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Forner O, Schiby A, Ridley A, Thiriez G, Mugabo I, Morel V, Mulin B, Filiatre JC, Riethmuller D, Levy G, Semama D, Martin D, Chantegret C, Bert S, Godoy F, Sagot P, Rousseau T, Burguet A. Extremely premature infants: How does death in the delivery room influence mortality rates in two level 3 centers in France? Arch Pediatr 2018; 25:383-388. [PMID: 30041886 DOI: 10.1016/j.arcped.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/27/2018] [Accepted: 06/20/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Mortality rates of very preterm infants may vary considerably between healthcare facilities depending on the neonates' place of inclusion in the cohort study. The objective of this study was to compare the mortality rates of live-born extremely preterm neonates observed in two French tertiary referral hospitals, taking into account the occurrence of neonatal death both in the delivery room and in the neonatal intensive care unit (NICU). METHODS Retrospective observational study including all pregnancy terminations, stillbirths and live-born infants within a 22- to 26-week 0/6 gestational age range was registered by two French level 3 university centers between 2009 and 2013. The mortality rates were compared between the two centers according to two places of inclusion: either the delivery room or the NICU. RESULTS A total of 344 infants were born at center A and 160 infants were born at center B. Among the live-born neonates, the rates of neonatal death were similar in center A (54/125, 43.2%) and center B (33/69, 47.8%; P=0.54). However, neonatal death occurred significantly more often in the delivery room at center A (31/54, 57.4%) than at center B (6/33, 18.2%; P<0.001). Finally, the neonatal death rate of live-born very preterm neonates admitted to the NICU was significantly lower in center A (25/94, 26.6%) than in center B (27/63, 42.9%; P=0.03). CONCLUSIONS This study points out how the inclusion of deaths in the delivery room when comparing neonatal death rates can lead to a substantial bias in benchmarking studies. Center A and center B each endorsed one of the two models of preferential place of neonatal death (delivery room or NICU) detailed in European studies. The reasons behind the two different models and their impact on how parents perceive supporting their neonate need further investigation.
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Affiliation(s)
- O Forner
- Service maternité-obstétrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France.
| | - A Schiby
- Service réanimation néonatale et pédiatrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - A Ridley
- Service médecine pédiatrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - G Thiriez
- Service réanimation néonatale et pédiatrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - I Mugabo
- Service maternité-obstétrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - V Morel
- Service réanimation néonatale et pédiatrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - B Mulin
- Réseau périnatalité de Franche-Comté, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - J-C Filiatre
- Réseau périnatalité de Franche-Comté, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - D Riethmuller
- Service gynécologie obstétrique, hôpital Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - G Levy
- Service gynécologie obstétrique, hôpital Nord Franche-Comté, 100, route de Moval, 90400 Trevenans, France
| | - D Semama
- Service réanimation néonatale et pédiatrique, hôpital d'enfants, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - D Martin
- Service réanimation néonatale et pédiatrique, hôpital d'enfants, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - C Chantegret
- Service réanimation néonatale et pédiatrique, hôpital d'enfants, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - S Bert
- Service maternité obstétrique, hôpital d'enfants, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - F Godoy
- Service réanimation néonatale et pédiatrique, hôpital d'enfants, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - P Sagot
- Service gynécologie obstétrique, CHU de Dijon, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - T Rousseau
- Service gynécologie obstétrique, CHU de Dijon, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - A Burguet
- Service réanimation néonatale et pédiatrique, hôpital d'enfants, 14, rue Paul-Gaffarel, 21000 Dijon, France
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Abdou A, Daoui L, Charlesworth A, Chiaverini C, Algros MP, Puzenat E, Chantegret C, Vabres P, Lacour JP, Aubin F. [Recessive epidermolysis bullosa due to composite heterozygote mutations in the COL7A1 gene]. Ann Dermatol Venereol 2015; 142:346-9. [PMID: 25683012 DOI: 10.1016/j.annder.2015.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/17/2014] [Accepted: 01/06/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dystrophic epidermolysis bullosa (DEB) is a genodermatosis characterized by various abnormalities of anchoring fibrils, composed mainly of type VII collagen, at the dermal-epidermal junction. These changes are induced by mutations in the type VII collagen gene (COL7A1). PATIENTS AND METHODS A new-born boy was diagnosed with recessive DEB on the basis of typical skin lesions composed of multiple blisters with erosions on trauma-exposed body sites, including the hands and feet and the navel. Diagnosis was confirmed by pathology examination and irregular immunofluorescence staining of type VII collagen. Genomic DNA from the patient and parents were subjected to direct sequencing for the COL7A1 gene. Two heterozygous mutations were detected in the affected child. Each parent was a carrier of one heterozygous mutation. DISCUSSION Over 730 mutations of the COL7A1 gene have been identified as responsible for phenotypic polymorphism of EBD. The relatively mild phenotype seen in our patient, known as "non-Hallopeau-Siemens" or "mitis" EBD, is due to residual synthesis of collagen VII. The mutation present on the maternal allele that prevents synthesis of collagen VII is compensated by the mutation on the paternal allele, which enables more or less functional collagen VII synthesis.
