Poster session I: Follow up examinations
Postpartum depressive disorder and early attachment. A follow up evaluation of standardized
videotaped mother-child interaction
*Andreas Wiefel, Karen Bartling, Ulrike Lehmkuhl, Joachim Dudenhausen, Christine Klapp
Charité Universitätsmedizin Berlin, CC17, Berlin, Germany; (2) Max-Planck-Institut, Babylab, Berlin,
Germany
Introduction: Postpartum depression (PPD) is a frequent mental disorder but it often goes undetected
and therefore is not treated sufficiently. PPD poses a high risk of malfunction of mother-child
attachment, particularly with regard to the mother’s emotional availability. PPD is already known to
influence the cognitive, emotional and mental development of the infant. Therefore, mother-child
interaction is of central importance for counseling and therapy of depressive mothers and their
infants.
Method: After the screening of over 700 women for an 18 week postpartum period by Edinburgh
Postnatal Depression Scale (EPDS), nine women reached classification for depressive disorder
according to DSM-IV/ICD-10 criteria confirmed by the Structured Clinical Interview for DSM IV
(SKID-I). They were matched to nine mentally healthy mother-child dyads (SKID-I). The quality of
mother-child interaction was compared for both groups at the age of 18-22 weeks of the infant.
Video-tasks were accessed using the “still-face-paradigm“ and rated with the Coding Interactive
Behavior Scales (CIB).
Results: Depressive mothers showed significantly reduced interaction quality compared to the
healthy control group. Demonstrating and explaining these findings to mothers was well accepted
and encouraged their motivation for therapy.
Discussion: Screening mothers for postpartum depression and offering videotaped analysis of
mother-child-interaction in postpartum depression is recommended. In combination with individual
counseling this is an important contribution to primary and secondary prevention and therapy of
mental disorders, both in mothers as well as in infants.
Corresponding author:
Andreas Wiefel
christine.klapp@charite.de
Phone: ++49 30 450666043
Fax: ++49 30 450566923
488
Poster session I: Follow up examinations
Sideways in treatment of obese child: a personal experience
Slavica Dautovic (1), Radomir Dautovic (2), *Svetlana Stefanovic (1)
(1) Institute for Child and Youth Health Care of Vojvodina, endocrinology, diabetes and metabolic
diseases, Novi Sad, Serbia; (2) Institute for Public Health of Vojvodina, microbiology, Novi Sad,
Serbia
The prevalence of overweight children and adolescents is one of the most important public health
challenges today. The impact of this early obesity extends into adulthood: increased mortality and
morbidity from a variety of conditions and adverse socio-economic consequences. No single
approach to the treatment of childhood overweight has been demonstrated to be more effective than
another. Challenges faced in managing obese child is selecting the approach that will be adhered to
on a long-term basis, involving whole family in the health lifestyle regarding the child's age, sex,
cultural and entire environmental background.
Aim: finding the best therapeutic approach for obese child.
Methods: a two years follow up effects of lifestyle modification (dietary, physical activity,
psychotherapy) and/or drug (sibutramine) for treating obesity in 40 children (mean age 13 years) with
the support of family members. Children with eating disorders, diabetes mellitus, secondary or
syndromic obesity were excluded. Lifestyle interventions, focused on physical activity and changing
eating habits, with behaviorally orientated treatment were implemented in all. Sibutramine used in
children with BMI ≥95th percentile (20 children). Reduction in overweight at 6, 12, 18 and 24 months
follow up was observed in all children; addition of sibutramine showed more significant weight lost in
longer time period (15% vs. 8% after two years) with less psychological disturbances and better selforiented outcomes.
Conclusions: combined behavioral lifestyle interventions have a significant and meaningful reduction
in overweight in children and adolescents. Pharmacotherapy is an effective adjunct to lifestyle
interventions in morbid obese child.
Corresponding author:
Slavica Dautovic
drdautovic@yahoo.com
Phone: ++881 21 6366308
489
Poster session I: Follow up examinations
Severe Intrauterine Growth Restriction (IUGR) – Growth and development evaluation
*Gabriela Pereira (1), Bernarda Sampaio (1), Carla Sá (1), Albina Silva (1), Eduarda Abreu (1),
Alexandra Cadilhe (2), José Matos Cruz (2), Almerinda Pereira (3)
(1) São Marcos Hospital, Neonatal Intensive Care Unit, Braga, Portugal; (2) São Marcos Hospital,
Fetal Medicine and Prenatal Diagnosis Unit, Braga, Portugal; (3) São Marcos Hospital, Neonatal
Intensive Care Unit; Fetal Medicine and Prenatal Diagnosis Unit, Braga, Portugal
Background: Newborns with IUGR had suffered one anoxia that disturbed their growth. Cognitive
impairment, motor delay, language and behavior problems can occur.
Aims: Growth and development evaluation of prenatal diagnosed severe IUGR.
