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Respiratory distress in preterm infant

Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Sezin Unal, Dilek Ulubas Isik, Ahmet Yagmur Bas, Zehra Arslan, Nihal Demirel
Introduction The incidence and risk factors for inguinal hernia (IH) is not a thoroughly evaluated issue of preterms. Prematurity is the single most important risk factor. There exists no study in our country which reported the incidence of IH in preterms. The purpose of this study is to investigate the incidence and time of diagnosis of IH in very low-birth-weight (VLBW) infants. Patients and Methods This retrospective case-control study was conducted in Etlik Zubeyde Hanim Women's Health Training and Research Hospital and included discharged VLBW infants with gestational age less than 32 weeks...
October 18, 2016: European Journal of Pediatric Surgery
Akwugo A Eziefule, Solafa Elshatanoufy, Mili Thakur, Frederico G Rocha
Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse...
October 2016: American Journal of Perinatology Reports
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
Sandra Kruchov Thygesen, Morten Olsen, John R Østergaard, Henrik Toft Sørensen
OBJECTIVES: Infant respiratory distress syndrome (IRDS) is a known risk factor for intracerebral haemorrhage/intraventricular haemorrhage (ICH/IVH) and periventricular leucomalacia. These lesions are known to increase the risk of cerebral palsy (CP). Thus, we wanted to examine the long-term risk of CP following IRDS in moderately late and late preterm infants. DESIGN: Population-based cohort study. SETTING: All hospitals in Denmark. PARTICIPANTS: We used nationwide medical registries to identify a cohort of all moderately and late preterm infants (defined as birth during 32-36 full gestational weeks) born in Denmark in 1997-2007 with and without hospital diagnosed IRDS...
October 11, 2016: BMJ Open
François Olivier, Sophie Nadeau, Georges Caouette, Bruno Piedboeuf
BACKGROUND: Late preterm infants (34-36 weeks' gestation) remain a population at risk for apnea of prematurity (AOP). As infants affected by respiratory distress syndrome (RDS) have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants. OBJECTIVE: The primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP...
2016: Frontiers in Pediatrics
Smeeta Sardesai, Manoj Biniwale, Fiona Wertheimer, Arlene Garingo, Rangasamy Ramanathan
Respiratory distress syndrome (RDS) due to surfactant deficiency is the most common cause of respiratory failure in preterm infants. Tremendous progress has been made since the original description that surfactant deficiency is the major cause of RDS. Surfactant therapy has been extensively studied in preterm infants and has been shown to significantly decrease air leaks and neonatal and infant mortality. Synthetic and animal-derived surfactants from bovine as well as porcine origin have been evaluated in randomized controlled trials...
October 5, 2016: Pediatric Research
Crista A Hopp, Ida Sue Baron
OBJECTIVE: Children delivered at the edge of viability are at greatest risk of medical and neuropsychological disability, their adverse outcomes overshadowing extremely preterm survivors with more optimal outcomes. We aimed to describe an exceptionally early-born extremely preterm (EEEP) preschooler whose neurobiological, familial, and socioeconomic factors likely influenced her unexpected cognitive resilience. METHOD: Baby G was a 3-years 10-months-old, English-speaking, Caucasian, singleton girl born weighing 435 g at 22(5/7) weeks' gestation to well-educated married parents...
October 5, 2016: Clinical Neuropsychologist
Vincent Rigo, Caroline Lefebvre, Isabelle Broux
: Less invasive surfactant therapies (LIST) use surfactant instillation through a thin tracheal catheter in spontaneously breathing infants. This review and meta-analysis investigates respiratory outcomes for preterm infants with respiratory distress syndrome treated with LIST rather than administration of surfactant through an endotracheal tube. Randomised controlled trial (RCT) full texts provided outcome data for bronchopulmonary dysplasia (BPD), death or BPD, early CPAP failure, invasive ventilation requirements and usual neonatal morbidities...
