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https://www.readbyqxmd.com/read/28859764/no-347-obstetric-management-at-borderline-viability
#1
Noor Niyar N Ladhani, Radha S Chari, Michael S Dunn, Griffith Jones, Prakesh Shah, Jon F R Barrett
OBJECTIVE: The primary objective of this guideline was to develop consensus statements to guide clinical practice and recommendations for obstetric management of a pregnancy at borderline viability, currently defined as prior to 25+6 weeks. INTENDED USERS: Clinicians involved in the obstetric management of women whose fetus is at the borderline of viability. TARGET POPULATION: Women presenting for possible birth at borderline viability. EVIDENCE: This document presents a summary of the literature and a general consensus on the management of pregnancies at borderline viability, including maternal transfer and consultation, administration of antenatal corticosteroids and magnesium sulfate, fetal heart rate monitoring, and considerations in mode of delivery...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28757329/infections-following-surgical-patent-ductus-arteriosus-ligation-in-vlbw-neonates
#2
Katarzyna Kopeć-Godlewska, Jadwiga Wójkowska-Mach
BACKGROUND: Very low birth weight (VLBW) neonates (<1,500 g) comprise approximately 1% of liveborn infants in Poland. Patent ductus arteriosus (PDA) is a common complication of prematurity. This study aimed to determine how many VLBW neonates treated in the participating units needed a surgical correction of PDA, and to evaluate the incidence of various types of post-operative infections, and their microbiology. METHODS: Observational study in five neonatology departments by the Polish Neonatology Surveillance Network, involving 2039 VLBW newborns of whom 103 (5...
July 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28715154/the-role-of-oxidative-stress-in-acute-renal-injury-of-newborn-rats-exposed-to-hypoxia-and-endotoxin
#3
Egor Y Plotnikov, Tatiana A Pavlenko, Irina B Pevzner, Ljubava D Zorova, Vasily N Manskikh, Denis N Silachev, Gennady T Sukhikh, Dmitry B Zorov
Neonatal kidney injury is a frequent pathology, especially among premature infants. The search for effective nephroprotection requires the creation of adequate experimental models of nephropathy in newborns. In this study, we explored the development of acute kidney injury (AKI) in neonatal rats during hypoxia or administration of endotoxin. We found that 2-h hypoxia (8% O2 ) and the intraperitoneal injection of 4 mg·kg(-1) lipopolysaccharide (LPS) causes the appearance of AKI markers, such as kidney injury molecule-1 (КIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in the rat urine after 24 and 72 h of exposure...
July 17, 2017: FEBS Journal
https://www.readbyqxmd.com/read/28665066/comparison-of-follow-up-courses-after-discharge-from-neonatal-intensive-care-unit-between-very-low-birth-weight-infants-with-and-without-home-oxygen
#4
Ji Sook Kim, Jae Won Shim, Jang Hoon Lee, Yun Sil Chang
In order to investigate the clinical impact of home oxygen use for care of premature infants, we compared the follow-up courses after neonatal intensive care unit (NICU) discharge between very low birth weight infants (VLBWIs) with and without home oxygen. We retrospectively identified 1,232 VLBWIs born at 22 to 32 weeks of gestation, discharged from the NICU of 43 hospitals in Korea between April 2009 and March 2010, and followed them up until April 2011. Clinical outcomes, medical service uses, and readmission and death rates during follow-up after the NICU discharge were compared between VLBWIs with (HO, n = 167) and those without (CON, n = 1,056) home oxygen at discharge...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28536728/neonatologist-performed-point-of-care-functional-echocardiography-in-the-neonatal-intensive-care-unit
#5
Woei Bing Poon, Keng Yean Wong
Functional echocardiography (fECHO) refers to a bedside, limited assessment of the ductus arteriosus, myocardial performance and pulmonary or systemic haemodynamics that is brief in nature and addresses a specific clinical question or management dilemma. This point-of-care ultrasonography is increasingly used internationally and locally among neonatal units to assist with management of neonatal haemodynamic conditions. This article intends to explain the modality, its indications, interpretation and implications for management, and how it impacts long-term outcomes, particularly in chronic lung disease for premature infants born before 32 weeks of gestation...
