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SUMMARY Skin disinfection with povidine-iodine (PVP-I) is widely used in obstetrics. We evaluated the influence of PVP-I in mothers at delivery on the serum thyroid stimulating hormone concentrations of their infants at the time of screening for congenital hypothyroidism. The study covered 4745 infants who were either breast fed (3659, 77%) or bottle fed (1086, 23%); 3086 (65%) of them were born to mothers with no iodine overload (controls) and 1659 (35%) to mothers with iodine overload. Compared with the control group, the breast and bottle fed infants born to mothers with iodide overload had a shift of neonatal thyroid stimulating hormone concentration towards high values. The shift was maximal in the breast fed infants with a 25 to 30 fold increase in the recall rate at screening for congenital hypothyroidism (serum thyroid stimulating hormone >50 mU/l) while in the bottle fed infants, the recall rate was barely modified. In conclusion, the use of PVP-I in mothers at delivery induces a transient impairment of thyroid function in their infants, especially if breast fed. This situation is detrimental to screening for congenital hypothyroidism. Consequently PVP-I is not recommended in obstetrics.Skin disinfection with povidone-iodine (PVP-I) is widely used in obstetrics in epidural anaesthesia or caesarean section. This procedure results in iodide overload of the mother due to cutaneous absorption of iodine. 1 Iodide readily crosses the placenta2 and is actively concentrated in the mammary gland.3 Consequently, newborn infants born to mothers treated with PVP-I are also exposed to iodine overload, especially if breast fed.4The thyroid gland of newborns is highly sensitive to the blocking effect of excess iodide on thyroid hormone synthesis, and a raised concentration of serum thyroid stimulating hormone is the most reliable index of impairment of thyroid function.5The objective of the present work was to evaluate the influence of cutaneous application of PVP-I in mothers at delivery on the concentrations of thyroid stimulating hormone in their infants at the time of screening for congenital hypothyroidism. In order to appreciate the specific role of the iodine contained in breast milk, a comparative study was performed between breast and bottle fed infants. Patients and methodsThe study included 4745 (96%) of the 4923 infants born in our maternity ward during a two year period. Of the 178 infants who were not included in the study, three were omitted because they had permanent congenital hypothyroidism due to thyroid agenesis with an appreciably raised serum thyroid stimulating hormone concentration and a low thyroxine concentration at screening and diagnosis. One hundred and seventy five (45 full term and 130 premature infants) were omitted because they were neither breast nor bottle fed: they were severely ill and received total parenteral nutrition until at least the fifth day of life. None of these 175 infants had a serum thyroid stimulating hormone concentration >50 mU/l at the time of screening for congeni...

The authors report a new method of diagnosing hyaline membrane disease (HMD) in newborns: ultrasound. Babies with HMD display a specific pattern with retrohepatic hyperechogenicity on abdominal ultrasound. The specificity of the pattern was verified in 40 prematures with respiratory distress syndrome. The sign was present in 24, and in 22 of these the final diagnosis was moderate or marked HMD. In the last 2, mild HMD was suggested. The pattern was absent in the 16 others, none of whom had HMD. The pattern probably results from an ultrasound artifact: summation of multiple aerated airways surrounded by collapsed alveoli. Follow-up examinations were possible in 13 babies with HMD. Hyperechogenicity disappeared in 8 of these patients within 6-9 days and in 3 within 10-20 days; it persisted for 60 and 70 days in 2 with bronchopulmonary dysplasia. In conclusion, retrohepatic hyperechogenicity in newborns is pathognomonic for HMD and allows an instant diagnosis. The persistence of the pattern could be a useful criterion for evaluation of the prognosis.

This paper reviews the effects of storage and bacterial content contaminating human milk on some milk constituents. Moreover, it reviews the inhibitory effect of refrigeration and freezing on bacterial growth. Our results suggest that the type and length of storage have an effect on some milk constituents, that this effect is modulated by the bacterial contamination of the milk and that refrigeration has a significant inhibitory effect on bacterial growth which is not observed after freezing. This stresses the importance of collecting noncontaminated milk and justifies the choice of refrigeration at 0-4°C for storage up to 8 days.