Search

Neonatal seizures are a frequently encountered neurological condition, with intracranial aneurysms being a rare but notable cause. Cerebellar imaging plays a pivotal role in their diagnosis. Treatment options are microsurgery or embolisation. In this report, we present the case of a 26‐day‐old neonate who experienced a neonatal seizure, revealing a ruptured aneurysm. The condition was successfully treated surgically, resulting in a favourable outcome. [ABSTRACT FROM AUTHOR]

Background: Congenital protein C deficiency is a rare hereditary thrombophilia, neonatal purpura fulminans is the most serious form of this deficit. The purpose of this observation is two-fold. The first is the need to make an early diagnosis in order to improve the prognosis. The second, is to discuss the need. In case of extensive purpura fulminans in the neonatal period, the search for a deficiency in anticoagulant factor, in particular the dosage of protein C, in the newborn and in both parents. Methods: The diagnosis is biological and is based on the quantitative determination of functionally active protein C. We use the Berichrom® Protein C assay on an automated coagulation analyzer from Siemens Healthcare Diagnostics, which allows the chromogenic determination of Protein C activity. Results: We report an observation of cutaneous necrosis in a newborn having developed a purpura fulminans extensive secondary to a total congenital protein C deficiency. In front of this clinical picture, thrombophilia assessment is requested, revealing an isolated deficit in protein C < 1%. Conclusions: In the case of extensive purpura fulminans in the neonatal period, the search for a deficiency in anticoagulant factor, in particular the dosage of protein C, is essential in the newborn and in both parents. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding (BF) is one of the most effective ways to ensure child health and survival. In Morocco the BF rate decreased from 51% to 27,8% between 1992 and 2011. The breast feeding rate in neonatal intensive care unit (NICU) is lower 12,4%. Studies showed if we improve the mothers knowledge, the BF practice rate increase in NICU. We aim to determine associated factors of mothers knowledge about BF in NICU of Ibn Rochd teaching hospital in Casablanca (Morocco). Methods: A cross-sectional study was conducted between 04 January and 23 April 2021 in NICU ward of teaching hospital Ibn Roch of Casablanca (Morocco). We included Moroccan mothers who can practice the BF presents during the study period. We used face to face interview using questionnaire. A scoring system from 0 to 16 points was used to measure the knowledge. The student, ANOVA, Mann-Whitney-Wilcoxon, Kruskal Wallis, Pearson and spearman correlation tests were used to test association between BF and potential associated factors. Associated factors with p≤0.05 were considered as determinants of BF. Data were analyzed using R 3.6.3. Results: We included 111 mothers. The mean score of knowledge was 10.38 ≤ 2.31. Associated factors with BF knowledge were: healthcare staffs support (yes mean score =11.06 and no=9.72; p=0.002); getting prior information about BF (yes mean score =10.53 and no=9; p=0.012). The knowledge increase with age of mother (correlation coefficient = 0.26; p=0.005) and parity (correlation coefficient = 0.30; P=0.001). Conclusions: Mothers and specifically younger primiparous should receive more attention from training program and healthcare staffs in NICU to improve the knowledge and practice of BF. [ABSTRACT FROM AUTHOR]