May 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28392287/blocked-delayed-or-obstructed-what-causes-poor-white-matter-development-in-intrauterine-growth-restricted-infants
#6
REVIEW
Mary Tolcos, Steven Petratos, Jonathan J Hirst, Flora Wong, Sarah J Spencer, Aminath Azhan, Ben Emery, David W Walker
Poor white matter development in intrauterine growth restricted (IUGR) babies remains a major, untreated problem in neonatology. New therapies, guided by an understanding of the mechanisms that underlie normal and abnormal oligodendrocyte development and myelin formation, are required. Much of our knowledge of the mechanisms that underlie impaired myelination come from studies in adult demyelinating disease, preterm brain injury, or experimental models of hypoxia-ischemia. However, relatively less is known for IUGR which is surprising because IUGR is a leading cause of perinatal mortality and morbidity, second only to premature birth...
July 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/28268184/feeding-premature-neonates-kinship-and-species-in-translational-neonatology
#7
Mie S Dam, Sandra M Juhl, Per T Sangild, Mette N Svendsen
Kinship, understood as biogenetic proximity, between a chosen animal model and a human patient counterpart, is considered essential to the process of 'translating' research from the experimental animal laboratory to the human clinic. In the Danish research centre, NEOMUNE, premature piglets are fed a novel milk diet (bovine colostrum) to model the effects of this new diet in premature infants. Our ethnographic fieldwork in an experimental pig laboratory and a neonatal intensive care unit (NICU) in 2013-2014 shows that regardless of biogenetics, daily practices of feeding, housing, and clinical care hold the potential for stimulating and eroding kinship relations between human and nonhuman actors...
April 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28086969/multicenter-neonatal-databases-trends-in-research-uses
#8
REVIEW
Liza M Creel, Sean Gregory, Catherine J McNeal, Madhava R Beeram, David R Krauss
BACKGROUND: In the US, approximately 12.7% of all live births are preterm, 8.2% of live births were low birth weight (LBW), and 1.5% are very low birth weight (VLBW). Although technological advances have improved mortality rates among preterm and LBW infants, improving overall rates of prematurity and LBW remains a national priority. Monitoring short- and long-term outcomes is critical for advancing medical treatment and minimizing morbidities associated with prematurity or LBW; however, studying these infants can be challenging...
January 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28068438/variation-in-performance-of-neonatal-intensive-care-units-in-the-united-states
#9
Jeffrey D Horbar, Erika M Edwards, Lucy T Greenberg, Kate A Morrow, Roger F Soll, Madge E Buus-Frank, Jeffrey S Buzas
Importance: Hospitals use rates from the best quartile or decile as benchmarks for quality improvement aims, but to what extent these aims are achievable is uncertain. Objective: To determine the proportion of neonatal intensive care units (NICUs) in 2014 that achieved rates for death and major morbidities as low as the shrunken adjusted rates from the best quartile and decile in 2005 and the time it took to achieve those rates. Design, Setting, and Participants: A total of 408 164 infants with a birth weight of 501 to 1500 g born from January 1, 2005, to December 31, 2014, and cared for at 756 Vermont Oxford Network member NICUs in the United States were evaluated...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28040456/exhaled-breath-condensate-analysis-from-intubated-newborns-by-nano-hplc-coupled-to-high-resolution-ms
#10
A S Kononikhin, N L Starodubtseva, V V Chagovets, A Y Ryndin, A A Burov, I A Popov, A E Bugrova, R A Dautov, A O Tokareva, Y L Podurovskaya, O V Ionov, V E Frankevich, E N Nikolaev, G T Sukhikh
Invasiveness of examination and therapy methods is a serious problem for intensive care and nursing of premature infants. Exhaled breath condensate (EBC) is the most attractive biofluid for non-invasive methods development in neonatology for monitoring the status of intubated infants. The aim of the study was to propose an approach for EBC sampling and analysis from mechanically ventilated neonates. EBC collection system with good reproducibility of sampling was demonstrated. Discovery-based proteomic and metabolomic studies were performed using nano-HPLC coupled to high resolution MS...
