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Aix-en-Provence, France

Pertussis is a potentially serious illness in very young infants. The growing number of cases encountered in the past few years is partly explained by the loss of immunity, either natural or post vaccinal. To prevent the occurrence of pertussis in newborns and very young infants, it is mandatory to ensure compliance with vaccination recommendations regarding the general population (vaccination of young adults likely to have a child, of fathers and siblings during pregnancies, of mothers soon after birth), as well as professionals in contact with infants too young to have received their three doses of primary vaccination (diphtheria-tetanus-polio-pertussis booster may be performed as soon as the latest is more than two years). Obstetricians, midwives and pediatricians are directly concerned by this vaccinal strategy, owing to their prominent place in both informing couples during pregnancy and after delivery, and performing maternal vaccines soon after birth. © 2011 Elsevier Masson SAS.


Monnot S.,University of Paris Descartes | Gigarel N.,University of Paris Descartes | Samuels D.C.,Vanderbilt University | Burlet P.,University of Paris Descartes | And 11 more authors.
Human Mutation | Year: 2011

Mitochondrial DNA (mtDNA) mutations cause a wide range of serious diseases with high transmission risk and maternal inheritance. Tissue heterogeneity of the heteroplasmy rate ("mutant load") accounts for the wide phenotypic spectrum observed in carriers. Owing to the absence of therapy, couples at risk to transmit such disorders commonly ask for prenatal (PND) or preimplantation diagnosis (PGD). The lack of data regarding heteroplasmy distribution throughout intrauterine development, however, hampers the implementation of such procedures. We tracked the segregation of the m.3243A>G mutation (MT-TL1 gene) responsible for the MELAS syndrome in the developing embryo/fetus, using tissues and cells from eight carrier females, their 38 embryos and 12 fetuses. Mutant mtDNA segregation was found to be governed by random genetic drift, during oogenesis and somatic tissue development. The size of the bottleneck operating for m.3243A>G during oogenesis was shown to be individual-dependent. Comparison with data we achieved for the m.8993T>G mutation (MT-ATP6 gene), responsible for the NARP/Leigh syndrome, indicates that these mutations differentially influence mtDNA segregation during oogenesis, while their impact is similar in developing somatic tissues. These data have major consequences for PND and PGD procedures in mtDNA inherited disorders. © 2010 Wiley-Liss, Inc.


Vinurel N.,Hopital Femme Mere Enfant | Van Nieuwenhuyse A.,Center Pluridisciplinaire Of Diagnostic Prenatal | Cagneaux M.,Hopital Femme Mere Enfant | Cagneaux M.,Center Pluridisciplinaire Of Diagnostic Prenatal | And 9 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2014

In order to illustrate the significance of a new anatomical finding, distortion of the interhemispheric fissure (DIHF) associated with impacted medial borders of the frontal lobes, we report a retrospective observational study of 13 fetuses in which DIHF was identified on prenatal imaging. In 10 cases there were associated anatomical anomalies, including mainly midline anomalies (syntelencephaly (n = 2), lobar holoprosencephaly (n = 1), Aicardi syndrome (n = 2)), but also schizencephaly (n = 1), cortical dysplasia (n = 1) and more complex cerebral malformations (n = 3), including neural tube defect in two cases. Chromosomal anomaly was identified in two cases, including 6p deletion in a case without associated central nervous system anomalies and a complex mosaicism in one of the cases with syntelencephaly. In two cases, the finding was apparently isolated on both pre- and postnatal imaging, and the children were doing well at follow-up, aged 4 and 5 years. The presence of DIHF on prenatal imaging may help in the diagnosis of cerebral anomalies, especially those involving the midline. If DIHF is apparently isolated on prenatal ultrasound, magnetic resonance imaging is recommended for careful analysis of gyration and midline, especially optic and olfactory structures. Karyotyping is also recommended. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.


Dudkiewicz-Sibony C.,Maternite | Dudkiewicz-Sibony C.,Center Dtude Et Of Conservation Des Oeufs Et Du Sperme
Medecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie | Year: 2011

We have just gone through a great period of turbulence with the questioning of the principle of anonymity in gamete donation. The violence of the debate between proponents of maintaining the anonymity and those of his emergence, was surprising. It has obviously led the CECOS to question their principles: anonymity, free, volunteer. The voices that have affected us are those of some children born with a donation of sperm and claiming to know the identity of their donor.


Kivilevitch Z.,Womens Medical Center | Salomon L.J.,Center Hospitalier Intercommunal Of Poissy St Germain | Benoit B.,Maternite | Achiron R.,Chaim Sheba Medical Center | Achiron R.,Tel Aviv University
Ultrasound in Obstetrics and Gynecology | Year: 2010

Objectives: The aims of this study were to establish normal ranges of values for interlens distance (ILD) during gestation, and to assess the correlation between ILD and growth of the orbits and other fetal biometric parameters. Methods: A cross-sectional study of morphologically normal, singleton fetuses was carried out in low-risk pregnant women. We measured the distance between the centers of the fetal lenses from 12 to 37 completed weeks of gestation. An oblique anterior coronal section was used to measure the ILD. The biorbital diameter (BOD) was measured in the same plane. We analyzed the correlation between the ILD and gestational age (GA), BOD, biparietal diameter (BPD), head circumference (HC), femur length (FL) and abdominal circumference (AC). Fetal gender was assessed to evaluate possible significant differences. Results: Four hundred and fifty normal fetuses were recruited for the study. In 427 fetuses appropriate ILD measurements were obtained, and complete evaluation of all parameters was accomplished in 377 of these. ILD demonstrated a high positive correlation with GA (r2 = 0.969), BPD (r2 = 0.959), HC (r2 = 0.962), AC (r2 = 0.949) and FL (r 2 = 0.956) as pregnancy advanced. The mean BOD: ILD ratio was 1.50 ± 0.08, remaining constant throughout pregnancy (linear regression r 2 = 0.006). No statistically significant differences were found between genders for mean ILD and GA of the study population (P = 0.604 and 0.595, respectively). Conclusions: The Results: of this study confirm previous hypotheses regarding the close relationship between eyeball growth and growth of the surrounding bony structures. Measurement of fetal ILD, which can be used interchangeably with BOD measurement in either the axial or coronal plane, can be taken to reflect the expected development of the fetal orbits whilst simultaneously providing valuable information on eyeball development. It is likely that ILD could be used as a complementary tool in the elaboration of various severe abnormalities, mainly related to craniofacial and nervous system malformations. Copyright © 2010 ISUOG.

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