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Décrire l'incidence, les facteurs de risque, les facteurs associés ainsi que l'évolution à court terme de l'hémorragie pulmonaire (HP) dans une population d'extrême prématuré. Étude rétrospective cas témoin incluant 33 prématurés < 29 SA ayant présenté une HP au cours du premier mois de vie, du 1er septembre 2014 au 30 juillet 2017. Chaque enfant a été apparié à un nouveau-né, né le plus proche chronologiquement, de même sexe, même terme et même poids de naissance. Les données concernant l'évolution jusqu'à la sortie d'hospitalisation ont été collectées. Sur cette période, la prévalence de l'hémorragie pulmonaire était de 7 %. L'âge gestationnel (AG) moyen était de 25 + 0 SA, le poids de naissance moyen de 760 g, identiques dans les deux groupes. En analyse univariée, une cure incomplète de corticoïdes (< 2 doses) en anténatale (p = 0,01), le recours à l'OHF (p < 0,001), au NO (p = 0,01) et à la dopamine (p < 0,01) étaient des facteurs associés à HP. En analyse multivariée, l'absence de cure complète de corticoïdes en anténatale reste un facteur de risque de survenue d'HP (p = 0,04). Les données concernant le canal artériel ne sont pas différentes entre les 2 groupes tout comme la durée de ventilation invasive, les taux de DBP à 36 SA corrigée, d'ECUN et d'infections secondaires. Il existe une surmortalité dans le groupe HP (60,6 vs 12,1 %) avec une augmentation de la survenue des hémorragies intraventriculaire (HIV) 3 et 4, (60,6 vs 18,2 %). Dans la population des HP, les facteurs de risque associés au décès sont le sexe masculin (p < 0,01) et un pH à la naissance plus bas (p < 0,02). Un AG bas et une administration très précoce de surfactant semblent plus fréquent chez les nouveau-nés décédés sans que ces différences ne soient significatives (p = 0,06). L'hémorragie pulmonaire s'associe à une mortalité élevée dans la population des extrêmes prématurés. Une corticothérapie anténatale incomplète apparaît être un facteur de risque de survenue HP et le sexe masculin un facteur de risque de décès. To describe the incidence, associated factors and risk factors, the short-term course for the occurrence and death of pulmonary hemorrhage in the population of premature extremes. This was a retrospective case-control study involving 33 premature infants < 29 weeks who had HP during the first month of life, frome 1st september 2014 to 30th July 2017. A control was selected for each case: the closest chronologically born, child of the same gestational age, same gender and similar weight at birth. The data concerning the evolution until the discharge of hospitalization were collected. The prevalence of pulmonary hemorrhage was 7 %. Mean gestational age (GA) was 25 ± 0 weeks, the average birth weight was 760 g in both groups. In univariate analysis, an incomplete course of corticosteroids (< 2 doses) in antenatal (P = 0.01), the use of HFOV (P < 0.001), NO (P = 0.01) and dopamine (P < 0.01) were factors associated with HP. In multivariate analysis, the absence of a complete course of corticosteroids in the antenatal period remains a risk factor for the occurrence of HP (P = 0.04). The arterial duct data were not different between the 2 groups, as was the duration of invasive ventilation, bronchopulmonary dysplasia at 36 weeks corrected, necrotizing enterocolitis, and secondary infections. There is excess mortality in the HP group (60.6 vs. 12.1 %) with an increase in the occurrence of intraventricular haemorrhage ¾ (60.6 % vs. 18.2 %). In the HP population, risk factors associated with death are male (P < 0.01) and lower pH at birth (P < 0.02). Low AG and very early surfactant administration appear to be more common in deceased infants without these differences being significant (P = 0.06). Pulmonary hemorrhage is associated with high mortality in the population of premature extremes. Incomplete antenatal corticosteroids and the male sex appear to be a risk factor of death of HP. [ABSTRACT FROM AUTHOR]

Le pneumothorax de l'enfant est rare avec une prise en charge hétérogène liée à l'absence de recommandations pédiatriques spécifiques. Chez le nouveau-né, le pneumothorax survient sur un terrain favorisant et/ou malformatif et son traitement est fonction de la tolérance et du contexte. Chez l'adolescent, la physiopathologie reste méconnue, notamment le rôle des lésions emphysémateuses apicales (bulles, blebs) dans la survenue du pneumothorax spontané et sa potentielle récidive. Une pathologie sous-jacente doit systématiquement être recherchée. Le pneumothorax est confirmé par un cliché de radiographie de thorax de face en inspiration. La réalisation d'un scanner thoracique (examen le plus sensible) ne semble pas indispensable en cas de premier épisode paucisymptomatique avec un pneumothorax < 2 cm (traitement conservateur) et en l'absence d'argument pour une étiologie secondaire. Elle reste discutée lorsqu'un drain thoracique a dû être posé, dans le but de rechercher des bulles ou une pathologie sous-jacente. L'échographie pleurale peut présenter un intérêt diagnostique en situation d'urgence extrême ou dans le suivi de patients de soins intensifs. La supériorité du drainage versus exsufflation à l'aiguille lors d'un premier épisode reste débattue. Le taux de récidive après un premier épisode de pneumothorax est de 50–60 % chez l'enfant. Le traitement chirurgical du pneumothorax est réalisé en cas de récidive ou en cas de bullage persistant après 48 heures de drainage. Une résection de l'apex avec pleurodèse mécanique (pleuro-abrasion, pleurectomie) est à privilégier chez l'enfant, malgré son taux de récidive rapporté supérieur à la pleurodèse chimique (5 % contre 1 %). L'information de l'enfant et de sa famille sur les activités éventuellement contre-indiquées est nécessaire. The rare occurrence and the absence of dedicated recommendations in pediatric pneumothorax lead to very heterogenous management courses. In neonatal pneumothorax, specific risk factors or congenital malformations are usually found. The treatment of neonatal pneumothorax depends on tolerance and context. Pathophysiology of pneumothorax in adolescents remains uncertain, including the exact role of emphysematous lesions of the lungs (bullae, blebs) in spontaneous pneumothorax or in possible recurrence. An underlying condition should always be sought. Diagnostic of pneumothorax is made using chest X-ray. A first episode of well-tolerated primitive spontaneous pneumothorax with pneumothorax < 2 cm should be managed conservatively and CT-scan (highest sensitivity) should not be systematic, unless a secondary cause is suspect. CT-scan should be discussed in cases requiring chest tube drainage, in order to look for bullae or an underlying cause. Pleural ultrasound may be used for diagnosis in life-threatening cases or as a follow-up tool in intensive care patients. The superiority of chest tube drainage versus needle exsufflation in the management of a first episode remains debated. In children, recurrence following a first episode of spontaneous pneumothorax occurs in 50 to 60% of cases. Surgical management should be performed in recurrent pneumothoraces or persistent bubbling after 48 hours of efficient drainage. Bullectomy with mechanical pleurodesis (pleurectomy, pleuroabrasion) should be preferred to chemical pleurodesis in children, despite its higher recurrence rate (5% versus 1%). The child and their parents must be informed on contraindicated activities. [ABSTRACT FROM AUTHOR]