Background: Improving breast milk feeding (BF) can avoid globally per year 800000 deaths in children under 5 years old. In Morocco the breast milk feeding rate decreased from 51% to 27,8% between 1992 and 2011, the breast feeding rate in neonatal intensive care unit (NICU) is lower (12,4%). The objective of this study is to determine the associated factors of BF practice in NICU. Methods: A cross-sectional study was conducted between 04 January and 20 April 2021 in NICU ward of teaching hospital Ibn Roch of Casablanca (Morocco). We included Moroccan couples mother/newborn who can practice the BF presents during the study period. We used face to face interview using questionnaire. Student, Mann-Whitney-Wilcoxon and Khi2 tests were used to test association between BMF and potential associated factors. The potential associated factors with p[0.05 were considered as associated factors of BF practice. Data were analyzed using R 3.6.3. Results: We included 107 couple mother/newborn. Around 77% of mothers practice BF. The mother factors associated with BF practice were: residence (30.5% rural; 69.5% urban; p=0.007); marital status (2.4% single; 0% divorced; 97.6% married; p=0.02); getting prior information about BF (6.2% no; 93.8%yes; p=0.02), mother knowledge score about BF (median score yes = 10, no=9;p= 0.03). The newborn associated factors were: hospitalization reasons (50.7% respiratory distress; 17.3% infections; 13.3% jaundice; 18.7% others; p=0.03) and the gender (58.2% male; 41.8% female; p=0,02) Conclusions: The practice rate is lower for rural single mother who don’t get any prior information about BF (lower knowledge). These mothers must get more attention from the healthcare staffs and training programs to improve the breast feeding in NICU. [ABSTRACT FROM AUTHOR]

Background: Globally infectious diseases remain the leading causes of child hood mortality and morbidity accounting for 65% of all deaths in under-five children which can be prevented if proper sanitation and hygiene measure undertaken. The aim of this study is to determine the factors associated to hand hygiene of newborn mothers in NICU of Ibn Rochd teaching hospital in Casablanca (Morocco). Methods: A cross-sectional study was performed from 04 January to 15 April 2021. We included Moroccan couple newborn/mother presents in NICU during the study period. We used face to face interview using close ended questionnaire. The number of time per day the mothers used soap or alcohol for hand hygiene(<3; 3-6; >6 times per day) was used to measure the variable ‘‘hand hygiene practice’’ The Khi2 and Kruskal-wallis tests were used to test association between hand hygiene and potential associated factors. Associated factors with p≤0.05 were considered as significantly associated factors of hand washing practice. Data were analyzed using R 3.6.3. Findings: We included 89 couple mother/newborn. Forty five percent practice adequate hand hygiene (washing with soap or hand rub sanitizer) between 3 and 6 times per day. Factors significantly associated with hand hygiene were: mothers’ residence (rural 33.7%; urban 66.3%; p = 0,026); prenatal visit number (visits number mean: < 3 times =3.67; 3-6 times = 3.30; > 6times = 5.08; p = 0,011). Conclusions: The mothers from urban residence accessing more prenatal visits practice hand hygiene more frequently than single mothers from rural residence with limited access of prenatal visits. So this study suggests the training programs to enhance mothers hand hygiene practice should prioritize the mothers from rural residence who attended less prenatal visits. Key messages: We can protect the fragile hospitalized newborn from infections by cheapest gestures like hand hygiene. Hand hygiene must be continually promoted targeting all actors involved about newborn care specifically newborn mothers. [ABSTRACT FROM AUTHOR]

La maladie hémolytique du nouveau-né est une situation clinique où les globules rouges fœtaux sont détruits par des allo-anticorps maternels de type IgG dirigés contre les antigènes paternels. Contrairement à l'allo-immunisation érythrocytaire fœto-maternelle dans le système RHD qui entraîne une maladie hémolytique sévère, l'allo-immunisation érythrocytaire fœto-maternelle dans le système ABO entraîne généralement une hémolyse bénigne. On vous présente une étude rétrospective portant sur huit cas d'ABO sévère, colligée sur une période de 5 ans allant de janvier 2016 à décembre 2022. Toutes les mères étaient de groupage O+ avec RAI négatives. Les critères de sévérité étaient le caractère précoce de l'ictère, le test de Coombs positif et l'hémolyse sévère avec une anémie profonde. Hemolytic disease of the newborn is a clinical situation in which fetal red blood cells are destroyed by maternal IgG-type alloantibodies directed against paternal antigens. Unlike fetal-maternal alloimmunization in the RHD system, which leads to severe hemolytic disease, fetal-maternal alloimmunization in the ABO system generally results in benign hemolysis. We present a retrospective study of eight cases of severe ABO, collected over a 5-year period from January 2016 to December 2022. All the mothers were O+ grouped with negative RAI. Severity criteria were early jaundice, positive Coombs test and severe hemolysis with profound anemia. [ABSTRACT FROM AUTHOR]

