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P Hohlfeld

Publications and source records attributed to P Hohlfeld.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Perinatal hemolytic disease. Part 1: physiopathology].

Perinatal hemolytic disease is characterized by the destruction of fetal red blood cells by maternal antibodies directed against membrane antigens and can lead to immune fetal hydrops. More than 250 blood group antigens have been described. After considering the particular situation of ABO incompatibility, this article describes the classification of red blood cells antigens, with particular reference to the Rhesus system. Other antigens such as Kell, Kidd, Duffy, MNSs, P and Lutheran are also considered.

Blood Group Antigens↗
PubMed1998

[Perinatal hemolytic disease. Part 2: Prevention and management].

There has been a dramatic reduction in the incidence of neonatal mortality due to fetal hemolytic disease since the introduction of Rhesus prophylaxis. Although routinely used since 1968, the exact mode of action of anti-D IgGs is still not fully understood. Notable advances have taken place in the screening and the management of fetal hemolytic disease. This article describes the antibody detection in the mother, and the fetal management with ultrasound amniocentesis, fetal blood sampling and intrauterine transfusions. Finally, the postnatal management is also considered.

Algorithms↗
PubMed1997

Hematological features of fetal triploidy: a report of 11 cases.

Using fetal blood sampling, the diagnosis of triploidy can be strongly suspected on the basis of the peculiar hematological picture. Triploid fetuses present with anemia, marked anisopoikilocytosis, and grossly increased mean corpuscular volume, associated with thrombocytopenia and significant platelet anisocytosis. These findings are of considerable immediate diagnostic value. They allow physicians to immediately counsel parents about the prognosis of the fetus. In case of fetal or neonatal distress, this information could orientate decisions about obstetrical and pediatric management while waiting for the definitive diagnosis.

Blood Cell Count↗
PubMed1996

Blood smears and prenatal diagnosis.

Fetal blood sampling is a widely used technique for both diagnostic and therapeutic purposes. However, despite the fact that examination of blood smears is a critical step in the study of a large variety of disorders, the place of fetal blood smears analysis has been overshadowed by more sophisticated diagnostic tools such as those offered by molecular biology. Nevertheless, as highlighted by four cases presented in this paper, the role of fetal blood smears examination must be re-emphasized. The recognition of abnormal cytological findings limits the number of possible aetiologies, thus elegantly contributing to the diagnosis without multiplying unnecessary test techniques.

Fetal Blood↗
PubMed1995

Toxoplasma infection among pregnant women in Switzerland: a cross-sectional evaluation of regional and age-specific lifetime average annual incidence.

A simple generalized linear model of toxoplasmosis incidence has been applied to serologic data from more than 9,000 women who delivered babies in Switzerland. This model, based on an assumption of constant incidence of toxoplasmosis throughout time and ages, yields estimates of incidence rates that show marked contrasts between subgroups of women categorized on the basis of their geographic origin and duration of residence in Switzerland. The patterns observed are in agreement with previously reported data from specific areas. When applied to Swiss resident women of different age groups, the average incidence rate estimates obtained were remarkably similar. This was not the case among the subgroup of Portuguese immigrant women, nor when the model was applied to previously published data from Sweden where toxoplasmosis incidence has clearly decreased in the last 20 years. Although models for the analysis of cross-sectional data involve major simplifying assumptions, it appears that they can yield useful epidemiologic information and that departures from the assumed simplified structure of the data can sometimes be identified.

Adolescent↗
PubMed1995

Seroprevalence of rubella among women of childbearing age in Switzerland.

