Publications of Patrick EMONTS
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See detailL’activité physique de la femme enceinte et de l'accouchée
GUINHOUYA, BENJAMIN C.; BARIBEAU, ANISSA; BISSON, MICHELE et al

Book published by LAVOISIER (2021)

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See detailL’induction élective du travail chez la patiente nullipare : stop ou encore ?
TREMBLAY LEMOINE, Pierre Luc ULiege; Van Linthout, Christine ULiege; Emonts, Patrick ULiege et al

in Revue medicale de Liege (2020), 75(10), 676-681

In Wallonia, almost one fourth of cesarean sections are performed on nulliparous women with vertex nonanomalous singleton gestations who underwent induction of labor. The purpose of this study is to ... [more ▼]

In Wallonia, almost one fourth of cesarean sections are performed on nulliparous women with vertex nonanomalous singleton gestations who underwent induction of labor. The purpose of this study is to compare maternal and neonatal outcomes with elective induction of labor versus spontaneous onset of labor. Data for all deliveries at CHU de Liège over a two-year period were obtained. Women with vertex nonanomalous singleton gestations who delivered from 3900 to 40+6 weeks were selected. We tested the association of elective induction and operative vaginal delivery, cesarean section, post-partum hemorrhage, episiotomy and perineal lacerations, length of labor, length of stay, 1-min and 5-min APGAR inferior to 7 and admission to neonatal intensive care unit. Length of stay was significantly longer in all induced women. In nulliparous women, there was a 45 % probability of operative vaginal delivery or cesarean section delivery in those who underwent elective induction of labor. In light of these results, it seems that our policy of elective induction of labor in nulliparous women is causing unnecessary and potentially avoidable interventions. [less ▲]

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See detailBelgian clinical guidance on anticoagulation management in hospitalised and ambulatory patients with COVID-19.
Vanassche, Thomas; Orlando, Christelle; VANDENBOSCH, Kristel ULiege et al

in Acta Clinica Belgica (2020)

OBJECTIVES: COVID-19 predisposes patients to thrombotic disease. The aim of this guidance document is to provide Belgian health-care workers with recommendations on anticoagulation management in COVID-19 ... [more ▼]

OBJECTIVES: COVID-19 predisposes patients to thrombotic disease. The aim of this guidance document is to provide Belgian health-care workers with recommendations on anticoagulation management in COVID-19 positive patients. METHODS: These recommendations were based on current knowledge and a limited level of evidence. RESULTS: We formulated recommendations for the prophylaxis and treatment of COVID-related venous thromboembolism in ambulatory and hospitalised patients, as well as recommendations for the use of antithrombotic drugs in patients with prior indication for anticoagulation who develop COVID-19. CONCLUSIONS: These recommendations represent an easy-to-use practical guidance that can be implemented in every Belgian hospital and be used by primary care physicians and gynaecologists. Of note, they are likely to evolve with increased knowledge of the disease and availability of data from ongoing clinical trials. [less ▲]

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See detailComment j’explore… le retard de croissance intra-utérin
PAQUAY, Pauline ULiege; Gérard, Marie ULiege; PIELTAIN, Catherine ULiege et al

in Revue medicale de Liege (2019), 74(10), 543-552

Intrauterine growth restriction (IUGR) is a common obstetrical condition (10 % of all pregnancies). Its origin is most often vascular, but it may also be a symptom of another fetal pathology (infectious ... [more ▼]

Intrauterine growth restriction (IUGR) is a common obstetrical condition (10 % of all pregnancies). Its origin is most often vascular, but it may also be a symptom of another fetal pathology (infectious, genetic, syndromic). Screening may be complicated due to the low sensitivity of the clinical examination as well as ultrasound. However, IUGR exposes the newborn to increased perinatal morbidity and mortality. In addition, various studies show that children born with low birth weight have a higher incidence of metabolic disorders in the long term. If an IUGR is discovered, an etiological development and management strategy must be carried out in a multidisciplinary manner.Le retard de croissance intra-utérin est une pathologie obstétricale fréquente (10 %). Le plus souvent d’étiologie vasculaire, il peut cependant être le symptôme d’une pathologie fœtale autre (infectieuse, génétique, syndromique). Le dépistage peut être compliqué en raison d’une faible sensibilité, tant clinique qu’échographique. Il expose pourtant le nouveau-né à une morbi-mortalité périnatale augmentée à court terme. Par ailleurs, différentes études montrent que les enfants nés avec un faible poids présentent, à plus long terme, une incidence majorée de pathologies métaboliques. En cas de découverte d’un retard de croissance intra-utérin, une mise au point étiologique et une stratégie de prise en charge doivent être réalisées de façon multidisciplinaire. [less ▲]

