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Perinatology

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https://www.readbyqxmd.com/read/28230835/sudden-versus-gradual-pressure-wean-from-nasal-cpap-in-preterm-infants-a-randomized-controlled-trial
#1
S Amatya, M Macomber, A Bhutada, D Rastogi, S Rastogi
OBJECTIVE: In preterm infants, nasal continuous positive airway pressure (NCPAP) is widely used for treatment of respiratory distress syndrome. However, the strategies for successfully weaning infants off NCPAP are still not well defined and there remains considerable variation between the methods. The objective of this study is to determine whether gradual weaning of NCPAP pressure is more successful than sudden weaning off NCPAP to room air. STUDY DESIGN: A randomized controlled trial was conducted in a level 3 neonatal intensive care unit on 70 preterm neonates who were born between 26 and 32 weeks gestation and required NCPAP for at least 48 h...
February 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28230834/risk-stratification-for-congenital-diaphragmatic-hernia-by-factors-within-24%C3%A2-h-after-birth
#2
K Terui, K Nagata, Y Kanamori, S Takahashi, M Hayakawa, H Okuyama, N Inamura, H Yoshida, T Taguchi, N Usui
OBJECTIVE: To establish a simple risk stratification system for patients with congenital diaphragmatic hernia (CDH) based on postnatal information within 24 h after birth. STUDY DESIGN: A multi-institutional retrospective cohort study was conducted including 348 neonates who had isolated CDH born between 2006 and 2010. Based on the two most powerful variables for 90-day survival selected by multivariate analyses, a risk stratification system was established. RESULTS: Multiple logistic regression analysis identified two adverse prognostic factors: an Apgar score at 1 min (Ap1) of 0-4 (odds ratio (OR) 3...
February 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206999/early-eeg-power-predicts-mri-injury-in-infants-with-hypoxic-ischemic-encephalopathy
#3
S V Jain, J M Zempel, P Srinivasakumar, M Wallendorf, A Mathur
OBJECTIVE: Early identification of infants with hypoxic-ischemic encephalopathy who have adverse outcomes despite neuroprotection with therapeutic hypothermia (TH) is urgently needed. Recent studies have found limited value of amplitude integrated EEG (aEEG) for predicting short-term outcomes in this population. Other quantitative electroencephalography (EEG) variables reflecting EEG amplitude, such as EEG power, could provide early stratification of a high-risk cohort in this population...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206998/dynamic-outcome-prediction-in-a-socio-demographically-diverse-population-based-cohort-of-extremely-preterm-neonates
#4
M A Steurer, J Anderson, R J Baer, S Oltman, L S Franck, M Kuppermann, L Rand, K K Ryckman, J C Partridge, L L Jelliffe-Pawlowski, E E Rogers
OBJECTIVE: Accurate outcome prediction is crucial for counseling parents and providing individualized treatment to extremely premature infants. We sought to improve upon existing prediction model by using a diverse population-based cohort of extremely premature live births (⩽28 weeks' gestation) for survival and survival without severe neonatal morbidity at different times throughout the first week of life and to evaluate potential differences by race/ethnicity and maternal education...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206997/pulmonary-hypertension-in-preterm-infants-results-of-a-prospective-screening-program
#5
C G Weismann, J D Asnes, A Bazzy-Asaad, C Tolomeo, R A Ehrenkranz, M J Bizzarro
OBJECTIVE: Determine prevalence and associations with pulmonary hypertension (PH) in preterm infants. STUDY DESIGN: Prospective institutional echocardiographic PH screening at 36 to 38 weeks' corrected gestational age (GA) for infants born <32 weeks' GA who had bronchopulmonary dysplasia (BPD; group BPD), and infants without BPD who had a birth weight (BW) <750 g, or clinical suspicion for PH (group NoBPD). RESULTS: Two hundred and four infants were screened (GA 25...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206996/the-quest-for-sustained-multiple-morbidity-reduction-in-very-low-birth-weight-infants-the-antifragility-project
#6
J W Kaempf, N M Schmidt, S Rogers, C Novack, M Friant, L Wang, N Tipping
OBJECTIVE: Can a comprehensive, explicitly directive evidence-based guideline for all therapies that might affect the major morbidities of very low-birth-weight (VLBW) infants help a neonatal intensive care unit (NICU) further improve generally favorable morbidity rates? Can Antifragility principles of provider adaptive growth from stressors, enhanced infant risk assessment and adherence to effective therapies minimize unproven treatments and reduce all morbidities? STUDY DESIGN: Prospectively planned observational trial in VLBW infants: control group born October 2011 to September 2013 and study group October 2013 to September 2015...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206995/patent-ductus-arteriosus-in-premature-infants-to-treat-or-not-to-treat