Introduction: to help reduce neonatal mortality in Burkina Faso, we identified the prognostic factors for neonatal mortality at the Sourô Sanou University Hospital. Methods: we conducted a cross-sectional and analytical study in the neonatal department from July 25, 2019 to June 25, 2020. Patients' medical records, consultation and hospital records were reviewed. Prognostic factors for neonatal mortality were identified using a Cox model. Results: data from 1128 newborn babies were analysed. Neonatal mortality was 29.8%. Most of these deaths (89%) occurred in the early neonatal period. The mean weight of newborns at the admission was 2,285.8 ± 878.7 and 43.6%. They were at a healthy weight. Four out of five newborns had been hospitalized for infection or prematurity. The place of delivery (HR weight <1000g = 5.45[3.81 -7.79]) and the principal diagnosis (HR asphyxiation= 1.64[1.30-2.08]) were prognostic factors for neonatal mortality. Conclusion: improving technical facilities for the etiological investigation of infections and an efficient management of low-weight newborns suffering from respiratory distress would considerably reduce in-hospital neonatal mortality in Bobo-Dioulasso. [ABSTRACT FROM AUTHOR]

Orofacial clefts are one of the most frequent congenital oral and maxillofacial abnormalities. When these babies are roughly three months old, lip rebuilding, also known as cheiloplasty, is a critical concern. In several cleft facilities, To improve the treatment success, presurgical Nasoalveolar Molding (NAM) has been included in the therapy protocol. In patients with cleft lip and palate, this technique is routinely used to bring the alveolar segments into normal alignment and improve nasal symmetry. In this article, the benefits of using this method as part of a treatment plan for infants with cleft lip and palate will be described. By gradually shifting the bone segments into a better suitable position, presurgical NAM can assist to lower the prevalence of the initial cleft deformity, reducing the extent of surgical correction essential to unite the lip parts and making nose surgery more straightforward. By use of presurgery 'NAM', surgical repairement of nose and lip is performed first with less effort which reduces formation of scar as well as improves cosmestic outcome. This method also helps to get the desire cosmetic outcome by removing the need of repeated surgical procedures. [ABSTRACT FROM AUTHOR]

Extremely low birth weight infants are a public health problem in developing countries. The objective of this study was to evaluate the prognosis of extremely low birth weight newborns hospitalized at Saint Camille Hospital in Ouagadougou (HOSCO). Method: This was a descriptive and analytical study with retrospective data collection on newborns with birth weight <1000g, in the neonatology department from January 2017 to December 2021. Results: A total of 319 newborns were admitted giving a hospital frequency of 8.62%. Male sex was predominant with a sex ratio of 1.02. The mean age was 0.18 ± 0.71 days. The main signs on admission were hypothermia 88.40% and respiratory distress 92.16%. The evolution was marked by 92.79% of deaths of which 90.20% occurred during the early neonatal period. Hypothermia, birth outside HOSCO and maternal age less than 20 years were the factors associated with mortality. Conclusion: The management of low birth weight remains difficult because of the very limited resources in our countries. Simple and inexpensive interventions can considerably improve the survival of these newborns. [ABSTRACT FROM AUTHOR]

Adrenal hematoma is the most common adrenal mass in newborns. Adrenal hemorrhage (AH) of the newborn has a wide spectrum of disease severity and, as a result, the literature reports a varying incidence, initially thought to range from 1.7 to 3 per 1000 live births. Majority of AH is, however, asymptomatic and the frequency at which it occurs incidentally has only recently been appreciated. Several studies retrospectively assessed the presence of AH with screening abdominal ultrasounds in newborns, suggesting a more common occurrence of 16–29 per 1000 live births. Most newborns with recognized disease do not require treatment, as even 10% functional cortisol-producing tissue is sufficient to prevent adrenal insufficiency (AI). Additionally, the newborn adrenal is a highly regenerative organ. Those that do progress to AI and require treatment, though rare, show quick resolution. We offer a literature review of AH in newborns, as well as a unique presentation of bilateral disease in the setting of traumatic delivery. Our patient has been followed to 18 months of age and has shown no persistent AI. [ABSTRACT FROM AUTHOR]

Cri-du-chat syndrome is a rare genetic disorder, due to a deletion of the short arm of chromosome 5 (5p-). Its incidence is ranging from 1/15000 to 1/50000 live births. This was a one-day-old male newborn from a non-consanguineous marriage, the first pregnancy uncomplicated and carried to term with a birth weight of 2295g. Clinical examination revealed: craniofacial dysmorphism with hypertelorism and microcephaly, hypotonia, poor suction and clubfoot more marked on the right, the rest of the examination was unremarkable. During hospitalization, a high-pitched monochromatic cry mimicking a cat's meow was observed. The clinical diagnosis was confirmed by fluorescence in situ hybridization, showing a deletion of the short arm of chromosome 5 (5p15.2). The basic malformative work-up came back without any other abnormalities. The association of a high-pitched monochromatic cry with craniofacial dysmorphism in a newborn should indicate the need for cytogenetic study, in particular fluorescence in siti hybridization. [ABSTRACT FROM AUTHOR]

La prise en charge hospitalière à domicile des nouveau-nés se développe en France ces dernières années, répondant aux demandes des familles et s'intégrant dans l'évolution des soins de néonatologie, centrés sur l'enfant et sa famille. Des nouveau-nés encore immatures et non autonomes sur le plan de l'alimentation peuvent continuer leur hospitalisation à domicile, soutenus par des équipes spécialisées en lien avec une unité de néonatologie. L'hospitalisation à domicile (HAD) permet de raccourcir le séjour initial et le temps de séparation des familles, de mieux accompagner la sortie et de diminuer l'anxiété parentale, de soutenir l'allaitement maternel et le développement des enfants. L'évolution du cadre légal français avec, d'une part, les HAD avec la mention pédiatrique « enfant de moins de 3 ans » ayant une convention avec une unité de néonatologie et, d'autre part, le dispositif expérimental de soins de néonatologie à domicile, par les équipes de néonatalogie, vont permettre de proposer cette alternative à l'hospitalisation traditionnelle à davantage de familles sur le territoire. In recent years, neonatal home care in France has undergone development in response to family demands and as part of the evolution of neonatology towards family-centered care. Infants who are still immature and require neonatal care such as tube feeding (not independent in terms of food) can continue their hospitalization at home, assisted by specialized teams in collaboration with a neonatology unit. Neonatal home care makes it possible to shorten the initial hospital stay and reduce parent-infant separation, better prepare the family for discharge and reduce parental anxiety, support breastfeeding and child development. The French legal framework changed recently. On the one hand, a neonatal home care unit can obtain a pediatric mention "child under 3 years old". It can admit newborns if it has an agreement with a neonatology unit. On the other hand, neonatology teams are allowed to take care of their patients at home in a new experimental setting. This will make it possible to offer this alternative to traditional hospitalization to more families in the area. [ABSTRACT FROM AUTHOR]

