[Neonatal screening of congenital toxoplasmosis. Prospective study]

While toxoplasmosis infection in women is often benign, transmission of maternal infection to the fetus can lead to severe sequelae. Because the majority of patients with acute toxoplasmosis are asymptomayic, a systematic serologic screening program will needed with monthly serologic screening of all seronegative pregnant women until delivery. The aim of this study was to identify cases of congenital toxoplasmosis among all live births of women found to be seronegative in pregnancy once at least. During a prospective study period of 16 months [from 07/02/2003 to 30/06/2004] we conduct a neonatal screening of all live births of women found to be seronegative in pregnancy once at least. Peripheral samples were obtained from every couple mother/ infant. Serological methods performed for diagnosis of toxoplasma specific IgM and IgG antibodies were Hemaglutination and Enzyme-linked immunosorbent assay [ELISA]. Four cases of congenital toxoplasmosis were diagnosed after birth. All cases were asymptomatic and a specific treatment was started soon after diagnosis. The clinical and serologic evolution was normal in three cases. A serologic rebound at two years was reported in one case with a chorioretinitis in the examination of the ocular fundus. Neonatal as well maternal screening during pregnancy and at birth should be systematic to prevent, diagnose and treat early the affected neonates usually asymptomatic

[Neonatal prognosis of second twin]

Twin pregnancy is associated to high neonatal morbidity particularly for the second twin. To assess twin delivery practice in our department and prognosis of second twin. retrospective study of medical files of parturition women with twin pregnancy between January 2003 and December 2006. Were excluded women delivered before 28 weeks gestation, twin pregnancies with death or malformation of one of twins. Descriptive and comparative analyses were realised. one hundred forty six twin pregnancies were counted. Vaginal delivery was attempted with 90 parturition women with 85,5% of success. Caesarean section delivery rate was 47,2%. Overall there's no difference between twins considering neonatal complication. In case of vaginal delivery, the second twin's 5 minutes Apgar score was statistically under the one of the 1st twin if compared to the caesarean section delivery. This difference was no more significant if regarding the Apgar score under 7 at 5 minutes. Apgar score of the second twin was also under the one of the first twin in non cephalic presentation. vaginal delivery of twin pregnancy was not associated to high risk for twins. Obstetrical manoeuvres should be well controlled to reduce obstetrical trauma

[Prospective epidemiologic study of group B streptococcus vaginal colonization in pregnant woman]

Group B streptococcus is known to be the principal medium responsible of maternal and severe neonatal infection. Assessing the prevalence of group B streptococcus [GBS] in our population, emphasize risk factors of GBS vaginal colonization and main characteristics of isolated strains. Prospective study of GBS vaginal colonization at admission for delivery upper to 34 amenorrhea weeks. Two hundred and seven vaginal swabs were carried out. Prevalence of GBS was 13%. Primigravida represents a risk factor of GBS vaginal colonization regarded to multigravida. False negative rate was 1,6%, All isolated strains were susceptible to penicillin C and to ampicilin, 44,4%were resistant to erythromycin. Systematic screening of GBS must be introduced in our population. Per partum antibioprophylaxis must consider susceptibility of isolated strains to antibiotics

[Foetopathology study: 88 cases of spina bifida]

Letal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida 1,05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia [46 cases] and hydrocephaly [21 cases]. Prevention is based on obstetric health care and hygieno dietetic advices to avoid alimentary deficit

syndrome de Jarcho-levin: a propos de 6 cas

The authors report six cases of new borns carriers of Jarcho Levin syndrome. It is called also spondylo costal dysostosis. The diagnosis is made in all cases on short thorax and short neck with diminished ribs and multiple vertebral defects. Cranio facial and associated abnormalities are inconstant. The radiologic study confirm the diagnostic in all cases on the presence of thoracic and vertebral caracteristic abnormalities. The letal evolution in all cases associated with parent consanguinity, the reach of the two sex, the family cases and healthy parents plead forautosomal recessive inheritance severe form. The severean form associated with recurrent risk justifies the practice of genetic counseling and prenatal diagnosis