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See detailAlcool, grossesse et allaitement.
Emonts, Patrick ULiege; CAPELLE, Xavier ULiege; GRANDFILS, Sébastien ULiege et al

in Revue medicale de Liege (2019), 74(5-6), 360-364

Perinatal studies over the last ten years report that 3 % of pregnant women have alcohol consumption. The malformative and neurological consequences of prenatal exposure to alcohol have been known for ... [more ▼]

Perinatal studies over the last ten years report that 3 % of pregnant women have alcohol consumption. The malformative and neurological consequences of prenatal exposure to alcohol have been known for more than 50 years. Research has shown that the effects of alcohol during pregnancy and breast-feeding go far beyond visible abnormalities at birth. Neurological consequences, from minor psychomotor retardation to severe behavioural disorders, make all the severity of this intoxication and justify strict instructions to refrain from taking alcohol during pregnancy and breast-feeding. [less ▲]

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See detailLe cas clinique du mois. Syndrome de Cushing au cours d'une grossesse: Difficultés diagnostiques et thérapeutiques
Gellner, K; Emonts, Patrick ULiege; HAMOIR, Etienne ULiege et al

in Revue Médicale de Liège (2018), 73

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See detailMeeting the Needs of Mothers During the Postpartum Period: Using Co-Creation Workshops to Find Technological Solutions.
Slomian, Justine ULiege; Emonts, Patrick ULiege; Vigneron, Lara ULiege et al

in JMIR Research Protocols (2017), 6(5), 76

BACKGROUND: The postnatal period is associated with many new needs for mothers. OBJECTIVE: The aim of this study was to find technological solutions that meet the needs of mothers during the year ... [more ▼]

BACKGROUND: The postnatal period is associated with many new needs for mothers. OBJECTIVE: The aim of this study was to find technological solutions that meet the needs of mothers during the year following childbirth. METHODS: Two co-creation workshops were undertaken with parents and professionals. The aim of the first workshop was to create a list of all the criteria the proposed solution would have to address to meet the needs of mothers after childbirth. The aim of the second workshop was to create solutions in response to the criteria selected during the first workshop. RESULTS: Parents and health professionals want solutions that include empathy (ie, to help fight against the feelings of abnormality and loneliness), that help mothers in daily life, that are personalized and adapted to different situations, that are educational, and that assures some continuity in their contact with health professionals. In practice, we found that parents and professionals think the solution should be accessible to everyone and available at all times. To address these criteria, technology experts proposed different solutions, such as a forum dedicated to the postpartum period that is supervised by professionals, a centralized website, a system of videoconferencing, an online exchange group, a "gift voucher" system, a virtual reality app, or a companion robot. CONCLUSIONS: The human component seems to be very important during the postnatal period. Nevertheless, technology could be a great ally in helping mothers during the postpartum period. Technology can help reliably inform parents and may also give them the right tools to find supportive people. However, these technologies should be tested in clinical trials. [less ▲]

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See detailUne hypokaliémie à Liège
VALDES SOCIN, Hernan Gonzalo ULiege; EMONTS, Patrick ULiege; HAMOIR, Etienne ULiege et al

Conference (2016, October 15)

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See detailIdentification des besoins des mères dans l’année suivant leur accouchement : une étude qualitative.
Slomian, Justine ULiege; EMONTS, Patrick ULiege; Vigneron, Lara et al

Poster (2016, May)

Contexte de l’étude : La grossesse et l’accouchement sont deux étapes fondamentales dans la vie d’une femme. Plusieurs études ont montré que le malaise psychologique était relativement fréquent dans ... [more ▼]

