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https://www.readbyqxmd.com/read/29139556/delivery-outcomes-of-large-for-gestational-age-newborns-stratified-by-the-presence-or-absence-of-gestational-diabetes-mellitus
#1
Hadar Rosen, Anat Shmueli, Eran Ashwal, Liran Hiersch, Yariv Yogev, Amir Aviram
OBJECTIVE: To evaluate separate and combined contributions of gestational diabetes mellitus (GDM) and large-for-gestational age (LGA) on delivery outcomes. METHODS: In a retrospective cohort study of term singleton deliveries between 2007 and 2014 in Tel Aviv, Israel, outcomes were compared between non-GDM/AGA pregnancies (reference) and three study groups: non-GDM/LGA, GDM/appropriate for gestational age (AGA) and GDM/LGA. RESULTS: Overall, there were 62 102 deliveries, of which 53 201 (85...
November 15, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29108501/occult-massive-visceral-fat-necrosis-following-therapeutic-hypothermia-for-neonatal-encephalopathy
#2
Salwa Khedr, Anna Piskorski, Adrienne R Bingham, Justin Goldstein, Abbot R Laptook, Monique E De Paepe
Therapeutic hypothermia (head or whole-body cooling) improves survival and neurodevelopmental outcome in term newborns with moderate-to-severe encephalopathy. Hypothermia treatment is well tolerated; the most common side effect is thrombocytopenia. In about 1% of infants, focal subcutaneous fat necrosis has been reported. We describe a case of clinically unsuspected massive visceral fat necrosis in a term infant with Apgar score 0 at 1 min ("resuscitated apparently stillborn" infant) who was treated with therapeutic hypothermia for 72 h and expired on the 25th day of life following a neonatal course complicated by severe encephalopathy, pulmonary artery hypertension, persistent thrombocytopenia, hypoglycemia, and severe basal ganglia-thalamic abnormalities on magnetic resonance imaging...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29067513/does-antenatal-steroids-treatment-prior-to-elective-cesarean-section-at-34-37%C3%A2-weeks-of-gestation-reduce-neonatal-morbidity-evidence-from-a-case-control-study
#3
Michal Kirshenbaum, Shali Mazaki-Tovi, Uri Amikam, Ram Mazkereth, Eyal Sivan, Eyal Schiff, Yoav Yinon
OBJECTIVE: To determine whether antenatal corticosteroids administration prior to an elective cesarean section (ECS) at 34-37 weeks gestation is associated with improved neonatal outcome. MATERIALS AND METHODS: A case control study of women with singleton pregnancies who underwent ECS between 34 and 37 weeks of gestation including two groups: (1) study group in which patients were treated with betamethasone prior to ECS (n = 58) and (2) control group matched for gestational age at delivery in which patients did not receive betamethasone (n = 107)...
October 24, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29036213/the-value-of-real-time-continuous-glucose-monitoring-in-premature-infants-of-diabetic-mothers
#4
Hean-Pat Saw, Nai-Wei Yao, Cheng-Di Chiu, Jia-Yuh Chen
To determine the feasibility of using a real-time continuous glucose monitoring system (RTGMS) in intensive care units, our study focus on preterm infants with diabetic mothers owing to their high risk of blood sugar abnormalities. Thirty preterm babies (M = 15 and F = 15; ≤ 36 week gestation age) were studied from within 72 hours of delivery. These babies were admitted to the newborn intensive care and were further categorized into groups based on whether their mothers with or without diabetic mellitus. Blood sugar levels were monitored by both RTGMS and the traditional intermittent arterial line (A-Line) glucose method...
2017: PloS One
https://www.readbyqxmd.com/read/29025524/-neonatal-morbidity-and-gestational-diabetes-coincidence-or-consequence-of-the-2011-protocol
#5
Gabriela Mimoso, Guiomar Oliveira
INTRODUCTION: Gestational diabetes is one of the diseases associated with pregnancy with higher rate of complications. Despite being a transitory condition, short and long term complications related to gestational diabetes have been described. There is scientific evidence to say that good metabolic control decreases perinatal complications. In 2011, new criteria was proposed for its diagnosis, which made possible its diagnosis during the 1st trimester of pregnancy. The aim of this study is to compare neonatal morbidity in two groups of women with gestational diabetes diagnosis before and after the latest Portuguese guidelines for diabetes and pregnancy were published (February 2011)...
