[Maternal serum screening for Down's syndrome: a user's club experience]. / Dépistage du risque de trisomie 21 foetale par les marqueurs sériques maternels: expérience d'un cercle d'utilisateurs.

Screening of Down syndrome using maternal serum markers requires specific quality management. We report here a user's club experience (Down's Club Abbott) in surveying performances of AxSYM total beta hCG and AFP reagents combined to Maciel software. Regular analysis was carried out during three years (1998 to 2000). Values from five laboratories were collected to achieve calculation of medians for each parameter, multiple of the medians and initial positive rate (cut-off of 1/250 established in France). The large size of the observed population (3,1020 women during the studied period) increased the performances of statistical evaluations. In July 1999, five months after a change in reagents leading to new medians, these latter were recalculated in agreement with the manufacturer. Our experience exhibits that only the concomitant analysis of all parameters (medians, multiple of medians and initial positive rate) can allow the monitoring of a potential drift (bound or not to reagents). Moreover, such user's clubs enhance the individual quality management of the laboratories and allow a good follow-up of the performances of the testing in time.

[Efficacy of oral administration of a micellaar solution of vitamin K during the neonatal period]. / Efficacité de l'administration orale d'une solution micellaire de vitamine K en période néonatale.

BACKGROUND: Oral administration of vitamin K to neonates is quite satisfactory for preventing hemorrhagic disease of the newborn. The aim of this study is to test efficacy of a micellar solution of vitamin K at birth. POPULATION AND METHODS: Thirty full term infants, exclusively breast-fed during the first month of life, were included in this study. Seven of them (control group Cos) were given oral supplementation with 5 mg vitamin K1, cremophor; 15 other infants were given oral supplementation with 3 mg micellar solution of vitamin K1 (group MMos) and 7 were given an intramuscular injection of 1.5 mg micellar solution of vitamin K1 (group MMim). Prothrombin time activity and plasma vitamin K concentration were measured in the cord blood, 24 +/- 12 hours and 1 month after supplementation. RESULTS: No hemorrhage was seen and tolerance to vitamin K was good in the 3 groups. Mean prothrombin time activity was 54% in the cord blood, around 55% and 75%, 24 hrs and 1 month after supplementation, respectively; only one infant had low value (41%) by 1 month despite normal plasma vitamin K concentration. Two infants had low plasma vitamin K1 concentration by the second control despite normal prothrombin time activity; one belonged to the MMos group and the other to the Cos group. Mean values of plasma vitamin K1 concentration were higher by 1 month in the MMos group. CONCLUSION: A unique dose of micellar solution of vitamin K given orally at birth seems effective to prevent hemorrhagic disease.

[Transient osteoporosis of the hip in pregnancy. Report of three cases (author's transl)]. / Algodystrophie décalcifiante de la hanche au cours de la grossesse. A propos de trois observations.

Three cases of transient osteoporosis of the hip in pregnant women are reported, and compared with 13 similar observations, published in world literature. The disease occurs during second half of pregnancy, revealed byrnotion hip pain, and slight limitation of mobility. On radiography, the femoral head and acetabulum are radiolucent and heterogenous. These modifications may be impressive but careful analysis of X rays rules out coxitis or malignant osteolysis. Major functional disturbance is common but the course of pregnancy and delivery is not impaired. Healing, without sequelae, occurs in a few months. Before delivery, attention should be paid to the fetal risk when prescribing X rays examinations or drug treatment. Pathogeny is unclear; the role of nerve or vein compression by the pregnant womb is discussed.