Who needs prenatal counselling with a pediatric surgeon? Experience from a large tertiary care university hospital

Objectives To describe our experience with prenatal counselling for surgical anomalies in a large volume center. The secondary aim is to suggest a list of prenatal abnormalities warranting counselling by a pediatric surgeon. Methods We reviewed all prenatal counselling consultations performed by the pediatric surgery team between January 1st, 2015 and December 31st, 2016. Results A total of 169 patients or couples had a prenatal consultation with a pediatric surgeon. Prenatal work-up included a fetal MRI in 26% of cases, mainly for digestive and thoracic pathologies (56.1% of cases). Consultation with the pediatric surgeon led mainly to recommendations concerning the place of delivery. Induction for reasons related to the fetal anomaly occurred in 22.2% of cases. Most children were surgically treated within the first year of life (63.5%). Correlation between predicted prognosis and actual status at four years of life was 96.9%. Correlation between prenatal and postnatal diagnosis was 87.4%. Conclusions Prenatal counselling by a pediatric surgeon allows couples to obtain clear information on the pathology of their unborn child, giving them greater autonomy in their decision to continue the pregnancy.

Updating preventive measures of children disability

The article provides an overview of special literature, which gives an opportunity to redefine some issues of disability prevention in children with rare (orphan) diseases, which will improve the organizational measures in this area. The prevention of children’s disability is considered as a system of measures to protect the health of the mother and child throughout childhood. The early disability prevention system in children and support for families raising children with disabilities remain among the main priorities of the State social policy of the Russian Federation. The authors describe modern technologies for reducing the genetic burden in the population from the point of view of preventing hereditary and congenital pathologies. They identify the priority areas of disability prevention in children with rare (orphan) diseases, i.e. introduction of prenatal and preimplantation diagnostics; use of the Prenatal Consultation organizational model; conducting a wider screening for congenital and hereditary metabolic diseases with the inclusion of the most common nosological forms of rare (orphan) diseases; finding pathogenetic therapy methods; increasing the knowledge of pediatricians about rare (orphan) diseases.

Early Neonatal Mortality’s Determinants in the Neonatology Department of Mohamed V Hospital in Tangier, Morocco

Objective: This study aims to identify the determinants of early neonatal mortality in the neonatology department of Mohamed V hospital in Tangier.Material and methods: This is a prospective study including all newborns hospitalized and deceased in the pediatric department of the hospital Mohammed V from June 1 to December 31, 2019. The recorded cases were processed and analyzed by SPSS software.Results: 529 newborns were hospitalized in the pediatric department during the study period, of which 92 died (17.39%) between 0 and 7 days. Four leading causes justified this frequency: prematurity occupies first place (59%), followed by perinatal asphyxia (22%), neonatal infection (15%) in third place, congenital malformations (3%) in fourth place. Parturients aged between 20 and 35 years are the most affected (76%). The majority of women (71.4%) in our series had not undergone prenatal consultation (PNC) or had done so in insufficient numbers.Conclusion: Neonatal mortality remains high. Improvement of this situation requires education of women, reinforcement of surveillance before, during pregnancy, during delivery, and the postpartum period, as well as effective management of premature newborns in the first week of life, should improve the neonatal prognosis by reducing the intra-hospital incidence of neonatal mortality in our setting.