September 27, 2016: European Journal of Pediatrics
Adam S Dingens, Tessa S Fairfortune, Susan Reed, Caroline Mitchell
BACKGROUND: Bacterial vaginosis (BV) during pregnancy is a well-established risk factor for preterm birth and other preterm pregnancy complications. Little is known about adverse neonatal outcomes associated with BV exposure in full-term births, nor its influence on adverse outcomes independent of its effect on gestational age. The purpose of this study was to examine the relationship between BV during pregnancy and adverse neonatal outcomes among full-term and preterm infants. METHODS: We conducted a retrospective cohort study of Washington State mother/infant pairs from 2003-2013, stratified by full-term (primary outcomes) and preterm births (secondary outcomes)...
2016: BMC Pregnancy and Childbirth
Monera Mm Mohammed, Sirageldin Mk Abdel Rahman
Hyperglycaemia has become a significant risk factor for morbidity and mortality of the smaller fragile infants surviving the neonatal period. Its risk is inversely related to gestational age, birth weight and baby's clinical condition. The aim of this study was to determine the frequency, some clinical aspects and immediate outcome of hyperglycaemia in neonates admitted to the neonatal intensive care unit (NICU) at Gaafar Ibnauf Children's Hospital, Khartoum. The study was a prospective, descriptive and hospital-based, conducted during the period of 1st January to 31st December 2014...
2016: Sudan J Paediatr
Vahid Siavashi, Simin Asadian, Masoud Taheri-Asl, Homa Babaei, Samaneh Keshavarz, Mohammad Bazaei, Seyed Mahdi Nassiri
Many infants who develop bronchopulmonary dysplasia (BPD) are born with serious respiratory distress syndrome (RDS), which is associated with impaired vascular and alveolar growth. RDS is a breathing disorder that mostly affects preterm infants and occurs in infants whose lungs have not yet been fully developed. The use of surfactant in RDS treatment does not necessarily prevent BPD. Endothelial progenitor cells (EPCs) may contribute to lung angiogenesis for the prevention and treatment of BPD. The aim of this study was to evaluate the therapeutic efficacy of phototherapy for EPC release in preterm infants born with RDS...
September 20, 2016: Journal of Cellular Biochemistry
David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
September 21, 2016: Neonatology
Senem Alkan Ozdemir, Esra Arun Ozer, Ozkan Ilhan, Sumer Sutcuoglu
BACKGROUND: Mechanical ventilation is an essential therapy in the treatment of respiratory failure in preterm infants. However, optimal ventilation strategy continues to be difficult to define. OBJECTIVE: To compare the effects of volume guarantee (VG) combined with intermittent mandatory ventilation (SIMV) and VG combined with pressure support ventilation (PSV) on the pulmonary mechanics and short term prognosis in preterm infants with respiratory distress syndrome...
September 13, 2016: Pediatric Pulmonology
Veronica Mardegan, Elena Priante, Elisabetta Lolli, Paola Lago, Eugenio Baraldi
Heated, humidified high-flow delivered by nasal cannulae (HHHFNC) is increasingly used for noninvasive respiratory support in preterm infants and critically ill children due to its perceived effectiveness and ease of use. Evidence from randomized controlled trials suggests that HHHFNC and continuous positive airway pressure (CPAP) are equally effective as postextubation support in preterm infants. HHHFNC is also used for weaning preterm infants from CPAP. Data on HHHFNC used as the primary support for treating respiratory distress syndrome are conflicting...
September 2016: American Journal of Perinatology
Maike Röhr, Martin Poryo, Johannes Bay, Ludwig Gortner, Sascha Meyer
In preterm neonates, the use of invasive ventilation may be mandatory because of respiratory distress syndrome (RDS). In this short communication, we demonstrate that invasive ventilation in this susceptible cohort may be associated with episodes of both hypo- and hypercapnia, and that inadequate ventilatory support is associated with the occurrence rate of bronchopulmonary dysplasia (BPD; p < 0.05). Also, inadequate mechanical ventilation is aggravated by a shortage of medical staff.