#7
M A Mohamed, M El-Dib, S Alqahtani, K Alyami, A N Ibrahim, H Aly
OBJECTIVE: Closing patent ductus arteriosus (PDA) is a widely accepted approach in the management of very low birth weight (VLBW) infants. Our objective is to test the hypothesis that conservative management (no treatment) of PDA will not affect survival without chronic lung diseases (CLD). STUDY DESIGN: This retrospective study utilizes a prospectively collected database to compare two cohorts of VLBW infants. Infants in the first group (2001 to 2009) had their PDA treated with pharmacological and if necessary with surgical ligation...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206994/defining-the-limitations-of-transcutaneous-bilirubin-measurement-in-late-preterm-newborns
#8
K L Fine, W A Carey, J A W Schuster, S C Bryant, W J Cook, B S Karon
OBJECTIVE: The objective of this study is to determine the impact of postnatal age on the bias between transcutaneous (TcB) and total serum bilirubin (TSB), and evaluate a TcB screening protocol. STUDY DESIGN: Preterm and term infants had paired TcB and TSB performed on days 1 to 3 of life; a subset of preterm infants had measurements on days 4 to 7. Sensitivity and specificity of TcB (plotted on an age-specific TSB nomogram) for prediction of high-intermediate (HIR) or high-risk TSB were calculated...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206993/hemodynamic-effects-of-sodium-bicarbonate-administration
#9
A C Katheria, M K Brown, K Hassan, D M Poeltler, D A Patel, V K Brown, J B Sauberan
OBJECTIVE: To describe the hemodynamic changes that occur with sodium bicarbonate (NaHCO3) administration in premature neonates. STUDY DESIGN: This retrospective study included premature neonates 23 to 31+6 weeks of gestational age who underwent continuous cardiac and cerebral monitoring as participants in prospective trials at our institution, and who received NaHCO3 infused over 30 min in the first 24 h of life. Blood pressure (BP), heart rate, cardiac output (CO), SpO2 and cerebral oximetry (StO2) were captured every 2 s...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28206992/heme-oxygenase-1-promoter-polymorphisms-do-they-modulate-neonatal-hyperbilirubinemia
#10
M Kaplan, R J Wong, D K Stevenson
The role of genetic factors in the modulation of serum bilirubin levels and the pathophysiology of neonatal hyperbilirubinemia is being increasingly recognized. Heme oxygenase-1 (HO-1) is the rate-limiting enzyme by which heme is catabolized to biliverdin and thence to bilirubin, with the simultaneous release of equimolar quantities of ferrous iron (Fe(3+)) and carbon monoxide. Polymorphisms of the HO-1 gene promoter may modulate transcriptional activity, thereby augmenting or attenuating HO-1 expression with resultant modulation of the production of bilirubin...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28181998/zinc-protoporphyrin-heme-ratio-as-parameter-of-iron-status-in-moderately-preterm-infants-natural-course-and-associations-in-the-first-4-months
#11
C G de Waal, L Uijterschout, M Abbink, B Boersma, P Vos, W W Rövekamp, F Hudig, M D Akkermans, J B van Goudoever, F Brus
OBJECTIVE: To determine the natural course of zinc protoporphyrin/heme ratio (ZnPP/H) and its role in the detection of iron deficiency (ID) and iron-deficiency anemia (IDA) in the first 4 months of life in moderately preterm infants. STUDY DESIGN: ZnPP/H was measured at 1 week, 6 weeks and 4 months postnatal age in a prospective cohort of 161 Dutch infants born at a gestational age of 32+0 to 36+6 weeks who did not receive an erythrocyte transfusion or iron supplementation...
February 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28181997/inter-center-variation-in-death-or-tracheostomy-placement-in-infants-with-severe-bronchopulmonary-dysplasia
#12
K Murthy, N F M Porta, J M Lagatta, I Zaniletti, W E Truog, T R Grover, L D Nelin, R C Savani
OBJECTIVE: To estimate the presence and sources of inter-center variation (ICV) in the risk of death or tracheostomy placement (D/T) among infants with severe bronchopulmonary dysplasia (sBPD)Study design:We analyzed the Children's Hospitals Neonatal Database between 2010 and 2013 to identify referred infants born <32 weeks' gestation with sBPD. The association between center and the primary outcome of D/T was analyzed by multivariable modeling. Hypothesized diagnoses/practices were included to determine if these explained any observed ICV in D/T...