September 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29020813/early-neonatal-hypoglycemia-incidence-of-and-risk-factors-a-cohort-study-using-universal-point-of-care-screening
#6
Ruben Bromiker, Assaf Perry, Yair Kasirer, Sharon Einav, Gil Klinger, Floris Levy-Khademi
OBJECTIVE: The objective of this study is to determine the true incidence of early neonatal hypoglycemia and to confirm potential risk factors. STUDY DESIGN: The study was conducted at tertiary Medical Center in Israel, between June and September 2014. First blood glucose concentrations of all infants admitted to the nursery were measured using a "point of care" analyzer (Accu-Chek). We recorded risk factors for hypoglycemia such as birth weight, gestational age, maternal diabetes and demographics and analyzed their association with two hypoglycemia cutoffs: 40 and 47 mg/dl...
October 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28942514/intrauterine-hyperglycemia-induced-inflammatory-signalling-via-the-receptor-for-advanced-glycation-end-products-in-the-cardiac-muscle-of-the-infants-of-diabetic-mother-rats
#7
Ritsuko Kawaharada, Haruna Masuda, Zhenyi Chen, Eric Blough, Tomoko Kohama, Akio Nakamura
PURPOSE: Gestational diabetes is associated with increased risk to the health of the mother and her offspring. In particular, the infants of diabetic mothers (IDMs) exhibit elevated levels of preterm birth, macrosomia, hypoglycemia, hypocalcemia, and cardiomyopathy. We have previously reported that IDMs showed abnormalities in cardiac Akt-related insulin signalling, and that these deficiencies in Akt-related signalling were attenuated by supplementing the maternal diet with fish-oil. Herein, we investigated whether the eicosapentaenoic acid (EPA) found in fish oil can be used to attenuate diabetes associated impairments in cardiomyocyte signalling...
September 23, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28932408/golden-hour-of-neonatal-life-need-of-the-hour
#8
REVIEW
Deepak Sharma
"Golden Hour" of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept in neonatology has been adopted from adult trauma where the initial first hour of trauma management is considered as golden hour. The "Golden hour" concept includes practicing all the evidence based intervention for term and preterm neonates, in the initial sixty minutes of postnatal life for better long-term outcome. Although the current evidence supports the concept of golden hour in preterm and still there is no evidence seeking the benefit of golden hour approach in term neonates, but neonatologist around the globe feel the importance of golden hour concept equally in both preterm and term neonates...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28916591/continuous-glucose-monitoring-in-very-preterm-infants-a-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Alfonso Galderisi, Andrea Facchinetti, Garry M Steil, Paulina Ortiz-Rubio, Francesco Cavallin, William V Tamborlane, Eugenio Baraldi, Claudio Cobelli, Daniele Trevisanuto
BACKGROUND AND OBJECTIVES: Impaired glucose control in very preterm infants is associated with increased morbidity, mortality, and poor neurologic outcome. Strategies based on insulin titration have been unsuccessful in achieving euglycemia in absence of an increase in hypoglycemia and mortality. We sought to assess whether glucose administration guided by continuous glucose monitoring (CGM) is more effective than standard of care blood glucose monitoring in maintaining euglycemia in very preterm infants...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28901668/dilatation-of-the-ductus-arteriosus-by-diazoxide-in-fetal-and-neonatal-rats
#10
Katsuaki Toyoshima, Kazuo Momma, Tetsuko Ishii, Toshio Nakanishi
BACKGROUND: Diazoxide, an ATP-sensitive potassium channel opener, is the main therapeutic agent for treating hyperinsulinemic hypoglycemia. We aimed to determine the in vivo ductus-dilating effects of diazoxide in fetal and neonatal rats. METHODS: Near-term rat pups delivered via a cesarean section were housed at 33°C. After rapid whole-body freezing, The ductus arteriosus (DA) diameter was measured using a microscope and a micrometer. Full-term pregnant rats (gestational day 21) were intraperitoneally injected with diazoxide (10 and 100 mg/kg) 4 h before delivery, and the neonatal DA diameter was measured at 0, 30, or 60 min after birth...
