ABSTRACT
OBJECTIVE: To assess the risk of tracheal intubation at birth in very premature neonates related to the type of maternal anesthesia in case of elective cesarean. POPULATION AND METHODS: All 219 live-born very premature neonates (28-32 weeks of gestation), delivered after an elective cesarean in the 27 maternity wards of 2 French semi-rural neonatal networks. Eighty-three percent (182/219) were delivered in level III maternity wards in university hospitals. RESULTS: Of the very preterm neonates, 33.3% (73/219) were intubated in the delivery room, either for respiratory distress syndrome or a low APGAR score. Very preterm neonates delivered after maternal general anesthesia were more often intubated than those delivered after spinal anesthesia (48.7% vs 25.2%; OR: 2.8; 95% CI: 1.8-5.1). The risk of intubation related to maternal general anesthesia remained statistically significant after an adjustment for gestational age, fetal growth retardation, respiratory distress syndrome, type of maternity ward, and a propensity score that took into account maternal sociodemographic characteristics and the causes of very preterm birth (aOR: 3.4; 95% CI: 1.4-8.2). The risk of intubation related to general anesthesia was lower after adjusting for the 5-min APGAR score (aOR: 2.8; 95% CI: 1.0-7.3). CONCLUSION: Very preterm neonates delivered after cesarean with general anesthesia require tracheal intubation in the delivery room more often than those delivered with spinal anesthesia. This study cannot assess a causal link between anesthesia and the need for neonatal intubation. However, neonatologists have to be aware of the type of maternal anesthesia because it may interfere with the non-invasive ventilation support policy of the very preterm neonate.
Subject(s)
Anesthesia, General/adverse effects , Anesthesia, Obstetrical/adverse effects , Delivery Rooms , Infant, Premature , Intubation, Intratracheal , Premature Birth , Respiratory Distress Syndrome, Newborn/therapy , Apgar Score , Cesarean Section/adverse effects , Female , Gestational Age , Humans , Infant, Newborn , Pregnancy , Respiration, Artificial/methods , Respiratory Distress Syndrome, Newborn/chemically induced , Risk FactorsSubject(s)
Abnormalities, Multiple/diagnostic imaging , Contractile Proteins/genetics , Craniofacial Abnormalities/genetics , Microfilament Proteins/genetics , Musculoskeletal Abnormalities/genetics , Abnormalities, Multiple/genetics , Abnormalities, Multiple/pathology , Craniofacial Abnormalities/diagnostic imaging , Craniofacial Abnormalities/pathology , DNA/chemistry , DNA/genetics , Female , Fetus , Filamins , Humans , Infant, Newborn , Musculoskeletal Abnormalities/diagnostic imaging , Musculoskeletal Abnormalities/pathology , Mutation, Missense , Polymerase Chain Reaction , Pregnancy , Syndrome , Ultrasonography, Prenatal , Young AdultABSTRACT
We report a case of generalized infantile myofibromatosis with favorable outcome despite systemic involvement. Elevated urinary bFGF levels during the active phase of the disease suggested an angiogenic stimulation in the pathogenesis of myofibromatosis.
Subject(s)
Fibroblast Growth Factor 2/urine , Myofibromatosis/pathology , Skin Neoplasms/pathology , Biomarkers/urine , Biopsy, Needle , Female , Follow-Up Studies , Humans , Infant , Magnetic Resonance Imaging , Myofibromatosis/diagnosis , Remission, Spontaneous , Severity of Illness Index , Skin Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
Fetal alcohol syndrome is frequently observed. It is estimated that 0.2% of newborns in France have fetal alcohol syndrome, a rate which reaches 1% in certain studies. Ultrasound diagnosis is straightforward, based on: - intrauterine growth retardation, predominantly involving the limbs and occurring early without oligoamnios; - specific facial dysmorphism with two essential signs, frontal rounding of the philtrum, suppression of the Cupidon arch; - several malformations involving the corpus callosum, ocular and renal tissue; - markedly higher incidence in multiple parity women over thirty who gain little weight during pregnancy. We report seven cases observed between 1994 and 1999 and discuss the growth curve and the facial dysmorphism.
Subject(s)
Fetal Alcohol Spectrum Disorders/diagnostic imaging , Ultrasonography, Prenatal , Adult , Agenesis of Corpus Callosum , Corpus Callosum/diagnostic imaging , Craniofacial Abnormalities/diagnostic imaging , Female , Fetal Growth Retardation/diagnostic imaging , France , Gestational Age , Humans , Infant, Newborn , Male , PregnancySubject(s)
Calcinosis/diagnosis , Liver Diseases/diagnosis , Prenatal Diagnosis , Calcinosis/congenital , Female , Humans , Male , Pregnancy , UltrasonographyABSTRACT
High dose gammaglobulin therapy for pregnant women with idiopathic thrombocytopenic purpura may be suitable for both mother and foetus during pregnancy. A newborn with severe thrombocytopenia secondary to maternal illness, was treated successfully by intravenous gammaglobulin, without toxicity. In such a case, we believe the platelet count is not the only criterion for starting immunoglobulin therapy.
Subject(s)
Immunization, Passive , Pregnancy Complications, Hematologic/drug therapy , Purpura, Thrombocytopenic/drug therapy , Adult , Female , Humans , Infant, Newborn , Platelet Count , Pregnancy , Pregnancy Complications, Hematologic/immunology , Purpura, Thrombocytopenic/immunologySubject(s)
Fetal Diseases/diagnosis , Tachycardia, Paroxysmal/diagnosis , Ultrasonography , Adult , Female , Humans , PregnancySubject(s)
Facial Muscles/abnormalities , Hydronephrosis/complications , Lip/abnormalities , Humans , Infant , Lip/pathology , MaleABSTRACT
The occurrence of unexplained coma in a 15 day-old infant led to suspect an intoxication. Major ethanol poisoning (alcohol blood level: 4.4 g/l) was thus discovered in this child treated with alcohol-containing dressings. Symptomatic treatment alone resulted in favourable evolution of coma in a few hours. Half-life of alcohol was shown to be 17 hours in this child. The interest of the case reported is to remind of the dangers of percutaneous absorption of some products, especially in young infants and the importance of toxicological investigations in children with unusual manifestations of unknown etiology.
Subject(s)
Alcoholic Intoxication/diagnosis , Coma/chemically induced , Ethanol/administration & dosage , Infant, Newborn, Diseases/chemically induced , Alcoholic Intoxication/complications , Ethanol/blood , Humans , Infant, Newborn , Male , Skin AbsorptionABSTRACT
Waardenburg syndrome was diagnosed in a nine-month-old female infant with dystopia canthorum, broad nasal bridge, overdeveloped eyebrows, cutaneous hypopigmentation, and deafness. Seizures occurred, which makes this case unusual. CAT scan demonstrated wide subarachnoid spaces without ventricular dilatation.
