Choix du lieu de naissance du foetus cardiopathe. Expérience liégeoise et recommandations internationales

in Revue Médicale de Liège (2018), 73(1), 28-33

Optimal choice of delivery site after a diagnosis of congenital heart disease (CHD) improves neonatal mortality and morbidity. We report the CHU of Liège experience and review the international ... [more ▼]

Optimal choice of delivery site after a diagnosis of congenital heart disease (CHD) improves neonatal mortality and morbidity. We report the CHU of Liège experience and review the international recommendations. Between 2011 and 2016, 54 fetuses were diagnosed with CHD in our service. Retrospectively we estimated the appropriateness of the site of delivery considering the postnatal outcome. We confronted our experience with the recent international recommendations for in utero transfer to a tertiary center. The latter are based on the risk of hemodynamic instability at birth but differ for the ductal-dependent cardiopathy. The postanatal evolution and the low emergency transfer rate (4 %) in our series demonstrate the quality of our policy. We propose to validate the French transfer in utero recommendations for our obstetrical department, especially for ductal-dependent cardiopathy. [less ▲]

Impact of the angle used in 2D Ultrasonography on the foetal femur diaphysis measurement

in Facts, Views and Vision in Obgyn (2017), 9(2), 101-104

Objective: The purpose of this pilot study is to compare the 2D scanning measurement of the foetal femoral diaphysis using anterior or lateral/external incidence at ultrasound. Methods: In August 2016, 30 ... [more ▼]

Objective: The purpose of this pilot study is to compare the 2D scanning measurement of the foetal femoral diaphysis using anterior or lateral/external incidence at ultrasound. Methods: In August 2016, 30 consecutive patients underwent a second trimester morphology ultrasound between 21 and 24 weeks of gestation by a senior sonographist. In each case, the femur length was measured either with an anterior angle, estimating the straight aspect of the diaphysis or with a lateral angle, assessing its curved aspect. The two measures were collected prospectively. The difference between paired measurements was calculated and expressed in percentage (mm) and in percentile. Results: The median difference between the two ultrasound angles in terms of femur length was 3,55% and in terms of percentile variation was 17,16. Conclusion: An anterior angle of measurement of the femur length seems to allow an optimal measure of the straight and longest aspect of the diaphysis. According to our results, this angle should be considered when scoring the quality of a morphological ultrasound, but further and larger studies should be done to confirm our hypothesis. [less ▲]

Improved computer-assisted analysis of the global lymphatic network in human cervical tissues.

in Modern Pathology : An Official Journal of the United States & Canadian Academy of Pathology, Inc (2017), 30(2), 313

Impact of the angle used in 2D Ultrasonography on the foetal femur diaphysis measurement

in Facts, Views and Vision in Obgyn (2017), 9(2), 101

Objective: The purpose of this pilot study is to compare the 2D scanning measurement of the foetal femoral diaphysis using anterior or lateral/external incidence at ultrasound. Methods: In August 2016, 30 ... [more ▼]

Objective: The purpose of this pilot study is to compare the 2D scanning measurement of the foetal femoral diaphysis using anterior or lateral/external incidence at ultrasound. Methods: In August 2016, 30 consecutive patients underwent a second trimester morphology ultrasound between 21 and 24 weeks of gestation by a senior sonographist. In each case, the femur length was measured either with an anterior angle, estimating the straight aspect of the diaphysis or with a lateral angle, assessing its curved aspect. The two measures were collected prospectively. The difference between paired measurements was calculated and expressed in percentage (mm) and in percentile. Results: The median difference between the two ultrasound angles in terms of femur length was 3,55% and in terms of percentile variation was 17,16. Conclusion: An anterior angle of measurement of the femur length seems to allow an optimal measure of the straight and longest aspect of the diaphysis. According to our results, this angle should be considered when scoring the quality of a morphological ultrasound, but further and larger studies should be done to confirm our hypothesis. [less ▲]

Modeling pre-metastatic lymphvascular niche in the mouse ear sponge assay.

in Scientific Reports (2017), 7

Lymphangiogenesis, the formation of new lymphatic vessels, occurs in primary tumors and in draining lymph nodes leading to pre-metastatic niche formation. Reliable in vivo models are becoming instrumental ... [more ▼]

Lymphangiogenesis, the formation of new lymphatic vessels, occurs in primary tumors and in draining lymph nodes leading to pre-metastatic niche formation. Reliable in vivo models are becoming instrumental for investigating alterations occurring in lymph nodes before tumor cell arrival. In this study, we demonstrate that B16F10 melanoma cell encapsulation in a biomaterial, and implantation in the mouse ear, prevents their rapid lymphatic spread observed when cells are directly injected in the ear. Vascular remodeling in lymph nodes was detected two weeks after sponge implantation, while their colonization by tumor cells occurred two weeks later. In this model, a huge lymphangiogenic response was induced in primary tumors and in pre-metastatic and metastatic lymph nodes. In control lymph nodes, lymphatic vessels were confined to the cortex. In contrast, an enlargement and expansion of lymphatic vessels towards paracortical and medullar areas occurred in pre-metastatic lymph nodes. We designed an original computerized-assisted quantification method to examine the lymphatic vessel structure and the spatial distribution. This new reliable and accurate model is suitable for in vivo studies of lymphangiogenesis, holds promise for unraveling the mechanisms underlying lymphatic metastases and pre-metastatic niche formation in lymph nodes, and will provide new tools for drug testing. [less ▲]