Urinary tract infection in prenatal care: role of public health nurses

Objetivo: Explorar y describir el rol de la enfermera de salud pública en la consulta prenatal para prevenir y controlar la infección del tracto urinario. Métodos: Estudio descriptivo cualitativo realizado en 24 unidades básicas de salud en el sur de Piauí, noreste de Brasil. El estudio involucró a 22 enfermeras de salud pública y se llevó a cabo de febrero a marzo de 2016. Los datos se recolectaron a través de un cuestionario semiestructurado que contenía datos sociodemográficos seguido de las preguntas de la entrevista. Para el análisis de datos se utilizó el software IRAMUTEQ mediante el método de Clasificación Jerárquica Descendente. Resultados: Se desarrollaron las siguientes clases a partir de las palabras evocadas: 1 - Atención de rutina a enfermeras de salud pública que atienden a gestantes; 3 - Actuación de las enfermeras de salud pública en el tratamiento y prevención de la infección del tracto urinario en mujeres embarazadas; 4 - Dificultades en el diagnóstico de infección del tracto urinario en mujeres embarazadas; 2 - La educación sanitaria como principal medida adoptada por las enfermeras de salud pública para prevenir la infección del tracto urinario en la gestante. Conclusiones: Las enfermeras de salud pública carecen de protocolos y cumplimiento de las guías. Las principales medidas para la prevención y el control de la infección del tracto urinario en mujeres embarazadas fueron una adecuada higiene íntima, mayor ingesta de líquidos e higiene antes y después de las relaciones sexuales. Objective: To explore and describe public health nurses' role in the prenatal consultation to prevent and control urinary tract infection. Methods: A qualitative, descriptive study was conducted in 24 basic health units in southern Piauí, northeastern Brazil. The study included 22 public health nurses and was carried out from February to March 2016. Data were collected through a semi-structured questionnaire containing sociodemographic data followed by the interview questions. The IRAMUTEQ software was used for data analysis using the Descending Hierarchical Classification method. Results: The following classes were created based on the evoked words: 1 - Routine care of public health nurses assisting pregnant women; 3 - Public health nurse's conduct for treatment and prevention of urinary infection in pregnant women; 4 - Difficulties in diagnosing urinary tract infection in pregnant women; 2 - Health education as the main measure adopted by public health nurses to prevent urinary tract infection in pregnant women.Conclusions: Public health nurses lacked protocols and agreement to guidelines. The main measures for preventing and controlling urinary tract infection in pregnant women were adequate intimate hygiene, increased fluid intake, and hygiene before and after sexual intercourse. Objetivo: Explorar e descrever o papel do enfermeiro de saúde pública na consulta de pré-natal para prevenir e controlar a infecção do trato urinário. Métodos: Estudo qualitativo descritivo realizado em 24 unidades básicas de saúde do sul do Piauí, nordeste do Brasil. O estudo envolveu 22 enfermeiros de saúde pública e foi realizado no período de fevereiro a março de 2016. Os dados foram coletados por meio de um questionário semiestruturado contendo dados sociodemográficos seguidos das questões da entrevista. O software IRAMUTEQ foi utilizado para a análise dos dados pelo método de Classificação Hierárquica Descendente. Resultados: As seguintes classes foram elaboradas a partir das palavras evocadas: 1 - Rotina de atendimento dos enfermeiros de saúde pública que atendem gestantes; 3 - Conduta do enfermeiro de saúde pública no tratamento e prevenção de infecção urinária em gestantes; 4 - Dificuldades no diagnóstico de infecção do trato urinário em gestantes; 2 - A educação em saúde como principal medida adotada pelos enfermeiros de saúde pública para prevenir a infecção do trato urinário em mulheres grávidas. Conclusões: Enfermeiros de saúde pública carecem de protocolos e concordância com as diretrizes. As principais medidas de prevenção e controle da infecção do trato urinário em gestantes foram higiene íntima adequada, aumento da ingestão de líquidos e higiene antes e após a relação sexual.

Anemia during pregnancy: Epidemiological, clinical and therapeutic aspects at the obstetric gynecology department of Labe Regional Hospital, Guinee

