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Neonate and cyanosis

Michael L Rigby
Major congenital or acquired heart disease in neonates presents with cyanosis, hypoxia, acute circulatory failure or cardiogenic shock. Antenatal diagnosis is made in up to 50% but heart disease is unanticipated in the remainder. The presence of significant heart disease in premature infants is also frequently not suspected at first; in general, whatever the underling cardiac anomaly, the clinical condition is worse, deteriorates more quickly and carries a poorer prognosis in premature and low birth weight infants...
October 13, 2016: Early Human Development
Faith J Ross, Denise Joffe, Gregory J Latham
Total anomalous pulmonary venous connection (TAPVC) is a potentially devastating form of congenital heart disease in which all pulmonary blood flow returns to the systemic venous circulation rather than the left atrium. Anomalous pulmonary venous flow may be obstructed at birth, and affected infants present with severe cyanosis and poor cardiac output unresponsive to standard resuscitation with prostaglandin. Obstructed TAPVC remains one of the few indications for emergent neonatal cardiac surgery. This review will discuss the physiology and perioperative management of isolated TAPVC without associated cardiac lesions...
September 29, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Joel Noutakdie Tochie, Simeon-Pierre Choukem, Regina Ndasi Langmia, Esther Barla, Paul Koki-Ndombo
INTRODUCTION: Neonatal respiratory distress (NRD) is a main cause of neonatal morbidity and mortality in developing countries. Early detection of its risk factors and early treatment of its etiologies are major challenges. However, few studies in developing countries have provided data needed to tackle it. We aimed to determine the prevalence, predictors, etiologies and outcome of NRD in a tertiary health care centre of Cameroon. METHODS: We analyzed the hospital files of all newborns admitted to the Neonatal unit of Douala General Hospital from 1(st) January 2011 to 28(th) February 2013...
2016: Pan African Medical Journal
Binh T T Ho, Alexandra Y Kruse, Hue T H Le, Phuong N Cam, Freddy K Pedersen
Background. Neonatal deaths constitute the majority of child mortality in Vietnam, but studies are scarce and focus on community settings. Methods. During a 12-month period, all sick neonates admitted to a pediatric department in a province hospital were studied. Potential risk factors of death covering sociodemographic factors, pregnancy history, previous neonatal period, and status on admission were registered. The neonates were followed up until discharge or death or until 28 completed days of age if still hospitalized or until withdrawal of life support...
2016: BioMed Research International
Jana Lozar-Krivec, Maja Stepic, Tinka Hovnik, Mladen Krsnik, Darja Paro-Panjan
Neonatal cyanosis is rarely due to hemoglobin variants with low oxygen affinity. We describe the clinical course and results of molecular genetic analysis of a boy who presented after birth with severe cyanosis. Arterial blood-gas analysis demonstrated a pronounced shift of the oxygen-hemoglobin dissociation curve to the right and molecular genetic analysis revealed a γ-globin variant, Hb F-Sarajevo. The patient presented is the second reported case of neonatal cyanosis due to this mutation, which was first described in 2012 by Zimmermann-Baer and coauthors...
October 2016: Journal of Pediatric Hematology/oncology
Julio César López-Valdés, Rocío Escarcega-Servín
UNLABELLED: Nowadays appendicitis is the leading cause of acute surgical abdomen. It occurs mainly between the first and third decade of life and is very rare in the neonatal period. The pathophysiology and clinical manifestations differ from the typical signs and symptoms, making it difficult to diagnose, which is in mostly cases at the time of surgery, and 74% of them appear with perforation and peritonitis. During the first day there were no complications; however, antibiotic therapy was initiated due to the risk of sepsis...
May 2016: Gaceta Médica de México
L Chu, J Zhang, Y N Li, X Meng, Y Y Liu
OBJECTIVE: To investigate the clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of the gestation. METHODS: Nine cases of pregnant women diagnosed as infective endocarditis with vegetations in Beijing Anzhen Hospital, Capital Medical University from January 2001 to October 2015 were enrolled in retrospective analysis. Consultations were held by doctors from department of obstetrics, anesthesiology, cardiology, cardial surgery and extracorporeal circulation to decide the individualized treatment plan for the 9 cases of pregnant women after admissions...
