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Through the forecast context that it creates, the prenatal diagnosis, both on the baby's side and on its environment, is an experimental situation of chain emotional resurgences that makes it possible to analyze how areas of memory are reactivated to cope with the anticipation of the future stages of pregnancy, birth and the first years of the child's life. Interdisciplinarity within the field of obstetrics had enabled child psychiatrists to be alert to the emergence of deleterious emotional disorders in the establishment of parent-child relationships: interactive disharmony, postpartum depression, and subsequent developmental disorders. The teams discovered their own capacities to refine the identification of emotional shifts and the decoding of states of parental distress. The anniversary dates that mark psychic life had long alerted psychotherapists who interpreted the impact after the fact. The turning point offered by the active approach to anticipating antenatal diagnosis is to allow the context of the occurrence of emotional reactivation to occur when it occurs, thereby mobilizing the risk of traumatic repetition. By taking a detailed anamnesis, anticipating the dates at risk becomes a major public health issue for each professional involved in obstetrical monitoring, provided that he/she does not remain alone in the face of a complex family situation. The possibilities of intervention of the child psychiatrist/psychologist in first and/or second line allow the whole team to enrich their prevention capacities. [ABSTRACT FROM AUTHOR]

Posterior urethral valves (PUV) represent one of the main etiologies of end stage renal failure in male children. Furthermore, this anomaly represents the most common cause of lower urinary tract obstruction in the fetus; their incidence is about 2.1/10,000 births. Antenatal diagnosis allows considering termination of the pregnancy for the more serious cases (those with severe oligohydramnios and/or polymalformative syndrome). For less severe cases, it permits optimization of the postnatal management. At each stage, at each age, a multidisciplinary approach is mandatory in order to optimize the follow-up and to provide complete information to the parents and professionals caring for the patients. The present review article considers the every patients journey starting from the antenatal diagnosis, followed by the neonatal management and subsequently surveillance throughout adolescence. The aim being to treat as rapidly as possible complications that may occur and preventing evolution towards end- stage renal failure. The multidisciplinary approach along with constant exchange of information allows a continuous optimized management. [ABSTRACT FROM AUTHOR]

Some clinical situations in antenatal diagnosis are particularly complex due to severe foetal malformations. These abnormalities are often the reason that the parents terminate a pregnancy, as the risks regarding the baby's future quality of life are too high. This article presents a specific situation in which the parents, despite the severe abnormalities of their future child, decide to continue the pregnancy. In addition, during the child's hospitalisation, they opposed the termination of medical procedures requested by the paediatric team. Regarding the many questioning of the medical team, we would like to contribute our commentary as parents. Specifically, as parents who listen to other parents. Aside from the case studied here, our aim is to aid medical teams to be more adjusted to their patients and to improve their practice, by taking into account what is at stake for the parents. [ABSTRACT FROM AUTHOR]

En décembre 2014, M. et Mme B. ont accompagné leur fils Gabriel dans sa courte vie. Le diagnostic de trisomie 13 avait été porté pendant la grossesse, Gabriel était porteur de malformations compromettant son pronostic vital à court terme. Trois ans après, ils livrent leur témoignage sur ce qu'ils ont vécu et comment ils l'ont vécu. Ils racontent leur parcours : depuis l'annonce des malformations, la poursuite de la grossesse, la valorisation de ce temps, notamment avec leurs aînés, l'élaboration du projet de naissance et d'accompagnement de leur fils. Ils abordent leurs motivations à l'élaboration d'un tel projet, le regard porté par les professionnels sur l'accompagnement et la vie de Gabriel. Ils évoquent également les maladresses rencontrées, les attentions particulières, ce qu'ils ont ressenti, ce qui les a aidés, ce qui les a gênés, tout au long de la grossesse et de la vie de Gabriel. Parallèlement à cela, l'équipe de soins palliatifs qui a accompagné ce couple dans ce projet porte elle aussi un regard sur cette situation qui lui a permis d'évoluer dans sa propre culture palliative. Chacun trouve donc chez l'autre des ressources pour avancer sur son propre chemin. [ABSTRACT FROM AUTHOR]

La maladie des brides amniotiques (MBA) est un ensemble de malformations congénitales complexes, intéressant principalement les membres, mais aussi la région craniofaciale. La pathogénie exacte de cette affection est encore mal connue. C'est une pathologie relativement rare, avec une incidence, selon la littérature, entre 1/1 200 et 1/15 000. Les malformations de cette embryofœtopathie acquise sont multiples, polymorphes et asymétriques. Le diagnostic de cette maladie repose classiquement sur l'existence d'au moins trois signes : des sillons, des amputations et des pseudosyndactylies. Nous rapportons un cas de MBA découvert fortuitement chez un nouveau-né à sa naissance et insistons sur l'intérêt du suivi des grossesses et sur l'amélioration du diagnostic anténatal. [ABSTRACT FROM AUTHOR]