Objectives: Calculate the frequency of anemia during pregnancy, describe the epidemiological profile and describe the management of anemia during pregnancy in the gynecology-obstetrics Department of the Labé regional hospital. Methodology: This was a prospective, descriptive study lasting six (6) months from September 1, 2020 to February 28, 2021 All pregnant women who developed anemia and treated were considered for the study in the service. All pregnant women without anemia were included. Our data were analyzed by Epi-Info version 7.2.2.6 software, entered and presented by Pack office 2016 software. Results: The frequency of anemia in pregnant women was 27.61% in the department. The epidemiological profile of anemia in pregnant women at the Labé regional hospital was that of: a woman aged 25-29 (30.63%), housewives (72.97%), women not attending school (66, 67 %.), those Coming from the rural areas (76.58%), married women (100%), pauciparous (29.73%) and only 14.42% did not carry out an antenatal consultation. The anemia occurred in the 3rd trimester (76.58 %,). The main reason for consultation was paleness of the conjunctivae and integuments (92.79%) and malaria the dominant antecedent (60.36%). Severe anemia was the most dominant clinical form (54.96%). Transfusion was performed in 54.95% of women with anemia. The average length of stay was 4.9 days with extremes of 1 and 10 days. The maternal prognosis was favorable in 96.40% with a maternal death rate of 3.60%. Conclusion: Anemia is a major problem for pregnant women in the Gynecology-Obstetrics department at the Labé regional hospital. The improvement of the maternal prognosis would pass by chemoprophylaxis of malaria, the use of impregnated mosquito nets with long-lasting insecticide (LLINs), the prevention of intestinal parasitoses, the regular administration of iron, folic acid and the provision of quality prenatal consultation.

Rapid survey to determine the predictive factors of vaccination coverage in children aged 0 to 59 months in Guinea

Background: The Expanded Program on Immunisation has made it possible to prevent more than 3 million deaths in children under 5 years. The objectives of this study were to estimate the vaccination coverage of children from 0 to 59 months and identify factors associated with incomplete vaccination coverage.Methods: A cross-sectional study was carried out in a dispensary in Conakry, Guinea between January and February 2020. Sociodemographic and vaccination information was collected from mothers of 380 randomly select children aged 0 to 59 months. Information on immunisation coverage was gathered from records vaccination cards and maternal reports. Logistic regression was used to identify factors independently associated with incomplete immunisation coverage.Results: Most (66.5%) children aged 12 months were up-to-date with their vaccinations. Factors associated with incomplete vaccination in this age group included: unavailability of vaccination cards (adjusted odds ratio [aOR] 7.58; 95% confidence interval [CI]: 2.56–22.44) and lack of prenatal consultation attendance (aOR 2.93; 95% CI: 1.15–7.48). In contrast only 19.8% (95% CI: 13.9–26.7) of children aged 12–59 months were fully immunised. Factors associated with incomplete vaccination coverage in children aged 12–59 months included high birth order (aOR 10.23; 95% CI: 2.06–19.43), and lack of prenatal consultation attendance (aOR 5.34; 95% CI: 1.48–19.23).Conclusion: Child immunisation coverage is low in Guinea. These results highlight the need to develop strategies based on an integrated approach to overcome obstacles to childhood immunisation in Guinea.

Classifying and Evaluating Fetuses With Ventriculomegaly in Genetic Etiologic Studies

The association between genetics and fetuses with ventriculomegaly (VM) is unknown. This study aimed to classify and evaluate abnormal copy number variations (CNVs) in fetuses with VM. From December 2016 to September 2020, amniotic fluid or umbilical cord blood from 293 pregnant women carrying fetuses with VM was extracted for single-nucleotide polymorphism microarray (SNP array). Among 293 fetuses with VM, 31 were detected with abnormal CNVs, including 22 with pathogenic CNVs (7.51%) and nine with variation of uncertain clinical significance (VUS) CNVs (3.07%). Of the 22 fetuses with pathogenic CNVs, 13 had known disease syndromes. Among the 293 fetuses, 133 had mild isolated VM [pathogenic CNVs, 7/133 (5.26%)]; 142 had mild non-isolated VM [pathogenic CNVs, 13/142 (9.15%)]; 12 had severe isolated VM [pathogenic CNVs, 2/12 (16.67%)]; and six had severe non-isolated VM (no abnormal CNVs was detected). There was no statistical significance in the rate of pathogenic CNVs among the four groups (P = 0.326, P > 0.05). Among the 267 fetuses with successful follow-up, 38 were terminated (of these, 21 had pathogenic CNVs). Of the 229 fetuses, two had developmental delay and the remaining 227 had a good prognosis after birth. Overall, the results are useful for the detection of fetal microdeletion/microduplication syndrome and for the accurate assessment of fetal prognosis in prenatal consultation.