Contexte de l’étude : La grossesse et l’accouchement sont deux étapes fondamentales dans la vie d’une femme. Plusieurs études ont montré que le malaise psychologique était relativement fréquent dans l’année suivant un accouchement. Objectifs : L’objectif de cette étude était de déterminé les besoins des mères dans l’année suivant leur accouchement (qu’elles aient vécu un épisode psychologique pathologique ou non). Méthode : Plusieurs étapes qualitatives ont été entreprises dans cette étude. Premièrement, nous avons conduit 22 entretiens individuels et un focus group réunissant des mères ayant vécu ou non un épisode de détresse psychologique. Nous avons ensuite mené deux autres focus : un avec des professionnels de la santé, l’autre avec des pères. Le but était de comparer les besoins maternels avec la perception des professionnels ainsi que des pères. Règles éthiques : Cette étude a reçu l’accord du comité d’éthique hospitalo-facultaire du CHU de Liège sous le numéro : 2015/48. Chaque participante a signé un formulaire de consentement éclairé quant à sa participation à l’étude ainsi qu’à l’autorisation de diffuser les résultats de façon confidentielle. Résultats : Les besoins des mères après leur accouchement ont été classés en 4 grandes catégories : le besoin d’information, le besoin de soutien psychologique, le besoin de partage d’expériences et le besoin de support matériel et pratique. Les femmes ne se sentent pas assez informées dans cette période de vie difficile. Elles ne se sentent pas non plus assez soutenues au point de vue psychologique mais également dans les tâches ménagères. Elles sont souvent fatiguées et se posent beaucoup de questions. Elles ont besoin de partager cette expérience de vie et elles ont besoin d’être rassurées et de se sentir comprises. Il semblerait qu’il y ait des différences de vécu d’expériences entre les mères et les professionnels mais également entre les mères et les pères. Conclusion : L’arrivée d’un bébé est une étape importante dans la vie d’une femme et d’un couple. Cela demande un remaniement tant sur les plans physique que psychologique et social. Les mères semblent ressentir un manque de support à différents niveaux au cours de la période postnatale. Cette étude procure des pistes pour répondre à leurs besoins et tenter de prévenir le risque de détresse psychologique dans la période postnatale. [less ▲]

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See detailA reversible posterior leucoencephalopathy syndrome including blindness caused by preeclampsia.
Vandenbossche, Gautier; Maquet, J.; Vroonen, Philippe et al

in Facts, Views and Vision in Obgyn (2016), 8(3), 173-177

Complications of (pre)eclampsia may involve multiple systems and organs. Neurological symptoms may occur. Visual symptoms concern up to 25% the of patients with severe preeclampsia and 50% of the patients ... [more ▼]

Complications of (pre)eclampsia may involve multiple systems and organs. Neurological symptoms may occur. Visual symptoms concern up to 25% the of patients with severe preeclampsia and 50% of the patients with eclampsia. An uncommon effect of severe preeclampsia is sudden blindness. Blindness may be part of a clinical and radiological presentation named Posterior Reversible Encephalopathy Syndrome (PRES). PRES may lead to permanent neurological deficit, recurrences or death. We report the case of a 24-year-old Caucasian patient, gravida 5 para 2 who developed preeclampsia and PRES complicated with blindness at 32 weeks of gestation. Optimal care allowed visual symptoms to resolve within 24 hours and a favourable maternal outcome and no long- term sequelae. We describe different causes and manifestations of PRES and highlight the need for immediate care in order to optimize the chance of symptoms reversibility. [less ▲]

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See detailAssuétudes et grossesse: comment détruire un projet de naissance
Emonts, Patrick ULiege; MASSON, Véronique ULiege; CHANTRAINE, Frédéric ULiege et al

in Revue Médicale de Liège (2013), 68(5-6), 239-244

Les femmes enceintes sont conscientes que toute forme d’addiction durant leur grossesse peut être préjudiciable à leur enfant. Pourtant, de nombreuses gestantes continuent de fumer, de boire de l’alcool ... [more ▼]

Les femmes enceintes sont conscientes que toute forme d’addiction durant leur grossesse peut être préjudiciable à leur enfant. Pourtant, de nombreuses gestantes continuent de fumer, de boire de l’alcool, de consommer des drogues illicites ou d’absorber des médicaments, car ces dépendances sont particulièrement tenaces. Le quatuor de tête en termes de préjudice fœtal est composé du tabac, de l’alcool, de la cocaïne et de l’ecstasy. La période de grossesse est le meilleur moment pour mettre fin à ces addictions. Aussi, est-il indispensable de sensibiliser le grand public, les pouvoirs politiques ainsi que les médecins sur le fait que les assuétudes durant la grossesse représentent une inégalité de santé et d’espérance de vie importante pour l’enfant à naître. [less ▲]

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See detailPrise en charge du diabete gestationnel.
Philips, J. C.; EMONTS, Patrick ULiege; Pintiaux, Axelle ULiege et al

in Revue Médicale de Liège (2013), 68(9), 489-96

Pregnancy is associated with relative carbohydrate intolerance and insulin resistance. Gestational diabetes mellitus (GDM) is recognized as a risk factor for a number of adverse outcomes during pregnancy ... [more ▼]