The antenatal diagnosis is ambiguous.We expect a positive information. The misunderstanding is that parents have always to live with an existential doubt. They project and expect that professional avoid doubt and help them to take rational decision. Professionals only support parents with a conciliation between a rigourous feedback information and the uncertainty. Antenatal diagnosis always deals with uncertainty. [ABSTRACT FROM AUTHOR]

Hypnosis is an altered state of consciousness, spontaneous or induced, different from the sleep and waking state. Hypnosis increases the thresholds of pain sensation by reducing its cognitive and affective components. The conversational hypnosis, based on the positive language, is commonly used by the caregivers. The formal hypnosis is the basis of the hypnosedation and the hypnoanalgesia. This technique complete our therapeutic and clinical tools in obstetric anesthesia and analgesia: analgesia for childbirth or antenatal diagnosis, anesthesia for cesarean section, especially emergency CS, and assistance to the management of pregnancy associated pathologies such as preeclampsia, premature rupture of membranes and post-partum hemorrhage; but also assisted procreation, oncology, breast surgery and gynecology. [ABSTRACT FROM AUTHOR]

Esophageal atresia is a rare malformation affecting 1/2500-1/3500 live births. Different subtypes exist but the disruption of the continuity of the esophagus is associated most of the time with a tracheo esophageal fistula (90%). Prenatal diagnosis is perceived to be advantageous as diagnosis of associated anomalies can be offered (by ultrasound, RMI, amniocentesis). Parents could be prepared to the birth and treatment of an affected infant and prenatal diagnosis also allows optimal neonatal management. Polyhydramnios and absent or small stomach bubble on routine ultrasound are the most common signs encountered in case of esophageal atresia but they are not specific. Ultrasound or RMI visualization of a blind ending pouch (proximally dilated esophagus) in the fetal neck or upper mediatinum during fetal swallowing can improve the specificity of prenatal diagnosis. However, prenatal diagnosis of EA is still hazardous and less than 50% are suspected during pregnancy. Amniotic fluid digestive enzyme assay could improve prenatal diagnosis. [ABSTRACT FROM AUTHOR]

Cystinuria, an inherited autosomal recessive metabolic disorder, is characterized by the inadequate reabsorption of dibasic amino acids in the proximal convoluted tubules during the filtering process in the kidneys. Homozygous patients make cystine stones, and in the long term this causes renal failure. In the service of gynecology-obstetrics of the hospital of The Conception and in the antenatal diagnostic centre of the hospital of Timone, we observed a patient whose fetus showed a hyperechogenic colon during the third term obstetric ultrasonography. The genetic investigation confirmed the diagnosis of cystinuria in the fetus and in other siblings. A premature diagnosis of cystinuria can therefore prevent the complications of cystinuria by applying simple remedies like hyperhydration and alkalization. [ABSTRACT FROM AUTHOR]

Fetal and neonatal cerebral lesions due to hemorrhage in keeping with alloimmune thrombocytopenia require precise imaging assessment, to enable counseling and optimal pre- and postnatal management. Genetic, parental, and familial counseling, pointing the risk of alloimmunization and treating later pregnancies, help prevent the occurrence fetal hemorrhage. [ABSTRACT FROM AUTHOR]

Methods derived from hospice care may be im1plemented to great benefit in situations of hardship connected with maternity, be it during the pregnancy, in the case of a child diagnosed with a lethal condition, or in the post-natal setting when the life of the infant is uncertain. Could the presence of a volunteer to support the parents be relevant in such distressing circumstances? The study is based on the results and analysis of two questionnaires, one answered by parents, the other one by medical and nursing staff of a neonatal unit, followed by an experiment within this unit. More than 90% of the 29 parents surveyed made clear that such support would answer their need to share this experience, be listened to and comforted. And yet the medical team has been much less supportive of such a project. The organizations of volunteers are now well established and have proved that the implementation of this project required both good training of the volunteers and a clear definition of the framework in which to operate. If, at the start, some reluctance on the part of the medical staff was legitimate, it should not preclude the implementation of measures tailored to meet parents’ needs, even in maternity wards. This should be done without disrupting the smooth running of the services and in a spirit of mutual respect of the persons involved who are all working in an emotionally charged atmosphere. [ABSTRACT FROM AUTHOR]