September 13, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28804631/the-influence-of-d-chiro-inositol-and-d-myo-inositol-in-pregnant-women-with-glucose-intolerance
#11
Domenico Dell'Edera, Francesca Sarlo, Arianna Allegretti, Francesca Simone, Maria Giovanna Lupo, Annunziata Anna Epifania
The aim of the present study was to demonstrate that the use of inositol and folic acid from the first trimester of pregnancy, counteracts the onset of gestational diabetes mellitus (GDM) in women at risk, preserving the infants from macrosomia, hypoglycemia and preterm delivery. The authors collected data from the pregnant women at the laboratory (Unit of Cytogenic and Molecular Genetics), from January 2014 to April 2016, all with first trimester fasting plasma glucose (FPG) >92 mg/dl. A total of 40 women were treated with 250 mg/day D-chiro-inositol, 1...
August 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28767190/insulin-degludec-in-the-first-trimester-of-pregnancy-report-of-two-cases
#12
Agostino Milluzzo, Andrea Tumminia, Nunzio M Scalisi, Lucia Frittitta, Riccardo Vigneri, Laura Sciacca
Insulin degludec is an extra-long-acting insulin analog that allows for enhanced efficacy and flexibility in the injection time. However, it is not approved for use during pregnancy. We report the pregnancy outcome and newborn conditions in two women with type 1 diabetes who continued preconception degludec treatment during embryogenesis. No pregnancy complication or congenital neonatal malformation was observed. Both babies presented with hypoglycemia and required neonatal intensive care unit admission. Degludec treatment did not cause adverse effects in the mothers or malformations in the newborns...
August 2, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28764827/using-dextrose-glucose-gel-to-reverse-neonatal-hypoglycemia
#13
Patricia Scheans, Catherine Bennett, Deborah Harris
Hospitals are challenged to implement measures to improve health outcomes, decrease costly interventions, and increase patient satisfaction. By following a nurse-driven protocol, our institution has successfully met these three challenges in our treatment of newborns diagnosed with neonatal hypoglycemia (NH). Based on results of a randomized clinical trial, a multidisciplinary team trialed glucose gel as a standard treatment for NH. During the first year, admission rates to the NICU for NH decreased by 73 percent...
July 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28757749/successful-treatment-of-a-newborn-with-congenital-hyperinsulinism-having-a-novel-heterozygous-mutation-in-the-abcc8-gene-using-subtotal-pancreatectomy
#14
Chi-Feng Yen, Chi-Yu Huang, Chon-In Chan, Chiung-Hsing Hsu, Nien-Lu Wang, Tao-Yeuan Wang, Chiung-Ling Lin, Wei-Hsin Ting
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in newborns and infants. CHI is characterized by unregulated secretion of insulin from pancreatic β: cells. Here, we reported the case of a large-for-gestational-age, full-term newborn that suffered from CHI and developed severe and persistent hypoglycemia at an early stage of life. The infant was nearly unresponsive to medical treatment, which included continuous intravenous glucagon infusion, oral diazoxide, and nifedipine...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28737197/-congenital-hyperinsulinism-of-the-newborn-a-case-report
#15
Josefina Sáez, Juan Carlos Pattillo, Pilar Orellana, Claudia Godoy
Congenital hyperinsulinism (CH) is the most frequent cause of persistent hypoglycemia in the newborn and it is characterized by an inappropriately elevated insulin level in presence of hypoglycemia. Initial management is medical treatment, but if it fails, partial pancreatectomy is the surgical procedure of choice. OBJECTIVE: To report a case of a newborn with CH to aware on this condition and update its multidisciplinary management. CASE REPORT: The case of a full term newborn with severe symptomatic hypoglycemia unresponsive to medical treatment is reported ...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28695270/maternal-use-of-prednisolone-is-unlikely-to-be-associated-with-neonatal-adrenal-suppression-a-single-center-study-of-16-cases
#16
Leanne de Vetten, Margriet van Stuijvenberg, Ido P Kema, Gianni Bocca
The use of supra-physiological, exogenous corticosteroids in pregnancy may lead to neonatal adrenal suppression. We report on a single-center, case series study carried out between 2006 and 2014, which included all newborns (n = 16) of mothers using prednisolone ≥10 mg/day during pregnancy. Newborns were routinely assessed according to hospital protocol, with follow-up until 6 weeks after birth. We investigated the clinical symptoms and biochemical findings of adrenal suppression occurring in the newborns...
