Depistage echographique de la maladie luxante de hanche : qu'en est-il de la gemellite comme facteur de risque ?

Objectif : Le depistage echographique de la maladie luxante de hanche repond a des indications particulieres; dont l'existence de facteurs de risque. La gemellite fait partie de ces facteurs derisque. Le but de cette etude etait d'apprecier l'incidence reelle de la grossesse gemellaire dans la survenue de la maladie luxante de hanche. Materiels et Methodes : Nous avons realise une etude retrospective; de fevrier 1991 a mars 2004; de 316 dossiers d'echographies de hanche; realisees de maniere systematique chez des jumeaux; par une equipe pratiquant la methode morphologique de GRAF. Resultats : L'age moyen des nourrissons au premier examen etait de 2 mois en moyenne (de 1 a 3;4 mois). Dans 81 des cas; l'examen echographique initial etait normal. Les enfants presentant une hanche de type IIa etaient ages de 1;7 mois en moyenne. Ces hanches de type IIa; controlees dans un delai moyen de 1;8 mois; se sont normalisees dans 98;4 des cas. Seulement deux nourris- sons ont ete traites; un pour une hanche de type IIb unilateral; l'autre pour des hanches de type IIc bilateral. Ces deux nourrissons etaient nes en presentation de siege des cas. Seulement deux nourrissons ont ete traites; un pour une hanche de type IIb unilateral; l'autre pour des hanches de type IIc bilateral. Ces deux nourrissons etaient nes en presentation de siege

Congenital Hydrocephalus in Mono and Dizygotic Twins

Background: Information regarding the occurrence of hydrocephalus (HC) in twins is important in establishing the significance of environmental factors as well as a genetic basis in congenital HC aetiology. This was the basis for this study. Methods: A single institution retrospective study was conducted between August 1; 2006 and July 31; 2008. Only those cases of hydrocephalus (based on clinical and radiological testscranial Computeried tomographic or Magnetic resonance imaging scan) that required placement of a ventricular shunt or endoscopic third ventriculostomy were included in the study. Data regarding the patient's demographics; clinical history; examination and the maternal demographics were retrieved and analysed. DNA analysis was done to confirm the fraternity of the twins when applicable. Results: Fifty-eight patients with congenital hydrocephalus presented to the unit over the study period. We identified three sets of twins in the study. Only one set were identical (both male) and both had hydrocephalus. In the remaining two sets only one out of each pair had hydrocephalus (one male and one female). Two of the patients (1male; 1female) were twins with discordant HC. All the children had normal thumbs. DNA analysis confirmed identical twins in both the like sex twins. The mothers were not known diabetics; hypertensive or sickle cell patients neither did they smoke or take alcohol. There was no family history of hydrocephalus in all patients. Conclusion: Concordance for HC is likely if the twins are like sex and identical. Congenital hydrocephalus seems to be a multifactorial disorder; triggered by environmental factors in genetically predisposed individuals