Problématique de l’anticoagulation durant la grossesse : étude portant sur 30 gestantes porteuses de prothèses cardiaques mécaniques

IntroductionThe heart prosthesis pregnant women are becoming more frequent due to the persistence of rheumatic fever in the country sends developments.ObjectiveTo propose management strategies from preconception to pregnancy and postpartum.Materials and methodsProspective study from 2009–2014 about parturientes followed in cardiology and maternity on center Hospitalo University Oran.ResultsThirty patients were followed, ejection fraction was equal to 60% in 29 cases. A single case of stenosis of the aortic prosthesis. Sixteen received low molecular weight heparins (LMWH) enoxaparine kind between 6 and 12 weeks, 13 received l’acenocoumarol (AVK) in the first quarter. One patient had been insufficient dose enoxaparine to 1/day and complicate ischemic stroke, abortion of a fetus of 16 weeks malformed in a mother who received acenoucoumarol (AVK) in the first quarter. Maternal mortality was null.DiscussionLMWHs were 100% effective in sufficient doses, the VKA and LMWH relay period was critical and should be done in a hospital setting.ConclusionWearing a prosthetic valve is compatible with supervised pregnancy LMWHs were 100% effective, provided they were used in sufficient doses between 6–12 weeks of amenorrhea.     

拉玛泽减痛分娩法对母乳分泌的影响

目的 探讨在导乐陪伴分娩的过程中实施拉玛泽减痛分娩法对母乳分泌的影响.方法 将106例自然分娩的初产妇随机分为观察组52例和对照组54例,观察组在导乐陪伴分娩的基础上实施拉玛泽减痛分娩法;对照组仅按导乐陪伴分娩进行护理.观察2组产妇泌乳始动时间、泌乳量,采用t检验和χ2检验.结果 观察组比对照组泌乳始动时间提前,泌乳量增加.结论 在导乐陪伴分娩的过程中实施拉玛泽减痛分娩法能促进产后早泌乳,且泌乳量充足.     

Maternal immunization modulates the primary immune response to 2-phenyl-oxazolone in BALB/c mice

The development of the antibody repertoire in newborn mice is greatly influenced by idiotypic network interactions. It has been demonstrated that anti-idiotypic antibodies either directly injected or transferred from the mother may alter the repertoire for life. For an elucidation of the underlying mechanisms we have analyzed the primary immune response to 2-phenyl-5-oxazolone (phOx) coupled to chicken serum albumin (CSA) in BALB/c mice after complete disappearance of maternal antibodies which originated from different stages of affinity maturation. Depending on the serum titers of the mothers after primary (1° mo), secondary (2° mo) or tertiary (3° mo) immunization, maternal anti-phOx IgG persisted in F1 mice for up to 9 months. In addition, F1 mice born to 2° mo developed – even without immunization – an anti-phOx IgM titer which reached levels similar to an antigen-induced primary response. An enhancement of the early primary anti-phOx as well as anti-CSA response was seen in F1 mice born from 1° mo, whereas the response was delayed when born to 2° mo and 3° mo. The antibody titers in the latter group of mice remained at a lower level for 3 months. In contrast, mice of the F2 generation which received a smaller amount of the same collection of maternal antibodies as F1 mice from 3° mo exhibited a quite different primary response: (i) They showed an earlier onset in their anti-CSA response. (ii) Whereas normally a plateau in antibody titer was reached by the 4th weak after immunization, in 55 % of the F2 mice a prolonged increase of the anti-phOx and anti-CSA antibody titers was observed. At 12 weeks after antigenic challenge, titers reached plateau levels of 6 × 10⁵ which were never before seen in a primary phOx or CSA response. Thus, depending on its own immunological experience, the maternal immune system induces a state of memory in the offspring which results in a faster and/or enhanced immune response in the F1 and F3 generations.     

Risk Factors for a First Febrile Seizure: A Matched Case-Control Study

Summary We conducted a matched casecontrol study to identify risk factors for first febrile seizures, with special emphasis on characteristics of the acute illness episode. Cases were identified through hospital emergency departments; controls were identified through outpatient clinics and emergency departments. Sixtynine children with first febrile seizures and no history of previous unprovoked seizures were matched for age (±6 months), site of routine pediatric care, and date of visit (±weeks) with 1 or 2 febrile controls who had no history of previous febrile or unprovoked seizures. Medical records for the index visit were reviewed, and parents were interviewed by telephone. Illness characteristics examined included height of temperature, type of underlying illness, contact with a physician during the illness but before the index visit, and use of acetaminophen or decongestants. Family history of febrile and of unprovoked seizures, sociodemographic characteristics, daycare use, and selected preand perinatal variables were also studied. On multivariable analysis, significant independent risk factors were height of temperature, history of febrile seizures in a firstor in a higher degree relative. Gastroenteritis as the underlying illness had a significant inverse (i.e., protective) association with febrile seizures. Maternal smoking during pregnancy was a marginally significant predictor of febrile seizures.     

