Château-du-Loir, France
Château-du-Loir, France

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PubMed | Service de reanimation neonatale, France Inter, Association SOS Prema, Center Hospitalier Intercommunal Of Creteil and Unite de neonatologie
Type: Journal Article | Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie | Year: 2016

The experience of becoming the parent of a sick or premature newborn can be particularly distressing for parents. They often encounter challenges to the development of their parenting roles. Perception of the hospital stay has never been analyzed on a large scale.To analyze parents perception of their involvement in the care of their newborn.An internet-based survey started in France in February2014on the basis of a validated questionnaire composed of 222neonatal care-related items. A quantitative and qualitative analysis was performed on the items dealing with parents involvement until August2014.The survey was completed by 1500parents, 98% of whom were mothers. The infants had a mean GA of 32weeks and a mean birth weight of 1600g. Parents rated their first care of their infant with mixed emotions (joy, stress, etc.). Parents were willing to practice new skills through guided participation, even for more complex care. Skin-to-skin care was only proposed after 7days for 20% of the parents; 10% of the parents did not feel secure during this practice. The need for privacy and professional guidance was essential for meaningful skin-to-skin contact.Parents perception of participating actively in their infants care was positive and they felt guided by the nursing team. Most of them would have been more active with guidance. Skin-to-skin care was appreciated and desired, but could become stressful if the conditions were not optimal.


Mazarin N.,Service de reanimation pediatrique | Rosenthal J.-M.,Service de reanimation neonatale
Archives de Pediatrie | Year: 2014

The risks related to dengue virus infection during pregnancy have been increasingly better described over the past 10. years. The possibility of maternal-fetal transmission is now recognized, but the diagnosis is still too late because of a wide range of clinical signs that the infected newborn child can present. From December 2009to October 2010, Guadeloupe Island underwent an exceptional dengue epidemic. During this epidemic, at least four cases of vertical virus transmission were biologically proved. The purpose of this article is to describe the clinical aspects of these cases, some of which have rarely been described in this pathology. Of the four cases, one showed fetal growth restriction, one neonatal cholestasia, one twin pregnancy, and what seems to be the first case of hemophagocytic syndrome associated with a newborn child infected by this virus. Although the proportion of vertical transmission proved is low, compared with the number of adults affected during an epidemic, some severe cases urge us to be increasingly watchful with this emergent arbovirus, especially because its real incidence is still unknown. © 2014 Elsevier Masson SAS.


PubMed | Limoges University Hospital Center, Service de reanimation pediatrique, Service de reanimation neonatale, Pole de biologie and 2 more.
Type: Journal Article | Journal: European journal of human genetics : EJHG | Year: 2016

Homozygous frameshift variants in CNTNAP1 have recently been reported in patients with arthrogryposis and abnormal axon myelination. In two brothers with severe congenital hypotonia and foot deformities, we identified compound heterozygous variants in CNTNAP1, reporting the first causative missense variant, p.(Cys323Arg). Motor nerve conductions were markedly decreased. Nerve microscopical lesions confirmed a severe hypomyelinating process and showed loss of attachment sites of the myelin loops on the axons, which could be a characteristic of Caspr loss-of-function. We discuss the pathophysiology of the myelination process and we propose to consider this disorder as a congenital hypomyelinating neuropathy.


PubMed | Service de reanimation neonatale, Hopital Couple Enfant Grenoble, Service de pediatrie, Service de radiologie and Center hospitalier Lyon Est
Type: Case Reports | Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie | Year: 2016

Cat scratch disease is an infection caused by Bartonella henselae. The main clinical form is a lymphadenopathy with fever. However, uncommon bone involvement has been described.In this paper, we report a case of osteomyelitis in a 13-year-old teenager infected with B.henselae. The diagnosis was made based on PCR only because the serology was negative. A literature review reports 65cases of osteomyelitis due to cat scratch disease. For each case, serology and PCR were notified.Osteomyelitis caused by B.henselae is a rare clinical manifestation. The diagnosis can be difficult, but the medical history must be accurate to search for contact with a cat and a cat scratch.


Henri H.,Service de Reanimation Neonatale
Medecine Therapeutique Pediatrie | Year: 2011

Legislative developments in France over the last decade have allowed the emergence of palliative care to newborns in delivery room. The population concerned includes babies with severe congenital malformation and extremely preterm newborns at the limits of viability. This support is focused on the child's comfort and offers parents to be involved in it. The palliative care allows to anchor the dying babies in humanity. It offers the parents to play their real parents' role. The caregivers can fulfill their mission of care with dignity and empathy. The future is also prepared with a reduced risk of pathological grief and replacement child. The palliative care support for nonviable newborns is a new practice in delivery room. It may offend some caregivers because they feel criticism of past practices as an aggression. It is nevertheless very important to get out of the illegal or unsaid practices. The ethics component of the EPIPAGE 2 study, beginning in 2011, is expected to make an inventory of actual practices relating to the management of death in the neonatal period in France.