Material and Methods: Descriptive and prospective study of severe IUGR, percentile of fetal growth
<3 in unifetal pregnancy, diagnosed since July 1st 2005 to June 30th 2006.
Maternal risk factors, placental disorders and neonatal morbidity. Growth evaluation using the
National Centre for Health and Statistics growth charts and development evaluation with the Denver
II scale and Pediatric Evaluation Development Status (PEDS). Follow-up until 3rd year.
Results: 14 fetuses with severe IUGR. Maternal age 30.4±6.4 years. Smokers 4/14, arterial
hypertension 4/14, gestational diabetes 1/14. Median diagnostic gestational age 33 weeks. 5/12
placentas showed infarcts and 2/12 revealed infection. Median gestational age at birth 33.5 weeks.
Symmetric IUGR 13/14. Very low weight 8/14. The most common neonatal diagnosis were
prematurity and jaundice. Follow-up on 13/14. Average current age 31±4.7 months. Persistence of
weight, height and head circumference P<5 2/13 and weight <P5 2/13.
Sat without support 7.8±2.6; walk independently 14.5±4.5, first words 13.8±4, first simple phrases
20.6±4.6 months. Gross motor impairment 3/13, fine motor impairment 1/13 and language problems
2/13. No social behavior impairment.
3/13 parents showed concerns on PEDS.
Commentaries: Currently, average age 31 months, 4/13 with persistent weight <P5. Development
impairment reported on 3 areas: language, gross and fine motor. The parents who have affected
children are worried about that development delay, according PEDS.
Corresponding author:
Gabriela Pereira
gabrielamarquespereira@gmail.com
Phone: +351 91 5301658
490
Poster session I: Follow up examinations
Neuromotor and cognitive development in preterm infants with normal brain maturation
evaluated by serial diffusion tensor imaging (DTI)
*Patrizia Corsin (1), Graziano Barera (1), Cristina Baldoli (2), Roberta Longaretti (2), Paola Scifo (2),
Rosanna Rovelli (1), Antonella Poloniato (1)
(1) H San Raffaele, Neonatal Unit - Pediatric Department, Milan, Italy; (2) H San Raffaele,
Neuroradiology Department, Milan, Italy
Many neurological and neurobehavioral disorders begins in early structural and functional cerebral
organization and maturation. DTI is a powerful technique to explore the structural basis of normal
brain development and provides early evidence of hypoxic-ischaemic damages.
Aim of the study is to estimate the neuro-cognitive development of children with any brain damage at
conventional MRI and to correlate maturative modifications of the brain and the acquisition of the
normal competences.
From 2005 to 2006 12 infants, in-born at GA 31.6 wks (1460g±320) with normal MRI were enrolled
and studied with at least two examinations with conventional study and study of DTI (1st examination
at GA <34th wks, 2nd at 40wks post-conceptional age, 3rd at 2nd month of corrected age). Griffiths’
scale was performed at 20 months CA. Calculation of quantitative parameters of Dm and FA studied
in vivo the brain maturation, showing normal maturation trend in all children and in all regions of
interest calculated, (reduction Dm, increase FA). Areas with precocious myelination (commissural
and deep projection tracts) were distinguished from those with slower and late maturation
(association and subcortical projection tracts) and also normal values were identified for revaluations.
Otherwise in absence of predictive clinical and neuroradiological datas, the development of the
neuromotor and cognitive competences underlined disabilities stronger in the area of the
performance and less evident in the area of the visual-motor coordination. In preterm with normal
MRI and normal maturation trend Griffiths scales are important instruments for screening
neurocognitive delays.
Corresponding author:
Patrizia Corsin
poloniato.antonella@hsr.it
Phone: ++0039 02 26432673
Fax: ++0039 02 26436747
491
Poster session I: Follow up examinations
Follow-up of children who had suffered from intrauterine hypoxia of various duration and
degree in their first year of life
*Zulfiya S. Khodzhaeva (1), Elena N. Baibarina (2), Elena A. Shatiryan (1), Natalia V. Barkalina (1)
(1) Research Center of Obstetrics, Gynecology and Perinatology, Obstetric Complications, Moscow,
Russia; (2) Research Center of Obstetrics, Gynecology and Perinatology, Perinatology, Moscow,
Russia
Aim of study: to assess health status of children who had suffered from intrauterine hypoxia of
various degree and duration according to antenatal cardiotocography Results.
Material and methods: the study included 50 women and their 50 children. All babies were delivered
at term by caesarean section because of antenatal CTG signs of progressive fetal distress.
Newborns were examined in neonatal period and at month 3, 6 and 12. We performed general
clinical examination and used additional methods for health status evaluation (including The Clinical
Adaptive Test/Clinical Linguistic and Auditory Milestone Scale - CAT/CLAMS).