May 25, 2016: Zhonghua Fu Chan Ke za Zhi
Braden K Pew, R Alan Harris, Elena Sbrana, Milenka Cuevas Guaman, Cynthia Shope, Rui Chen, Sylvain Meloche, Kjersti Aagaard
BACKGROUND: Neonatal respiratory distress syndrome in preterm infants is a leading cause of neonatal death. Pulmonary insufficiency-related infant mortality rates have improved with antenatal glucocorticoid treatment and neonatal surfactant replacement. However, the mechanism of glucocorticoid-promoted fetal lung maturation is not understood fully, despite decades of clinical use. We previously have shown that genetic deletion of Erk3 in mice results in growth restriction, cyanosis, and early neonatal lethality because of pulmonary immaturity and respiratory distress...
September 2016: American Journal of Obstetrics and Gynecology
Pavan Judge, Garth Meckler Mshs
Congenital heart disease is the most common form of all congenital malformations and, despite advances in prenatal and newborn screening, it may present undiagnosed to the emergency department. Signs and symptoms of congenital heart disease are variable and often nonspecific, making recognition and treatment challenging. Patient presentations can range from life-threatening shock or cyanosis in a neonate to respiratory distress or failure to thrive in infants. Advances in surgical techniques have improved short- and long-term survival of infants and children with congenital heart disease, but these children are at risk for a variety of complications related to the underlying or surgical anatomy and physiology...
May 2016: Pediatric Emergency Medicine Practice
Thomas A Hooven, Ellen M Hooper, Sandeep N Wontakal, Richard O Francis, Rakesh Sahni, Margaret T Lee
Neonatal cyanosis resulting from a fetal methaemoglobin variant is rare. Most such variants are only described in a few published case reports. We present the case of a newborn with unexplained persistent cyanosis, ultimately determined to have a γ-chain mutation causing Hb FM-Fort Ripley. This neonatal haemoglobinopathy can be challenging to diagnose, as significant oxygen desaturation may result from barely detectable levels of the mutant haemoglobin and co-oximetry studies may show a falsely normal methaemoglobin level...
2016: BMJ Case Reports
Juan Gu, Yunxia Cai, Bin Liu, Sheng Lv
BACKGROUND: We describe the anesthetic management for cesarean section in a pregnant woman with uncorrected double-outlet right ventricle. The anesthetic method, treatment of complications and lessons are discussed. CASE PRESENTATION: A 28-year-old woman visited our emergency room for progressive dyspnea and recurrent hemoptysis at 30 weeks' gestation. Her New York Heart Association functional class was III-IV. Echocardiography indicated that she had congenital heart disease of double-outlet right ventricle...
2016: SpringerPlus
Priya Pillutla, Tina Nguyen, Daniela Markovic, Mary Canobbio, Brian J Koos, Jamil A Aboulhosn
Congenital heart disease (CHD) increases the risk of adverse maternal and neonatal outcomes. However, previous studies have included mainly women with low-risk features. A single-center, retrospective analysis of pregnant women with CHD was performed. Inclusion criteria were the following high-risk congenital lesions and co-morbidities: maternal cyanosis; New York Heart Association (NHYA) functional class >II; severe ventricular dysfunction; maternal arrhythmia, single ventricle (SV) physiology, severe left-sided heart obstruction and severe pulmonary arterial hypertension...
May 15, 2016: American Journal of Cardiology
Michael Osovsky, Joanne Yacobovich, Lea Sirota, Hannah Tamary
Neonatal cyanosis is relatively common. It is usually a consequence of cyanotic heart disease or a pulmonary disorder, and warrants a thorough and quick investigation. Mutations causing decreased affinity of hemoglobin to oxygen may change α1 to β2 binding. We describe a new mutation (asp 102 serine), in the γ chain of hemoglobin, causing neonatal cyanosis which resolves as the baby matures. In this case we would like to emphasize the importance of early diagnosis in order to avoid unnecessary disease workup...