Champion V.,Service de reanimation neonatale | Durrmeyer X.,Service de reanimation neonatale | Dassieu G.,Service de reanimation neonatale
Archives de Pediatrie | Year: 2010

The rate of infants born at 34-36 weeks gestation has increased over the last 10 years. These babies are at higher risk of morbidity and mortality than full-term infants. At present, prenatal steroids are given until 34 weeks. The purpose of this study was to present the epidemiologic data of the late preterm infants and look for respiratory distress risk factors. This is a descriptive, single-center study including 59, 55 and 72 children born at 34, 35 and 36 weeks gestation, respectively, in a level III center in 2005 and 2006 for babies born at 34 weeks and in 2006 for the babies born at 35 and 36 weeks. Of the mothers who delivered at 34 and 35 weeks, 63% and 49%, respectively, had a morbidity. The cesarean-section delivery rate before labor was 36% for the infants born at 34 weeks and 25% for the infants born at 35 weeks. Prenatal steroids were used for 57% of the mothers who delivered at 34 weeks and for 27% of the mothers who delivered at 35 weeks. In the population of the babies born at 34 weeks, a mean delay between the last dose of steroid and delivery was 18.9 days. Of the infants born at 34, 35 and 36 weeks, 27%, 18% and 8% suffered from respiratory distress. The mechanical ventilation rate was 8.5% and 5.5% for the infants born at 34 and 35 weeks' gestation. Surfactant was given to all infants born at 34 weeks who were intubated. Twenty percent of the 34-week-gestation infants and 12.7% of the 35-week-gestation infants required mechanical ventilation or noninvasive continuous positive airway pressure. Respiratory distress was mainly caused by respiratory distress syndrome or transient tachypnea of the newborn. There were no cases of meconium aspiration syndrome. There was 1 case of infection and 2 cases of pneumothorax. One-third of the infants born at 34-35 weeks were admitted to the neonatal intensive care unit. The number dropped to 11% at 36 weeks' gestation. The gestational age was the only significant risk factor for respiratory distress. There was a strong tendency of the respiratory distress rate to decrease in the babies whose mothers had received steroids (odds ratio = 0.39, p = 0.06). © 2009 Elsevier Masson SAS. All rights reserved.


Following antenatal diagnosis of a lethal disorder, some parents are so overwhelmed by grief that therapeutic abortion is seen as the least traumatic option. However, the impending death and anticipated mourning create a particularly complex emotional situation. When faced with such dramatic circumstances, some parents seek to restore meaning to their parenthood by accompanying their baby through to the end of its life. Methods derived from hospice care may be appropriate in such situations, considering the unborn child as "a living being among the living", pregnancy as the first chapter of every life, and death as a natural process. This approach, which may be adopted in maternity wards and neonatal intensive care units, requires the medical team to provide consistent information to the parents and to ensure their close involvement. These new parental demands must be clearly understood if they are to be met as effectively as possible.


Vasilescu C.,Service de reanimation neonatale | Van Overbeke V.,Service de reanimation neonatale | Zupan-Simunek V.,Service de reanimation neonatale
Archives de Pediatrie | Year: 2013

The South and West Francilien Pediatric Network (Réseau Pédiatrique du Sud et Ouest Francilien [RPSOF]) has established a protocol for the developmental follow up of infants inspired by the existing developmental scales adapted to the current practice of out patient consultation. The consultation described here collects a set of very simple objects and trade toys that are a support for a qualitative exploration of the development for the infants of less than 4. years of age. Different fields are taken into account: global motor skills, hand-eye coordination, manipulation and construction, communication and language, attentional capacity, relational and social behaviour. The time of exchange and play between the paediatrician and the infant allows a first detection of possible problems: the orientation towards a specialized professional for a consultation, a standard check-up or even a therapeutic care becomes easier and clearer. This playful environment also offers a space for the parents, and supports their participation as primary role players in the development of their child. This time, integral part of the consultation, is completed by the somatic examination and sensory screening tests. At present reserved for children identified as being at risk, this type of consultation could be universalised for all infants. © 2013 Elsevier Masson SAS.


Lahmiti S.,Service de reanimation neonatale | El Fakiri K.,Service de reanimation neonatale | Aboussad A.,Service de reanimation neonatale
Archives de Pediatrie | Year: 2010

The antiseptics are antimicrobial substances that are applied to living tissue to reduce the growth of microorganisms. The physiological particularities of newborns, and especially premature, reduce the list of used antiseptic in neonatology. The choice of antiseptic in neonates depends on its activity, its presentation and its tolerance. Using a large spectrum antiseptic like iodine and chlorhexidin seems to be the best choice; however the thyroid toxicity of iodine products contraindicates their use in the newborn. The usage of minor antiseptics like hexamidin shows no interest due to their limited spectrum and their long action delay. Using eosin for umbilical cord care is not recommended because it doesn't have any antiseptic activity and causes neonatal infections. Through this article, the authors review the principal aspects of antiseptic and report the properties and advantages-disadvantages of each antiseptic. The goal is to facilitate the choice of antiseptic used in neonatology. © 2009 Elsevier Masson SAS. All rights reserved.


Birth asphyxia occurs in 0.5% of term deliveries. Prognosis of newborns with birth asphyxia depends on clinical features of neonatal encephalopathy. The outcome of infants without encephalopathy is excellent. In contrast, neurological outcome of infants with encephalopathy is poor: 40 to 100% of neurodevelopmental disabilities according to the grade of encephalopathy. Prognosis can be more accurately assessed by EEG and MRI. Infants with encephalopathy following birth asphyxia must be referred as soon as possible in centers where neuroprotection by hypothermia is available. © 2010 Elsevier Masson SAS.

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