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Affiliation(s)
- A Abdou
- Service de dermatologie, CHU Ibn Sina, Rabat, Maroc
| | - L Daoui
- Service de dermatologie, CHU Ibn Rochd, Casablanca, Maroc
| | - A Charlesworth
- EA3181, service de dermatologie, CHU, université de Franche-Comté, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - C Chiaverini
- EA3181, service de dermatologie, CHU, université de Franche-Comté, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - M-P Algros
- Centre de référence des épidermolyses bulleuses héréditaires, Inserm U634, service de dermatologie, CHU, BP3079, 06202 Nice cedex 3, France
| | - E Puzenat
- Laboratoire d'anatomie pathologique, CHU, 25030 Besançon cedex, France
| | - C Chantegret
- Service de pédiatrie, CHU, 3, rue du Faubourg-Raines, 21000 Dijon, France
| | - P Vabres
- Service de dermatologie, CHU, 3, rue du Faubourg-Raines, 21000 Dijon, France
| | - J-P Lacour
- EA3181, service de dermatologie, CHU, université de Franche-Comté, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - F Aubin
- EA3181, service de dermatologie, CHU, université de Franche-Comté, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.
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Macé G, Feyeux C, Mollard N, Chantegret C, Audia S, Rebibou JM, Spagnolo G, Bour JB, Denoyel GA, Sagot P, Reynes JM. Severe Seoul hantavirus infection in a pregnant woman, France, October 2012. Euro Surveill 2013. [DOI: 10.2807/ese.18.17.20464-en] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- G Macé
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire (CHU) Bocage, Burgundy University, Dijon, France
| | - C Feyeux
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire (CHU) Bocage, Burgundy University, Dijon, France
| | - N Mollard
- Centre National de Référence des Hantavirus, Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France
| | - C Chantegret
- Neonatal Intensive Care Unit, CHU Bocage, Burgundy University, Dijon, France
| | - S Audia
- Department of internal medicine, CHU Bocage, Burgundy University, Dijon, France
| | - J M Rebibou
- Intensive Care Unit of Nephrology, CHU Bocage, Burgundy University, Dijon, France
| | - G Spagnolo
- Department of Obstetrics and Gynecology, Centre Hospitalier, Mâcon, France
| | - J B Bour
- Department of Virology, CHU Bocage, Burgundy University, Dijon, France
| | - G A Denoyel
- Department of Virology, Biomnis, Lyon, France
| | - P Sagot
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire (CHU) Bocage, Burgundy University, Dijon, France
| | - J M Reynes
- Centre National de Référence des Hantavirus, Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France
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Boissier K, Varlet MN, Chauleur C, Cochin S, Clemenson A, Varlet F, Bellicard E, Chantegret C, Patural H, Seffert P, Chêne G. [Early fetal megacystis at first trimester: a six-year retrospective study]. ACTA ACUST UNITED AC 2009; 37:115-24. [PMID: 19200766 DOI: 10.1016/j.gyobfe.2008.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2008] [Accepted: 12/16/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVE A fetal megacystis is defined by a longitudinal bladder diameter more than 7 mm. The purpose of this study is to describe the prenatal ultrasound findings of this early fetal pathology and to assess pronostic and aetiologycal criteria. PATIENTS AND METHODS Between January 2003 and December 2008, 12 cases of early fetal megacystis were identified in our referral fetal medicine unit (Saint-Etienne hospital, France). RESULTS There were two cases of spontaneous resolution and one case wasn't a fetal megacystis. Termination of pregnancy for medical indications was realised for another cases because of associated malformations and bad evolution (six cases) and three chromosomal abnormalities (two cases of trisomy 18 and one of trisomy 21). DISCUSSION AND CONCLUSION Sonographic follow-up and fetal karyotyping are important to evaluate prognosis. However, our data suggest that fetal megacystis is a severe condition when diagnosed in early pregnancy.
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Affiliation(s)
- K Boissier
- Service de gynécologie-obstétrique, CHU de Saint-Etienne, hôpital Nord, avenue Albert-Raimond, 42055 Saint-Etienne cedex 02, France
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