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Preterm management

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https://www.readbyqxmd.com/read/28104401/leading-causes-of-preterm-delivery-as-risk-factors-for-intraventricular-hemorrhage-in-very-preterm-infants-results-of-the-epipage-2-cohort-study
#1
Marie Chevallier, Thierry Debillon, Veronique Pierrat, Pierre Delorme, Gilles Kayem, Mélanie Durox, François Goffinet, Stephane Marret, Pierre Yves Ancel
BACKGROUND: Intraventricular hemorrhage is a major risk factor for neurodevelopmental disabilities in preterm infants. However, few studies have investigated how pregnancy complications responsible for preterm delivery are related to intraventricular hemorrhage. OBJECTIVE: To investigate the association between the main causes of preterm delivery and intraventricular hemorrhage in very preterm infants born in France during 2011 between 22 and 31 weeks of gestation...
January 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28102856/the-impact-of-integrated-evaluation-of-hemodynamics-using-targeted-neonatal-echocardiography-with-indices-of-tissue-oxygenation-a-new-approach
#2
Y N Elsayed, R Amer, M M Seshia
OBJECTIVE: To study the impact of integrated evaluation of hemodynamics (IEH) using targeted neonatal echocardiography, together with regional tissue oxygenation, fractional oxygen extraction using near-infrared spectroscopy on the management of infants with compromised hemodynamics. STUDY DESIGN: Retrospective cohort comparison of two groups of infants with compromised hemodynamics. EPOCH 1: did not undergo IEH (January 2012 to March 2014); EPOCH 2: underwent IEH (April 2014 to December 2015)...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28100980/accessory-mitral-valve-leaflet-causing-severe-left-ventricular-outflow-tract-obstruction-in-a-preterm-neonate-with-a-partial-atrioventricular-septal-defect
#3
J Kevin Wilkes, Charles D Fraser, Thomas J Seery
Atrioventricular septal defects represent a class of congenital cardiac malformations that vary in presentation and management strategy depending upon the severity of the particular lesions present. We present the case of a premature neonate who had a partial atrioventricular septal defect and an accessory mitral (or left atrioventricular) valve leaflet. The latter caused severe left ventricular outflow tract obstruction and severely depressed left ventricular function. We found only one other report of this atrioventricular valve abnormality in association with atrioventricular septal defect...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28099365/melanoma-during-pregnancy-a-report-of-60-pregnancies-complicated-by-melanoma
#4
Jorine de Haan, Christianne A Lok, Christianne J de Groot, Marianne B Crijns, Kristel Van Calsteren, Karina Dahl Steffensen, Michael J Halaska, Sevilay Altintas, Ingrid A Boere, Robert Fruscio, Wojciech Kolawa, Petronella O Witteveen, Frédéric Amant
The management of melanoma during pregnancy is challenging as maternal benefits and fetal risks need to be balanced. Here, we present an overview of the incidence, the demographic and clinical characteristics and the treatment modalities used. After analysis of obstetric, fetal and maternal outcome, recommendations for clinical practice are provided. From the 'International Network on Cancer, Infertility and Pregnancy' database, pregnant patients with melanoma were identified and analysed. Sixty pregnancies were eligible for analysis...
January 17, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28098674/diethylstilbestrol-potential-health-risks-for-women-exposed-in-utero-and-their-offspring
#5
J Leocadia Conlon
Diethylstilbestrol (DES) is a synthetic estrogen given to pregnant women to prevent miscarriages and preterm labor; the drug was used between 1941 and 1971 in the United States and into the 1980s in other countries. DES exposure is associated with significant long-term health effects, including increased risk for breast cancer, cervical and vaginal clear cell adenocarcinoma, reproductive tract abnormalities, infertility, poor pregnancy outcomes, and early menopause. This article reviews the potential health risks associated with DES exposure, how to assess which patients are at risk, and management recommendations for patients exposed to DES...
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28096129/current-knowledge-of-necrotizing-enterocolitis-in-preterm-infants-and-the-impact-of-different-types-of-enteral-nutrition-products
#6
REVIEW
Jocelyn Shulhan, Bryan Dicken, Lisa Hartling, Bodil Mk Larsen
Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birth-weight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required...