L'infection congénitale à cytomégalovirus est la principale cause d'embryofœtopathie infectieuse. Connaître les caractéristiques épidémiologiques, cliniques et paracliniques de l'infection congénitale à CMV. Étude rétrospective au Service de médecine et de réanimation néonatale à l'Hôpital Harrouchi à Casablanca à propos de 4 cas atteints de CMV congénitales. L'âge moyen de diagnostic était à J25 de vie, le sexe masculin était prédominant et dans les 4 cas la grossesse n'était pas suivie. Les manifestations cliniques comprennent : un RCIU, une hépatite avec insuffisance hépatocellulaire, une dysplasie bronchopulmonaire, et une atteinte multiviscérale. Le diagnostic a été fait par le couple sérologie–PCR CMV. Le traitement par ganciclovir a été démarré chez 3 cas avec bonne évolution. Nos cas illustrent que l'infection congénitale à CMV est à considérer chez les nouveau-nés présentant des anomalies cérébrales congénitales, une atteinte hématologique, une atteinte hépatique ou une hypotrophie. Congenital cytomegalovirus infection is the leading cause of embryofoetopathy infectious embryo-fœtopathy. To know the epidemiological, clinical and paraclinical characteristics of congenital CMV infection. Retrospective study in the department of medicine and neonatal resuscitation at the Harrouchi Hospital in Casablanca about 4 cases of congenital CMV. The average age of diagnosis was at D25 of life, the male sex was predominant and in the 4 cases the pregnancy was not followed. The clinical manifestations included: IUGR, hepatitis with hepatocellular failure, bronchopulmonary dysplasia, hepatitis, bronchopulmonary dysplasia, and multivisceral involvement. The diagnosis was made by the serology-PCR CMV couple. Ganciclovir treatment was started in 3 cases with good cases with good evolution. Our cases illustrate that congenital CMV infection is to be considered in newborns with congenital cerebral anomalies, hematological impairment hepatic impairment or hypotrophy. [ABSTRACT FROM AUTHOR]

