metastasis was 10.8% (4/37). We encountered 2 major intra operative complications (5.4%). Post operative morbidity was low (13.5%). Median follow up was 27 months (95% CI 24–30). Median disease free survival (DFS) was 16 months (95% CI 2.4- 29.6). Patients with negative LN had a median DFS of 24 months (NA) although patients with positive LN had a median DFS of 9 months (95% CI 6.9-11.9). Conclusions: In this series we report that robot assisted laparoscopic para-aortic lymphadencetomy provided the surgeon with useful information to avoid understaging in 10.8% of women with LACC, at the expense of low morbidity (13.5%). Presence of microscopic para-aortic LN metastasis is correlated with shorter DFS. The number of patients with positive LN doesn’t allow us to draw any firm conclusion. [less ▲]Detailed reference viewed: 26 (0 ULg)
Robotic surgery in benign gynaecological pathology
in Gynecological Surgery (2010), 7Detailed reference viewed: 7 (1 ULg)
Défaut d'observance et inertie therapeutique en obstétrique.
Masson, Véronique ; Petit, Philippe ; Foidart, Jean-Michel
in Revue Médicale de Liège (2010), 65(5-6), 395-8
Observance around pregnancy includes two parts: what can be done before conception and what must be done during pregnancy. Preconception care, if efficaciously performed, offerss real benefits for foetal ... [more ▼]
Observance around pregnancy includes two parts: what can be done before conception and what must be done during pregnancy. Preconception care, if efficaciously performed, offerss real benefits for foetal and child development. Its efficacy will depends on the involvement and motivation of physicians and particularly also on the patient's observance. In this article we summarize essential pieces of advice to be given to each patient before pregnancy. Therapeutic inertia in obstetrics presents two differents aspects: on the one hand, the delay to initiate a therapeutic strategy when a complication arises such as a postpartum hemorrhage; on the other hand, the continuation of obsolete practices, such as the therapy of uterine hypersystolia. [less ▲]Detailed reference viewed: 76 (3 ULg)
Traitement de la prééclampsie sévère: jusqu'où, et pour quels risques/bénéfices?
PETIT, Philippe ; ; CHANTRAINE, Frédéric et al
in Revue Médicale de Liège (2009), 64(12), 620-625Detailed reference viewed: 113 (11 ULg)
Les défauts d'implantation placentaire et leurs conséquences sur la fonction endothéliale maternelle
Foidart, Jean-Michel ; Noël, Agnès ; Chantraine, Frédéric et al
in Bulletin Académique National de Médecine (2009), 193(5), 1059-66Detailed reference viewed: 95 (23 ULg)