A seroepidemiological study was carried out in Switzerland to define the population susceptible to rubella among women of childbearing age. IgG antibodies to rubella virus were determined in 9,046 women giving birth between 1 August 1990 and 30 September 1991 in 23 of 26 Swiss cantons. These sera represented 10-20% of the yearly total number of births in each Swiss canton. Anti-rubella IgG was measured by an automated enzyme-linked fluorescent assay for use with a commercial system (Vidas Rub IgG, bio-Mérieux, France). Before the study population was screened, the commercial system was compared to the traditional hemagglutination-inhibition (HAI) test using 500 consecutive samples from parturient women. The sensitivity was 97.7%, the specificity was 100%, and agreement between the two tests was 97.8%. The discrepancies corresponded to very low titres of antibodies as measured by HAI. The seroprevalence of rubella nationwide in women of childbearing age in Switzerland was 94.3%. The seroprevalence was higher (96.5%) in the 5,677 women of Swiss nationality than in the 3,090 women of a different nationality (90.4%) (p < 0.001). In Swiss women the seroprevalence of rubella did not increase significantly with age and was identical in primiparous and in multiparous women, thus indicating that women of childbearing age are probably not sufficiently immunised.

Adult↗
PubMed1995

[Epidemiology of toxoplasmosis in Switzerland: national study of seroprevalence monitored in pregnant women 1990-1991].

A national study was performed to assess the seroprevalence of anti-Toxoplasma gondii IgG in pregnant women at the time of delivery. The study was organized between 1990 and 1991 in 23 out of 26 Swiss cantons. 9059 women, corresponding to 11.8% of the annual total of births in those cantons, were included. The global seroprevalence of specific IgG was 46.1% (95% confidence interval: 45.0-47.1%). There was no significant difference in seroprevalence between different cantons after adjustment according to age. At the national level, the seroprevalence was 46.0% for Swiss women and 45.8% for women of other nationality (information on nationality was available only for 8382 persons). The use of a model of linear regression according to age showed that the risk of seroconversion among seronegative women during their 9 months of pregnancy was 1.21%. In addition, a certain number of data were calculated from that value to "simulate" a theoretical situation with absence of specific serological screening during pregnancy at a national level and consequently, absence of appropriate treatment. It was estimated that 548 cases of seroconversion would occur annually during pregnancy. This would lead to 183 congenital transmissions of toxoplasmosis, among which, 75% would be asymptomatic at birth. The number of expected pathologies would be: 40 cases of chorioretinitis with impared vision, 18 cases of cerebral lesions, and 2.7 cases of perinatal death. We observed positive results for specific anti-T. gondii-IgM in 1.7% of persons tested. This result can be the source of medical interpretation difficulties if the serum sample is the first done during pregnancy.

Adolescent↗
PubMed1995

[Toxoplasmosis in pregnancy: prevention, prenatal diagnosis and treatment].

Maternal infection with Toxoplasma gondii acquired during pregnancy occurs in more than 500 women per year in Switzerland. Systematic screening at the beginning of pregnancy allows the introduction of health education programs. The screening during pregnancy is performed to diagnose primary maternal infections and to propose prenatal diagnosis and treatment. The administration of specific antibiotherapy during pregnancy (spiramycine or the association of pyrimethamine and sulfonamides) significantly reduces the risk of fetal infection. Prenatal diagnosis of congenital toxoplasmosis is possible and reliable. It avoids unnecessary termination of pregnancy when the fetus is not infected and specific therapy in case of infection (association of pyrimethamine and sulfonamides). Prenatal treatment may be proposed without prenatal diagnosis as of the 16th week of gestation. In any case, prenatal treatment seems to reduce the incidence of severe congenital toxoplasmosis.

Coccidiostats↗
PubMed1995

[Congenital toxoplasmosis: pediatric approach. Consensus report of the Swiss infectious disease pediatricians].

The first part of this paper reviews: (1) the spectrum of clinical features of congenital toxoplasmosis; (2) the natural course of fetal infection; (3) the influence of antitoxoplasma therapy on the course of the disease; (4) methods for diagnosing the toxoplasma infection and assessing the severity of the disease; (5) currently used antitoxoplasma drugs and different therapeutic regimens. The second part suggests a practical approach to the problem of congenital toxoplasma infection, including diagnostic work-up, drug therapy, and follow-up. This practical approach is modulated according to the clinical syndrome in the infant and diagnostic and therapeutic considerations in the mother.

Coccidiostats↗