Neonatal pancytopenia in a child, born after maternal exposure to natalizumab throughout pregnancy.

Natalizumab is a monoclonal antibody indicated for the treatment of patients with relapsing-remitting multiple sclerosis. Its use is prohibited during pregnancy. However, natalizumab exposures throughout the gestation period or during the third trimester, because of intense disease activity, are possible and begin to be reported. There are enough reassuring arguments against a teratogenicity, through pregnancy registries; but deleterious effects in the monitoring of newborn, are not well known. A disorder of hematopoiesis is possible with anemia, thrombocytopenia or pancytopenia, as discussed by the author through an observation. These hematological disorders seem to be asymptomatic; they resolve spontaneously and require a simple biological and clinical monitoring of the newborn.

Symptomatic inferior vena cava filter thrombosis: clinical study of 30 consecutive cases.

Inferior vena cava (IVC) filter thrombosis has not been described as a clinical entity. Thirty patients with IVC percutaneous filter thrombosis were assessed by cavography, computed tomographic (CT) scan and/or duplex ultrasonography. All patients had proximal venous thrombosis when the filter was placed, and the indication for filter placement was a contraindication to anticoagulant therapy in eight patients (27%). Filter thrombosis occurred within 6 months following filter placement in 15 patients (early filter thrombosis group). Among these patients, 10 were not treated with oral anticoagulant, and none of the other five received adjusted anticoagulation. No patients with late filter thrombosis received anticoagulant at the time of the diagnosis. Early filter thrombosis was mainly associated with LGM filters (12 of the 15 cases). Occlusion was revealed by recurrent venous thrombosis in 18 cases. A thrombus above the filter and pulmonary embolism was found in 10 patients (33%). Thrombolytic therapy failed in 5 out of 7 cases, and all but two patients were treated with anticoagulant therapy. In conclusion, early filter thrombosis appears to be due to intracaval extension of deep vein thrombosis, and this emphasizes the need for appropriate anticoagulation. In the case of temporary contraindication to anticoagulation at the time of the filter placement, anticoagulant should be reassessed later.

[Hypertrophic kidneys in utero and neonatal renal failure caused by diffuse mesangial sclerosis]. / Gros reins in utero et insuffisance rénale néonatale par sclérose mésangiale diffuse.

The authors report an unusual mode of onset of diffuse mesangial sclerosis in a newborn. Fatal neonatal renal failure, and not infantile nephrotic syndrome, was the main symptom after birth. In utero, ultrasonography revealed hypertrophy and hyperechogenicity of the kidneys associated with oligoamnios.

[Craniopharyngioma. A relatively uncommon etiology for an amenorrhea at the age of 45. Apropos of a case]. / Le craniopharyngiome. Etiologie peu commune d'une aménorrhée à l'âge de 45 ans. A propos d'un cas.

In reference to a case of secondary, pseudomenopausal amenorrhea, due to a craniopharyngioma discovered late, the need for a complete hypothalamo-hypophyseal exploration of every secondary, non-uterine, normogonadotrophic amenorrhea is reminded. The semiological value of the titration of serum prolactin and hypophyseal tests in lesions which are not only hypophyseal but also hypothalamic, is emphasized. In conclusion, the determining diagnostic contribution of tomodensitometry in tumors of this region is presented.

[Occlusive syndromes in pregnancy and puerperium. Apropos of 2 cases]. / Les syndromes occlusifs au cours de la gravido-puerpéralité. A propos de deux cas.

The authors recall the aetio-pathogenesis of intestinal obstruction in pregnancy and stress the difficulty of the diagnosis. They insist upon the importance of a simple and rapid surgical procedure which can be completed in the post-partum period if need be to prevent further episodes. From the obstetric point of view, the pregnancy usually progresses favourably, provided that an early delivery is induced routinely. Vaginal delivery is permissible, but should be assisted. The maternal prognosis depends on how early the diagnosis is made, but usually seems to be favourable. However, foetal mortality still remains high, between 10 and 15%.

[A thousand obstetrical sutures of the perineum using a slow absorption synthetic suture material (author's transl)]. / Un millier de sutures périnéales obstétricales avec un matériel de suture synthétique à résorption lente.

A thread which is absorbed slowly and which has a polyglycolic acid base has been used since 1975 in the Sainte-Foy-les-Lyon Maternity Unit to sew up episiotomies and perineal tears. The authors had 98.70 p. 100 of excellent results out of 1082 cases from the anatomic, aesthetic and functional angle. This technique appears to be a useful one in early mobilisation in obstetrics.