August 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28667719/screening-for-hypoglycemia-in-exclusively-breastfed-high-risk-neonates
#17
Princy Singh, Amit Upadhyay, Vishnubhatla Sreenivas, Vijay Jaiswal, Pranjali Saxena
OBJECTIVE: To determine incidence of hypoglycemia in exclusively breastfed, high-risk but healthy newborns, and risk factors for its development. METHODS: This observational study enrolled 407 exclusively breastfed high-risk (low birth weight newborns (1800-2499 g), late preterms, small-for-gestation, large-for-gestation and infant of diabetic mother), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Hypoglycemia was defined as blood glucose £46 mg/dL (2...
June 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28633556/oxidative-stress-and-dna-damage-in-newborns-born-to-mothers-with-hyperglycemia-a-prospective-cohort-study
#18
K Dulasi Durga, B Adhisivam, G Vidya, B Vishnu Bhat, Zachariah Bobby, Parkash Chand
BACKGROUND: Hyperglycemic mothers have increased oxidative stress during pregnancy, which can adversely affect the outcome in their neonates. OBJECTIVES: To measure the oxidative stress and DNA damage in newborns born to mothers with hyperglycemia and correlate their immediate outcome with the amount of oxidative stress and DNA damage. METHODS: This prospective cohort study conducted in a tertiary care teaching hospital, South India included three groups - newborns born to pregestational diabetic mothers, gestational diabetic mothers, and euglycemic mothers with 24 newborns in each...
July 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28593892/neonatal-hypoglycemia-risk-factors-and-outcomes
#19
Orhideja Stomnaroska, Elizabeta Petkovska, Snezana Jancevska, Dragan Danilovski
BACKGROUND AND AIMS: Severe neonatal hypoglycemia (HG) leads to neurologic damage, mental retardation, epilepsy, personality disorders, impaired cardiac performance and muscle weakness. We aimed to assess the clinical characteristics of children with hypoglycemia in a random population of newborns. PATIENTS, METHODS AND RESULTS: We investigated 84 patients (M:F=35:48) born at the University Clinic for Gynecology and Obstetrics in Skopje (hospitalized in the NICU) who were found to have hypoglycemia...
March 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28579620/c-section-prevalence-among-obese-mothers-and-neonatal-hypoglycemia-a-cohort-analysis-of-the-department-of-gynecology-and-obstetrics-of-the-university-of-l%C3%A3-beck
#20
Kay Neumann, Ineke Indorf, Christoph Härtel, Christoph Cirkel, Achim Rody, Daniel A Beyer
INTRODUCTION: Data from the World Health Organization (WHO) demonstrates an increasing prevalence of obesity in Western countries. This study investigates the influence of obesity on the mode of delivery and the occurrence of hypoglycemia in newborns. MATERIALS AND METHODS: A retrospective analysis of all deliveries at the Department of Gynecology and Obstetrics of the University of Lübeck, Germany was conducted over a period of eleven years with the primary outcome as non-elective C-sections and hypoglycemia of newborns from obese mothers...
May 2017: Geburtshilfe und Frauenheilkunde
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