Publications by authors named "Mathias Rossignol"

11 Publications

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Maternal Intensive Care Unit Admission as an Indicator of Severe Acute Maternal Morbidity: A Population-Based Study.

Anesth Analg 2021 May 14. Epub 2021 May 14.

From the Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris University, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA), Paris, France.

Background: Severe acute maternal morbidity (SAMM) accounts for any life-threatening complication during pregnancy or after delivery. Measuring and monitoring SAMM seem critical to assessing the quality of maternal health care. The objectives were to explore the validity of intensive care unit (ICU) admission as an indicator of SAMM by characterizing the profile of women admitted to an ICU and of their ICU stay, according to the association with other SAMM criterion.

Methods: We performed a secondary analysis of the 2540 women with SAMM included in the epidemiology of severe acute maternal morbidity (EPIMOMS) multiregional prospective population-based study (2012-2013, n = 182,309 deliveries). The EPIMOMS definition of SAMM, based on national experts' consensus, is a combination of diagnosis, organ dysfunctions, and intervention criteria, including ICU admission. Among women with SAMM, we identified characteristics associated with maternal ICU admission with or with no other SAMM criterion compared with ICU admission, by using multivariable multinomial logistic regression models.

Results: Overall, 511 women were admitted to an ICU during or up to 42 days after pregnancy, for a population-based rate of 2.8 of 1000 deliveries (511/182,309; 95% confidence interval [CI], 2.6-3.1); 15.5% of them (79/511; 95% CI, 12.4-18.9) had no other SAMM criterion compared with ICU admission. Among women with SAMM, the odds of ICU admission with no other morbidity criterion were increased in women with preexisting medical conditions (adjusted odds ratio (aOR), 2.13; 95% CI, 1.17-3.86) and cesarean before labor (aOR, 3.12; 95% CI, 1.47-6.64). Women admitted to ICU with no other SAMM criterion had more often decompensation of a preexisting condition, no interventions for organ support, and a shorter length of stay than women admitted with other SAMM criteria.

Conclusions: Among women with SAMM, 1 in 5 is admitted to an ICU; 15.5% of those admitted in ICU have no other SAMM criterion and a less acute condition. These results challenge the use of ICU admission as a criterion of SAMM.
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May 2021

Time-frequency scattering accurately models auditory similarities between instrumental playing techniques.

EURASIP J Audio Speech Music Process 2021 11;2021(1). Epub 2021 Jan 11.

LS2N, CNRS, Centrale Nantes, Nantes University, 1, rue de la Noe, Nantes, 44000 France.

Instrumentalplaying techniques such as vibratos, glissandos, and trills often denote musical expressivity, both in classical and folk contexts. However, most existing approaches to music similarity retrieval fail to describe timbre beyond the so-called "ordinary" technique, use instrument identity as a proxy for timbre quality, and do not allow for customization to the perceptual idiosyncrasies of a new subject. In this article, we ask 31 human participants to organize 78 isolated notes into a set of timbre clusters. Analyzing their responses suggests that timbre perception operates within a more flexible taxonomy than those provided by instruments or playing techniques alone. In addition, we propose a machine listening model to recover the cluster graph of auditory similarities across instruments, mutes, and techniques. Our model relies on joint time-frequency scattering features to extract spectrotemporal modulations as acoustic features. Furthermore, it minimizes triplet loss in the cluster graph by means of the large-margin nearest neighbor (LMNN) metric learning algorithm. Over a dataset of 9346 isolated notes, we report a state-of-the-art average precision at rank five ([email protected]) of 990±1. An ablation study demonstrates that removing either the joint time-frequency scattering transform or the metric learning algorithm noticeably degrades performance.
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January 2021

SARS-CoV-2-associated cold agglutinin disease: a report of two cases.

Ann Hematol 2020 08 26;99(8):1943-1944. Epub 2020 Jun 26.

Department of Internal Medicine, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, University of Paris, 2 rue Ambroise Paré, 75010, Paris, France.

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August 2020

Efficient similarity-based data clustering by optimal object to cluster reallocation.

PLoS One 2018 1;13(6):e0197450. Epub 2018 Jun 1.

Ircam, CNRS, Paris, France.