March 15, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27915314/programs-for-detecting-and-treating-retinopathy-of-prematurity-role-of-the-neonatal-team
#11
Sudhanshu Grover, Deeksha Katoch, Mangat R Dogra, Praveen Kumar
High quality perinatal-neonatal care can prevent severe Retinopathy of Prematurity (ROP) in most cases. Preterm infants who do develop retinopathy can also have good visual outcomes if screening and treatment are done timely. National Neonatology Forum published clinical practice guidelines for timely screening and treatment of ROP in neonatal care units in the country in 2010. It is also listed as one of the condition under Rashtriya Bal Swasthya Karyakram for early identification and early intervention, and is currently a focus area under the National Program for Control of Blindness...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27887680/emergency-video-telemedicine-consultation-for-newborn-resuscitations-the-mayo-clinic-experience
#12
Jennifer L Fang, Christopher A Collura, Robert V Johnson, Garth F Asay, William A Carey, Douglas P Derleth, Tara R Lang, Beth L Kreofsky, Christopher E Colby
OBJECTIVE: To describe the Mayo Clinic experience with emergency video telemedicine consultations for high-risk newborn deliveries. PATIENTS AND METHODS: From March 26, 2013, through December 31, 2015, the Division of Neonatal Medicine offered newborn telemedicine consultations to 6 health system sites. A wireless tablet running secure video conferencing software was used by the local care teams. Descriptive data were collected on all consultations. After each telemedicine consult, a survey was sent to the neonatologist and referring provider to assess the technology, teamwork, and user satisfaction...
December 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27723726/renal-injury-in-neonates-use-of-omics-for-developing-precision-medicine-in-neonatology
#13
REVIEW
Mandar S Joshi, Kelsey A Montgomery, Peter J Giannone, John A Bauer, Mina H Hanna
Preterm birth is associated with increased risks of morbidity and mortality along with increased healthcare costs. Advances in medicine have enhanced survival for preterm infants but the overall incidence of major morbidities has changed very little. Abnormal renal development is an important consequence of premature birth. Acute kidney injury (AKI) in the neonatal period is multifactorial and may increase lifetime risk of chronic kidney disease.Traditional biomarkers in newborns suffer from considerable confounders, limiting their use for early identification of AKI...
January 2017: Pediatric Research
https://www.readbyqxmd.com/read/27637021/intraocular-pressure-in-premature-low-birth-weight-infants
#14
Sandeep Grover, Zimei Zhou, Shamim Haji, Wassia Khaja, Kumar Sambhav, Merrill Stass-Isern, K V Chalam
PURPOSE: To evaluate the intraocular pressure (IOP) and central corneal thickness (CCT) in premature low birth weight (LBW) infants and their correlation with gestational age (GA). METHODS: IOP and CCT were measured in premature LBW infants (defined as a birth weight ≤ 1,500 g or birth GA ≤ 30 weeks) admitted to the neonatal intensive care unit at the University of Florida Division of Neonatology, UF Health Jacksonville. RESULTS: Ninety eyes of 45 premature LBW infants with mean birth GA of 28...
September 1, 2016: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/27597734/personalized-antenatal-consultations-for-preterm-labor-responding-to-mothers-expectations
#15
MULTICENTER STUDY
Nathalie Gaucher, Sophie Nadeau, Alexandre Barbier, Annie Janvier, Antoine Payot
OBJECTIVE: To explore prospective mothers' perspectives regarding antenatal consultations by neonatology teams for threatened preterm delivery. STUDY DESIGN: In a prospective multicenter study, women at risk of preterm delivery between 26 and 32 weeks of gestational age were surveyed during the 72 hours following their antenatal consultation. The questionnaire used was developed and validated during a single-center study. RESULTS: Over 18 months, 229 mothers completed the survey (73% response rate), at a median gestational age of 30 weeks...