La maladie hémolytique Rhésus du nouveau-né résulte de l'alloimmunisation des globules rouges maternels contre les antigènes des globules rouges pour lesquels la mère et le fœtus sont incompatibles. L'IFM Rhésus peut conduire à la mort périnatale si l'anémie fœtale est non traitée et peut causer une hyper-bilirubinémie grave chez les nouveau-nés survivants. Le traitement postnatal conventionnel repose principalement sur la PTH intensive, l'exsanguino-transfusion (EST) et la transfusion de globules rouges. Le traitement par immunoglobulines intraveineuses (IgIV) combinées avec la photothérapie a été suggéré comme thérapie alternative pour réduire le besoin en EST depuis quelques années. L'objectif principal de cette étude était de tester l'efficacité des IgIV dans le traitement des IFM rhésus en termes de réduction du recours à l'EST, de la durée de PTh et d'hospitalisation, et le besoin en transfusion de Culot globulaires. Une étude prospective, descriptive, comparative et analytique portant sur l'utilisation des IgIV dans le traitement de l'ictère néonatal par incompatibilité érythrocytaire fœto-maternelle dans le système Rhésus chez 38 nouveau-nés pris en charge au service de médecine et de réanimation néonatale de L'Hôpital universitaire d'Enfants Abderrahim Harrouchi sur une période allant du 1er janvier 2013 au 31 décembre 2017. L'étude comparative a été effectuée à l'aide d'un groupe historique de 49 nouveau-nés pris en charge au service de médecine et de réanimation néonatale de L'Hôpital universitaire d'Enfants Abderrahim Harrouchi du 1er janvier 2009 jusqu'au 31 décembre 2012 qui remplissent les mêmes critères d'appariement que ceux du groupe IGIV. Dans notre série, les caractéristiques épidémiologiques n'ont eu aucune influence ni sur l'évolution de la maladie ni sur les résultats finaux dans les deux groupes d'étude. Il n'y avait pas de différence significative de l'ensemble des antécédents maternels. Le traitement par les IGIV était efficace dans cette série en termes de réduction : du recours à l'EST : 7,9 % dans le groupe IGIV versus 26 % dans le groupe témoin (p = 0,001) ; du nombre de séances de PTH intensive : 1,71 séances pour le groupe IGIV versus 2,04 séances dans le groupe témoin (p = 0,020) ; du nombre de transfusions au cours de l'hospitalisation : 10,5 % pour le groupe IGIV et 26 % pour le groupe témoin (p = 0,010) ; de la durée de l'hospitalisation : 4,87 jours pour le groupe IGIV et 6,48 jours pour le groupe témoin (p = 0,037). Aucune différence significative n'a été enregistrée entre les deux groupes en termes de réduction : du nombre d'hémolyse tardive : 15,7 % pour le groupe IGIV et 14,2 % pour le groupe témoin (p = 0,526) ; du nombre de ré-hospitalisations : 21 % pour le groupe IGIV et 14,2 % pour le groupe témoin (p = 0,142). À la lumière des résultats de notre étude et en se référant à l'analyse de la littérature internationale, on s'aperçoit que les IGIV associées à la PTH sont efficaces dans la prise en charge des ictères par IFM Rh et permettent une réduction du recours aux EST, de la durée de PTH et d'hospitalisation. Elles sont bien tolérées et peuvent être un adjuvant thérapeutique dans l'ictère néonatal sévère par IFM Rhésus. Rhesus hemolytic disease of the fetus and newborn (rhesus HDFN) results from maternal red cell alloimmunization against red blood cell antigens for which the mother and fetus are incompatible. Rhesus HDFN can lead to perinatal death if fetal anemia is left untreated and can cause severe hyperbilirubinemia in neonatal survivors. Conventional postnatal treatment consists mainly of intensive phototherapy, exchange transfusions (ETS) and top-up red blood cell transfusion. Treatment with intravenous immunoglobulin (IVIg) combined with phototherapy has been suggested as an alternative therapy to reduce the need for ETS. Study objective The main objective of this study was to test the efficacy of IgIV in the treatment of rhesus HDFN in reducing the need for ET, the duration of PTH and hospital stay, and the need for top-up red blood cell transfusion. A Prospective, descriptive, comparative and analytical study of IVIg in the treatment of rhesus HDFN in neonates, over a period from 1 January 2013 to 31 December 2017. The comparative study was carried out using a historical group of newborns from 1 January 2009 to 31 December 2012 which fulfill the same matching criteria as those of the IGIV group. A total of 87 cases have been included in this study. Main results In our series, the epidemiological characteristics had no influence neither on the evolution of the disease or on the final results in the two study groups. There was no significant difference in overall maternal antecedents between the two groups studied. IVIG treatment was effective in this series in terms of reduction of: the need for ETs: 7.9 % in the IGIV group versus 26 % in the control group (P = 0.001); the duration of intensive PTH: 1.71 session for the IGIV group versus 2.04 session in the control group (P = 0.020); the use of top-up red blood cell transfusion during hospital stay: 10.5 % for the IGIV group and 26 % for the control group (P = 0.010); duration of hospital stay: 4.87 days for the IGIV group and 6.48 days for the control group (P = 0.037). No significant difference was found between the two groups in terms of reduction of: the number of late hemolysis: 15.7 % for the IGIV group and 14.2 % for the control group (P = 0.526); number of rehospitalization: 21 % for the IGIV group and 14.2 % for the control group (P = 0.142). In light of the results of our study and referring to the analysis of the international literature, it can be seen that IVIGs associated with intensive PTH can reduce the need for ET and the duration of PTH and hospitalization. They are well tolerated and can be a therapeutic adjunct in severe neonatal jaundice by rhesus HDFN. [ABSTRACT FROM AUTHOR]