Results: The most difficult postnatal adaptation was observed in children in whom ill-defined
antenatal CTG signs of fetal distress had persisted for approximately 3 weeks. The fact that these
signs are ill-defined wrongly assures an obstetrician that there is still a possibility to prolong
pregnancy under close fetal surveillance. However, physical development in this cohort of children in
their first year life is characterized by severe disadaptation, slow weight gain and more profound
harmonical disturbances.
Conclusions: Although antenatal CTG remains the most accepted method for fetal condition
monitoring, there is no consensus on how long conservative management in patients with signs of
fetal distress should be continued and when exactly these babies should be delivered. Introduction of
new diagnostic tools might help to improve obstetriсian's approach.
Corresponding author:
Zulfiya Khodzhaeva
zkhodjaeva@mail.ru
Phone: +7 499 1454496
Fax: +7 499 1454496
492
Poster session I: Follow up examinations
Our experience, estimation of the vitality of the newborns born with vaginal
childbirth with no pain
*Rozita Hadzi - Mancheva (1), Marina Pop-Lazarova (1), Jasna Anastasovska (1), Lidija Spasova (1),
Mane Hadzi - Manchev (2)
(1) Re Medika, Neonatology, Skopje, Macedonia; (2) Re Medika, Surgery, Skopje, Macedonia
Today epidural analgesy is the most often used method for no pain in vaginal childbirth. In some
hospitals in the world the percent of applicated epidural is about 50% and in some others even more.
-Through vital parameters (Apgar score and ABS) to show vitality of newborn, childbirth with epidural
analgesy in comparison with newborn without pain in vaginal childbirth.
–263 vaginal childbirth are processed and from them 181 were with epidural analgesy,82 with without
it. All children as parameters for vitality are used Apgar score in first and in fifth minute and ABS and
it is made comparation between both analyzed groups.
–In group of 181 childbirth with epidural analgesy, there are not any babies with Apgar score in first
minute between 0-6 points, with 7 points were 3 babies and other were with 8 or more points in first
minute. From 81 childbirths without anaglesy there are not any babies with Apgar score in first minute
between 0-6, with 7 points were 4 babies, and others were with 8 or more points. Apgar score in fifth
minute in both groups was over 8 points. In relative of the way of completing the childbirth in realtiv of
use of vacuum extraction in second birth time in 263 childbirths was 5,and 2 were with epidural
analgesy, and other 3 without analgesy.
-Epidural analgesy doesn’t make bigger the risk of finishing the childbirth using vacuum. There is no
difference in grades for vitality on childbirth in both groups, but the satisfaction of pregnant woman
with epidural is bigger.
Corresponding author:
Rozita Hadzi - Mancheva
hadzimanchev@yahoo.com
Phone: ++389 72 443116
Fax: ++389 2 2603103
493
Poster session I: Follow up examinations
Follow up study of psychomotor development in neonates with Rhesus isoimmunisation
*Svetlana Stefanovic (1), Slobodan Sekulic (2), Vladan Stefanovic (3), Vladana Stefanovic (4)
(1) Institute for children and youth health care, neonatology, Novi Sad, Serbia; (2) Clinical Centar of
Vojvodina, neurology, Novi Sad, Serbia; (3) Health Care Centar, Novi Sad, Serbia; (4) Medical
Faculty, Novi Sad, Serbia
Introduction: Rhesus isoimmunisation in neonates should be promptly treated to avoid toxic effects of
high bilirubin level on brain cells known as Kernicterus
Nowdays, it is a very rare complication due to modern treatment (EST, Phototherapy).
Yet we can clinically recognize (neurologic assessment) neonates with high levels of bilirubin in first
days of life although there is little evidence showing adverse neurologic outcome in infancy
Aim: is to notice if there is any significant differences in neurologic outcome during the first year of life
in children with neonatal haemolytic disease treated with or without EST
Material and Methods: Prospective clinical study in 100 term neonates with Rhesus isoimmunisation
during 5 years period who formed 2 groups a) with EST and b) without EST.
Neurological assesmentis done at 6 weeks, 3, 6, 9 and 12 months, Psycho test at age of 9 and 12
months.
Results: Hypotonia in 50%. Hypertonia in 2% without differences between groups.
Psychotest reveals normal score in both groups but at the bottom range (RQ 91.66) with significant
difference between boys and girls (90.16:93.16)
Conclusions: There is no evidence of pathologic psychomotor development.
Psychomotor development was in the range of the lowest normal level for age.
Slight differences in psychomotor development were recognized in infants of different sex.
There is a possibility that CNS in male neonates is more sensitive toward toxic effect of bilirubin.