La politique de dépistage néonatal de la surdité se justifie par l'intérêt majeur de la précocité de la prise en charge des surdités de perception uni- et bilatérales de l'enfant afin de permettre un développement neuro-cognitif optimal. Mis en place dans de nombreux pays, le dépistage de la surdité est proposé à la naissance à chaque nouveau-né sur le territoire français avec un taux de couverture excellent. Toutefois des améliorations dans l'organisation de ce dépistage, avec en particulier l'introduction d'une troisième étape différée après la sortie de la maternité et l'amélioration de la participation de tous les professionnels de l'enfant, sont importantes pour diminuer le nombre de perdus de vue et diminuer le nombre de faux positifs. En parallèle, les nouvelles connaissances dans le domaine des infections materno-fœtales à cytomégalovirus (CMV) et en génétique de la surdité questionnent sur l'évolution de ces programmes de dépistage néonataux avec de nombreuses problématiques éthiques. Quoi qu'il en soit, la précocité de prise en charge des enfants bénéficie de ce dépistage néonatal, dont l'amélioration doit se faire de concert avec l'amélioration des structures d'aval de prise en charge, en particulier celle des plateaux spécialisés en audiologie infantile. Early identification of deafness in newborns elicits early intervention leading to optimal neurocognitive development in children. The universal newborn hearing screening program is available for all newborns in France, with a coverage rate near 100%. However, improvement of the programs, including a third step assessment and better participation of childcare professionals should be important to decrease the number of children lost of follow-up and the number of false positive cases. New knowledge in child deafness genetics and in newborn cytomegalovirus (CMV)-mediated deafness advocates for the evolution of screening programs, with ethical considerations to be solved. However, early identification of deafness in newborns leads to early intervention even if improvement of screening programs should be continued in parallel to audiology centers' structuration improvement. [ABSTRACT FROM AUTHOR]

Neonatal sepsis is a significant cause of neonatal morbidity and mortality, predominantly in developing countries. The bacterial causes of neonatal sepsis and their antimicrobial susceptibility patterns are however dynamic. Globicatella sanguinis is a streptococcus-like bacterial agent capable of causing serious infection in humans that has been rarely isolated from clinical samples, and is an uncommon pathogen that is difficult to identify. Identification based on phenotypic methods alone can misidentify many bacteria, and this may affect precise antibiotic treatment. We report the isolation of a rare bacterial pathogen, G. sanguinis from a three-hour-old preterm female neonate (28 weeker, extremely low birth weight) with sepsis and respiratory distress syndrome (RDS) at Federal Teaching Hospital Katsina, Nigeria, and to the best of our knowledge, one of the very few reported cases all over the world. Blood sample was aseptically collected from the neonate and cultured on BacT/Alert automated system (BioMérieux, Mercy-Etoile, France). A rare bacterium was identified from a positive culture, and in vitro susceptibility test using VITEK-2 compact system showed the isolate to be sensitive to gentamicin, cefuroxime, ceftriaxone, and ceftazidime. Despite antibiotic treatment and other standards of care, on day 9 of admission, the baby developed apnea and all resuscitative measures proved abortive. In a developing country like Nigeria where child mortality due to infection is high, the inclusion of advanced technologies such as improved VITEK-2 compact system, PCR, MALDI-TOF MS, and next-generation sequencing, could play a significant role in its reduction. [ABSTRACT FROM AUTHOR]

Le monoxyde d'azote inhalé (NOi), un vasodilatateur pulmonaire sélectif, est utilisé pour le traitement des nouveau-nés en insuffisance respiratoire hypoxémique (IRH) associée à une hypertension pulmonaire persistante du nouveau-né. Idéalement, il doit commencer à être administré après la confirmation échocardiographique de ce type d'hypertension. L'utilisation de NOi est recommandée chez les nouveau-nés peu prématurés ou à terme chez qui survient une IRH malgré des stratégies d'oxygénation ou de ventilation optimales. Cependant, il n'est pas recommandé d'y recourir systématiquement chez les nouveau-nés prématurés sous assistance respiratoire. On peut l'envisager comme traitement de secours chez les nouveau-nés prématurés en IRH précoce associée à une rupture prolongée des membranes ou à un oligoamnios, ou en IRH tardive en cas d'hypertension pulmonaire liée à une dysplasie bronchopulmonaire et accompagnée d'une insuffisance ventriculaire droite marquée. On peut aussi l'envisager chez les nouveau-nés atteints d'une hernie diaphragmatique congénitale qui présentent une IRH persistante, malgré un recrutement pulmonaire optimal, des signes échocardiographiques d'hypertension pulmonaire suprasystémique et un fonctionnement ventriculaire gauche approprié. [ABSTRACT FROM AUTHOR]

Group B Streptococcus late-onset disease, occurring from 7 through 89 days of life, remains an important cause of sepsis and meningitis in infants. The pathogenesis and mode of transmission associated with group B Streptococcus late-onset disease remain unclear. Neonate's digestive tract mucosa colonization may be acquired perinatally or postpartum, from maternal or non-maternal sources. Although maternal sources appear predominant, group B Streptococcus late-onset disease is not influenced by intrapartum antibiotic prophylaxis. Among non-maternal sources of transmission, horizontal nosocomial transmission is possible and may be underestimated in the neonate intensive care unit setting, accounting for about 10% of cases. The origin of transmission may be another patient, a caregiver or the intensive care unit environment. Awaiting for better understanding of transmissions routes and efficient strategies of prevention, clinicians facing such a case in a hospitalized neonate should maintain a high index of suspicion for a nosocomial origin and a potential cluster, ensure routine submission of isolate to a reference laboratory and reinforce infection control precautions. [ABSTRACT FROM AUTHOR]

The optimal oxygenation target needed to prevent the extremes of hypoxia and oxygen toxicity in premature and sick newborns has been the subject of much research and debate. The advent of the pulse oximeter has allowed the continuous monitoring of oxyhemoglobin saturation and the delivery of oxygen with greater precision. Well-run, large clinical trials to determine the safest oxygen concentration have led to several revisions in guidelines for neonatal care. However, monitoring of oxyhemoglobin saturation has its limitations and does not provide a comprehensive assessment of tissue oxygenation. To identify optimal oxygen therapy, various other factors (partial pressure of arterial carbon dioxide, hemoglobin concentration, blood pH, and tissue metabolic demand) that influence perfusion and tissue oxygenation need to be considered.

Les infections sont une pathologie fréquente de la période néonatale, touchant entre 1 et 5 % des nouveau-nés. La mortalité de ces infections néonatales reste préoccupante malgré les progrès en néonatologie. Les conséquences des infections sont possibles à court terme mais aussi à long terme, avec notamment des troubles du neurodéveloppement. Les caractéristiques et les conséquences des infections néonatales varient selon leur caractère précoce (dans les 3 premiers jours de vie) ou tardif (entre le 3e et le 28e jour de vie) et selon le terrain sur lequel elles surviennent (nouveau-né à terme ou prématuré notamment). Le diagnostic des infections néonatales est difficile en raison des signes cliniques aspécifiques. L'identification d'une bactérie dans le sang ou le liquide cérébrospinal permet d'affirmer le diagnostic. Les infections néonatales bactériennes précoces sont majoritairement liées au streptocoque du groupe B et à Escherichia coli. Les infections néonatales bactériennes tardives sont à distinguer selon deux cadres nosologiques : les infections communautaires et les infections associées aux soins, fréquentes chez les nouveau-nés prématurés. [ABSTRACT FROM AUTHOR]