L'incompatibilité fœto-maternelle dans le système ABO est la plus fréquente des incompatibilités érythrocytaires fœto-maternelles. Le but de cette étude est de décrire les caractéristiques : épidémiologiques, cliniques, biologiques et thérapeutiques des cas colligés au service de médecine et de réanimation néonatale de l'hôpital d'enfants A. Harouchi de Casablanca. Notre travail est une étude prospective portant sur les cas d'ictère néonatal par incompatibilité ABO colligés au service durant la période allant du 1er janvier au 30 septembre 2017. Quarante-cinq cas ont été enregistrés soit 27,9 % de la totalité des ictères néonataux et 5,7 % des hospitalisations au service. Les incompatibilités O-A ont été retrouvées dans 62,2 % des cas. L'âge à l'admission variait entre huit heures et seize jours. Le caractère précoce était retrouvé dans 35,5 % et était associé à des signes neurologiques dans 15,6 %. Le taux de bilirubine était supérieur à 200 mg/L dans 33,3 % des cas. Tous les nouveau-nés ont bénéficié d'une photothérapie intensive. Les immunoglobulines étaient administrées chez deux nouveau-nés. Un test direct à l'antiglobuline positif et/ou test d'élution positif étaient significativement associés à un ictère précoce et à plus de séances de photothérapie. Les ictères néonataux par incompatibilité ABO continuent à poser dans notre contexte un problème de prise en charge en rapport avec un retard de consultation ainsi qu'aux sorties précoces de la maternité. Fetal-maternal ABO incompatibility is the most common fetal-maternal erythrocyte incompatibility. The purpose of this study is to describe the epidemiological, clinical, biological and therapeutic characteristics of the cases collected in the department of medicine and neonatal resuscitation at children's hospital A. Harouchi of Casablanca. Our work is a prospective study on the cases of neonatal jaundice by ABO incompatibility collected in the department during the period from January 1st to September 30th, 2017. Forty-five cases were recorded, i.e. 27.9% of the total neonatal jaundice and 5.7% of the hospitalizations in the department. O-A incompatibilities were found in 62.2% of cases. The age at admission ranged from eight hours to sixteen days. Precocious character was found in 35.5% and was associated with neurological signs in 15.6%. Bilirubin levels were above 200 mg/L in 33.3% of cases. All newborns received intensive phototherapy. Immunoglobulins were administered to two newborns. A positive direct antiglobulin test and/or positive elution test were significantly associated with early jaundice and more phototherapy sessions. Neonatal jaundice due to ABO incompatibility continues to pose a management problem in our context in relation to delayed consultation and early discharge from the maternity ward. [ABSTRACT FROM AUTHOR]

Neonatal tetanus (NT) remains common in developing countries. Its poor prognosis is characterized by a high mortality rate.Patients and methods – Our retrospective review concerned 50 cases of NT admitted to the intensive care and neonatology units in the Casablanca Children''s Hospital between 1990 and 1999. The diagnosis was made on clinical signs and gravity was evaluated with the Dakar score.Results – NT accounts for 0.5% of cases admitted in our service. A low socio-economical level, and home delivery without asepsis were found in 90%. 80% of patients were of rural origin. A Dakar score &ges;4/6 was noted in 76%. Since 1994 therapeutic management has improved but with heavier costs and longer hospitalization. Nevertheless, the mortality rate reached 66%.Conclusion – Prevention based on vaccination, easier access to healthcare, or education of the population will help to solve this problem. [Copyright &y& Elsevier]