Corresponding author:
Svetlana Stefanovic
medicoexpert@gmail.com
Phone: ++381 21 6369806
Fax: ++381 21 520436
494
Poster session I: Follow up examinations
Prospective clinical study of Amikacyn level in neonates with severe infection
*Svetlana Stefanovic (1), Ana Sabo (2), Srdjan Kisic (3)
(1) Institute for Children\'s and Youth health care of Vojvodina, neonatology, Novi Sad, Serbia;
(2) Medical faculty, pharmacology, Novi Sad, Serbia; (3) Institute for Occupational health, Novi Sad,
Serbia
Introduction: One of the main problems in neonatal practice is to choose antibiotics that can
efficiently solve severe neonatal infection without leaving concequinces to imature renalfunction
Aim: of our prospective study is to 1) measure blood level of Amikacyn in neonates treated with
Amikacyn during 2 weeks2) to compare our Results to nontoxic concentration of (20 umg/l) 3) to find
out if there are any differences in Amikacyn level between neonates in early and late neonatal
periods as renal function develops in first days.
Material and Methods It is prospective clinical study of 60 term neonates hospitalized on our neonatal
department, treated with Amikcyn in therapeutic doses (12-15mg /kg BW/24h) during 14 days divided
in:
Experimental group <7 days of life
Control group >8 days of life. Their blood sample for Amikacyn concentration is taken in these points
1) 10 minutes after the first application of Amikacyn 2) a few minutes before the second application,3)
before the last application,4)10 minutes after the last application and 5) 24 hours after last
applications
Results and Conclusion: Amikacyn blood levels in our study are beoyond nontoxic dosis according to
literature data.
There is no significant differences between Amikacyn levels in all points of measurement in
experimental and control group. It is safe to treat neonates even in the first week of age with
Amikacyn although renal function is starting to developing after birth.
Corresponding author:
Svetlana Stefanovic
medicoexpert@gmail.com
Phone: ++381 21 6369806
Fax: ++381 21 520436
495
Poster session I: Follow up examinations
Uterine myomas in pregnancy: Priliminary data of an ongoing study
Ruya Deveer, Erkan Sağlam, Ismail Mert, Özlem Yörük, İrfan Tarhan, Nuri Danışman
Zekai Tahir Burak Maternity Hospital, Obstetrics and Gynecology, Ankara, Turkey
Introduction: Uterine myomas are the most common bening tumors in women of reproductive age
which also make it common in pregnancy and affect the pregnancy outcome. We presented obstetric
outcomes of myoma uteri detected during pregnancy.
Patients and Methods: 33 pregnant women with diagnosis of uterine myoma between April 2008February 2009 were included prospectively to determine the obstetric outcome.
Results: The mean age of the patients was 33. Seventeen of the them were primigravid The mean
size of the myoma was 58.6mm. In 18 patients, myomas were detected at the anterior uterine wall
while 15 were at the posterior. 13 patients had multiple myomas. 10 of the patients had severe pelvic
pain mostly during early second trimester which lasted about 5 days. 7 of these had myomas on
posterior uterine wall with a mean size of 75mm. 4 patients suffered bleeding in early pregnancy and
another 4 had spontaneous miscarriages. The mean gestational week at delivery was 39.1. Of the 29
term pregnancies, 26 (90%) delivered by caesarean section and 3 (10%) per vaginum.
Malpresentation rate was 34% (10 out of 29). Myomectomy was performed during caesarean section
in 4 patients. 3 of them needed blood transfusion. The mean birth weight was 3,100 gram. One
pregnancy was complicated by SGA. No preterm delivery was seen.
Discussion: Depending on the size, location and associated factors, myomas can cause
complications. In our study posterior uterine myomas were more frequently complicated by pelvic
pain A successful pregnancy and delivery is common with appropriate surveillance and supportive
management.
Corresponding author:
Ismail Mert
isomert2002@yahoo.com
Phone: ++90 505 7281842
Fax: ++90 312 3124931
496
Poster session I: Follow up examinations
Postpartum curettage and the prediction of retained products of conception
*João Alves, José Metello, Cristina Leite, Teresa Avillez, Manuel Hermida
Hospital Garcia de Orta, Serviço Obstetrícia, Almada, Portugal
Aim: To assess whether delivery details, clinical features at presentation, echographic image before
curettage could accurately predict the presence of retained products of conception (RPOC) following
a postpartum curettage (PPC).
Methods: A retrospective chart review of patients who underwent a PPC at a tertiary referral hospital
over a 2-year period. We included only gestations with more than 37 weeks. All cases with retained
placenta were excluded.
Results: Forty nine patients were included in the study and thirty (61%) patients who had histological
evaluation demonstrated retained product of conception. Most (60%) postpartum curettage was done
within 48 hours post partum. The clinical features at presentation were unrelated with final histology.
However, patients with more than one birth were found more likely to have RPOC (p<0.05). The
sensitivity and specificity of ultrasound in detecting RPOC was 80% and 60% for a presence of a
thickened endometrium of more than 21mm. Analyzing the type of RPOC we had more membranes
in a younger women without symptoms, with only one birth, and having PPC earlier.
Conclusion: A PPC has a low diagnostic yield. Ultrasound has a low specificity (60%) in detecting
RPOC. While the therapeutic benefit of PPC is unclear, expectant management should be evaluated
especially in the presence of young women without symptoms, with only one birth, and a ultrassound
with thickened endometrium of less than 22mm.