L'hypotrophie néonatale est responsable d'une morbidité et mortalité néonatale surtout dans les pays en développement. L'objectif de cette étude était de déterminer les facteurs associés dans le contexte de ressources limitées. Il s'agissait d'une étude de type cas-témoins réalisée de mars à novembre 2021 au service de néonatologie de la maternité Issaka Gazoby de Niamey. Les nouveau-nés hospitalisés au service, ainsi que leurs mères ont été étudiés. Les caractéristiques des mères, les données relatives aux nouveau-nés ont été étudiées. Les données ont été analysées grâce au logiciel Sphinx Plus2 version 5.0.0.82. Le test de Chi2 de Pearson et le test exact de Fisher ont été utilisés (p < 0,05). Sur 5310 nouveau-nés, 116 cas d'hypotrophie néonatale ont été retrouvés (2,2 %). Les cas étaient plus observés chez les mères qui n'ont pas d'activité professionnelle (66,38 %) [ p > 0,05]. Les principaux facteurs de risque significatifs étaient l'âge maternel (OR = 1,93; p = 0,02), la dénutrition maternelle (OR = 120,97; p < 0,01) et l'insuffisance du suivi des grossesses (OR = 1,64 et p = 0,01). Pour les caractéristiques des nouveau-nés, la prématurité a été retrouvée comme facteur de risque (OR = 7,57; p < 0,01). L'hypoglycémie, l'hypothermie et les décès étaient plus observés chez les nouveau-nés hypotrophes (p < 0,01). Les principaux déterminants maternels de l'hypotrophie néonatale étaient l'âge avancé, la dénutrition et l'insuffisance de suivi de la grossesse. Chez les nouveau-nés, il s'agissait de la prématurité. Les complications néonatales associées étaient l'hypoglycémie, l'hypothermie et les décès. Neonatal hypotrophy is responsible for neonatal morbidity and mortality especially in developing countries. The objective of this study was to determine the associated factors in the context of limited resources. This was a case-control study conducted from March to November 2021 in the neonatology department of Issaka Gazoby maternity hospital in Niamey. Newborns hospitalized in the department, as well as their mothers were studied. The characteristics of mothers and the data on the newborns were studied. Data were analyzed using the Sphinx Plus2 software version 5.0.0.82. Pearson's Chi2 test and Fisher's exact test were used (P < 0.05). Out of 5310 newborns, 116 cases of neonatal hypotrophy were found (2.2 %). The cases were more observed in mothers without professional activity (66.38 %) [ P > 0.05]. The significant risk factors were maternal age over 20 years (OR = 1.93; P = 0.02), maternal undernutrition (OR = 120.97; P < 0.01) and inadequate pregnancy follow-up (OR = 1.64 and P = 0.01). For newborn characteristics, prematurity was found to be a risk factor (OR = 7.57; P < 0.01). Hypoglycemia, hypothermia and death were more observed in hypotrophic newborns (P < 0.01). The main maternal determinants of neonatal hypotrophy were advanced age, undernutrition and inadequate pregnancy follow-up. In neonates, it was prematurity. Associated neonatal complications were hypoglycemia, hypothermia and death. [ABSTRACT FROM AUTHOR]

Cytosteatonecrosis is an acute condition of unknown pathogenesis that occurs in the first weeks of extra-uterine life. It presents clinically in the form of a large plaque, indurated and sometimes nodular. It often sits on the trunk, buttocks and thighs (root of the limbs). The course of cytosteatonecrosis is benign but sometimes enamelled with complications such as hypercalcemia and metabolic disorders. The rarity of this affection would be justified by the ignorance of the cutaneous signs. We report here a case of neonatal cytosteatonecrosis remarkable for the delay in diagnosis and the efficacy of low-dose corticosteroid therapy. [ABSTRACT FROM AUTHOR]

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Burns in neonates are a rare pathology with a significant impact on the patient, the family and the healthcare system. At present, scarce information exists on the etiology of this type of injury. A comprehensive worldwide literature review of all publications, including our personal case series, was conducted in order to analyse the etiology of neonatal burns and summarize the available evidence. A total of 41 publications were identified in the last 4 decades, comprising of 105 cases from 20 countries, thus confirming that neonatal burns are, indeed, a rare pathology. All types of burns were recorded in neonates, the most frequent being contact burns, followed by flames and scalds. Almost 60% of burns occurred in a hospital setting due to human factors, malfunctioning devices, or hospital infrastructure deficiency. Compared to domestic burns, iatrogenic injuries occurred at an earlier age (5.4±9.1 days vs. 15.7±9.8 days, p<0.0001) and in neonates with significantly smaller weights (2102.7±1350g vs. 3197±300.8g, p<0.0001). The number of cases was almost equally distributed between developed and developing countries, but developed countries were characterised by a significantly higher preponderance of iatrogenic burns, while in developing countries domestic burns were more frequent (p<0.0001). We believe that this systematic review outlines the potential causes of neonatal burns and provides essential information for formulating prevention strategies. [ABSTRACT FROM AUTHOR]

Aims: To determine the epidemiological profile of newborn dermatitis and to describe the different clinical aspects of the observed neonatal dermatitis. Procedure: The study took place at the University Hospital of Cocody (Abidjan). The study was cross-sectional, descriptive and analytical, carried out on the basis of prospective recruitment. The study included newborns who were seen in outpatient or inpatient settings by 4 april 2018 to 23 August 2018 and in whom the pediatrician had observed cutaneous and/or mucosal lesions. The diagnosis was made with the collaboration of a dermatologist. Results: During the study period, 116 newborns were identified. The age of the patients seen in pediatrics with dermatitis varied from 1 to 28 days, with a mean of 16.86 ± 8.4 days. The median age was 19 days. The most representative age range (32.8%) was 24-28 days. The sex ratio (M/F) was 1. In almost 2/3 of the cases, the children were born at term, 29.3% were premature and 5.2% were born after term. In almost 2/3 of the cases (63.8%), the newborns had a birth weight of more than 2500 g. Only 3.4% of newborns seen in pediatric consultations were referred for a dermatitis. The age of the lesions at the time of consultation varied from 1 to 26 days, with a mean of 06.19 days ± 5.13. In more than half (53.5%) of the cases, the lesions had evolved for less than 5 days. Transient dermatitis was more frequent (51.7%), followed by infectious dermatitis (32.8%). Transient dermatitis of the newborn was dominated by sweaty miliaria (40%). Infectious dermatitis were mainly represented by mycotic (68.4%) and bacterial (31.9%) infections. Bacterial dermatitis were composed of neonatal impetigo (83.3%) and folliculitis (16.7%). In almost half of the cases (46.1%) the mycotic dermatitis were represented by candidosis intertrigo and in 38.5% of the cases there was oral candidiasis. The other neonatal dermatitis observed were dominated by diaper rash (64.3%) (Photo 2) and congenital nevi (21.5%). More than half (57.1%) of the cases of toxic erythema neonatorum occurred between days 6 and 10 of life. Nearly half (41.6%) of the cases of sudoral miliaria occurred between birth and day 5 of life. More than half (57.1%) of the cases of sebaceous hyperplasia occurred before the 5th day of life. All cases of neonatal scaling and mongoloid spots were already present between birth and day 5 of life. The mean age of patients with transient dermatitis was 14.31 days compared with 19.41 days for those with the other dermatitis. The difference in age was statistically significant (p < 0.05). The transient dermatitis predominated in male neonates while the other dermatitis predominated in females, however the difference observed at the level of sex was not statistically significant (p > 0.05). Conclusion: The diagnosis of neonatal dermatitis is not always obvious, especially on black skin where few publications have been published. [ABSTRACT FROM AUTHOR]

