In France, approximately 500 deaths per year are related to sudden infant death syndrome (SIDS). After a 75% reduction of SIDS-related deaths in the 1990s, thanks to large prevention campaigns directing parents to put their infants to sleep on their back, the number of SIDSrelated deaths remains stable. However we estimate that 100 to 200 deaths of infants per year in France could be preventable with a better education to the risk factors of SIDS.In this prospective and descriptive monocentric study, we aimed at evaluating the level of expecting women's knowledge about SIDS. Questionnaires were distributed during a midwife consult. A score about sleeping conditions, environment and protective factors was determined with coefficients attributed according to the relevance to SIDS.Out of 296 questionnaires distributed, 202 were completed and included in the analysis from March, 1 st to September, 21 th 2018. Score were distributed from 2 to 46/50. The average note was 28.6/50. Ways of getting information was principally from media and not health professionals. When the information was delivered by a caregiver, in particular by the paediatrician, we observed a better knowledge of these women. This study shows that it is important for health professionals to take the time to inform future mothers about risk factors of SIDS, especially the population the least informed such as young mothers and from lower socio-economic status, in order to decreases the number of infant's avoidable deaths.
Despite the wide use of fentanyl for analgesia in newborns, concerns have been raised about potential haemodynamic side-effects. Since sick newborns may lose their cerebral blood flow autoregulation, a drug-induced haemodynamic instability could lead to brain injury. We assessed the effects of a 15-min infusion of fentanyl (3 micrograms/kg) on the general and cerebral haemodynamics in 15 newborns (median gestational age 29 weeks, 25th-75th percentile, range 28-31 weeks; birthweight 1170 g, range 955-1790 g). The heart rate and mean arterial blood pressure were continuously recorded. Mean cerebral blood flow velocity and pulsatility index were measured using pulsed Doppler ultrasound before, during and up to 60 min after the onset fentanyl administration. No significant modification of general or cerebral haemodynamics was observed. In conclusion, the infusion of 3 micrograms/kg of fentanyl did not lead to any deleterious effect on the general or cerebral haemodynamics in sick normovolaemic newborns.
The aim of this study was to assess the variability in individual fetal growth rhythms in comparison to averaged standard curves obtained from cross-sectional data. Biparietal diameter (BDP), abdominal transverse diameter (ATD) and femur length (FL) were measured by ultrasonography in 24 normal subjects, and the variance in growth rates determined for four time intervals: 12–26, 26–34, 34–37 and 37–39 weeks gestation. BPD, ATD and FL growths were always linear until 26 weeks with low variances in growth rates. Growth rates decreased thereafter whereas related variances increased significantly with a great diversity in individual growth trajectories. This study questions the relevance of mathematically smoothed curves which lead to an erroneous impression of growth trajectory uniformity when ultrasonography does not seem to be able to predict accurately newborn biometrical characteristics by the end of gestation.
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