Corresponding author:
João Alves
jmiguelalves@gmail.com
Phone: ++351 96 6125130
497
Poster session I: Follow up examinations
Outcome of antenatally suspected congenital sequestration malformation of the lungs in
Wales: 7 years experience 2000–2006
*Palghat N Gopalakrishnan (1), Jennifer K Calvert (1), David Tucker (2), Susan Morris (3),
Iolo Doull (4)
(1) University Hospital of Wales, Neonatology, Cardiff, U. K; (2) ABM University Hospital NHS Trust,
Congenital Anomaly Register and Information Service for Wales, Swansea, U. K; (3) University
Hospital of Wales, Paediatric Radiology, Cardiff, U. K; (4) University Hospital of Wales, Paediatric
Respiratory Medicine, Cardiff, U. K
Objective: To determine outcome of antenatally suspected congenital sequestration malformation of
the lungs over a 7 year period in Wales.
Methods: A retrospective study of babies with antenatally suspected sequestration. Data was
obtained from the CARIS (Congenital Anomaly Register and Information Service for Wales),
Neonatal and Radiology databases and Surgical and Respiratory records.
Results: 28 cases of sequestration were suspected antenatally. There was no hydrops and none of
the conceptus required ante-natal intervention. There was no pregnancy loss. In 6(21%) of cases the
lesion became less visible in subsequent ante-natal scans.
Postnatal information was unavailable in 4 cases. Post natal CT scan of the chest was performed in
21(75%) of cases of which 16 (76%) showed sequestration of lungs and 5(24%) showed variable
lung pathology. Five infants required surgical removal of the lesion between 1 to 5 years. The
histology was heterogeneous. Thirty five percent of cases were discharged from the follow up. Fifty
percent of cases were still being followed up. Of the 6(21%) of cases with suspected antenatal
resolution, 4 did not have post-natal CT of the chest and in the remaining two cases the CT chest
findings were heterogeneous.
Conclusion: The majority cases of sequestration are isolated and asymptomatic at birth. Although
some appear to resolve antenatally, most persist and post-natal CT scan findings are heterogeneous.
Therefore it is recommended that all cases have post-natal investigation and follow-up.
Corresponding author:
Palghat N Gopalakrishnan
sukagopa@hotmail.com
Phone: ++44 1633 810328
Fax: ++44 2920 745268
498
Poster session I: Follow up examinations
Long-term outcome of neonatal abdominal wall defects
Magdalena Kwiatkowska-Gruca (1), Klaudia Dabrowska (2), Jakub Behrendt (1),
Wojciech Korlacki (2), *Urszula Godula-Stuglik (1)
(1) Silesian Medical University, Department of Pediatrics, Zabrze, Poland; (2) Silesian Medical
University, Department of Pediatric Surgery, Zabrze, Poland
Aim: Assessment of long-term Results of the surgical treatment of omphalocoele and gastroschisis in
neonatal period and neurodevelopmental follow-up.
Material and methods. Within 10 years (1996-2005) 27 (15 male, 12 female) newborns with mean
birth weight 2709g and mean GA 37.5 weeks, were born with congenital defect of abdominal wall (16
with gastroschisis and 11 with omphalocoele). They were treated in the University Hospital in Zabrze.
24 neonates were operated in 1st and 3 in 2nd day of life, 23 newborns had one-step surgery, 4 –
multistep surgery using Shuster’s method. Ten neonates died in first month of life because of
operation complications and other congenital defects. (mainly heart defects) Mean time of
hospitalization was 40 days. 15 of 17 survived children in age from 1.5 to 10 years of life were
followed-up, included psychophysical development, necessity of post hospitalization treatment and
cosmetic effects of operation.
Results. Successive operations were necessary in 5 children with inguinal hernia, 7 children with
hernia in cicatrices, one with gastroaesophageal reflux. Cosmetic effect of wall defects operation was
good in 8, satisfactory in 4 and bad in 3 children. No neurodevelopmental, sensorial and physical
disorders in all 15 children were found.
Conclusion. Congenital abdominal wall defects are serious clinical problem with high mortality in
neonatal period. Isolated defects can influence on cosmetic effect with often necessity of secondary
correction, but without affecting the normal development.