February 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28181996/blood-pressure-during-pregnancy-neonatal-size-and-altered-body-composition-the-healthy-start-study
#13
A P Starling, A L B Shapiro, K A Sauder, J L Kaar, B M Ringham, D H Glueck, H L Galan, D Dabelea
OBJECTIVE: The objective of this study is to estimate associations between changes in maternal arterial pressure during normotensive pregnancies and offspring birth weight and body composition at birth. STUDY DESIGN: Prospective study of 762 pregnant normotensive Colorado women, recruited from outpatient obstetrics clinics. Repeated arterial pressure measurements during pregnancy were averaged within the second and third trimesters, respectively. Multivariable regression models estimated associations between second to third trimester changes in arterial pressure and small-for-gestational-age birth weight, fat mass, fat-free mass and percent body fat...
February 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28181995/is-the-bishop-score-significant-in-predicting-the-success-of-labor-induction-in-multiparous-women
#14
D Navve, N Orenstein, R Ribak, Y Daykan, G Shechter-Maor, T Biron-Shental
OBJECTIVE: To determine whether the Bishop-score upon admission effects mode of delivery, maternal or neonatal outcomes of labor induction in multiparous women. STUDY DESIGN: A retrospective study including 600 multiparous women with a singleton pregnancy, 34 gestational weeks and above who underwent labor induction for maternal, fetal or combined indications. Induction was performed with one of three methods- oxytocin, a slow release vaginal prostaglandin E2 insert (10 mg dinoprostone) or a transcervical double balloon catheter...
February 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28169187/reptile-perinatology
#15
REVIEW
Krista A Keller
Reptile perinatology refers to the time period surrounding hatching, for oviparous species, and immediately after birth, for viviparous species. Veterinarians working in myriad conservation and breeding programs require knowledge in this area. This article reviews anatomy and physiology of the amniotic egg, the basics of artificial incubation, when manual pipping is indicated, and basic medicine of the reptile hatchling or neonate.
February 4, 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28169181/reproductive-disorders-and-perinatology-of-sea-turtles
#16
REVIEW
Filippo Spadola, Manuel Morici, Mario Santoro, Matteo Oliveri, Gianni Insacco
Sea turtles' reproductive disorders are underdiagnosed; but potentially several diseases may affect gonads, genitalia, and annexes. Viruses, bacteria, and parasites may cause countless disorders; but more frequently the cause is traumatic or linked to human activities. Furthermore, veterinary management of the nest is of paramount importance as well as the care of newborns (also in captivity). This article gives an overview on the methods used to manage nests and reproductive activities of these endangered chelonians species...
February 4, 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#17
REVIEW
Sasima Dusitkasem, Blair H Herndon, Monsicha Somjit, David L Stahl, Emily Bitticker, John C Coffman
PURPOSE: To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. SOURCE: An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28162941/stem-cells-and-bronchopulmonary-dysplasia-the-five-questions-which-cells-when-in-which-dose-to-which-patients-via-which-route
#18
REVIEW
Martin Mueller, Boris W Kramer
Preterm birth is the leading cause of death in newborns and children. Despite advances in perinatology, immature infants continue to face serious risks such chronic respiratory impairment from bronchopulmonary dysplasia (BPD). Current treatment options are insufficient and novel approaches are desperately needed. In recent years stem cells have emerged as potential candidates to treat BPD with mesenchymal stem/stromal cells (MSCs) being particularly promising. MSCs originate from several stem cell niches including bone marrow, skin, or adipose, umbilical cord, and placental tissues...
December 24, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28151821/publication-rate-of-abstracts-presented-at-the-society-for-obstetric-anesthesia-and-perinatology-annual-meetings-2010-2014
#19
Brent Gerlach, Anuj M Shah, Michael T Lee, Cynthia A Wong, John T Sullivan, Paloma Toledo
The Society for Obstetric Anesthesia and Perinatology (SOAP) annual meeting provides a forum to present new scientific work with the goal of broader dissemination of knowledge. The objective of this study was to evaluate the proportion of research abstracts presented at SOAP meetings, from 2010 to 2014, which resulted in peer-reviewed publications. The abstract-to-publication rate was compared with the percent of abstracts presented at biomedical meetings resulting in publication, as estimated by a 2007 Cochrane Review...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28151496/prediction-of-large-for-gestational-age-by-various-sonographic-fetal-weight-estimation-formulas-which-should-we-use
#20
A Aviram, Y Yogev, E Ashwal, L Hiersch, E Hadar, R Gabbay-Benziv
OBJECTIVE: As sonographic estimation of fetal weight (EFW) carries substantial impact, especially in large-for-gestational-age (LGA) neonates, we aimed to compare the accuracy of various formulas for prediction of LGA neonates. STUDY DESIGN: Retrospective cohort study of singleton gestations at term, with EFW up to 7 days before delivery (2007 to 2014). Small-for-gestational-age neonates were excluded. LGA prediction for various formulas was evaluated by: (i) measures of performance (sensitivity, specificity, etc...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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