Revisiting the association between maternal smoking during pregnancy and ADHD

Objective

Studies examining the relationship between maternal smoking during pregnancy and the development of Attention Deficit Hyperactivity Disorder (ADHD) among offspring have yielded mixed results, with some studies suggesting a strong association and others finding no association. These studies have varied in quality of design and measures. The purpose of this study was to evaluate the association between maternal smoking during pregnancy and offspring ADHD, using detailed prospective smoking data and subsequent follow-up data from the Collaborative Perinatal Project (CPP).

Method

Maternal smoking status was collected throughout pregnancy during the original CPP study. Offspring were followed-up in early adulthood and questioned about ADHD symptoms and diagnosis. Logistic regression was used to model the association between maternal smoking during pregnancy and ADHD. Linear and logistic regression were used to examine clinical characteristics and remission rates associated with ADHD in relation to maternal smoking.

Results

No association was found between maternal smoking during pregnancy and offspring ADHD. Further, no differences in age of onset, number of symptoms, or likelihood of remission were found among ADHD subjects with and without a history of maternal smoking during pregnancy.

Conclusions

These findings do not support the hypothesis that maternal smoking during pregnancy is causally related to ADHD. Ongoing research should continue to strive to identify those environmental or genetic factors that may enhance the impact of maternal smoking on ADHD or that may be associated more clearly with the development and potential prevention of ADHD.     

Effects of maternal separation on behavioural sensitization produced by repeated cocaine administration in adulthood

We examined whether early maternal separation influenced the susceptibility to behavioural sensitization produced by repeated intravenous (i.v.) injections of cocaine in adult female rats. For the first 21 days of life litters were separated from their mother for either 15 min (MS-15) or 180 min/day (MS-180). Control animals were subjected only to regular cage changes (animal facility reared; AFR). In adulthood, these three groups did not differ in their locomotor response to placement in a novel environment or to an acute i.v. injection of cocaine. After six additional daily injections of either saline or cocaine and following a 7-day drug-free interval, sensitization was assessed by giving all rats a challenge i.v. injection of cocaine. Rats exposed to either period of maternal separation (MS-15 or MS-180) showed significantly less robust sensitization than AFR rats. Therefore, early maternal separation decreased susceptibility to behavioural sensitization produced by cocaine in adulthood and the specific duration of maternal separation had no effect on this outcome.     

社区外来工孕产妇保健模式的调查研究

目的:调查研究深圳外来工孕产妇保健管理模式、保障外来人口的母婴健康。方法:政府增加投入,引进高级人才设备,以社区为基础,社康中心为核心,建立1790名外来工孕产妇个人健康档案,实行社康与医院双向转诊模式,孕产妇保健、产前检查、高危妊娠筛查、健康教育由社康中心完成;产前检查、高危孕妇管理、住院分娩、社区医务培训等转由公立综合医院服务,产妇档案转社区,社康中心负责产妇访视、全面管理上报。结果:1790例外来工孕产妇建卡率由77.87%增加到99.10%,产检率由66.67%增长到95.59%,住院分娩率由84.95%增长到100%,产妇死亡率由132.74/10万降至18.0/10万,围产儿死亡率147.49/10万降至35.97/10万,初步达到同期866例常住孕产妇保健指标。结论:本方法适合深圳外来工孕产妇保健模式,外来孕产妇母婴健康可得到保障。     

Differential fos activation in virgin and lactating mice in response to an intruder

Lactating (L) mice display fierce aggression towards novel, male mice, while virgin (V) mice do not. This study compares patterns of brain activation in V and L mice in response to a novel intruder using immunohistochemical detection of Fos (Fos-IR). Animals were sampled 120 min after either a sham or real 10 min test with a male intruder. L mice were aggressive towards intruders, but V mice were not. In general, Fos-IR for both groups increased with exposure to an intruder, with L mice showing higher increases in Fos-IR than V mice. In only medial preoptic nucleus and ventral portion of bed nucleus of stria terminalis (BNST) was Fos-IR significantly increased in both groups with testing. In V mice, testing resulted in Fos-IR increases in an additional 10 regions examined that did not reach significance in L mice, including lateral septum, lateral and medial preoptic areas, and anterior hypothalamus. Fos-IR also increased with testing in nine regions unique to L mice, including the mitral and granular layers of accessory olfactory bulb, regions of the amygdala, dorsal BNST, and caudal portions of the hypothalamic attack area. These increases in Fos-IR with testing suggest alterations in the circuitry governing response to pheromonal cues and imply some commonalities between the circuitries governing maternal aggression and intermale aggression. These results support the hypothesis that pregnancy and lactation induce substantial changes in brain circuitry and function; changes that enable maternal defense of offspring by altering the neural response to an intruder male.