This paper attempts to illustrate the diagnostic, therapeutic and evolutionary aspects of a rare form of an acute neonatal arterial thrombosis. We report the case of a newborn female baby from a pregnancy complicated by gestational diabetes. At birth, we noticed a pallor of the left lower limb, coldness and absence of the distal pulses. Doppler ultrasound showed extensive thrombosis of the left femoral artery. Emergency treatment consisted of thrombolysis by tissue plasminogen activator, after eliminating contraindications. The evolution was rapidly spectacular with repermeabilization of the limb. Heparin was started as a relay treatment. The etiological assessment did not find any risk factor of arterial thrombosis. The dramatic outcome of arterial thrombosis of a limb is amputation. Early diagnosis and management can avoid this situation. [ABSTRACT FROM AUTHOR]

Anorectal atresia and rectal stenosis are rare types of anorectal malformations, accounting for only 1-2% of cases. We here report one case of anorectal atresia. The study involved a female newborn baby delivered at term via vaginal birth, weighing 3600g, who was admitted with failure to pass meconium, abdominal bloating and fever on day 6 of life. Clinical examination showed a temperature of 39°C, distended abdomen, normal anal location and peremeability, with prolapsed pinkish mass and no signs of necrosis. A cannula trocar stylet was inserted between the mass and rectal mucosa and stopped at about 3cm from the anal margin. Abdominal X-ray without treatment showed distended bowels and air-fluid levels, with no evidence of hollow-organ perforation. Due to suspicion of complete anorectal atresia, 16 gauge needle was inserted into the membrane and meconium was collected abundantly with considerable abdominal deflation. Surgical excision of the membrane was then performed. The postoperative course was uneventful and newborn baby was discharged at postoperative day 3. Anal dilatations were performed to treat anal stenosis. At 6-months' follow-up, functional outcome was satisfactory. Anorectal atresia manifesting as failure to pass meconium associated with mass protruding through the anus has not yet been described in the literature. Membrane puncture confirmed the diagnosis. Membrane was resected with good outcome. [ABSTRACT FROM AUTHOR]

Epidermolysis bullosa form a heterogeneous set of rare genodermatoses, the common point of which is skin and/or mucous membrane fragility, having a localized or generalized character. We report the case of a newborn baby diagnosed at birth with probably hereditary epidermolysis bullosa. It was about a male newborn, resulting from a first degree consanguineous marriage in whom the clinical examination noted at birth an epidermal detachment interspersed with spaces of healthy skin, associated with non-melicera erosions with strained bubbles. These lesions were located on the back, buttocks and limbs as well as damage to the oral mucosa. Epidermolysis bullosa are rare diseases, the severity and prognosis of which depend on the type of this affection. The repercussions of the disease are multiple and affect both the patient and his entourage, the short and long-term complications are mainly nutritional and infectious which requires multidisciplinary management involving neonatologists, pediatricians, psychologists, psychiatrists and other nutritionist. [ABSTRACT FROM AUTHOR]

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La prescription inappropriée d'antibiotiques constitue un problème de santé publique à travers le monde. Déterminer la prévalence de la prescription des antibiotiques chez le nouveau-né hospitalisé à Brazzaville, évaluer la qualité de la prescription et identifier les facteurs de prescription inappropriée. Il s'agit d'une étude multicentrique à recueil de données prospectif, et analytique, menée dans quatre services de néonatologie de Brazzaville durant 4 mois. Elle a intéressé les nouveau-nés hospitalisés chez qui un antibiotique était administré par voie générale. La prévalence de la prescription d'antibiotiques chez les nouveau-nés hospitalisés était de 54 % (2077/1121). L'âge moyen des nouveau-nés a l'admission était de 1 ± 4,5 jour (s) (extrêmes1et 27 jours). La détresse respiratoire constituait le motif d'admission le plus fréquent, 29,8 %. Le diagnostic d'infection néonatale était retenu chez 45,3 % nouveau-nés. Les molécules les plus prescrites étaient la gentamicine (92,7 %), suivie de l'amoxicilline (38,8 %). Concernant l'antibiothérapie empirique, l'indication était jugée pertinente dans la majorité des cas (79,4 %). Le choix était inapproprié dans 52 %, les posologies inadaptées dans 70,9 % et la durée excessive dans 57,4 % des cas. La qualité de la prescription était mauvaise chez 47,3 % des nouveau-nés. L'antibiothérapie dirigée a été prescrite chez 13,3 % nouveau-nés. Le choix était inapproprié dans la quasi-totalité des cas (91,3 %) et la qualité de la prescription mauvaise dans 77,9 %. Les facteurs associés à la mauvaise prescription des antibiotiques étaient les prescripteurs et la prématurité (p < 0,02). Les insuffisances constatées dans la prescription des antibiotiques chez le nouveau-né exigent la mise en place des guides nationaux pour réduire les mauvaises pratiques. Inappropriate prescription of antibiotics is a public health problem throughout the world. Determine the prevalence of antibiotic prescription in hospitalised neonates in Brazzaville, assess the quality of prescription and identify the factors of inappropriate prescription. This was a multicentre study with prospective and analytical data collection, conducted in four neonatology departments in Brazzaville over a period of 4 months. It concerned hospitalized neonates for whom an antibiotic was administered through parenteral route. The prevalence of antibiotic prescription among hospitalised newborns was 54% (2077/1121). The mean age of neonates on admission was 1 ± 4.5 days (extremes 1 and 27 days). Respiratory distress was the most frequent reason for admission, 29.8%. The diagnosis of neonatal infection was retained in 45.3% of newborns. The most prescribed drugs were gentamicin (92.7%), followed by amoxicillin (38.8%). Concerning empirical antibiotic therapy, the indication was considered relevant in the majority of cases (79.4%). The choice was inappropriate in 52% of cases, the dosage was inappropriate in 70.9% and the duration was excessive in 57.4% of cases. The quality of the prescription was poor in 47.3% of neonates. Directed antibiotherapy was prescribed in 13.3% of newborns. The choice was inappropriate in almost all cases (91.3%) and the quality of the prescription was poor in 77.9%. Factors associated with poor antibiotic prescription were prescribers and prematurity (P < 0.02). The shortcomings observed in the prescription of antibiotics in neonates require the setting up of national guidelines to reduce bad practices. [ABSTRACT FROM AUTHOR]

Les urgences chirurgicales néonatales sont peu fréquentes mais leur prise en charge anesthésique doit prendre en compte les multiples particularités physiologiques du nouveau-né et la physiopathologie de la malformation congénitale sous-jacente. Le comportement pharmacocinétique de la plupart des agents anesthésiques est modifié. L'immaturité hépatique est responsable, pour un grand nombre d'entre eux, d'une augmentation de la demi-vie d'élimination. Les capacités d'adaptation du myocarde sont limitées et les désaturations surviennent très rapidement au cours de toute apnée. Hyperoxie, hypotension, hyper- et hypocapnie sont délétères. Les apports hydroélectrolytiques sont assurés par une solution isotonique glucosée à 1 % et le remplissage vasculaire par du sérum physiologique en évitant les apports excessifs. La problématique de la hernie de coupole diaphragmatique réside dans l'agénésie pulmonaire sous-jacente. Le contrôle de l'hypertension artérielle pulmonaire est déterminant. La cure de l'atrésie de l'œsophage type 3 expose surtout aux difficultés ventilatoires jusqu'à la fermeture de la fistule, avec une place croissante pour la chirurgie thoracoscopique. Le laparoschisis conduit à des tableaux de gravité très variables selon l'atteinte digestive associée. Les cures de hernie de coupole, d'omphalocèle et de laparoschisis peuvent être responsables d'un syndrome du compartiment abdominal à l'origine d'une défaillance multiviscérale. Une analgésie insuffisante modifie le contrôle spinal et supra-spinal de la douleur. L'administration de la morphine tient compte des modifications de son métabolisme. L'anesthésie locorégionale exercerait des effets favorables après chirurgie majeure, en particulier sur la durée de ventilation contrôlée. Une immaturité des fonctions immunitaires augmente le risque infectieux. [ABSTRACT FROM AUTHOR]