Corresponding author:
Urszula Godula-Stuglik
jbeh@poczta.onet.pl
Phone: ++48 32 3704291
Fax: ++48 32 2718691
499
Poster session I: Follow up examinations
Sandhoff disease in infancy-diagnostic
*Adnan Bajraktarevic (1), Jasmir Musabegovic (2), Aida Djurdjevic Djulepa (3), Feriha Catibusic (4),
Ismet Suljevic (5), Jasmina Saric Ceman (6)
(1) Public Health Institution of Canton Sarajevo, Pediatrics Department, Sarajevo, Bosnia and
Herzegovina; (2) Pharmaceutical Faculty, Pharmacology Department, Sarajevo, Bosnia and
Herzegovina; (3) General Hospital, Perinatology Department, Sarajevo, Bosnia and Herzegovina;
(4) Pediatrics clinic, Neuropediatrics, Sarajevo, Bosnia and Herzegovina; (5) Clinical Medical Center,
Biochemistry Department, Sarajevo, Bosnia and Herzegovina; (6) Clinical Medical Center, Depart. for
Immunology, Sarajevo, Bosnia and Herzegovina
Introduction: The most common and severe form of Sandhoff disease begins in infancy. It is caused
by a deficiency of the enzyme beta-hexosaminidase, which Results in the accumulation of certain
lipids in the brain and other organs of the body. β-hexosaminidase A (β-N-acetyl-d-hexosaminidase)
is a lysosomal hydrolase composed of an α- and a β-subunit. It is responsible for the degradation of
GM2 ganglioside
Methods: Symptoms of Sandhoff disease can appear in childhood, adolescence and in adulthood.
There was a marked cerebellar atrophy on MRI, and proliferation of abundant PAS-positive foamy
macrophages in the rectal mucosa. Ultrastructural studies revealed numerous inclusions in the
cytoplasm of retinal ganglion cells and other neuronal cells.
Results: Substrate-specific effects of this mutation were demonstrated by the urinary oligosaccharide
pattern. Infants with this disorder typically appear normal until the age of 3 to 6 months, when
development slows and muscles used for movement weaken.
Discussion: It is clinically indistinguishable from Tay-Sachs disease, but affects two hexosaminidase
enzymes. Differential accumulation of alpha- and beta-synucleins in human lipidoses may be related
to functional differences between these two proteins.
Conclusion: Sandhoff disease does not have any standard specific treatment or cure. Signs and
symptoms can begin in childhood, adolescence, or adulthood and are usually milder than those seen
with the infantile form of Sandhoff disease. ELISA system involving anti-GM2 monoclonal antibodies
for measuring GM2 storage in fibroblasts from Tay-Sachs and Sandhoff disease patients are very
usefull.
Corresponding author:
Adnan Bajraktarevic
bajrakm@hotmail.com
Phone: ++387 61 199526
Fax: ++387 33 555391
500
Poster session I: Follow up examinations
Meckel's diverticulum causing obstruction in neonate
*Teresa Carrion (1), Fernando Alonso (1), Viviana Aguero (2), Juan Ferrer (3)
(1) Clinica Rotger, Pediatric Surgery, Palma de mallorca, Spain; (2) Clinica Rotger, NICU, Palma de
mallorca, Spain; (3) Clinica Rotger, NICU, Palma de mallorca, Spain
We report a male newborn of 18 day old presented with a 24 h history of poor feeding and
intermittent nonbilious vomiting. His stools were normal.
Case Report: He was born at term and weighed 4.1kg was quite well at birth and passes meconium
normally. He was breast-feeding every 3 hours.
On physical examination, the baby appears pale. He has a heart rate of 147 beats/min, respiratory
rate 52 breaths/min, blood pressure of 89/52mmHg. and temperature of 36.3ºC.
His cardiac and pulmonary examinations were normal.
The abdomen was soft and mildly distended, without masses.
The neurologic examination was normal for age. His rectal examination was normal.
Diagnostic Studies: The complete blood count, chemical, urine values and blood culture were normal.
Stool was negative for virus or bacteria.
Initial abdominal Rx: showed moderate dilated gas filled loops of small bowel, with air in the distal
large bowel and no free air in the abdominal cavity.
On the following day, he developed fecal vomiting and X ray findings were suggestive of a small
bowel obstruction requiring surgical exploration.
In the operating room, he was found to have a distal small bowel obstruction related to a Meckel
diverticulum and ectopic teste.
Treatment was the resection of the entire ileal dilated segment (12cms) with a normal end-to-end
bowel anastomosis.
Histopathological examination of the specimen showed dilated terminal ileum and no heterotopic
tissue.
Corresponding author:
Teresa Carrion
tcmera@terra.es
Phone: ++34 971 448500
Fax: ++34 971 722704
501
Poster session I: Follow up examinations
Hyperreactio luteinalis in an uncomplicated pregnancy - A case report
*Manju Nair (1), Tariq Mahmood (2), Amy Judson (3)
(1) Tameside General Hospital, Obs & Gynae, Manchester, United Kingdom; (2) Tameside General
Hospital, Obs & Gynae, Manchester, United Kingdom; (3) Tameside General Hospital, Obs & Gynae,
Manchester, United Kingdom
Hyperreactio luteinalis is a condition associated with bilateral or unilateral enlargement of the ovaries
with theca lutein cysts. This pathological entity has been reported to be associated with multiple
pregnancies, molar pregnancies, hyperandrogenic state and virilisation, fetal hydrops. There are only
a few cases of asymptomatic theca lutein cysts.
