[Mastocytosis in a newborn infant. Fetal-maternal Rh incompatibility, Duhring's disease in the mother].
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Biomedical subjects
Publications and source records attributed to C Amiel-Tison.
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1785 newborns of 37 weeks GA or more, were studied during a 15 months period at the Port-Royal Maternity Hospital. This study suggests that cerebral abnormalities during the neonatal period in fullterm neonates are related to deleterious intra partum factors. In 57 newborns, clear cut signs of cerebral birth injury were observed, in 31 newborns only mild and transitory signs were observed. These 88 newborns were compared with 1655 having had a normal neurological examination within the first week of life. We focused particulary on dysfunctional labor patterns, specifically false labor, protracted active phase dilatation, protracted descent or a marked caput succedaneum. When these abnormal patterns are followed by oxytocin infusion and forceps extraction, primiparity appears linked with a high risk of cerebral birth injury. Within cephalic presentations, the occipito-posterior position is carrying the same high risk. The most severe degree of cerebral birth injury has nearly disappeared. However, the main problem of modern obstetrics is one of eradicating brain damage of moderate degree without reaching an excessive incidence of C. section.
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53 cases of neonatal listeriosis were seen during the last five years at the Intensive Care Unit for newborn infants (Pr Minkowski) and the Neonatal Center (P. Varangot) of the Port-Royal Maternity Hospital. The significant decline in mortality to 22 p. 100, when compared with previous years, was attributed to improvements in the diagnosis during the first hours of life and the contribution of artificial ventilation. The most frequent initial clinical sign was respiratory distress (58 p. 100) whereas meningitis was relatively rare (11 p. 100). Discoloration of the amniotic fluid and a fever in the mother at the time of delivery, were also important diagnostic clues. The macroscopic examination of the placenta and particularly placental smears containing listeria monocytogenes (15 of the specimens) as well as the hematological alterations, particularly an increase of the fibrinogen level above 3-4 g/1 during the first 48 hous of life (72 p. 100 of the cases) contributed to an early diagnosis.