We present an iterative flat hard clustering algorithm designed to operate on arbitrary similarity matrices, with the only constraint that these matrices be symmetrical. Although functionally very close to kernel k-means, our proposal performs a maximization of average intra-class similarity, instead of a squared distance minimization, in order to remain closer to the semantics of similarities. We show that this approach permits the relaxing of some conditions on usable affinity matrices like semi-positiveness, as well as opening possibilities for computational optimization required for large datasets. Systematic evaluation on a variety of data sets shows that compared with kernel k-means and the spectral clustering methods, the proposed approach gives equivalent or better performance, while running much faster. Most notably, it significantly reduces memory access, which makes it a good choice for large data collections. Material enabling the reproducibility of the results is made available online.
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December 2018

Trauma and pregnancy: What anesthesiologist should know.

Anaesth Crit Care Pain Med 2016 Oct 5;35 Suppl 1:S27-S34. Epub 2016 Jul 5.

Department of anesthesiology, critical care and pre-hospital intensive care unit, hôpital Lariboisière, Assistance publique-Hopitaux de Paris, Paris, France. Electronic address:

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October 2016

Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF): in collaboration with the French Society of Anesthesiology and Intensive Care (SFAR).

Eur J Obstet Gynecol Reprod Biol 2016 Mar 21;198:12-21. Epub 2015 Dec 21.

INSERM U1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Paris, France; DHU Risques et Grossesse, 53 avenue de l'observatoire, Paris, France; Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.

Postpartum haemorrhage (PPH) is defined as blood loss ≥500mL after delivery and severe PPH as blood loss ≥1000mL, regardless of the route of delivery (professional consensus). The preventive administration of uterotonic agents just after delivery is effective in reducing the incidence of PPH and its systematic use is recommended, regardless of the route of delivery (Grade A). Oxytocin is the first-line prophylactic drug, regardless of the route of delivery (Grade A); a slowly dose of 5 or 10 IU can be administered (Grade A) either IV or IM (professional consensus). After vaginal delivery, routine cord drainage (Grade B), controlled cord traction (Grade A), uterine massage (Grade A), and routine bladder voiding (professional consensus) are not systematically recommended for PPH prevention. After caesarean delivery, placental delivery by controlled cord traction is recommended (grade B). The routine use of a collector bag to assess postpartum blood loss at vaginal delivery is not systematically recommended (Grade B), since the incidence of severe PPH is not affected by this intervention. In cases of overt PPH after vaginal delivery, placement of a blood collection bag is recommended (professional consensus). The initial treatment of PPH consists in a manual uterine examination, together with antibiotic prophylaxis, careful visual assessment of the lower genital tract, a uterine massage, and the administration of 5-10 IU oxytocin injected slowly IV or IM, followed by a maintenance infusion not to exceed a cumulative dose of 40IU (professional consensus). If oxytocin fails to control the bleeding, the administration of sulprostone is recommended within 30minutes of the PPH diagnosis (Grade C). Intrauterine balloon tamponade can be performed if sulprostone fails and before recourse to either surgery or interventional radiology (professional consensus). Fluid resuscitation is recommended for PPH persistent after first line uterotonics, or if clinical signs of severity (Grade B). The objective of RBC transfusion is to maintain a haemoglobin concentration (Hb) >8g/dL. During active haemorrhaging, it is desirable to maintain a fibrinogen level ≥2g/L (professional consensus). RBC, fibrinogen and fresh frozen plasma (FFP) may be administered without awaiting laboratory results (professional consensus). Tranexamic acid may be used at a dose of 1 g, renewable once if ineffective the first time in the treatment of PPH when bleeding persists after sulprostone administration (professional consensus), even though its clinical value has not yet been demonstrated in obstetric settings. It is recommended to prevent and treat hypothermia in women with PPH by warming infusion solutions and blood products and by active skin warming (Grade C). Oxygen administration is recommended in women with severe PPH (professional consensus). If PPH is not controlled by pharmacological treatments and possibly intra-uterine balloon, invasive treatments by arterial embolization or surgery are recommended (Grade C). No technique for conservative surgery is favoured over any other (professional consensus). Hospital-to-hospital transfer of a woman with a PPH for embolization is possible once hemoperitoneum is ruled out and if the patient's hemodynamic condition so allows (professional consensus).
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March 2016

Renal arteriovenous fistula revealed by severe hypertension during pregnancy.

