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https://www.readbyqxmd.com/read/28976987/assessing-the-neuroprotective-benefits-for-babies-of-antenatal-magnesium-sulphate-an-individual-participant-data-meta-analysis
#1
Caroline A Crowther, Philippa F Middleton, Merryn Voysey, Lisa Askie, Lelia Duley, Peter G Pryde, Stéphane Marret, Lex W Doyle
BACKGROUND: Babies born preterm are at an increased risk of dying in the first weeks of life, and those who survive have a higher rate of cerebral palsy (CP) compared with babies born at term. The aim of this individual participant data (IPD) meta-analysis (MA) was to assess the effects of antenatal magnesium sulphate, compared with no magnesium treatment, given to women at risk of preterm birth on important maternal and fetal outcomes, including survival free of CP, and whether effects differed by participant or treatment characteristics such as the reason the woman was at risk of preterm birth, why treatment was given, the gestational age at which magnesium sulphate treatment was received, or the dose and timing of the administration of magnesium sulphate...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28964284/management-of-cricopharyngeal-achalasia-in-an-8-month-child-using-endoscopic-cricopharyngeal-myotomy
#2
Cinzia Marchica, Faisal Zawawi, Sam J Daniel
A term baby was transferred to our tertiary care center with desaturations and inability to manage upper airway secretions. Rigid bronchoscopy and swallowing study revealed cricopharyngeal (CP) achalasia. A gastrostomy tube insertion and Botulinum Toxin-A injection were performed at 6 weeks of age. Improvement of symptoms was observed, however were short-lived requiring recurrent injections. Given the symptom severity, at 8 months, a successful endoscopic CP myotomy was performed. Patient was able to tolerate oral feeds as early as 2 months post-operatively...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28928195/reach-study-protocol-of-a-randomised-trial-of-rehabilitation-very-early-in-congenital-hemiplegia
#3
Roslyn N Boyd, Jenny Ziviani, Leanne Sakzewski, Iona Novak, Nadia Badawi, Kerstin Pannek, Catherine Elliott, Susan Greaves, Andrea Guzzetta, Koa Whittingham, Jane Valentine, Cathy Morgan, Margaret Wallen, Ann-Christin Eliasson, Lisa Findlay, Robert Ware, Simona Fiori, Stephen Rose
OBJECTIVES: Congenital hemiplegia is the most common form of cerebral palsy (CP). Children with unilateral CP show signs of upper limb asymmetry by 8 months corrected age (ca) but are frequently not referred to therapy until after 12 months ca. This study compares the efficacy of infant-friendly modified constraint-induced movement therapy (Baby mCIMT) to infant friendly bimanual therapy (Baby BIM) on upper limb, cognitive and neuroplasticity outcomes in a multisite randomised comparison trial...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28919481/feasibility-of-implementing-group-well-baby-well-woman-dyad-care-at-federally-qualified-health-centers
#4
Gabriela Duran, Mariam Faiz-Nassar, Kristin Mmari, Cynthia S Minkovitz, Katherine A Connor
OBJECTIVE: Group care has been shown to be effective for delivery of infant well child care. Centering Parenting™ (CP) is a model of group dyad care for mothers and infants. CP may improve quality and efficiency of preventive care, particularly for low income families. Federally Qualified Health Centers (FQHC) may be optimal sites for implementation, however facilitators and barriers may be unique. The aim of this qualitative study was to assess stakeholder perspectives on the feasibility of implementing Centering Parenting(TM) in FQHCs in Baltimore...
September 14, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28721056/onset-of-chronic-myeloid-leukemia-with-complex-karyotype-in-a-pregnant-patient-case-report-and-revision-of-literature
#5
Nicola Sgherza, Elisabetta Abruzzese, Gianni Perla, Maria Marta Minervini, Vincenzo Chiello, Natale Sciannamè, Nicola Cascavilla
Approximately 10%-12% of patients in chronic-phase chronic myeloid leukemia (CP-CML) have additional chromosomal aberrations at diagnosis; moreover, CML occurs in up to 10% of pregnancy-associated leukemias, with an annual incidence of 1 per 100,000 pregnancies. In this report we describe the case of a 36-year-old female with CP-CML diagnosed in the 18th week of pregnancy and with a new complex variant translocation t(4;9;22;21)(q24;q34;q11;q22) and an additional chromosomal aberration t(1;20)(p36;p11). In consideration of her pregnancy, the patient strictly monitored her blood cell count without any specific treatment...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28431256/neurodevelopmental-outcomes-of-neonates-undergoing-surgery-under-general-anesthesia-for-malrotation-of-intestines
#6
Suresh Birajdar, Shripada Rao, Judy McMichael
BACKGROUND: It is difficult to differentiate between the potential adverse effects of general anesthesia (GA) on the developing brain and the role of associated co-morbidities and syndromes that can adversely affect neurodevelopmental outcomes in neonates undergoing GA. Neonates with malrotation of the intestines without volvulus usually do not have co-morbidities or syndromes. In addition, majority of them recover very well after surgery and are discharged home within a few days. Neonates with malrotation are a clean cohort of babies to study the role of a single episode of GA on the developing brain...