We report a case of a 22year old primigravida who had a normal booking and anomaly scan. A scan
was done at 37weeks to confirm breech presentation. Both ovaries were enlarged with multiple cysts
of size 10cm. She was completely asymptomatic. A caesarean section was performed at 39 weeks
after an unsuccessful external cephalic version. During the operation both the ovaries were enlarged
as described in the scan, with multiple fluid filled cysts. Biposy of the ovarian tissue confirmed
hyperreactio luteanalis. An ultrasound scan performed postnatal at 6weeks demonstrated complete
regression of the cysts with normal ovaries.
This case highlights the fact that theca lutein cysts can occur even in a normal pregnancy and the
patient can be completely asymptomatic. If a scan had not been done for evaluation of the
malpresentation the cyst would not have been detected antenataly. It also stresses the importance of
examination of the adnexa at the time of any caesarean section. If the clinicians are familiar with the
appearance of the cyst and the nature of spontaneous regression unnecessary interventions like
oopherectomy can be avoided. It also stresses the importance of follow up scans to ensure complete
resolution.
Corresponding author:
Manju Nair
manju_arun@hotmail.com
Phone: ++44 0161 4451001
502
Poster session I: Follow up examinations
Achondroplasia: Case Report
Joana Dias (1), *Almerinda Pereira (1), Albina Silva (1), Eduarda Abreu (1), António Matos
Marques (1), Carla Sá (1), Alexandra Cadilhe (2), José M. Cruz (2)
(1) São Marcos Hospital, Neonatology Unit, Braga, Portugal; (2) São Marcos Hospital, Fetal Medicine
and Prenatal Diagnosis Unit, Braga, Portugal
Background
Achondroplasia is the most common condition associated with disproportionate short stature, with
variable incidence (1/15000- 1/40000 births). It is transmitted as an autossomical dominant trait,
Resulting from a mutation occurring in fibroblast growth factor receptor 3 (FGFR3), 80% are sporadic
cases. Prenatal diagnosis is possible after 20 weeks of gestation.
Case Report
A 29-year-old pregnant woman was transferred to this hospital at 20 weeks of gestation because of
short long bones had been detected by ultrasonography. Serried ultrasounds performed between 22
and 32 weeks of gestation showed long-bone foreshortening, frontal bossing, macrocephaly and
midface hypoplasia. Parents chose not to perform any additional study. The patient was born by
caesarean section at 40 weeks and had rhizomelic shortness of limbs, large head, and small chest,
characteristic of Achondroplasia. Radiographs showed shortness of the long bones and flaring of the
metaphyses. Nowadays, at 12 months, she has sleep roncopathy which is being evaluated and is
slightly delayed in her motor development, so she is on physiotherapy and occupational therapy
program.
Conclusion
Ultrasound is effective in prenatal diagnosis of achondroplasia allowing not only to counseling the
parents about the diagnosis as well as a soon confirmation after birth. In order to improve life-quality
of these patients it´s crucial to establish a plan of anticipatory care directed to identify children who
are at high risk of complications and intervening to prevent serious sequels.
Corresponding author:
Joana Dias
joanamprdias@gmail.com
Phone: ++351 253 209000
Fax: ++351 253 613334
503
Poster session I: Follow up examinations
Telematics and midwifery postnatal care to the mothers on the sexual and reproductive
women’s attention programme in Catalonia, Spain.
*Gloria (1), Angels Pauli (2), Eusebia Romano (3), Dolors Guix (4), Elisabet Bru (3),
Montserrat Santaella (5), Anna Zaragoza (6), Merce Llado (7), Montserrat Abella (8),
Gemma Falguera (9), Dolors Costa (10), Oriol Valls (11), M Isabel Gutierrez (12),
Telematics Postnatal Group (1)
(1) University of Barcelona, Midwifery Teaching Unit, Nursing School, Barcelona, Spain;
(2) Catalan Insitute of Health, PASSIR Badalona, Badalona, Spain;
(3) Catalan Insitute of Health, PASSIR Tarragona, Tarragona, Spain;
(4) Catalan Insitute of Health, PASSIR Granollers, Granollers, Spain;
(5) Catalan Insitute of Health, PASSIR Garraf, Vilanova i la Geltru, Spain;
(6) Catalan Insitute of Health, PASSIR Rio Janeiro, Barcelona, Spain;
(7) Catalan Insitute of Health, PASSIR Girones-P Estany, Girona, Spain;
(8) Catalan Insitute of Health, PASSIR Sabadell, Sabadell, Spain;
(9) Catalan Insitute of Health, PASSIR Regio Centre, Terrassa, Spain;
(10) Catalan Health Department, Health Services Planning and Evaluation, Barcelona, Spain;
(11) Barcelona, Spain;
(12) Catalan Insitute of Health, PASSIR Cornella, Cornella, Spain
Background: Women and families nowadays seek health information in Internet about maternity care
and are able to profit from benefits of e-health and telemedicine form the health services.
