Prescription of drugs during pregnancy: a study using EFEMERIS, the new French database.

Background: Because of the limited data concerning drug risks in pregnancy, health professionals are often deprived of relevant and sufficient information related to prescribing or dispensing during pregnancy. However, previous studies have emphasised the widespread French prescription of several drugs (sometimes "typically French") which have not been assessed in pregnant women.

Objectives: The aim of the present study was to create the first French database of drugs prescribed and dispensed during pregnancy and the outcome of these pregnancies.

Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases.

Background/purpose: Fetal ovarian cysts are frequently complicated by intracystic hemorrhage without associated clinical signs, which is often secondary to ovarian torsion leading to loss of the ovary. The aim of this study was to evaluate ovarian outcome and the place of prenatal management and surgery in the first few days of life in order to save the ovary.

Methods: Between January 1987 and June 2006, 82 fetal ovarian cysts in 79 patients were managed and clinically and ultrasonographically followed up for several months (median, 11 months; range, 6 months to 10 years) in all of the cases where the ovary was not removed.

Prenatal diagnosis of craniosynostosis: value of MR imaging.

Introduction: The aim of our study was to assess the utility and reliability of magnetic resonance imaging (MRI) in antenatal diagnosis of craniosynostosis.

Methods: We retrospectively reviewed the MRI examinations of the head of 15 fetuses requested over a period of 11 years on the basis of sonographic suspicion of craniosynostosis. The postnatal diagnosis was available for 14 neonates.

Prenatal diagnosis and outcome of congenital splenic cyst: report of two cases.

Congenital splenic cyst (CSC) is a rare condition, and only a few cases with prenatal diagnosis and no associated malformation have been reported. Spontaneous regression is possible in case of mild CSC (under 40 mm), but enlargement or secondary complications may lead to surgical treatment. We report, herein, two cases of isolated mild CSC with complete spontaneous postnatal regression.

Prenatal diagnosis of megacystis-microcolon-intestinal hypoperistalsis syndrome: contribution of amniotic fluid digestive enzyme assay and fetal urinalysis.

Objectives: Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a usually lethal disease during the first year of life. There is no specific ultrasound prenatal diagnosis and no identified genetic locus. The value of amniotic fluid digestive enzyme assay and fetal urine biochemistry in the prediction of MMIHS was analysed.

[Nuchal translucency: technical measurement and value].

Nuchal translucency measurement is a very powerful screening test to detect chromosomal anomalies or other malformations. The technique for measurement is based on strict guidelines that will be described in this paper. Training is mandatory.

Prenatal sonographic diagnosis of the congenital dislocated spine: a case report.

Study Design: A case of congenital dislocated spine diagnosed by prenatal sonography is reported.

Objectives: To report the first documented case of prenatal diagnosis, to point out the characteristic features of prenatal sonography of congenital dislocation of the spine, and to show the results of a careful management of birth in cases of congenital dislocated spine.

Summary Of Background Data: The congenital dislocated spine consists of an anterior defect in formation of the vertebrae with a displaced vertebra and angulation of the neural canal.

[Value of MR imaging of the fetal kidney].

Sonography is the imaging modality of choice for initial evaluation of the fetus. However, the role of MR imaging for fetal evaluation is expanding. Based on a review of seven cases, the role of MRI to further characterize renal abnormalities detected at US, especially hyperechoic kidneys, is demonstrated.

Mesoblastic nephroma: prenatal ultrasonographic and MRI features.

Antenatal detection of mesoblastic nephroma by US is possible. Reviewing the literature, we found 19 previously reported cases, only 1 of which underwent prenatal MRI. We present a further case diagnosed by US and confirmed with MRI.

[Parametrial pregnancy. Report of a case of "paracervical" pregnancy treated by medico-surgical management].

We report an exceptional case of para-cervical pregnancy. Ultrasonography enabled accurate diagnosis after explorative laparoscopy. Treatment was conservative involving methotrexate and surgical ablation of the pregnancy by vaginal approach with a successful outcome.

[Prenatal diagnosis of holoprosencephaly. A series of twelve cases].

Objective Of The Study: To determine the prenatal ultrasound criteria of holoprosencephaly and their correlation with embryogenesis.

Material And Methods: We report 12 cases of holoprosencephaly that have been discovered between January 1990 and June 1996 (eleven alobar holoprosencephalies and one semilobar holoprosencephaly) at La Grave Hospital, Toulouse.