Pregnancy is associated with relative carbohydrate intolerance and insulin resistance. Gestational diabetes mellitus (GDM) is recognized as a risk factor for a number of adverse outcomes during pregnancy, including excessive fetal growth, increased incidence of birth trauma and neonatal metabolic abnormalities. This recognition has led to recommendations to screen all pregnant women for GDM and to treat those whose glucose tolerance tests exceed threshold criteria. Numerous epidemiological studies show that GDM affects between 1 and 25% of pregnancies, depending on the ethnicity of the population studied and the diagnostic criteria. Intervention to change lifestyle and, if maternal hyperglycemia persists, treatment with additional oral medication or insulin injections have shown to improve perinatal outcomes. Patients with GDM have a high risk of developing type 2 diabetes in the years after delivery and these women are encouraged to practice specific health behaviours (dietary habits, physical activity) during the postpartum period. The present article discusses the management of GDM in the light of data from the latest studies and international recommendations. [less ▲]

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See detailla dépression maternelle en post-partum: actualisation et points pratiques
Battisti, Oreste ULiege; Emonts, Patrick ULiege

in colloque de l'EPU-Ulg (2012, May)

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See detailDétermination d'un index prédictif de la preeclampsie en préconceptionnel et propositions thérapeutiques de prévention primaire
Emonts, Patrick ULiege; Seaksan, Sontera; Seidel, Laurence ULiege et al

in Journal de Gynécologie, Obstétrique et Biologie de la Reproduction (2008), 37(5), 469-476

Objective To derive a prediction index based on the most salient history, laboratory and clinical parameters for identifying women at high risk of developing preeclampsia (PE) and to suggest a primary ... [more ▼]

Objective To derive a prediction index based on the most salient history, laboratory and clinical parameters for identifying women at high risk of developing preeclampsia (PE) and to suggest a primary prevention. Material and method Non-pregnant women with a history of PE (n =101) were compared to non-pregnant parous women with a history of one or more successful normotensive pregnancies (n =50) but with comparable age, gestation and parity profiles. The parameters included history and clinical examination; laboratory studies (hemostasis, coagulation, vitamins); and morphological and functional tests (cardiovascular and renal functions). Stepwise logistic regression analysis was applied to develop a three step PE prediction index based on the most discriminant parameters. Strategies to prevent PE in the high-risk group are described. Results Identification of women at high risk of PE can be done efficiently (88% sensitivity and specificity) using a predictive index based on a simple history, laboratory, clinical and functional information. Stategies to prevent PE in our high-risk group have given encouraging results during next pregnancy. Conclusion Our study gives a predictive index of PE outside of pregnancy and possibilities to do a primary prevention. [less ▲]

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See detailLa carence en vitamine d chez les femmes enceintes en region liegeoise: un probleme meconnu.
Cavalier, Etienne ULiege; Delanaye, Pierre ULiege; Morreale, Alessandro et al

in Revue Médicale de Liège (2008), 63(2), 87-91

We have evaluated the prevalence of the 25-hydroxy vitamin D (25VTD) deficiency in recently pregnant women and new mothers in the area of Liege, Belgium. The study took place in November 2006. Twenty four ... [more ▼]

We have evaluated the prevalence of the 25-hydroxy vitamin D (25VTD) deficiency in recently pregnant women and new mothers in the area of Liege, Belgium. The study took place in November 2006. Twenty four women who underwent a positive pregnancy test and 65 new mothers were enrolled. The level of 25VTD did not differ between the two groups. Only 12% of the pregnant women and 14% of the new mothers (>12 ng/ml) had an optimal level of 25VTD (>30 ng/ ml). We also observed a severe 25VTD deficiency in 21% of pregnant women and 32% of new mothers. Our results showed that more than 80% of pregnant women and new mothers in the area of Liege presented a deficiency in 25VTD. In Belgium, daily vitamin supplementation of pregnant women is common, but the level of vitamin D3 concentration range from 10 microg (400 UI) to zero microg. In our area, vitamin D production in the skin is not always important enough to achieve optimal levels. Our data show that vitamin D supplementation of pregnant women is not enough and that 25VTD deficiency is not diagnosed in this high-risk population. Children born from deficient mothers will present a higher risk of suffering from bone mineral diseases as well as other pathologies, as type 1 diabetes or neurological disorders. Of course, this insufficiency will also have an impact on mother's bone reserve, but these mothers will also be at higher risk for preeclampsia. [less ▲]

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