Objectives: To know the effectiveness of telematics intervention to the mothers in the postnatal
period in relation to the usual attention related to the women’s opinion, consultation and morbidity on
the Community Programme of the Sexual and Reproductive Women’s Attention (PASSIR).
Methodology:
Design: Multi-centre study and randomized controlled trial study.
Setting: Postnatal community clinics of Catalonia, Spain.
Participants: 400 women which prenatal care has been carried out on the clinics of PASSIR, who are
internet consumers. There have been two groups: women of the control group with usual midwifery
care and experimental group with telematics intervention with videoconference and phone calls and
usual care.
Method: The intervention has been carried out by the midwives by videoconference and phone to
mothers from clinics of PASSIR during the six first weeks of puerperium. Ethics. This project has
received the approval of the Ethics Commission.
Data analysis: A descriptive analysis will be presented as well as bivariante analysis.
Outcomes: The Results from January to September 2009 will be presented.
Funding: This research project has been financed by the Institute Carlos III, Minister of Health, Spain.
It has also received funds from Health Department of Catalonia.
Corresponding author:
Gloria Seguranyes
gseguranyes@ub.edu
Phone: ++34 93 4024247
504
Poster session I: Follow up examinations
Early postpartum discharge in a tertiary center with a wide geographic dispersion
*Nestor Herraiz (1), Maria Jose Boillos (1), Daniel Oros (1), Beatriz Vicente (1), Gerardo
Rodriguez (2), Manuel Angel Romero (1)
(1) HCU Lozano Blesa, Obstetrics and Gynecology, Zaragoza, Spain; (2) HCU Lozano Blesa,
Pediatrics, Zaragoza, Spain
Objectives: To evaluate the “Early postpartum discharge program” impact in a tertiary hospital
characterized by a wide geographic dispersion of its reference population.
Methods and Materials: The “Early postpartum discharge program” was fully developed in our center
in 2008. We compared all “Vaginal delivery without complicating diagnoses” (Diagnoses-related
group DRG-373) registered during 2008, with a similar historic cohort from 2003. Puerperal
readmission were recorded and classified as DRG-376 “Postpartum without operation room (OR)
procedures” or DRG-377 “Postpartum with operation room (OR) procedures”. Student-T for
independent samples and 2 test, were used for statistical analyzes.
Results: All vaginal deliveries without complications during 2003 and 2008 (2133 and 2304
respectively) were analyzed. No differences were found for any social or demographic
characteristics. Mean admission for RGD-373 during 2008 and 2003 was 3.18 days and 2.52 days
(p<0.001) respectively, mean difference 0.66 days/patient (CI 95% 0.62-0.69). Overall puerperal
readmission (DRG-376 and DRG-377) decreased from 1.98% in 2003 to 1.00% in 2008 (p<0.05),
proportions difference 0.88% (CI 95% 0.17-1.56). DRG-376 (without OR) fall from 1.18% to 0.56%
(p<0.05), proportions difference 0.62% (CI 95% 0.06-1.17). A non significant drop of readmissions for
DRG-377 (from 0.71 to 0.43% (p=0.29)) was observed.
Conclusion: The “Early postpartum discharge program” reduced hospital mean postpartum admission
in our centre. This lower mean admission was associated with a significant decrease of the overall
rate of puerperal readmissions (DGR-376; DRG-377), particularly without surgical complications
(DRG-376).
Corresponding author:
Nestor Herraiz
nestorherraiz@arrakis.es
Phone: ++34 976 765700
505
Poster session I: Follow up examinations
Follow-up study of children who were audiologically examined in prenatal
and postnatal period
*Ljiljana Jelicic (1), Mirjana Sovilj (1), Aleksandar Ljubic (2), Ksenija Ribaric Jankes (3)
(1) Institute for Experimental Phonetics and Speech Patholgy, Diagnostics and Speech Pathology,
Belgrade, Serbia; (2) Institute for Obstetrics and Gynecology – Clinical Center of Serbia, High Risk
Pregnancies, Belgrade, Serbia; (3) Institute of Neurology – Clinical Center of Serbia, Neurology,
Belgrade, Serbia
Early audiological examinations in prenatal period have a great importance as they enable prompt
application of early auditory stimulation procedures. The research aim was to examine the auditory
perception development in children who were examined by procedure of Prenatal Hearing Screening
(PHS) in prenatal period. Research sample comprised 62 children at the age from 3.5 to 4.5 years,
who were examined by PHS, and was divided into two groups: children from low risk pregnancies
(N1=30) and children from high risk pregnancies (N2=32). The audiological examinations in both
groups of children included: transient evoked otoacoustic emissions (TEOAE), tympanometry, pure
tone audiometry and comparsion of obtained audiological examinations with PHS Results. Results of
audiological examinations are discussed in relation to PHS Results and pregnancy conditions
Corresponding author:
Ljiljana Jelicic
lilijen@ymail.com
Phone: ++381 11 2624168
Fax: ++381 11 2625232
506