{"title":"[Good practices for the use of biological tools in infectious diseases during pregnancy].","authors":"Vincent Portet Sulla, Christelle Vauloup-Fellous","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Biological tools are essential in obstetrical infectious diseases for determining immune status, systematic screening, or confirming a primary infection in pregnant women. Early detection of fetal-risk infections, even asymptomatic, is key. Expert centers and multidisciplinary prenatal diagnostic centers are recommended for complex cases.Serological analysis, particularly IgM and IgG testing, is vital for identifying primary infections. Timing and patient history (clinical, vaccination, travel) must be considered. In specific cases, follow-up tests (IgG avidity or PCR) are required for confirmation. Serological testing should be conducted early in pregnancy and within the same laboratory to ensure consistency. IgG avidity tests help differentiate recent from older infections, especially in CMV, rubella, and toxoplasmosis, where gestational timing is critical. Techniques like immunoblot and western blot are used for confirming equivocal or inconsistent serology results.PCR provides highly sensitive detection of infectious agents' DNA or RNA and can be useful before antibodies become detectable. It is particularly useful for diagnosing viral infections from lesion samples, such as HSV or VZV, and plays a key role in prenatal diagnosis on amniotic fluid after maternal infection.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"613-616"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul Maurice, Loriane Franchinard, Lucie Guilbaud, Ferdinand Dhombres, Bertrand Lafon, Agnès Mailloux, Jean-Marie Jouannic
{"title":"[In utero treatment of fetal anemia].","authors":"Paul Maurice, Loriane Franchinard, Lucie Guilbaud, Ferdinand Dhombres, Bertrand Lafon, Agnès Mailloux, Jean-Marie Jouannic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fetal anemia may be central or peripheral and results in fetal hyperflow that progresses to hydrops, a state of generalized edema (a therapeutic emergency because it carries a high risk of fetal death). Diagnostic suspicion is based on ultrasound measurement of peak systolic velocity in the middle cerebral artery, which is then increased. The primary cause is anti-D alloimmunization, followed by parvovirus B19 and then anti-Kell alloimmunization, both of which are associated with the risk of early anemia. Pregnancies at risk for fetal anemia should be monitored by a fetal medicine center. In utero transfusion is performed under aseptic surgical conditions and ultrasound guidance. It must be performed only in expert centers. In general, anemia can be cured without any consequences for the fetus, although there is a risk of complications and in case of hydrops, there is a risk of cerebral lesions and delayed neurodevelopment.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"659-663"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Physician recertification: a false start? A real chore? Or a genuine opportunity?]","authors":"Jean-Michel Chabot","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"597-600"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charles Egloff, Christelle Vauloup-Fellous, Olivier Picone
{"title":"[Cytomegalovirus and pregnancy: Challenges and perspectives].","authors":"Charles Egloff, Christelle Vauloup-Fellous, Olivier Picone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cytomegalovirus (CMV), a member of the Herpesviridae family, is the leading infectious cause of congenital neurosensory impairment. This article reviews the key clinical aspects essential for its management during pregnancy and discusses upcoming challenges and future perspectives. In recent years, valacyclovir has demonstrated its efficacy in reducing the risk of maternal-fetal transmission following seroconversion during pregnancy. Based on this evidence, the health-economic evaluation of systematic CMV screening during the first trimester of pregnancy strongly supports its widespread implementation, despite its inability to address secondary infections. Since June 2025, the French National Authority for Health (HAS) has recommended routine screening for CMV infection during the first trimester of pregnancy (for pregnant women whose serostatus is negative or unknown). Emerging antivirals, such as valganciclovir and letermovir, currently under evaluation, could expand treatment options. Finally, research on a vaccine are ongoing, it holds the potential to revolutionize the long-term management of this infection.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"622-629"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Second-line treatments for Parkinson's disease].","authors":"Guillaume Carey, Luc Defebvre","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Following an initial phase characterized by a good response to dopaminergic therapies, Parkinson's disease progresses toward a stage marked by motor complications-notably motor fluctuations and dyskinesias. When the optimization of oral therapy proves insufficient, the use of second-line treatments must be considered. These strategies are based on three main approaches: deep brain stimulation, continuous subcutaneous infusions (apomorphine, foslevodopa-foscarbidopa), and intra-intestinal levodopa infusions. The indication for these therapies depends on a multidisciplinary assessment that considers dopa-responsiveness, motor and cognitive status, comorbidities, and the patient's lifestyle. At least 5 doses of L-dopa, 2 hours of OFF and 1 hour of disabling dyskinesias every day constitute a simple tool to identify eligible patients in routine practice. Therapeutic choices must be individualized, balancing efficacy, tolerability, and practical constraints. General practitioners play an essential role in identifying complications, monitoring treatment, and coordinating care. Early collaborative management can significantly improve patients' quality of life.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"587-593"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Ageism in healthcare: sad prejudices!]","authors":"Marc Verny","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The growing number of French people over the age of 80 is putting a strain on the healthcare system. Ageism, rooted in age-related stereotypes and discrimination, negatively impacts the care of older patients. It leads to diagnostic errors, inappropriate treatments, or the unjustified refusal of treatment. However, aging and illness are not synonymous, and many seniors remain independent. Combating these biases - particularly through training for healthcare professionals and appropriate policies - is essential to improving the quality of care and changing social perceptions.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"601-602"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Megamyxoma of the right atrium].","authors":"Sara Aouame","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"670"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stanley Soussan, Violaine Peyronnet, Christelle Vauloup-Fellous, Olivier Picone
{"title":"[Current methods of systematic serological testing for infections in pregnant women in France].","authors":"Stanley Soussan, Violaine Peyronnet, Christelle Vauloup-Fellous, Olivier Picone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Serological testing during pregnancy is an integral part of obstetric monitoring. This screening is essentially based on the detection and dosage of specific antibodies (IgM and IgG) of a virus, bacteria or parasite. Currently in France, 4 serologies are mandatory (toxoplasmosis, rubella, syphilis and hepatitis B) but others are recommended and systematically offered (HIV, HCV, CMV). Determination of immune status should ideally be done in the pre-conception period or as soon as possible after the diagnosis of pregnancy. In the absence of immunity (IgM-, IgG-), hygienic and dietary measures are recommended, and the monitoring methods vary with the pathogen concerned. If seroconversion is suspected (IgM+, IgG+), the patient must be referred to a specialized fetal medicine unit to discuss the need for additional testing and to begin treatment if necessary. If there is any doubt about the interpretation of the serology result, it is essential to refer the patient to a prenatal center or to seek advice from a national reference laboratory.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"608-612"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Emerging infectious diseases in France: what are the risks for pregnancy?]","authors":"Najeh Hcini, Charles Egloff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Emerging arboviral infections, a heterogeneous group with varied mechanisms of action and effects, pose a constant challenge in obstetric practice in overseas departments, with a potential risk of extension to mainland France. Teratogenic emerging arboviral infections such as Zika virus (ZIKV), Venezuelan equine encephalitis virus (VEEV), and more recently Oropouche virus are particularly alarming. Given climate change and globalization, these infections have the potential to spread geographically. Beyond their impact on maternal health, some infections can lead to obstetric complications, fetal and/or neonatal infections, and malformations that may result in long-term neurological and neurosensory sequelae. Their real impact seems to be underestimated. It is crucial to develop a coordinated international response within a global approach that includes human, animal, and environmental health to address the challenges posed by emerging and re-emerging infectious diseases. This may involve vaccine research, improved surveillance methods, and the development of rapid diagnostic tools.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"76 6","pages":"635-639"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}