Results: In all cases, severe facial anomalies have been (cyclopia, cebocephaly or ethmocephaly).

[Screening for trisomy 21 by measuring nuchal translucency during the first trimester of pregnancy].

The purpose of the present literature review is to assess the screening value of trisomy 21 by measurement of fetal nuchal translucency (NT) thickness in the first trimester. NT is a subcutaneous translucency between the skin and the soft tissues overlying the cervical spine, which disappears in the second trimester. Ultrasound examination was used to image a sagittal section of the fetus to measure the maximum thickness of the subcutaneous translucency.

Femur/foot length ratio for detection of Down syndrome: results of a multicenter prospective study. The Association Française pour le Dépistage et la Prévention des Handicaps de l'Enfant Study Group.

Objective: The aim was to determine the sensitivity and specificity of a short femur for detection of trisomy 21 in the second trimester.

Study Design: Thirty-six investigators in 12 centers measured biparietal diameter and femur and foot lengths in 3582 14- to 24-week-old fetuses in mothers undergoing amniocentesis for age, history of genetic disorder, or laboratory signs.

Results: Among the various ratios for evaluating femur shortening the femur/foot ratio appeared to be the most discriminatory.

Sonographic measurement of nuchal skinfold thickness for detection of Down syndrome in the second-trimester fetus: a multicenter prospective study. The AFDPHE Study Group. Association Française pour le Dépistage et la Prévention des Handicaps de l'Enfant.

Objective: To determine the sensitivity and specificity of soft-tissue nuchal-fold measurement in the second-trimester fetus for the detection of trisomy 21.

Method: Thirty-six investigators in 12 centers measured nuchal skinfold thickness in 3308 fetuses of 14-24 weeks' gestation. All mothers were referred for amniocentesis because of age, history of genetic disorder, or laboratory findings.

Termination of pregnancy for maternal toxoplasmosis.

Termination of pregnancy is usually recommended to pregnant women who have infection with Toxoplasma gondii before 26 weeks of pregnancy if the fetus is infected. No prospective studies are available on the outcome if such pregnancies are allowed to continue with anti-parasitic treatment. We prospectively studied 163 mothers with acute toxoplasma infection before 28 weeks of amenorrhoea.

Antenatal detection of subdiaphragmatic pulmonary sequestration: a case report.

Extralobar pulmonary sequestration is part of the spectrum of bronchopulmonary foregut malformations. Usually found in the thorax, it may be located in the retroperitoneum. We report one case of subdiaphragmatic pulmonary sequestration detected by prenatal ultrasound, and diagnosed at surgery after birth.

[Antenatal diagnosis of toxoplasmosis. 176 case reports].

Objective: To determine the value of antenatal diagnosis of congenital toxoplasmosis by ultrasound guided aspiration of cord blood for testing.

Material: This is a prospective study of 176 cases. As well as obtaining fetal blood and amniotic fluid the searched for specific IgM and A as well as culturing for the parasites on human fibroblasts and inoculation of mice, as well as researching them for non-specific signs of fetal infection.

Familial cystic hygroma. Report of 8 cases in 3 families.

The authors report 8 cases of familial cystic hygroma concerning 3 families. In the first family, the two affected fetuses with normal karyotypes showed cystic hygroma of the neck associated with campomelic long bone disease. No other fetal anomalies in the two fetuses were found in the second family, and only one of the four abortuses revealed associated malformations (meningomyelocoele, cleft palate) in the third family.

[Ovum sampling techniques for prenatal diagnosis of viral infections].

Two techniques can be used to achieve antenatal diagnosis of viral infections, i.e., amniocentesis and cord blood sampling.

[Biological reference values in the human fetus. 106 cord blood sampling in utero].

The authors give biological reference figures obtained from 106 fetuses that were sampled in utero between the 20th and 34th week of amenorrhoea. These fetuses were considered to be normal because there was no clinical or ultrasound evidence of an abnormality. Furthermore the biological values sought in antenatal testing and the absence of all pathology in the first year of life, confirmed that these were normal fetuses.

[Predictive value of non-specific signs of fetal infection in congenital toxoplasmosis].

Aims: To study the predictive value of 9 non-specific signs for congenital toxoplasmosis.

Method: The work was carried out as a prospective study comparing non-specific signs in 22 fetuses infected with toxoplasmosis and 59 fetuses free of the disease.

Results: Four of the nine parameters were found to be statistically higher in the group of infected fetuses.