[Antenatal care : anticipating for future mother and child].

Prenatal care allows early detection of risks and complications in the pregnant women in an attempt to minimize problems at birth and delivery. In Geneva, prenatal care is organized as a collaboration between private and liberal in-hospital network with a ranking in the pregnancy risk levels to adapt follow-up. The perinatal care structure should be built in a way to identify risks prompting professionals to adapt from the normal physiological care to a therapeutic escalation one appropriated to the detected risk level.

Myeloid proliferation without GATA1 mutations in a fetus with Down syndrome presenting in utero as a pericardial effusion.

An isolated pericardial effusion was observed during a routine prenatal ultrasound in a fetus of 30 and 3/7 weeks gestation. Amniocentesis was performed and revealed a trisomy 21. After prenatal counseling, the parents opted for termination of the pregnancy at 32 weeks.

[Antenatal screening for Down syndrome: a smattering of epidemiology].

Maternal age per se is not an indication for chorionic villous sampling or amniocentesis anymore. Although the risk for fetal Down syndrome increases with maternal age, it must be adjusted after other screening tests are performed. Current recommendations include ultrasound measurement of the fetal nuchal transluciency, and of maternal PAPP-A and free-b-hCG in addition to maternal age.

A neonate with isolated combined aortic and pulmonary valvar stenosis.

We present an extremely rare combination of isolated valvar pulmonary and aortic stenosis in a newborn patient. Most publications describe this feature in patients beyond the neonatal period and in association with other structural, myocardial or endocardial diseases. Our patient required an urgent and successful percutaneous pulmonary valvuloplasty due to poorly tolerated right ventricular hypertension and dilatation compressing the left ventricle.

Age-related performance of human papillomavirus testing used as an adjunct to cytology for cervical carcinoma screening in a population with a low incidence of cervical carcinoma.

Background: High-risk human papillomavirus (HR-HPV) testing has been proposed as a replacement for cytology or as an adjunct to cytology for primary cervical carcinoma screening. The objective of this study was to assess the age-specific prevalence of HR-HPV infection and the correlation between HR-HPV status and cytologic diagnosis.

Methods: The authors enrolled 7254 women receiving routine cytologic screening in a cross-sectional study that was conducted during 12 months.

Early and late half-life of human chorionic gonadotropin as a predictor of persistent trophoblast after laparoscopic conservative surgery for tubal pregnancy.

Background: To determine if the early or late half-lives (T0.5) of human chorionic gonadotropin (hCG) can identify patients with persistent trophoblastic activity after conservative surgery for tubal pregnancy.

Design: Prospective cohort study.

Is genetic analysis useful in the routine management of hydatidiform mole?

Complete hydatidiform mole and partial hydatidiform mole are two abnormal conceptuses that may be identified by clinical, ultrasonographic, gross morphological, histological, and genetic characteristics. Among all these criteria, the specific diagnosis is generally confirmed only upon histological review. However, an accurate diagnosis based on morphological criteria is difficult and several studies have shown that misclassifications are frequent, even for experienced pathologists.