Transient fetal hypothyroidism due to direct fetal administration of amiodarone for drug resistant fetal tachycardia.

Amiodarone, an anti-arrhythmic drug that contains 39% iodine, is rarely known to cause negative effects on fetal thyroid function after gestational exposure, when given orally to a pregnant woman. Two cases of fetal hypothyroidism after gestational exposure to amiodarone by direct fetal intravenous route are described here.

Neonatal screening for congenital cytomegalovirus infections.

We evaluated a screening program for the detection of congenital cytomegalovirus in 3075 unselected pregnant women. From each live-born child urine for CMV culture was collected within 7 days after birth. Each fetus expelled after a spontaneous second trimester abortion and each stillborn infant were also evaluated for a possible congenital CMV infection. For each congenital infection stored maternal sera were analysed to determine whether maternal infection was primary or recurrent. Fifteen out of the 3075 pregnancies studied resulted in a congenitally infected infant (0.49%). Nine maternal CMV infections were primary infections; five were recurrent infections, and in one case the type of infection could not be determined. Three congenital infections resulted in severe sequelae, leading to the termination of pregnancy in two instances and to neonatal death in one case. One of these severe fetal infections was due to a recurrent maternal infection. Follow-up of the other 12 neonates demonstrated hearing disorders in two children. One was born after a primary maternal infection and one after a recurrent maternal infection. We conclude that congenital CMV infections occurs in 0.49% of all pregnancies in the population studied. Twenty percent of the congenitally infected infants present severe sequelae at birth or during pregnancy, and an additional 17% have audiological deficits at 1 year of age. Severe sequelae may occur after both primary and recurrent maternal CMV infection.

Unusual location of an ovary: ultrasonographic features and surgical correlation.

We present a case of ectopic ovary in a 5-month-old baby presenting a firm nodule in the left labia majora. Ultrasonography was performed and revealed an ectopic ovary. The ectopic ovary was surgically returned in adnexial location. We describe the typical findings of this entity.

Enterocolonic fistula, a rare complication of necrotizing enterocolitis.

A case of an enterocolonic fistula as a late complication of necrotizing enterocolitis is presented in a 3-month-old premature baby. The fistula was diagnosed by contrast enema. We describe the typical features of this rare complication.

A clinical trial with an "anti-regurgitation" formula.

To determine whether a new "anti-regurgitation formula" containing a bean gum preparation decreases the number of regurgitations and gastro-oesophageal reflux (GOR), we studied 20 infants from 1 week to 4 months of age, referred for evaluation of regurgitation, in a double-blind prospective study. The number of regurgitations decreased significantly in both the treatment group (the formula with thickening product, positional treatment, parental reassurance) and the placebo group (the same formula without thickening product, positional treatment, parental reassurance) (P 0.002 and 0.032, respectively). The results of a 24-h oesophageal pH monitoring, performed before and during treatment, showed a significant decrease in the percentage of time oesophageal pH was < 4.0 in the treatment group. It is concluded that conservative treatment of regurgitation in infants, consisting mainly of parental reassurance and postural therapy, is sufficient to obtain clinical remission in most patients. In addition, milk thickening products tend to improve clinical remission and contribute to the normalisation of some pH metric parameters.

Abbreviated oesophageal pH monitoring in infants.

The results of 24 h oesophageal pH monitoring, performed in 129 infants aged 6-10 weeks, were compared to those in the same patients after shorter periods (3, 6, 9 and 12 h). In the investigated population there was no significant difference between the reflux index (percentage of time with a pH < 4.0) after 12 or 24 h. Moreover, the correlation coefficient between the reflux index after 12 and 24 h was excellent (r 0.95). However, the intra-individual difference in reflux index after 12 and 24 h was 5% in 19% of the infants, and even exceeded 10% in more than 5% of the infants, making the interpretation of the results unreliable. Even in this particular population of infants in whom a 24-h period could be divided into almost identical periods (including a feeding and a sleeping period), 24-h registrations provided the most reliable results. However, if for some reason the investigation had to be interrupted after a minimum of 12 h, the risk for erroneous interpretation of the data appeared to be acceptable. The results of this study must not be extrapolated to older children.