BMJ Case Rep 2013 Oct 8;2013. Epub 2013 Oct 8.

Department of Obstetric Gynecology, Lariboisiere Hospital, Paris, France.

A 35-year-old woman developed severe hypertension resistant to antihypertensive treatment during the second trimester of pregnancy at 24 weeks gestation. Doppler ultrasonography achieved the diagnosis of idiopathic renal arteriovenous fistula in the left kidney associated with parenchymal hypoperfusion. A Caesarean section was performed 6 days after the diagnosis because of severe pre-eclampsia. After delivery, the symptoms disappeared. Fistula persisted after follow-up for over 1 year but with a dramatic decrease in its blood flow and normalisation of the left kidney hemodynamics. Nevertheless, embolisation was performed without complications to prevent recurrence during the next pregnancy expected by the patient.
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October 2013

Diagnostic accuracy of insulin-like growth factor binding protein-1 for amniotic fluid embolism*.

Crit Care Med 2012 Jul;40(7):2059-63

Department of Anesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique- Hôpitaux de Paris, EA-3509 University of Paris 7 Denis Diderot, Paris, France.

Objective: To test whether serum insulin-like growth factor binding protein-1 could be used as a biomarker of amniotic fluid passage into the maternal circulation.

Design: Case-control study.

Setting: Thirteen centers in France.

Patients: This case-control study included a group with amniotic fluid embolism (the amniotic fluid embolism group) and a group with symptoms unrelated to amniotic fluid embolism (the non-amniotic fluid embolism group). Serum insulin-like growth factor binding protein-1 level was measured within 6 hrs from onset of symptoms. We also determined serum insulin-like growth factor binding protein-1 in four additional groups of patients with 1) postpartum hemorrhage, 2) uncomplicated labor, 3) normal pregnancy, and 4) non-pregnant patients with acute pulmonary embolism.

Interventions: None.

Measurements: Serum insulin-like growth factor binding protein-1 levels were determined using an immuno-enzymatic assay.

Main Results: The amniotic fluid embolism group included 25 patients, the non-amniotic fluid embolism group had 20 patients, the postpartum hemorrhage group had 24 patients, and the uncomplicated labor group had 50 patients. The serum levels of insulin-like growth factor binding protein-1 were higher in the amniotic fluid embolism group (234 134-635 µmol/L) compared with the non-amniotic fluid embolism, postpartum hemorrhage, and uncomplicated labor groups, which had serum levels of 56 36-91 µmol/L, 65 39-91 µmol/L and 49 30-78 µmol/L, respectively (p < .001). Serum insulin-like growth factor binding protein-1 level was not different in women during normal pregnancy (57 37-85 µg/L) compared to the uncomplicated labor group. Patients with acute pulmonary embolism had the lowest insulin-like growth factor binding protein-1 level (5 2-14 µg/L). The area under the receiver-operating-characteristic curve for serum insulin-like growth factor binding protein-1 was 0.98 0.97-1.00 for the amniotic fluid embolism diagnostic. Insulin-like growth factor binding protein-1 rose from 56 43-90 µg/L before symptoms to 458 161-1514 µg/L after the onset of symptoms in ten patients with available measurements of baseline serum insulin-like growth factor binding protein-1.

Conclusion: Increased serum levels of insulin-like growth factor binding protein-1 appear to be a valuable biomarker of amniotic fluid passage into the maternal circulation and may be used to diagnose amniotic fluid embolism.
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July 2012

Uterine conservation despite severe sepsis in a case of placenta accreta first treated conservatively: 3-month delayed successful removal of the placenta.

Fertil Steril 2009 May 21;91(5):1957.e5-9. Epub 2009 Mar 21.

Obstetrics and Gynecology unit, Lariboisière Hospital, APHP, Paris, France.

Objective: To report a case of successful delayed removal of a placenta accreta first treated conservatively. Secondary infectious complications can occur after conservative management in cases of placenta accreta, most often leading to hysterectomy.

