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Résumé Objectif Le taux de dépistage des fœtus petits pour l’âge gestationnel (PAG) est de 21,7 % en France. Des recommandations ont été élaborées pour l’améliorer grâce à l’échographie du troisième trimestre (T3), les conséquences néonatales pouvant être importantes. L’objectif est d’évaluer le dépistage des PAG à l’échographie T3 et de décrire les causes d’échec et les écarts aux recommandations du CNGOF. Méthodes Tous les fœtus nés inférieurs au 3 e percentile entre 2011 et 2012 ont été inclus dans cette étude observationnelle rétrospective et monocentrique. Nous avons noté si le diagnostic de PAG était posé dans le dossier. Ensuite, nous avons recalculé les estimations de poids fœtal (EPF) selon les formules de Hadlock 3 et Hadlock 4 au moyen des biométries relevées dans les comptes rendus, ainsi que les percentiles correspondants, permettant d’évaluer le taux de dépistage si les recommandations étaient appliquées. Résultats Un total de 142 patientes ont été incluses. En recalculant correctement toutes les EPF et en vérifiant les percentiles du périmètre abdominal le taux de dépistage de l’échographie T3 passait de 40 % à 50 % et le taux global de dépistage (échographique et clinique) de 54 % à 66 %. Conclusion En suivant les recommandations nous retrouvions une amélioration du taux de dépistage des fœtus PAG à l’échographie T3 avec un potentiel bénéfice pour leur prise en charge. Objectives Fetus small for gestational age (SGA) screening rate is evaluated around 21,7 % in France. Recommendations were developed to improve the efficiency of ultrasound conducted in the third trimester (T3), because neonatal consequences can be significant. This study aims to evaluate screening of SGA during T3 ultrasound and to describe causes for failure and differences with the recommendations of CNGOF. Methods All children born between 2011 and 2012 with a birth weight below the 3rd percentile were included in this observational, retrospective, monocentric study. We noted that the diagnosis of SGA was placed on file. Then, as recommended by the CNGOF, we calculated estimated fetal weight (EFW) with Hadlock 3 and Hadlock 4, and the corresponding percentiles, using the biometrics from the ultrasound report. We thus could evaluate a new screening rate with SGA fetus identified through this technique. Results A total of 142 patients were included. By calculating correctly all EFW and checking abdominal circumference percentiles, the screening rate of SGA fetuses with T3 ultrasound increased from 40 % to 50 % and the overall screening rate (clinical and ultrasound) from 54 % to 66 %. Conclusion By following the recommendations we found a real improvement in fetal SGA screening rates to T3 ultrasound with a potential benefit for their care. [ABSTRACT FROM AUTHOR]

Objective: SARS-CoV-2 is more likely to cause severe cases in pregnant women. They were part of the priority groups since April 2021 to benefit from SARS-CoV-2 vaccination before its extent to general population. This contribution aims to evaluate, in the postpartum period, the achievement of COVID-19 vaccination and factors associated in women during their pregnancy., Material and Method: Multicenter cross-sectional survey study conducted from September to December 2021 with online self-questionnaire. All postpartum patients hospitalized in one of the 6 participating maternity hospitals were invited to answer. The questionnaire asked patients about their demographic characteristics, vaccination modalities, vaccine tolerance, and their general perception of vaccination., Results: Of the 371 women who responded, the vaccination rate was 65.7% (IC95% [60.8-70.4]), whom 98.8% entirely during pregnancy. Associated factors with vaccination during pregnancy were older age, higher socio-professional category, and prior information provided by health professionals. Factors that appear to motivate vaccination were personal protection and protection of the newborn. Finally, main factors negatively influencing the vaccination process were the fear of vaccine side effects and the negative perception of vaccines in general., Discussion: Acceptability and information about the vaccine by health professionals is in constant improvement. Information campaigns should be continued to improve the acceptability of vaccination, in light of the accumulating data., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Objectives: To assess the benefit of non-pharmacological intervention promoting on smoking cessation, obstetric and neonatal outcomes, to offer pregnant women who smoke (PWS) optimal care., Methods: We searched Medline Database, Cochrane Library and consulted international guidelines., Results: "Counselling" involving globally all kind of non-pharmacological interventions has a benefit on smoking cessation (NP1) and a moderate benefit on birth weight and prematurity (NP2). The brief intervention seems ineffective on smoking cessation (NP2). The effects of motivational interviewing have not been demonstrated during pregnancy (NP2). Cognitive-behavioral interventions do not show superiority (NP2). Financial incentives have a benefit for smoking cessation and possibly for neonatal outcomes (NP1). Feedback interventions (Co tester) provide heterogeneous results (NP2). Self-help interventions (NP2) and health education (NP2) seem effective on smoking cessation. Hypnotherapy and acupuncture have been little or not studied in PWS. Moderate physical activity did not show a significant effect (NP2) on smoking cessation but seem to reduce craving for tobacco (NP3)., Conclusions: We recommend asking all PWS about their smoking consumption and detailing their smoking history, offering them different types of counselling according to their preferences and involving them multidisciplinary (grade A). The systematic use of feedback is not recommended (grade C) but experience suggests that the CO tester is important in establishing a therapeutic alliance (professional consensus). The use of self-help interventions (grade C) and health education (grade B) are recommended., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