January 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28087870/purls-deliver-or-wait-with-late-preterm-membrane-rupture
#7
Keri Bergeson, Shailendra Prasad
While ACOG recommends delivery for all women with ruptured membranes after 34 weeks' gestation, a new study finds expectant management may be the way to go.
November 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/28079822/successfully-treated-congenital-cystic-adenomatoid-malformation-by-open-fetal-surgery-a-care-compliant-case-report-of-a-5-year-follow-up-and-review-of-the-literature
#8
Dazhi Fan, Shuzhen Wu, Rui Wang, Yi Huang, Yao Fu, Wen Ai, Meng Zeng, Xiaoling Guo, Zhengping Liu
BACKGROUND: Congenital cystic adenomatoid malformation (CCAM) is a rare hamartomatous cystic lesion. Open fetal surgery currently provides a potential therapeutic option for management of a fetus with CCAM diagnosis. CASE SUMMARY: A 22-year-old G2P0 woman presented at (Equation is included in full-text article.)weeks' gestation for evaluation of a fetus with a left lung lesion and diagnosed as CCAM at (Equation is included in full-text article.)weeks' gestation...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067942/body-positioning-for-spontaneously-breathing-preterm-infants-with-apnoea
#9
REVIEW
Rami A Ballout, Jann P Foster, Lara A Kahale, Lina Badr
BACKGROUND: It has been proposed that body positioning in preterm infants, as compared with other, more invasive measures, may be an effective method of reducing clinically significant apnoea. OBJECTIVES: To determine effects of body positioning on cardiorespiratory parameters in spontaneously breathing preterm infants with clinically significant apnoea.Subgroup analyses examined effects of body positioning of spontaneously breathing preterm infants with apnoea from the following subgroups...
January 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28062422/spontaneous-rupture-of-renal-angiomyolipoma-during-pregnancy
#10
Li Ao, Eriko Ogasahara, Yasuhiko Okuda, Shuji Hirata
A renal angiomyolipoma (AML) is a rare benign tumour of kidney origin. Pregnancy is known to be associated with an increased risk of tumour rupture causing hypovolaemic shock, which is usually managed surgically or through an embolisation procedure. However, having surgery during pregnancy predisposes the mother to a preterm delivery, and the unknown influences of radiation exposure to the fetus make the management of such cases very challenging. A 30-year-old pregnant woman had a sudden onset of gross haematuria at the 20th week of her pregnancy...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28061799/ralstonia-picketti-neonatal-sepsis-a-case-report
#11
Deepak Sharma, Pradeep Sharma, Priyanka Soni, Basudev Gupta
BACKGROUND: Ralstonia genus are gram negative bacillus and includes four bacteria namely Ralstonia picketti, Ralstonia Solanacearum, Ralstonia insidiosa and Ralstonia mannitolilytica. These are opportunistic pathogens and cause infections in immunocompromised host. The sources of infection are usually contaminated solutions and water. The majority of the reported cases are caused by R. picketti. It is very rare cause of neonatal sepsis with less than twenty cases reported in literature till date...
January 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28060859/physiological-biochemical-and-biophysical-characterization-of-the-lung-lavaged-spontaneously-breathing-rabbit-as-a-model-for-respiratory-distress-syndrome
#12
Francesca Ricci, Chiara Catozzi, Xabier Murgia, Brenda Rosa, Davide Amidani, Luca Lorenzini, Federico Bianco, Claudio Rivetti, Silvia Catinella, Gino Villetti, Maurizio Civelli, Barbara Pioselli, Carlo Dani, Fabrizio Salomone
Nasal continuous positive airway pressure (nCPAP) is a widely accepted technique of non-invasive respiratory support in spontaneously-breathing premature infants with respiratory distress syndrome (RDS). Surfactant administration techniques compatible with nCPAP ventilation strategy are actively investigated. Our aim is to set up and validate a respiratory distress animal model that can be managed on nCPAP suitable for surfactant administration techniques studies. Surfactant depletion was induced by bronchoalveolar lavages (BALs) on 18 adult rabbits...