This paper attempts to illustrate the diagnostic and therapeutic approach of an extremely rare form of esophagogastritis with antenatal disclosure. We report the case of esophagogastritis with antenatal disclosure in a full-term newborn. E.K. was a newborn female baby from a pregnancy carried without complications. At birth, the amniotic fluid was hematic. Examination of the placenta at delivery was normal. The newborn presented hematemesis made of bright red blood, from the first hours of life, without any other associated signs or hemostasis disorder on the biological assessment. The initial therapeutic approach was exclusive parenteral nutrition combined with intravenous proton pump inhibitors. The evolution was marked by the occurrence of melenas and rectorrhagia, complicated by anemia requiring transfusion, without hemodynamic repercussions. An upper gastrointestinal endoscopy was performed on the third day of life and showed moderate erosive œsogastrobulbite. Follow-up was rapidly favorable. In severe neonatal digestive hemorrhages, FOGD plays a key role in the etiological diagnosis and therapeutic management. [ABSTRACT FROM AUTHOR]

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Introduction : le tétanos néonatal constitue une cause importante de morbidité et de mortalité néonatales dans les pays en développement. Méthodologie : il s’agissait de 3 cas de tétanos néonatal hospitalisés de janvier 2017 à juillet 2018 à la néonatologie de l’hôpital du Mali. Résultats : les nouveau-nés ont été reçus pour trismus. Ils étaient nés à terme par voie basse après une grossesse mal suivie. Leurs mamans n’étaient pas vaccinées contre le tétanos. Dès la première semaine de vie, ils ont présenté une fièvre et un trismus. Sous traitement, le premier est guéri au bout de 15 jours. Les deux autres sont décédés dès les premiers jours de leur hospitalisation dans un tableau d’hypertonie fébrile. Conclusion : le tétanos néonatal est une maladie grave évitable par la vaccination qui sévit encore dans les pays en développement.

Intranasal delivery of sedative or analgesic drug can be an easy, effective, and secure alternative to intravenous administration when not possible or not justified. Some neonatal studies have explored the feasibility of sedation with nasal midazolam or dexmedetomidine for intubation or radiological investigation. Fentanyl is the commonest analgesic medication by this route, Ketamine is another option. Utilization in a population at risk of respiratory distress should be done with caution. [ABSTRACT FROM AUTHOR]

The newborn pediatric examination is an event parents look forward to, as it determines the possibility for the family to go home. Its purpose is to detect possible medical problems, but above all to confirm that the baby is healthy. This is the opportunity to share with parents the newborn's observation and his skills in a suitable environment. To listen to parents and hear their concerns, answer their questions and transmit prevention messages, ensure good conditions for welcoming the baby at home, the pediatrician must be available. He especially must be available for interact with the baby, by adapting the tempo of examination to fit the baby's abilities. When parents are encouraged to support their baby during this pediatric exam, emotions can be shared and expessed.With strong knowledge of infant development, the pediatrician can convey baby's early basic needs. Nursing care, parent-child interactions, emotional sharing and psychic security, in a suitable physical and sensory environment, are necessary for a harmonious development of the baby. [ABSTRACT FROM AUTHOR]

The establishment of attachment bond concerns all caregivers in the perinatal period. Infant attachment behaviors, as well as maternal care are observed in the maternity ward and then in consultations by pediatricians, midwives and pediatric nurses. Nevertheless, since the beginning of pregnancy follow-up, every professional can spot indicators of insecurity or situations affecting maternal representations. Detailing the clinic of attachment behaviors makes it possible to assess this dimension during the daily care of newborns and their parents. In specific situations, such as hospitalization of the newborn, maternal psychological vulnerability or premature birth, healthcare teams must be particularly attentive to the clinical elements of the establishment of these first parent-- infant links. [ABSTRACT FROM AUTHOR]

Introduction : le paludisme est un problème de santé publique au Mali. Cependant il est si rare chez le nouveau-né que sa recherche n’est pas systématique chez ce dernier même fébrile. Observation : il s’agissait un nouveau-né prématuré de 21 jours admis pour fièvre à la néonatologie de l’Hôpital du Mali. Le diagnostic a été posé au test rapide (TDR) du paludisme. Un traitement comprenant l’artésunate, la transfusion de concentré globulaire et la perfusion du sérum glucosé 10% a été institué. L’évolution a été marquée par l’apyrexie, la reprise de l’alimentation et du poids, la diminution de la parasitémie et l’augmentation du taux de l’hémoglobine. Conclusion : le TDR du paludisme doit être systématique chez les nouveau-nés fébriles en zone d’endémie palustre pour ne pas passer à côté d’un paludisme néonatal.

INTRODUCTION: La paralysie obstétricale du plexus brachial est une affection relativement rare mais qui n´a pas disparu malgré les importants progrès en obstétrique. L´objectif de cette étude était de décrire les aspects épidémiologiques, thérapeutiques et évolutifs de cette affection dans notre contexte. METHODES: analyse rétrospective sur deux ans des dossiers de nouveau-nés ayant présenté une paralysie obstétricale du plexus brachial et pris en charge au Centre Hospitalier Universitaire de Bouaké. Les enfants reçus après l´âge de 3 mois n´ont pas été inclus. Les variables étudiées étaient d´ordre épidémiologique, thérapeutique et évolutif. RESULTATS: soixante patients ont été colligés, soit une fréquence de 28,5%. Il y avait 31 (52%) filles. L´âge moyen était de 8 jours [J0 et J35]. Les mères étaient multipares dans 94% des cas. L´accouchement a eu lieu dans un centre de santé dans 97% des cas. Tous les enfants étaient nés à terme avec 57 (95%) présentations céphaliques. L´accouchement était eutocique dans 74% des cas. Le poids moyen de naissance était de 3604 g [2150g et 4500g]. Il y avait 47 cas (78%) de paralysie C5-C6. L´immobilisation coude au corps associée à la rééducation a été réalisée chez 51 enfants (85%). La rééducation a été réalisée immédiatement chez 9 enfants (15%). La récupération fonctionnelle du membre lésé a été complète chez 50 enfants (83%) après un recul de 6 mois. CONCLUSION: la paralysie obstétricale du plexus brachial demeure une affection obstétricale d´actualité. Son traitement conservateur, seule alternative dans notre contexte donne de bons résultats.