June 2017: Early Human Development
https://www.readbyqxmd.com/read/28398697/effects-of-targeting-lower-versus-higher-arterial-oxygen-saturations-on-death-or-disability-in-preterm-infants
#7
REVIEW
Lisa M Askie, Brian A Darlow, Peter G Davis, Neil Finer, Ben Stenson, Maximo Vento, Robin Whyte
BACKGROUND: The use of supplemental oxygen in the care of extremely preterm infants has been common practice since the 1940s. Despite this, there is little agreement regarding which oxygen saturation (SpO₂) ranges to target to maximise short- or long-term growth and development, while minimising harms. There are two opposing concerns. Lower oxygen levels (targeting SpO₂ at 90% or less) may impair neurodevelopment or result in death. Higher oxygen levels (targeting SpO₂ greater than 90%) may increase severe retinopathy of prematurity or chronic lung disease...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28392287/blocked-delayed-or-obstructed-what-causes-poor-white-matter-development-in-intrauterine-growth-restricted-infants
#8
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/28384379/repeated-lumbar-or-ventricular-punctures-in-newborns-with-intraventricular-haemorrhage
#9
REVIEW
Andrew Whitelaw, Richard Lee-Kelland
BACKGROUND: Although in recent years the percentage of preterm infants who suffer intraventricular haemorrhage (IVH) has reduced, posthaemorrhagic hydrocephalus (PHH) remains a serious problem with a high rate of cerebral palsy and no evidence-based treatment. Survivors often have to undergo ventriculoperitoneal shunt (VPS) surgery, which makes the child permanently dependent on a valve and catheter system. This carries a significant risk of infection and the need for surgical revision of the shunt...
April 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28331972/safe-sleeping-positions-practice-and-policy-for-babies-with-cleft-palate
#10
Karen Davies, Iain A Bruce, Patricia Bannister, Peter Callery
Guidance recommends 'back to sleep' positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) decision making by clinical nurse specialists when advising parents of infants with cleft palate...
May 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28277490/erythropoietin-monotherapy-in-perinatal-asphyxia-with-moderate-to-severe-encephalopathy-a-randomized-placebo-controlled-trial
#11
R R Malla, R Asimi, M A Teli, F Shaheen, M A Bhat
OBJECTIVE: Erythropoietin (EPO) is neuroprotective after asphyxia in animal studies. The efficacy and safety of EPO monotherapy in term neonates with hypoxic ischemic encephalopathy (HIE) is uncertain. STUDY DESIGN: Hundred term neonates with moderate or severe HIE were randomized by random permuted block algorithm to receive either EPO 500 U kg(-1) per dose in 2 ml saline intravenously (50 neonates) on alternate days for a total of five doses with the first dose given by 6 h of age (treatment group) or 2 ml of normal saline (50 neonates) similarly for a total of five doses (placebo group) in a double-blind study...
May 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#12
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#13
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28122664/preterm-birth-inflammation-fetal-injury-and-treatment-strategies
#14
Ashley K Boyle, Sara F Rinaldi, Jane E Norman, Sarah J Stock
Preterm birth (PTB) is the leading cause of childhood mortality in children under 5 and accounts for approximately 11% of births worldwide. Premature babies are at risk of a number of health complications, notably cerebral palsy, but also respiratory and gastrointestinal disorders. Preterm deliveries can be medically indicated/elective procedures or they can occur spontaneously. Spontaneous PTB is commonly associated with intrauterine infection/inflammation. The presence of inflammatory mediators in utero has been associated with fetal injury, particularly affecting the fetal lungs and brain...
February 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#15
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#16
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27697883/the-baby-moves-prospective-cohort-study-protocol-using-a-smartphone-application-with-the-general-movements-assessment-to-predict-neurodevelopmental-outcomes-at-age-2%C3%A2-years-for-extremely-preterm-or-extremely-low-birthweight-infants
#17
A J Spittle, J Olsen, A Kwong, L W Doyle, P B Marschik, C Einspieler, Jly Cheong
INTRODUCTION: Infants born extremely preterm (EP; <28 weeks' gestation) and/or with extremely low birth weight (ELBW; <1000 g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants...
October 3, 2016: BMJ Open
https://www.readbyqxmd.com/read/27609826/maternal-prepregnancy-bmi-and-risk-of-cerebral-palsy-in-offspring
#18
Ingeborg Forthun, Allen J Wilcox, Katrine Strandberg-Larsen, Dag Moster, Ellen A Nohr, Rolv Terje Lie, Pål Surén, Mette C Tollånes
OBJECTIVES: To investigate the association between maternal pre-pregnancy BMI and risk of cerebral palsy (CP) in offspring. METHODS: The study population consisted of 188 788 children in the Mothers and Babies in Norway and Denmark CP study, using data from 2 population-based, prospective birth cohorts: the Norwegian Mother and Child Cohort Study and the Danish National Birth Cohort. Prepregnancy BMI was classified as underweight (BMI <18.5), lower normal weight (BMI 18...
October 2016: Pediatrics
https://www.readbyqxmd.com/read/27604839/the-effect-of-a-multidisciplinary-obstetric-emergency-team-training-program-the-in-time-course-on-diagnosis-to-delivery-interval-following-umbilical-cord-prolapse-a-retrospective-cohort-study
#19
Sean Copson, Katrina Calvert, Puvaneswary Raman, Elizabeth Nathan, Mathias Epee
BACKGROUND: Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. AIMS: This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval...
September 7, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27591025/cohort-profile-cerebral-palsy-in-the-norwegian-and-danish-birth-cohorts-moband-cp
#20
Mette C Tollånes, Katrine Strandberg-Larsen, Ingeborg Forthun, Tanja Gram Petersen, Dag Moster, Anne-Marie Nybo Andersen, Camilla Stoltenberg, Jørn Olsen, Allen J Wilcox
PURPOSE: The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS: MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries...
2016: BMJ Open
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