Design: Case report.

Setting: A French teaching hospital.

Patient(s): A 33-year-old woman.

Intervention(s): A healthy 33-year-old woman underwent Cesarean section for her first pregnancy. Diagnosis of placenta accreta was made at ultrasound scanning for her second pregnancy. She was first treated conservatively. Hysterectomy was planned 3 months after conservative treatment because of sepsis attributed to uterine retention. (Hysterotomy was first realized.)-??

Main Outcome Measure(s): Uterine conservation.

Result(s): The placenta was easily and successfully removed with no subsequent bleeding. The uterus was sutured and conserved.

Conclusion(s): In cases of delayed sepsis because of uterine retention after conservative treatment for placenta accreta, when medical treatment remains unsuccessful, manual removal of the placenta should be attempted. This approach might allow improved uterine conservation rates in women with placenta accreta treated conservatively.
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May 2009

High incidence of myocardial ischemia during postpartum hemorrhage.

Anesthesiology 2004 Jan;100(1):30-6; discussion 5A

Department of Anesthesiology and Critical Care Medicine, Hôpital Lariboisière, Paris, France.

Background: Postpartum hemorrhage remains a major cause of global maternal morbidity and mortality, even in developed countries, despite the use of intensive care units. This study sought to (1) assess whether myocardial ischemia could be associated with and even aggravate hemorrhagic shock in young parturients admitted for postpartum hemorrhage, and (2) identify the independent risk factors for myocardial ischemia.

Methods: On their referral to the intensive care unit, a multidisciplinary team managed parturients with severe postpartum hemorrhage. Ventilation, transfusion, catecholamines, surgery, or angiography with uterine embolization were provided as clinically indicated. Plasma cardiac troponin I levels were used as a surrogate marker of acute myocardial injury and electrocardiograms of myocardial ischemia.

Results: A total of 55 parturients were referred with severe postpartum hemorrhage, all in hemorrhagic shock. Twenty-eight parturients (51%) had elevated serum levels of cardiac troponin I (9.4 microg/l [3.7-26.6 microg/l]), which were associated with electrocardiographic signs of ischemia and deteriorated myocardial contractility and correlated with the severity of hemorrhagic shock. Indeed, multivariate analysis identified low systolic and diastolic arterial blood pressure (< 88 and < 50 mmHg, respectively) and increased heart rate (> 115 beats/min) as independent predictors of myocardial injury. In addition, all patients who were given catecholamines also had elevated cardiac troponin I levels.

Conclusions: These results suggest that treatment of postpartum hemorrhage-induced hemorrhagic shock should be coupled with concomitant prevention of myocardial ischemia, even in young parturients.
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January 2004

Association between a genomic polymorphism within the CD14 locus and septic shock susceptibility and mortality rate.

Crit Care Med 2002 May;30(5):969-73

Service de Réanimation Médicale, Hôpital Central, Nancy, France.

Objective: Genetic differences in immune responses may affect susceptibility to and outcome of septic shock. CD14 seems to be an important part of the innate immune system, initiating antimicrobial response. We evaluated the frequency of a recently discovered CD14 promoter gene polymorphism (C to T transition at base pair -159) among patients with septic shock compared with those in a control group.

Design: Multiple-center study.

Setting: Hospital research department.

Patients: Ninety consecutive white patients with septic shock were included. The control group consisted of 122 age- and gender-matched white subjects.

Interventions: In both groups, the C-159T CD14 promoter genetic polymorphism was determined by using polymerase chain reaction and subsequent Hae III restriction enzyme digestion of the polymerase chain reaction products.

Measurements And Main Results: The C-159T polymorphism and the TT genotype were significantly overrepresented among septic shock patients compared with controls. Within the septic shock group, the mortality of patients with TT genotype (71%) was significantly higher than in patients with other genotypes (48%; Pearson chi-square, p =.008). In a multiple logistic regression model, the TT genotype was independently associated with an increased relative risk of death (odds ratio, 5.30; 95% confidence interval, 1.20-22.50, p =.02).

Conclusions: The C-159T polymorphism affects susceptibility to septic shock and seems to be a new genetic risk factor for death.
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May 2002