INTRODUCTION: Ll´insuffisance pondérale à la naissance est considérée comme l´un des plus importants indicateurs de chances de survie d´un nouveau-né et un risque majeur de morbidité, de mortalité périnatale et infantile. L´objectif de cet article est d´étudier les facteurs associés à l´insuffisance pondérale à la naissance au Centre Hospitalier de Kingasani, à Kinshasa. METHODES: une étude rétrospective de type cas-témoins a été réalisée. Les informations sur les parturientes et leurs enfants nés du 1er janvier au 31 décembre 2016 ont été collectées dans le registre de la maternité du Centre Hospitalier Kingasani. 458 cas (moins de 2500 grammes) ont été comparés aux 458 témoins (2500-4000 grammes). L´analyse multivariée a été faite à l´aide de la régression logistique binaire pour identifier les facteurs associés au faible poids de naissance. RESULTATS: en 2016, 3451 naissances vivantes ont été enregistrées et la prévalence de l´insuffisance pondérale est estimée à 13,27%. Il a été trouvé, dans l´analyse bivariée, que la parité, le terme de grossesse, le type de grossesse et le sexe du nouveau-né sont des variables significativement associées à l´insuffisance pondérale à la naissance. Après ajustement sur les variables intégrées dans l´analyse multivariée, la parité, le terme de grossesse et le type de grossesse sont demeurés significativement associées à l´insuffisance pondérale à la naissance. CONCLUSION: de ces résultats, nous suggérons la promotion des études intégrant tous les paramètres impliqués dans la survenue de l´insuffisance pondérale à la naissance pour suivre l´évolution régulière de ce problème et des facteurs associés.

Introduction: obstetrical brachial plexus palsy is a relatively rare condition that has not disappeared although important progress has been made in obstetrics. The purpose of this study is to analyze the epidemiological, clinical, therapeutic and evolutionary features of this disorder in our context. Methods: we conducted a retrospective study of the medical records of newborns with obstetrical brachial plexus palsy treated at the Bouaké University Hospital over a period of two years. Children treated after the age of 3 months weren´t included. The variables studied were the epidemiological, therapeutic and evolutionary features. Results: the study included 60 patients, reflecting a rate of 28.5%. There were 31 (52%) girls. The average age of patients was 8 days (D0 and D35]. Multiparous mothers accounted for 94% of cases. Birth took place in a health center in 97% of cases. All children were born at term, 57 (95%) in cephalic presentation. Delivery was normal in 74% of cases. Average birthweight was 3604g [2150g and 4500g]. Forty seven cases (78%) had C5-C5-C6 palsies . Immobilization elbow off body associated with rehabilitation was performed in 51 children (85%). Rehabilitation was performed immediately in 9 children (15%). Functional recovery of the injured limb was complete in 50 children (83%) after a follow-up period of 6 months. Conclusion: obstetrical brachial plexus palsy is a current obstetric disorder. Conservative treatment, that is the only alternative in our context, gives good results. [ABSTRACT FROM AUTHOR]

Intestinal obstruction caused by a congenital anomalous band is a rare condition and can occur at any age. We report the case of a 35-dayold male admitted to our unit for vomiting, abdominal distension, and absence of bowel movements for two days. Emergency laparotomy performed showed multiple bands and adhesions, and a twist of the terminal ileum around the band causing a complete ileocecal valve obstruction. The bands were resected. He remained asymptomatic postoperatively and was discharged on post postoperative day six. Congenital anomalous bands should be included in the differential diagnosis of any neonatal intestinal obstructions. [ABSTRACT FROM AUTHOR]

The environment and accompaniment of the delivery and the birth have changed quite a lot during the last 60 years. The author reminds us from where we come and evokes the important changes of perinatal practice over time. Parents have been much more involved over time, especially in the neonatal units. [ABSTRACT FROM AUTHOR]

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The quality of the environment is now well recognized as an essential factor in the proper development of the newborn and especially of its nervous system. At birth, this environment can become particularly aggressive, as is the case during the care of premature newborns in intensive care units. Past studies have clearly shown the deleterious effects of excessive painful stimulations on the long-termexpression of visceral/somatic hypersensitivity abnormalities, stress adaptation disorders and the appearance of neuropathologies affecting cognitive performance and sociability. These observations have been well replicated in animal models and are the subject of numerous research studies aimed at identifying the underlying mechanisms and the most sensitive brain structures. Our laboratory has recently shown that non-painful (sound, light, smell, mother-child interactions) also play an important role. The work carried out in clinical and fundamental research is reviewed in this article which focuses on the situation of preterm newborn infants. The results obtained to date support the implementation of individualized developmental care, involving parents and caregivers in an environment where sensory stimulations are adjusted to the sensory capabilities and expectancies of preterm infants during a sensitive period of brain development. This care is likely to optimize their short term well-being, their proper development and their later cognitive performances. [ABSTRACT FROM AUTHOR]

Le neuroblastome est une tumeur solide commune de l´enfance mais sa présentation néonatale notamment dans sa forme thoracique reste rare. Le diagnostic différentiel inclut malformations pulmonaires congénitales, pneumonies et atélectasies. Nous rapportons un cas de neuroblastome congénital révélé par une détresse respiratoire géré initialement comme infection néonatale précoce pulmonaire.

Le bloc caudal est le bloc péri médullaire le plus pratiqué chez l´enfant et le nourrisson. C´est un bloc sûre et simple avec un taux de complications très faible. Nous décrivons à travers cette observation, la survenue d´un priapisme secondaire au bloc caudal, complication très rare, chez un nouveau né de 28 jours ainsi que ses mécanismes physiopathologiques et les modalités thérapeutiques.

Les troubles du rythme cardiaque mal tolérés du nouveau-né sont une véritable urgence nécessitant une prise en charge rapide et adéquate. Nous rapportons le cas d'un nouveau-né de 15 jours présentant une tachycardie atriale en défaillance cardiaque aigue ayant nécessité une cardioversion électrique.

The discovery of a severe foetal abnormality in utero can lead to a decision of medical termination of prepregnancy (TOP) and also to offer palliative care to the newborn at birth. In this context, interdisciplinary practice has quickly emerged. The encounter of the parents and the paediatrician during the prenatal period makes it possible to explain the impact of the pathology on a future child and whatever the final choice regarding pregnancy. In the context of palliative care at birth, it is then possible to anticipate this particular care by insisting on the positive value of lifetime and encounter. Obstetrical and neonatal teams can listen to the expectations of future parents, make proposals to parents and give them time for reflection. The common anticipation of the interactions between obstetrical and paediatric decisions makes it possible to aim at a coherence of the meaning given to this course during which different teams must succeed each other with the parents and the child in a nevertheless common approach. [ABSTRACT FROM AUTHOR]

We report the case of a newborn female, admitted on her second day of life for hyperextension of the left knee of more than 20 degrees. The diagnosis of a congenital reducible congenital genu, classified in stage A of Leveuf and Pais on homolateral quadriceptal Hypoplasia was posed. Orthopaedic treatment combining gentle manipulations and anterior posture splints was successfully applied after 3 weeks. [ABSTRACT FROM AUTHOR]