According to the 2016 National Perinatal Survey, 30.0 % of women smoked before pregnancy, 45.8 % quit smoking in the 1st or 2nd trimester. Many do this only for pregnancy and the risk of postpartum relapse is high (up to 82 % at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression. No drug treatment can be recommended to prevent the smoking postpartum relapse. Only global counseling can prevent this risk., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Objectives: To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy., Methods: Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest)., Results: "Counseling", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child's development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression., Conclusions: Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

A new coronavirus (SARS-CoV-2) highlighted at the end of 2019 in China is spreading across all continents. Most often at the origin of a mild infectious syndrome, associating mild symptoms (fever, cough, myalgia, headache and possible digestive disorders) to different degrees, SARS-Covid-2 can cause serious pulmonary pathologies and sometimes death. Data on the consequences during pregnancy are limited. The first Chinese data published seem to show that the symptoms in pregnant women are the same as those of the general population. There are no cases of intrauterine maternal-fetal transmission, but cases of newborns infected early suggest that there could be vertical perpartum or neonatal transmission. Induced prematurity and cases of respiratory distress in newborns of infected mothers have been described. Pregnancy is known as a period at higher risk for the consequences of respiratory infections, as for influenza, so it seems important to screen for Covid-19 in the presence of symptoms and to monitor closely pregnant women. In this context of the SARS-Covid-2 epidemic, the societies of gynecology-obstetrics, infectious diseases and neonatalogy have proposed a French protocol for the management of possible and proven cases of SARS-Covid-2 in pregnant women. These proposals may evolve on a daily basis with the advancement of the epidemic and knowledge in pregnant women. Subsequently, an in-depth analysis of cases in pregnant women will be necessary in order to improve knowledge on the subject., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Objective: We sought to evaluate whether the antenatal identification of small for gestational age (SGA) fetuses could influence the neonatal and obstetric prognosis., Methods: This was a retrospective cohort study. All liveborn singleton neonates with a birthweight<3rd centile, born>32 weeks of gestation between January 1, 2011 and December 31, 2012 were included. Fetuses were considered "suspected SGA" when the estimated fetal weight was<10th centile or when a diagnosis of clinical or ultrasound SGA was explicitly noted in the record. Obstetrical and neonatal follow-up and outcomes of suspected SGA (SGAS group) and non-suspected (SGANS group) were compared, with Chi 2 and the Fisher exact test when appropriate., Results: Hundred and forty-seven neonates were included. Among these, 54% were suspected SGA before birth. Gestational age was lower (38.5 weeks gestation [WG] vs. 39.6 WG, P<0.001) and there was a higher preterm birth rate in the SGAS group (10% vs. 0%, P=0.005). The rate of elective cesarean sections (17% vs. 3%, P=0.005) was higher in the SGAS group, whereas the rate of nonelective cesarean sections was lower (20% vs. 33%, P=0.002). Neonatal morbidity was similar in both groups, as well as birth weight., Conclusion: SGA fetal screening in our cohort was associated with a higher rate of medical intervention and preterm birth without neonatal benefit. Nevertheless, the study's power and methodology are not adequate to reduce the risk of fetal death in utero or severe asphyxia associated with non-identification of a SGA fetus., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)