August 30, 2016: Wiener Medizinische Wochenschrift
Eog van Vliet, G H Dijkema, E Schuit, K Y Heida, C Roos, Jam van der Post, E C Parry, L McCowan, D J Lyell, Y Y El-Sayed, D B Carr, A L Clark, Z A Mahdy, M Uma, N C Sayin, G F Varol, B W Mol, M A Oudijk
BACKGROUND: Preterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48 hours of rescue tocolysis improves neonatal outcome is unproven. OBJECTIVES: To evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta-analysis (IPDMA). SEARCH STRATEGY: We searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour...
October 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Erin V McGillick, Sandra Orgeig, Marie T Williams, Janna L Morrison
Administration of glucocorticoids (GCs) to women at risk of preterm delivery reduces the newborn's risk of respiratory distress syndrome (RDS) by 35% to 40%; however, not all infants respond to this treatment. Fetal growth restriction (FGR) increases the risk of prematurity, perinatal morbidity, and mortality. This review aims to synthesize current evidence reporting the difference in RDS risk between FGR and normally grown infants (Question 1) and whether antenatal GC administration reduces the risk of RDS morbidity in FGR infants (Question 2)...
November 2016: Reproductive Sciences
Giovanni Vento, Roberta Pastorino, Luca Boni, Francesco Cota, Virgilio Carnielli, Filip Cools, Carlo Dani, Fabio Mosca, Jane Pillow, Graeme Polglase, Paolo Tagliabue, Anton H van Kaam, Maria Luisa Ventura, Milena Tana, Chiara Tirone, Claudia Aurilia, Alessandra Lio, Cinzia Ricci, Alessandro Gambacorta, Chiara Consigli, Danila D'Onofrio, Camilla Gizzi, Luca Massenzi, Viviana Cardilli, Alessandra Casati, Roberto Bottino, Federica Pontiggia, Elena Ciarmoli, Stefano Martinelli, Laura Ilardi, Mariarosa Colnaghi, Piero Giuseppe Matassa, Valentina Vendettuoli, Paolo Villani, Francesca Fusco, Diego Gazzolo, Alberto Ricotti, Federica Ferrero, Ilaria Stasi, Rosario Magaldi, Gianfranco Maffei, Giuseppe Presta, Roberto Perniola, Francesco Messina, Giovanna Montesano, Chiara Poggi, Lucio Giordano, Enza Roma, Carolina Grassia, Gaetano Ausanio, Fabrizio Sandri, Giovanna Mescoli, Francesco Giura, Giampaolo Garani, Agostina Solinas, Maria Lucente, Gabriella Nigro, Antonello Del Vecchio, Flavia Petrillo, Luigi Orfeo, Lidia Grappone, Lorenzo Quartulli, Antonio Scorrano, Hubert Messner, Alex Staffler, Giancarlo Gargano, Eleonora Balestri, Stefano Nobile, Caterina Cacace, Valerio Meli, Sara Dallaglio, Betta Pasqua, Loretta Mattia, Eloisa Gitto, Marcello Vitaliti, Maria Paola Re, Stefania Vedovato, Alessandra Grison, Alberto Berardi, Francesco Torcetta, Isotta Guidotti, Sandra di Fabio, Eugenia Maranella, Isabella Mondello, Stefano Visentin, Francesca Tormena
BACKGROUND: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs...
2016: Trials
Carrie K Shapiro-Mendoza, Wanda D Barfield, Zsakeba Henderson, Arthur James, Jennifer L Howse, John Iskander, Phoebe G Thorpe
Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth (1). Infants born at earlier gestational ages, especially <32 0/7 weeks, have the highest mortality (Figure) and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance...
2016: MMWR. Morbidity and Mortality Weekly Report
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