2017: PloS One
https://www.readbyqxmd.com/read/28052185/early-administration-of-inhaled-corticosteroids-for-preventing-chronic-lung-disease-in-very-low-birth-weight-preterm-neonates
#13
REVIEW
Vibhuti S Shah, Arne Ohlsson, Henry L Halliday, Michael Dunn
BACKGROUND: Chronic lung disease (CLD) remains a common complication among preterm infants. There is increasing evidence that inflammation plays an important role in the pathogenesis of CLD. Due to their strong anti-inflammatory properties, corticosteroids are an attractive intervention strategy. However, there are growing concerns regarding short- and long-term effects of systemic corticosteroids. Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system with a lower risk of undesirable systemic side effects...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28050517/prosthodontic-approach-in-management-of-prolonged-neonatal-intubation
#14
Vikas B Kamble, Shital K Shah, Vishnu B Rathod, Priyanka S Ambadkar, Charudutt N Patil
Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28046188/comparative-effectiveness-of-nonsteroidal-anti-inflammatory-drug-treatment-vs-no-treatment-for-patent-ductus-arteriosus-in-preterm-infants
#15
Jonathan L Slaughter, Patricia B Reagan, Thomas B Newman, Mark A Klebanoff
Importance: Patent ductus arteriosus (PDA) is associated with increased mortality and worsened respiratory outcomes, including bronchopulmonary dysplasia (BPD), in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious in closing PDA, but the effectiveness of NSAID-mediated PDA closure in improving mortality and preventing BPD is unclear. Objective: To determine the effectiveness of NSAID treatment for PDA in reducing mortality and moderate/severe BPD at 36 weeks postmenstrual age...
January 3, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28042972/a-conservative-treatment-of-patent-ductus-arteriosus-in-very-low-birth-weight-infants
#16
J B Letshwiti, J Semberova, K Pichova, E M Dempsey, O M Franklin, J Miletin
BACKGROUND: Treatment of the patent ductus arteriosus (PDA) in the preterm infant remains contentious. There are numerous options of the PDA management from early targeted treatment, late (symptomatic) treatment to no treatment at all. AIMS: To evaluate a three different PDA management approaches in very low birth weight (VLBW) infants. STUDY DESIGN: A retrospective observational time series study of three cohorts of VLBW infants born between 2004 and 2011...
December 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/28041866/-management-of-patent-ductus-arteriosus-in-preterm-infants-an-evidence-based-approach
#17
V Gournay
A patent ductus arteriosus, very common in the preterm infant (incidence up to 70% in infants less than 28 weeks gestational age), causes a left-to-right shunt leading to overload of the pulmonary circulation and low systemic blood flow. These hemodynamic anomalies are associated with a higher incidence of respiratory, neurological, and digestive complications of prematurity, as well as a higher mortality rate. Although growing knowledge about the natural history, the pathophysiology, and the mechanisms of closure of the ductus arteriosus has resulted in therapeutic progress, management of the patent ductus arteriosus in the preterm infant is still a subject of intense controversy...
December 29, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28029462/-prediction-of-preterm-delivery-in-symptomatic-women-preterm-labor
#18
G Benoist
OBJECTIVES: To evaluate the predictors of spontaneous preterm birth in case of preterm labor. MATERIALS AND METHODS: Literature search in Medline and Cochrane databases and recommendations of international societies. Selection of studies in symptomatic women (with preterm labor). RESULTS: Preterm labor is defined as a clinical situation occurring between 22 and 36 weeks + 6 days, in which cervical changes are observed associated with uterine contractions, evolving spontaneously or not to preterm delivery (Professional consensus)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28026897/pregnancy-outcome-of-gestational-diabetes-mellitus-using-a-structured-model-of-care-wings-project-wings-10
#19
Ram Uma, Balaji Bhavadharini, Harish Ranjani, Manni Mohanraj Mahalakshmi, Ranjit Mohan Anjana, Ranjit Unnikrishnan, Arivudainambi Kayal, Belma Malanda, Anne Belton, Viswanathan Mohan
AIM: To evaluate the impact of a structured model of care (MOC) prepared for resource-constrained settings, on the pregnancy outcomes of Asian Indian women with gestational diabetes mellitus (GDM). METHODS: Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28025631/amniotic-band-syndrome-perinatal-hospice-and-palliative-care-versus-active-management
#20
Shadi Rezai, Justin Faye, Annika Chadee, Sri Gottimukkala, Ruchi Upadhyay, Carla Lara, Benamanahalli H Rajegowda, Andrew D Corwin, Rasila V Lala, Jessica Vernon, Dilfuza Nuritdinova, Stephen Chasen, Cassandra E Henderson
Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence...
2016: Case Reports in Obstetrics and Gynecology
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