[Early hospital discharge of preterm very low birt weight infants in the CMNT]

During a period of 2 years [2004-2005] 329 very low birth weight infants were discharged from the NICU of the CMNT. Mean birth weight was 1240g and mean gestational age was 30 weeks at admission. At discharge these babies weighed meanly 1575g and had post menstrual age of 35 weeks; 7, 2%of them were readmitted. The authors discuss the different conditions required for discharge of premature infants

Medical erros: talk them over for remedy

Error is human but prevention of medical errors is possible. Reduction of the iatrogenic risk to ensure the security of medical and paramedical healthcare must comply with certain regulations. Good medical practices should be developed and medical teams constant alertness to this risk and its prevention should be heightened

Evolution of twin pregnancies in the centre de maternite et de neonatalogie de Tunis

Multiples pregnancies and notably twin pregnancies are more and more frequent because of the development of the assisted reproduction technologies. These pregnancies contribute in a large part in the morbidity and the mortality among newborn because of prematurity. In this retrospective study, the authors fly to evaluate the status of twin pregnancies in the CMNT during 2001

[Balloon mitral commissurotomy in patients aged 60 years and more]

Of 745 patients treated by balloon mitral commissurotomy [BMC] between February 1988 and December 2002, 45 were over 60 years old. Immediate and late outcomes in this group [group 1] were compared with those in the patients aged under 60 years [group 2]. Baseline hemodynamic parameters were comparable in the two groups. Mitral surface area and hemodynamic parameters improved significantly after BMC in group 1: mean left atrial pressure fell from 18.76 +/- 6.18 to 10.65 +/- 4.38 mm Hg [p<0.001], mean transmitral gradient from 11.03 +/- 4.70 to 4.63 +/- 2.05 mm Hg [p< 0.001] and mitral valve area from 0.99 +/- 0.22 to 1.88 +/- 0.41 cm 2 [p< 0.001]. Similar significant improvements were seen in group 2. The hemodynamic result was good in 69% of group 1 patients. Tamponade occurred in one patient. Mitral regurgitation grade I or II developed in 8 patients and remained stable in 13 patients. These complication rates were comparable to those seen in group 2. In the group 1, a good result was maintained in 60% of patients after 43 +/- 23 months of follow-up. Although restenosis was observed in 40% of patients, functional amelioration was obtained in most of cases. In the group 2, restenosis was observed in 25% of patients. The data from this study suggest that BMC is effective first therapy in patients aged >/= 60 years with symptomatic mitral stenosis

[Non-ketotic hyperglycinaemia: the report of four affected families]

Non -ketotic hyperglycinaemia is an autosomal recessive disorder of inborn glycine metabolism caused by a defect in the glycine cleavage system. This disease leads to severe neurologic disorders beginning frequently in the neonatal period. The authors report the six cases of affected newborns diagnosed in the Neonatal Unit of le Centre de Maternite et de Neonatalogie de Tunis during a period of 17 years

[Roberts syndrome - a report of three cases and review of literature]

The Roberts syndrome is a rare syndrome characterized by a severe growth deficiency, a midfacial defect with hypomelia. The authors report the first and only three Tunisian cases described until now, with a review of the literature

[Newborn of myasthenic mother - a report of three cases]

Neonatal myasthenia gravis is a rare neuromuscular disease. It can be congenital or transient. We report three cases of sick new-borns of myasthenie mother. Clinical manifestations vary. Two of the new-borns have severe disorders and died despite symptomatic treatment. The third one had no respiratory insufficiency. He had only hypomimia and inability to swallow, so that prognosis was better. With this observation, we will discuss some pathophysiological and clinical particularities, as well as the treatment and the prognosis of the neonatal myasthenia gravis

[About a case of diabetes transient neonatal associated agenesis unilateral renal]

Transient neonatal diabetes is rare and seen in 1 case over 400.000 newborn babies. We report in this word what is, in our knowledge, the first case of transient neonatal diabetes associated with renal unilateral agenesis and a contralateral megalo-ureter

[Antenatal corticosteroid therapy: profits and risks]

The antenatal corticotherapy has proved its effectiveness in the reduction of the risk of occurrence of hyaline membrane disease and of intra-ventricular haemorrhage and also in a decreased mortality in the premature child. Some controversies still remain about the use of corticosteroid in preterm and premature membrane rupture, about the number of cures to be managed and the corticosteroid to be used. In this review we discuss these aspects according to recent data in the literature

[Infant of diabetic mother, new epidemiology in [le centre de maternite et de neonatalogie] Tunis]

We retrospectively studied all infants of diabetic mothers [IDM] [n=326] born in the "Centre de Maternite et de Neonatologie de Tunis [CMNT]" during 2001. The purpose was to establish the epidemiological trends of IDMs and to analyze main perinatal complications. IDM group was compared for some variables to a control one of infants of non diabetic mothers [INDM]. Gestational Diabetes represented 80.2% of all diabetic mothers. Systemic hypertension associated to or preceding pregnancy was noted in 33.1% of IDMs. Delivery by caesarian section occurred in 54% of cases in the IDM group vs 29% in INDM group [p=0.0001]. Fetal macrosomia was the most frequent complication in IDM group [41.1%]. Congenital malformations were noted in 3.4% of IDM group and were more frequent if diabetes was pregestational. Other complications were frequently noted in IDM group such as prematurity [30.1%], hypertrophic cardiomyopathy [8.5%]; respiratory distress [13.1%] which was dominated by transient tachypnea. Metabolic complications where represented by hypoglycemia and hypocalcaemia [32.6% and 22.6% respectively]. Hyperbilirubinemia was observed in 8.3% and in 1.2% respectively in IDM and INDM groups. Neonatal lethality was 4% and perinatal lethality was 5.5% in IDM group. Comparing our results to the first studies carried out in the 80s in the CMNT, we noted significant decrease, in term of perinatal morbidity and mortality. This was explained by extension of screening policies associated with the multidisciplinary management of diabetic mothers and their offspring