November 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27511502/management-of-hyperbilirubinemia-in-preterm-infants-in-turkey
#16
Nilüfer Güzoğlu, Ümit Ayşe Tandircioğlu, Didem Aliefendioğlu
BACKGROUND/AIM: Prematurity is a significant risk factor for developing unconjugated hyperbilirubinemia. This study investigated the current approach to managing hyperbilirubinemia in preterm newborns in Turkey. MATERIALS AND METHODS: A study-specific questionnaire on the management of jaundice in preterm infants was sent to 100 level III neonatal intensive care units in Turkey. RESULTS: Responses were obtained from 84 centers from all regions of Turkey...
2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27501070/establishment-of-the-relationship-between-fathers-and-premature-infants-in-neonatal-units
#17
Marie-Josée Martel, Isabelle Milette, Linda Bell, Denise St-Cyr Tribble, Antoine Payot
BACKGROUND: Parents and their preterm infants (born between 32-37 weeks of gestation) are often overlooked by the healthcare system. And very little attention is given to the relationship parents develop with their infants in the neonatal unit (NNU). Specifically, very few studies focused on fathers and how they establish a relationship with their infants. However, we know that the father-infant relationship is extremely important for their future social development and more. PURPOSE: This article presents the results of a qualitative study of the establishment of the father-premature infant relationship in an NNU...
August 5, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27479521/group-b-streptococcus-infections-in-neonates-admitted-to-a-german-nicu-emphasis-on-screening-and-adherence-to-pre-analytical-recommendations
#18
Claudia Reinheimer, Volkhard A J Kempf, Boris E Wittekindt, Antje Allendorf, Thomas A Wichelhaus, Michael Hogardt, Rolf L Schlößer, Doris Fischer
BACKGROUND: Infections by group B streptococci (GBS), e.g. Streptococcus agalactiae, presenting as early-onset disease (EOD) or late-onset disease (LOD), are leading causes of severe infections in newborn and premature patients. Although screening and intra partum antibiotic prophylaxis are frequently performed, vertically transmitted GBS remain a challenge for pediatrics. AIMS: In order to prevent or reduce potential life-threatening events, this study retrospectively investigated epidemiological, microbiological and clinical aspects of infants admitted to the Division of Neonatology at the Department of Pediatrics at the University Hospital Frankfurt, Germany (UHF)...
December 2016: Early Human Development
https://www.readbyqxmd.com/read/27424006/research-opportunities-to-improve-neonatal-red-blood-cell-transfusion
#19
REVIEW
Ravi Mangal Patel, Erin K Meyer, John A Widness
Red blood cell (RBC) transfusion is a common and lifesaving therapy for anemic neonates and infants, particularly among those born prematurely or undergoing surgery. However, evidence-based indications for when to administer RBCs and adverse effects of RBC transfusion on important outcomes including necrotizing enterocolitis, survival, and long-term neurodevelopmental impairment remain uncertain. In addition, blood-banking practices for preterm and term neonates and infants have been largely developed using studies from older children and adults...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27344192/methodological-issues-in-the-design-and-analyses-of-neonatal-research-studies-experience-of-the-nichd-neonatal-research-network
#20
Abhik Das, Jon Tyson, Claudia Pedroza, Barbara Schmidt, Marie Gantz, Dennis Wallace, William E Truog, Rosemary D Higgins
Impressive advances in neonatology have occurred over the 30 years of life of The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN). However, substantial room for improvement remains in investigating and further developing the evidence base for improving outcomes among the extremely premature. We discuss some of the specific methodological challenges in the statistical design and analysis of randomized trials and observational studies in this population...
October 2016: Seminars in Perinatology
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