La déshydratation hypernatrémique du nouveau-né (DHNN) est une situation fréquente, particulièrement dans les pays en développement. L'objectif était d'évaluer la fréquence, la clinique, les facteurs de risque et le pronostic de la DHNN dans une unité de soins intensifs néonatals de référence au Sénégal. Étude rétrospective descriptive et analytique, du 1er janvier 2013 au 31 décembre 2017 (5 ans). L'hypernatrémie était définie par une natrémie ≥ 150 mmol/L. Les données étaient recueillies sur Excel et analysées à l'aide du logiciel R 3.5.0. Nous avons recensé 235 cas, soit 8,6 % des admissions, avec un âge moyen de 10,2 jours et un sex-ratio de 0,91. La majorité (70 %) des cas était survenue entre juin et novembre, période chaude de l'année et 63 % des enfants recevaient un allaitement maternel exclusif. La symptomatologie clinique était dominée par la fièvre (68,9 %), le refus de téter (51,9 %) et les signes neurologiques (26,8 %). La perte de poids moyenne était de 13,9 % du poids de naissance. Les principales complications étaient détresse respiratoire (25 %), le choc hypovolémique (11 %), les convulsions (15 %). L'hypernatrémie était supérieure à 170 mmol/L dans 25,1 % des cas. Les anomalies biologiques associées étaient l'insuffisance rénale (17 %), l'hyperkaliémie (28,9 %) et l'hypoglycémie (10,6 %). L'échec de l'allaitement maternel représentait 62 % des circonstances étiologiques. Dans 68,9 % des cas, la vitesse de correction de la natrémie était inférieure à 0,5 mmol/L/h. La létalité était de 26,8 % (63 décès). La DHNN est associée à une morbi-mortalité élevée et doit être prévenue par des mesures de promotion de l'allaitement maternel et une surveillance pondérale dans les premiers jours de vie. Hypernatremic dehydration of the newborn (HDN) is a common situation, particularly in developing countries. The objective was to assess the frequency, clinical symptomatology, risk factors and prognosis of HDN in a reference neonatal intensive care unit in Senegal. Descriptive and analytical retrospective study, from January 1, 2013 to December 31, 2017 (5 years). Hypernatremia was defined by a natremia ≥ 150 mmol/L. Data were collected on Excel and analyzed using R 3.5.0 software. We recorded 235 cases, or 8.6% of admissions, with an average age of 10.2 days and a sex-ratio of 0.91. The majority (70%) of cases occurred between June and November, the hottest period of the year, and 63% of children were exclusively breastfed. Clinical symptomatology was dominated by fever (68.9%), refusal to breastfeed (51.9%) and neurological signs (26.8%). The average weight loss was 13.9% of birth weight. The main complications were respiratory distress (25%), hypovolemic shock (11%), convulsions (15%). Hypernatremia was greater than 170 mmol/L in 25.1% of cases. Associated biological abnormalities were renal failure (17%), hyperkalemia (28.9%) and hypoglycemia (10.6%). Breastfeeding failure accounted for 62% of the etiological circumstances. In 68.9% of cases, the correction rate of the natremia was less than 0.5 mmol/L/h. Lethality was 26.8% (63 deaths). HDN is associated with high morbidity and mortality and must be prevented through measures to promote breastfeeding and weight monitoring in the first days of life. [ABSTRACT FROM AUTHOR]

Separation related to the newborn's hospitalization and anxiety about his state of health can affect parent's caregiving behavior, which is the reciprocal parental system to child attachment system. The objective of the "digital cord" is to support the creation of the bond by allowing the parents and the family to access some video clips of the newborn recorded at carefully chosen moments in order to help them to involve psychically with the newborn. Although images cannot replace presence, this tool helps to mobilize the caregiving of absent parents. [ABSTRACT FROM AUTHOR]

Résumé: Les méningites à Neisseria meningitidis sont exceptionnelles en période néonatale. Leur gravité est liée à l'immaturité du système immunitaire des nouveau-nés. Elles diffèrent des méningites de l'enfant plus âgé et de l'adulte par de nombreux points qui rendent leur diagnostic difficile. Nous rapportons le premier cas de méningite néonatale à méningocoque isolé au service de microbiologie au CHU Hassan II de Fès. Il s'agit d'un nouveau-né de 10 jours, admis pour hypotonie avec fièvre. L'examen direct du liquide céphalo-rachidien et les antigènes solubles ont permis d'identifier le germe. Les céphalosporines de troisième génération étaient le traitement de choix. L'évolution était favorable. [ABSTRACT FROM AUTHOR]

Different factors are likely to weaken the continuity and consistency of the care of a sick newborn. Some are related to variability, that is, difference in care policy or conditions of announcement from one institution to another, and from one professional to another. Usually presented as a lack of competence by benchmarking studies, even seeking to be corrected by the recommendations established by the learned societies, this variability probably partially relates to other origins belonging to the "palatability" of the teams for a particular type of medical practice or communication. This article aims to help professionals of all disciplines to become aware of their positioning in the way of delivering care and communicating with families. It is a question of walking together to understand why it is so difficult to apply the medical recommendations while taking into account the subjectivity of each situation. Limiting the impact of what may be felt as a lack of medical coherence in the eyes of parents seems like a goal not to let go. Resuscitation situations at the threshold of viability have made us make considerable progress in the anticipatory movement carried out with antenatal parents so that they can accept and accompany the stay in intensive care of their child and the subsequent follow-up in a continuity sufficient to avoid the development of attachment disorders. It is now up to us to reflect on this continuity in less critical but everyday situations. [ABSTRACT FROM AUTHOR]

La rupture prématurée des membranes se produit dans 20 % des cas entre 34 et 37 semaine d'aménorrhée (SA). L'objectif de notre étude était de déterminer l'attitude obstétricale et la morbidité néonatale liée à cette RPM. Étude descriptive, rétrospective et monocentrique réalisée sur 12 mois. Les femmes enceintes entre 34 et 36 + 6SA sans malformation fœtale présentant une RPM ont été incluses. En 2017, nous avons relevé 3604 naissances et 46 femmes ont été hospitalisées pour RPM. Parmi celles-ci, 33 parturientes ont accouché spontanément et 13 autres ont été déclenchées pour prélèvement bactériologique positif (n = 8), anomalies du rythme cardiaque fœtal (n = 3) et rupture prolongée des membranes (n = 2). Près de 80 % des accouchements sont survenues avant la 48e heure d'ouverture de l'œuf. Quatorze enfants ont nécessité des gestes de réanimation en salle de naissance. Seize nouveau-nés ont présenté une détresse respiratoire transitoire et un seul a nécessité l'administration du surfactant pour maladie des membranes hyalines. Sur les 41 naissances en contexte de rupture prolongée, 26,8 % nouveau-nés ont nécessité une réanimation et 34 % ont présenté une détresse respiratoire. Une infection néonatale bactérienne précoce a été suspectée chez 28 nouveau-nés avec un seul cas probable devant la présence des signes cliniques et un facteur de risque (Escherichia coli dans le liquide gastrique). La détresse respiratoire était très fréquente et l'attitude obstétricale étaient conformes aux recommandations du CNGOF. Premature rupture of membranes occurs in 20 % of cases between 34 and 37 week of Amenorrhea (SA). The objective of our study was to determine the obstetrical attitude and neonatal morbidity associated with this RPM. Descriptive, retrospective and monocentric study performed over 12 months. Pregnant women between 34 and 36 + 6SA without fetal malformation with RPM were included. In 2017, we found 3604 births and 46 women were hospitalized for RPM. Of these, 33 parturients gave spontaneous delivery and 13 others were started for positive bacteriological specimens (n = 8), abnormal fetal heart rate (n = 3) and prolonged membrane rupture (n = 2). Nearly 80 % of deliveries occurred before the 48th hour of egg opening. Fourteen children required reanimation procedures in the birth room. Sixteen neonates had transient respiratory distress and only one required surfactant for hyaline membrane disease. Of the 41 births in a context of prolonged rupture, 26.8 % neonates required resuscitation and 34 % presented with respiratory distress. Early neonatal bacterial infection was suspected in 28 neonates with a single probable case in the presence of clinical signs and a risk factor (Escherichia coli in gastric fluid). Respiratory distress was very common and obstetrical behavior was consistent with CNGOF recommendations. [ABSTRACT FROM AUTHOR]