Prise en charge de la mort in utero: quel bilan proposer ?

RÉSUMÉ Objectifs : Evaluer l'intérêt des examens paracliniques prescrits dans les morts du foetus in utéro pour aboutir à l'établissement d'un nouvel algorithme de prise en charge du bilan des morts in utero. Matériel et méthodes : Analyse rétrospective d'une série de 106 morts in utero recensées entre septembre 1989 et décembre 1998 dans le département de gynécologie - obstétrique du CHUV (maternité de type 3) à Lausanne. Nous avons défini la mort in utero à partir de la date limite de viabilité foetale. Seules les grossesses de 24 semaines ou plus ont été inclues dans cette série. Nous avons exclu les morts in utero survenues en cours d'interruption thérapeutique de grossesse ainsi que les cas présentant un dossier incomplet. La classification étiologique utilisée est celle décrite par Fretts. L'analyse a porté sur les différents examens demandés, ainsi que sur l'évaluation de leur pertinence dans l'établissement du diagnostic étiologique de chaque cas. La recherche de facteurs de risque significatifs a également été prise en considération. Nous avons comparé notre prise en charge aux données de la littérature, afin de proposer un nouvel algorithme. Résultats : L'étiologie de la mort foetale a pu être définie dans 90% des cas. Les causes principales en étaient les retards de croissance in utero (19,8 %), les anomalies congénitales et chromosomiques foetales (18,9%), les infections (15,1%), le décollement placentaire (7,5%), la prééclampsie (5,6%), le diabète maternel (3,8%). Le 18,9% restant se répartissant par petits nombres entre diverses autres causes. Dans 10,4% des cas nous n'avons pas trouvé d'explication à la mort in utero. Les examens les plus profitables dans le bilan de la mort in utero était l'autopsie foetale, qui était anormale dans 92,7% des cas examinés, l'anatomopathologie placentaire, anormale dans 93% des cas et le babygramme (radiographie du squelette foetal), pathologique dans 53% des cas. La sérologie maternelle infectieuse était informative dans 6,6% des cas. Conclusion : Nous présentons un protocole de prise en charge du bilan de la mort in utero différencié en fonction des circonstances entourant l'événement, afin de limiter les examens superflus.

Effects of diazepam on Mycobacterium bovis-induced infection in hamsters

The in utero exposure of hamsters to low doses of diazepam results in impaired host defense against Mycobacterium bovis during adulthood. Delayed developmental immunotoxicity, however, represents a specific situation that might not be general. The present experiment was undertaken to investigate the effects of diazepam on hamster resistance to M. bovis using adult animals. The effects of diazepam treatment on serum cortisol levels were also studied. Adult hamsters (N = 10 for each group) were treated with diazepam (E1 = 1.0, E2 = 2.0 or E3 = 3.0 mg kg-1 day-1 subcutaneously) or with control solution (C) for 30 days. Seven days after the beginning of the treatment, the animals received identical inoculum concentrations of M. bovis. Hamsters treated with the higher (2.0 and 3.0 mg kg-1 day-1) doses of diazepam exhibited: 1) increased granuloma areas in the liver (C = 1.81 ± 1.39, E2 = 10.29 ± 4.64 and E3 = 15.80 ± 4.82) and lung (C = 0.54 ± 0.55, E2 = 6.28 ± 3.85 and E3 = 6.31 ± 3.56) and 2) increased scores of M. bovis colony-forming units isolated from liver (C = 2.0, E2 = 3.0 and E3 = 3.5), lung (C = 1.0, E2 = 3.0 and E3 = 3.5) and spleen (C = 1.0, E2 = 2.5 and E3 = 4.0). These effects were dose dependent, and were not detected or were less severe in animals treated with the lowest (1.0 mg/kg) dose of diazepam as well as in those of the control group. Furthermore, diazepam treatment (3.0 mg kg-1 day-1 for 30 days) increased (E3 = 71.32 ± 2.99; N = 10) the serum levels of cortisol compared to control hamsters (C = 22.61 ± 2.75; N = 10). The present data, that demonstrate an impaired defense against M. bovis in adult hamsters treated with diazepam, were tentatively explained on the basis of a direct and/or indirect action of diazepam on the cytokine network. The effects may be related to stimulation of peripheral benzodiazepine receptor binding sites (PBR) by macrophages and/or lymphocytes, or they may be mediated by PBR stimulation of the adrenals.

