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OBJECTIVE: Description of the characteristics of (suspected) child abuse after the establishment of a Child Abuse Team and the introduction of guidelines on how to deal with child abuse and a standardised registration form for suspicions of child abuse.DESIGN: Retrospective.METHOD: An inventory and analysis of the available data on the reporting of, approach to and care provided in case of(suspected) child abuse from I January 2oo0 to 30 April 2004 in the VU Medical Centre in Amsterdam, the Netherlands.RESULTS: The Child Abuse Team received 220 reports of suspected child abuse and the number of suspected and confirmed cases of child abuse increased each year. In 58 suspected cases, the suspicions were confirmed on the basis of additional information from the general practitioners or other attending physicians, or conversations with the parents and the child. There were 29 girls and 29 boys; 22 of them were from families with multiple problems. Of these 58 confirmed cases, 31 were reported to the national Advisory Centre for Registration of Child Abuse. In 120 of the 220 suspected cases of child abuse, this suspicion was refuted, while in 42 cases the suspicion could neither be refuted nor confirmed.CONCLUSION: An increased number of suspected cases of child abuse were reported and confirmed each year following the introduction of a standardised registration form and subsequent analysis by a multidisciplinary team. Broader application of this approach may contribute to improved insight into the prevalence and causes of child abuse.

During early human pregnancy, extravillus trophoblast cells invade the maternal uterine tissue, colonize the interstitium and replace the endothelium lining of spiral arteries in decidual and myometrial segments of the uterus. Invasion of endovascular trophoblast cells causes a physiological change of these arteries, in order to guarantee a constant bloodflow from the mother to the fetus. During early pregnancy, these extravillus endovascular trophoblast cells circulate in the maternal peripheral blood. Besides their use for prenatal diagnosis of genetic diseases, these extravillus trophoblast cells isolated from the peripheral blood of pregnant women can be useful for early detection of common pregnancy-associated diseases, like pre-eclampsia. In vitro culture of these trophoblast cells can be useful for investigation of regulation of the invasion process with respect to tumorbiology.

During early human pregnancy, extravillus trophoblast cells invade the maternal uterine tissue, colonize the interstitium and replace the endothelium lining of spiral arteries in decidual and myometrial segments of the uterus. Invasion of endovascular trophoblast cells causes a physiological change of these arteries, in order to guarantee a constant bloodflow from the mother to the fetus. During early pregnancy, these extravillus endovascular trophoblast cells circulate in the maternal peripheral blood. Besides their use for prenatal diagnosis of genetic diseases, these extravillus trophoblast cells isolated from the peripheral blood of pregnant women can be useful for early detection of common pregnancy-associated diseases, like pre-eclampsia. In vitro culture of these trophoblast cells can be useful for investigation of regulation of the invasion process with respect to tumorbiology.

In order to determine the prevalence of HIV in the general heterosexual population of Amsterdam, 16,709 pregnant women attending two hospitals and one maternity clinic in the period 1988-1995 were asked to undergo a HIV test, of whom 15,276 gave informed consent (91.4%). Pregnant women with a risk of HIV infection were possibly overrepresented in those who refused. The overall HIV prevalence in 1988-1995 was 0.28% and showed no significant differences over the years. In women with a known risk factor for infection the prevalence was 240:10,000, in those without 5:10,000. Whereas intravenous drug use was the most probable cause of infection before 1993, since then it was observed in only 2/20 of the HIV positive pregnant women. Heterosexual transmission appears to be increasing