[Factors associated with cesarean section in France. Results from the 1995 National Perinatal Survey]. / Les facteurs associés à la pratique d'une césarienne en France. Résultats de l'enquête nationale périnatale de 1995.

OBJECTIVE: to study the relationship between the cesarean section rates and the characteristics of newborns, mothers and maternity units, studying primary and repeat cesarean sections, and cesarean sections before and during labour separately. Population. Representative sample of births in France. METHOD: Univariate and multivariate analyses. RESULTS: The primary cesarean section rate (among women without previous cesarean section) was 11.0% and the repeat cesarean section rate was 62.9%. The main factors associated with primary cesarean sections were breech presentation, small-for-gestational age before term, and high birthweight, for characteristics of newborns, and parity 0,30 years old or more and high pre- pregnancy weight, for characteristics of mothers. These factors were linked to cesarean sections before labour and during labour. Preterm and post-term deliveries, educational level, and nationality played a different role before and during labour. Very few factors were linked to repeat cesarean sections. CONCLUSION: Various factors are associated with cesarean sections; they express the influence of both unfavorable medical conditions and particular medical care organisations.

Trends in risk factors for caesarean sections in France between 1981 and 1995: lessons for reducing the rates in the future.

OBJECTIVE: To assess the effects of the characteristics of mothers, fetuses and maternity units on the trends in caesarean section use, especially for primiparae. DESIGN: Cross sectional surveys. SETTING: Maternity units. POPULATION: Two representative national samples of births including 5410 newborns in 1981 and 13318 in 1995. METHOD: Univariate analysis and logistic regression analysis. RESULTS: The overall rate of caesarean section rose from 10.7% in 1981 to 15.3% in 1995. This trend is mainly attributable to the increases in the proportion of previously sectioned women (from 4.1% to 8.2%) and in caesarean sections for primiparae (from 12.6% to 17.8%). Among primiparae several maternal risk factors such as late childbearing and obesity before pregnancy were more frequent in 1995 than in 1981. The increase in caesarean sections affected both the high risk group (25.4% to 32.4%) and the low risk group (8.1% to 12.0%). CONCLUSION: A significant reduction in the overall rate cannot be achieved without regulating caesarean section use for primiparae. Strategies to change delivery patterns should be aimed at both high and low risk women.

[Surgical management of non-palpable breast lesions in ambulatory care]. / La prise en charge chirurgicale des lésions mammaires non palpables en ambulatoire.

OBJECTIVE: The aim of our study was to assess if surgery for non-palpable breast lesions could be compatible with a walk-in case hospitalization setting. METHOD: We retrospectively compared 75 patients with a traditional hospital stay to 68 patients with a walking case hospitalization. Overall 143 patients were treated during 1997. Studied parameters were: the quality of the surgical results, the duration of the hospital stay and the post operatives complications. Statistical analysis was realized using the chi 2 test. RESULTS: There was no difference between the studied populations according to the quality of surgical results either the post operatives complications. CONCLUSION: Surgery for non palpable breast lesions can be performed during a one day surgery. The reduction of the duration of the hospital stay decrease the cost of health care system. We should follow the evaluation of the walking case hospitalization for the breast cancer surgery especially when an axillary lymphadenectomy have to be performed.

[Quality control of cod liver oil, physicochemical methods of analysis]. / Contrôle de qualité de l'huile de foie de Morue, méthodes physicochimiques d'analyse.

The control of oils and fats requires analytical processes far surpassing the traditional framework of physical properties and chemical characteristics. The control of cod liver oil is improved by the use of these procedures. The present report is devoted to the measurement of vitamin A by ultraviolet spectrophotometry and of vitamin D3 by high performance liquid chromatography, to the determination of the profile of their fatty acids and polyunsaturated fats, as well as to their measurement by liquid gas chromatography after derivatisation. The results permit the definition of the cod liver oil's quality, the differentiation between fish oils and the detection of possible changes. A technique for verifying the absence of butylhydroxyanisol and of butylhydroxytoluen is also described.