Development of fetal nicotine and muscarinic receptors in utero

The role of acetylcholine in the central and peripheral nervous systems is well established in adults. Cholinergic modulation of vascular functions and body fluid balance has been extensively studied. In the embryo-fetus, cholinergic receptors are widespread in the peripheral and central systems, including smooth muscle and the epithelial lining of the cardiovascular, digestive, and urinary systems, as well as in the brain. Fetal nicotine and muscarinic receptors develop in a pattern (e.g., amount and distribution) related to gestational periods. Cholinergic mechanisms have been found to be relatively intact and functional in the control of vascular homeostasis during fetal life in utero at least during the last third of gestation. This review focuses on the development of fetal nicotine and muscarinic receptors, and provides information indicating that central cholinergic systems are well developed in the control of fetal blood pressure and body fluid balance before birth. Therefore, the development of cholinergic systems in utero plays an important role in fetal vascular regulation, gastrointestinal motility, and urinary control.

De hominis in utero formatione

Invokaatio: I.N.S.S.T.

Resistance as a factor in environmental exposure of anticoagulant rodenticides: a modelling approach

Anticoagulant rodenticide (AR) resistance in Norway rat populations has been a problem for fifty years, however its impact on non-target species, particularly predatory and scavenging animals has received little attention. Field trials were conducted on farms in Germany and England where resistance to anticoagulant rodenticides had been confirmed. Resistance is conferred by different mutations of the VKORC1 gene in each of these regions: tyrosine139cysteine in Germany and leucine120glutamine in England. A modelling approach was used to study the transference of the anticoagulants into the environment during treatments for Norway rat control. Baiting with brodifacoum resulted in lower levels of AR entering the food chain via the rats and lower numbers of live rats carrying residues during and after the trials due to its lower application rate and efficacy against resistant rats. Bromadiolone and difenacoum resulted in markedly higher levels of AR uptake into the rat population and larger numbers of live rats carrying residues during the trials and for long periods after the baiting period. Neither bromadiolone nor difenacoum provided full control on any of the treated farms. In resistant areas where ineffective compounds are used there is the potential for higher levels of AR exposure to non-target animals, particularly predators of rats and scavengers of rat carcasses. Thus, resistance influences the total amount of AR available to non-targets and should be considered when dealing with rat infestations, as resistance-breakers may present a lower risk to wildlife.

Evidence for interplay between genes and maternal stress in utero: monoamine oxidase A polymorphism moderates effects of life events during pregnancy on infant negative emotionality at 5 weeks

The low activity variant of the monoamine oxidase A (MAOA) functional promoter polymorphism, MAOA-LPR, in interaction with adverse environments (G × E) is associated with child and adult antisocial behaviour disorders. MAOA is expressed during foetal development so in utero G × E may influence early neurodevelopment. We tested the hypothesis that MAOA G × E during pregnancy predicts infant negative emotionality soon after birth. In an epidemiological longitudinal study starting in pregnancy, using a two stage stratified design, we ascertained MAOA-LPR status (low vs. high activity variants) from the saliva of 209 infants (104 boys and 105 girls), and examined predictions to observed infant negative emotionality at 5 weeks post-partum from life events during pregnancy. In analyses weighted to provide estimates for the general population, and including possible confounders for life events, there was an MAOA status by life events interaction (P = 0.017). There was also an interaction between MAOA status and neighbourhood deprivation (P = 0.028). Both interactions arose from a greater effect of increasing life events on negative emotionality in the MAOA-LPR low activity, compared with MAOA-LPR high activity infants. The study provides the first evidence of moderation by MAOA-LPR of the effect of the social environment in pregnancy on negative emotionality in infancy, an early risk for the development of child and adult antisocial behaviour disorders.

In utero protein restriction causes growth delay and alters sperm parameters in adult male rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Foraging Behavior and Mortality of Ectatomma brunneum (Hymenoptera, Formicidae) in Simultaneous Exposure to Ant Baits and Conventional Diet in Laboratory

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

In vitro exposure to fullerene C60 influences redox state and lipid peroxidation in brain and gills from Cyprinus carpio (Cyprinidae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Programaçao fetal por restrição proteica in utero: avaliação do imprinting estrogênico nas próstatas ventral e dorsolateral do rato Wistar

Pós-graduação em Biologia Geral e Aplicada - IBB