Prenatal diagnosis of a terminal chromosome 1 (q42-q44) deletion : original case report and review of the literature

in Facts, Views and Vision in Obgyn (2016), 8(2), 101-103

Terminal chromosome 1q deletion is rarely reported but causes typical malformations that have been well described in childhood. Clinical features include facial dysmorphy, growth and/or psychomotor ... [more ▼]

Terminal chromosome 1q deletion is rarely reported but causes typical malformations that have been well described in childhood. Clinical features include facial dysmorphy, growth and/or psychomotor retardation, brain agenesis or hypoplasia of the corpus callosum, epilepsy and occasional urogenital or cardiac malformations. The diagnosis of this condition is usually made at birth. The rare cases of antenatal diagnosis were based on microcephaly and growth retardation. In the present case, the foetus presented with an hypoplasia of the corpus callosum, a dysmorphic profile and a single umbilical artery. The foetal echocardiography suggested a noncompaction of the left ventricular myocardium. No microcephaly or growth retardation were noted. We compare our antenatal findings to those described in the literature with the aim to better define the antenatal phenotype of the terminal chromosome 1 deletion syndrome. [less ▲]

REGISTRE BELGE ET CENTRES DE RÉFÉRENCE POUR LES MALADIES TROPHOBLASTIQUES GESTATIONNELLES

in Revue Médicale de Liège (2015), 70(11), 550-556

Gestational trophoblastic diseases include placental pathologies comprising fertilization abnormalities (hydatidiform moles) and malignant lesions (choriocarcinoma, placental site trophoblastic tumor and ... [more ▼]

Gestational trophoblastic diseases include placental pathologies comprising fertilization abnormalities (hydatidiform moles) and malignant lesions (choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor). Due to their low incidence and heterogeneity, their diagnosis, management and treatment are not always optimal. Following the example of other European countries, a national registration system with two reference centers has been set up to guide physicians and patients and to propose individualized management. The centers offer their expertise through a systematic centralised pathology review by a panel of experts. HCG values are plotted in regression curves. In case of gestational trophoblastic neoplasia, an imaging work-up is proposed, from which the FIGO score and stage are derived and will guide the choice of treatment. Belgian centers offer a multidisciplinary approach, in partnership with the referent physician. More information for practitioners and patients is available on a web site: www.mole-chorio-bgog.eu, which also harbours a forum of discussion. [less ▲]

Unique recurrence patterns of cervical intraepithelial neoplasia following excision of the squamo-columnar junction.

in International journal of cancer. Journal international du cancer (2015), 136

Recent studies have identified a putative cell of origin for cervical intraepithelial neoplasia (CIN) and cervical cancer at the squamo-columnar junction (SCJ) and suggest that these cells may not ... [more ▼]

Recent studies have identified a putative cell of origin for cervical intraepithelial neoplasia (CIN) and cervical cancer at the squamo-columnar junction (SCJ) and suggest that these cells may not regenerate following excision (LEEP). This study addressed the impact of SCJ excision on the temporal dynamics, histologic and viral (HPV) characteristics of recurrent CIN. One hundred thirty one consecutive patients treated by excision and attending follow-up visits were enrolled. We compared recurrent and initial CIN with attention to excision margins, timing of recurrence, CIN grade, HPV types, p16 immunophenotype, and SCJ immunophenotype. During the follow-up period (up to four years), sixteen (12.2%) recurrences were identified. Four (25%) were identified at the first follow-up visit, closely resembled the initial CIN 2/3 in grade and HPV type, and were typically SCJ marker positive [SCJ(+)], suggesting non-excised (residual) disease. Twelve (75%) manifested after the first postoperative visit and all were in the ectocervix or in mature metaplastic epithelium. All of the 12 delayed recurrences were classified as CIN 1 and were SCJ (-). Nine of 11 SCJ (-) recurrences (82%) followed regressed spontaneously. Taken together, these results show that new lesions developing from any HPV infection are delayed and occur within the ectocervix or metaplastic epithelium. This dramatically lower risk of CIN 2/3 following successful SCJ excision suggests that removal of the SCJ could be a critical variable in reducing the risk of subsequent CIN 2/3 and cervical cancer. (c) 2014 Wiley Periodicals, Inc. [less ▲]

Belgian registery for gestationnal trophoblastic diseases: impact of central pathology review. A study of the BGOG in 237 patients.

Poster (2015)

Belgian registery for gestational trophoblastic diseases: how does hysterectomy impact the management of GTD/GTN. A retrospective analyses of 11 cases.

Poster (2015)