January 2016: Harefuah
Mohammed Hussien Alghamdi
Cor-triatriatum dexter is an extremely rare congenital heart defect in which there is complete persistence of the right valve of embryonic sinus venosus that results in partitioning of the right atrium into a smooth and trabeculated portion. The smooth portion receives venous blood from inferior vena cava, superior vena cava, and coronary sinus while the trabeculated portion contains the right atrial appendage and the opening of tricuspid valve. We report a 1-week-old child who presented with intermittent episodes of central cyanosis...
January 2016: Annals of Pediatric Cardiology
Amir-Mohammad Armanian, Ramin Iranpour, Eiman Faghihian, Nima Salehimehr
BACKGROUND: Apnea intervals frequently occur in premature infants. Periods of apnea occur more often with decreases in gestational age. Periods of apnea can cause damage to the infant's developing brain and other organs. This study was designed to investigate the preventive effects of caffeine on apnea incidence in higher-risk neonates. METHODS: In this single-center randomized control trial study, premature infants with a birth weight of ≤1200 g were eligible for enrollment...
January 28, 2016: Pediatrics and Neonatology
Luciana Carvalho Martins, Claudia Maria Vilas Freire, Carolina Andrade Bragança Capuruçu, Maria do Carmo Pereira Nunes, Cezar Alencar de Lima Rezende
BACKGROUND: Heart disease in pregnancy is the leading cause of non- obstetric maternal death. Few Brazilian studies have assessed the impact of heart disease during pregnancy. OBJECTIVE: To determine the risk factors associated with cardiovascular and neonatal complications. METHODS: We evaluated 132 pregnant women with heart disease at a High-Risk Pregnancy outpatient clinic, from January 2005 to July 2010. Variables that could influence the maternal-fetal outcome were selected: age, parity, smoking, etiology and severity of the disease, previous cardiac complications, cyanosis, New York Heart Association (NYHA) functional class > II, left ventricular dysfunction/obstruction, arrhythmia, drug treatment change, time of prenatal care beginning and number of prenatal visits...
April 2016: Arquivos Brasileiros de Cardiologia
M A Ali, T Tazmin, T Latif, S A Haque, M A Hossain, M N Islam, R H Khan, M A Hoque
Cantrell's Pentalogy is a rare congenital malformation consists of supraumbilical abdominal wall defect, defect in the lower part of sternum, agenesis of anterior portion of diaphragm, an absence of the diaphragmatic part of the pericardium and intracardiac malformation. This case report presents a female neonate, who was born at 40 weeks of gestation weighing 2400 gm and was admitted 4 hours after delivery with the complaints of something coming out from chest. On physical examination her vital signs were within normal limit, she had a systolic murmur on heart at lower left sternal area and there was a vascular structure present on the upper part of abdomen which was pulsatile and pulsation was synchronized with cardiac pulsation...
January 2016: Mymensingh Medical Journal: MMJ
Renata Lazari Sandoval, Carlos Moreno Zaconeta, Paulo Roberto Margotto, Maria Teresinha de Oliveira Cardoso, Evely Mirella Santos França, Cristina Touguinha Neves Medina, Talyta Matos Canó, Aline Saliba de Faria
OBJECTIVE: To report the case of a newborn with recurrent episodes of apnea, diagnosed with Congenital Central hypoventilation syndrome (CCHS) associated with Hirschsprung's disease (HD), configuring Haddad syndrome. CASE DESCRIPTION: Third child born at full-term to a non-consanguineous couple through normal delivery without complications, with appropriate weight and length for gestational age. Soon after birth he started to show bradypnea, bradycardia and cyanosis, being submitted to tracheal intubation and started empiric antibiotic therapy for suspected early neonatal sepsis...
September 2016: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Ahmad Mahir Shamsuddin, Abdul Rahim Wong, Robert H Anderson, Antonio F Corno
A neonate with cyanosis at birth was found to have a rare type of totally anomalous pulmonary venous connection. The pulmonary veins entered a confluence posterior to the left atrial wall, which drained into the right superior cavoatrial junction. There were no other major structural defects and no evidence of isomerism. Because of the severe cyanosis, and the restrictive nature of the interatrial communication, we performed balloon atrioseptostomy to improve oxygenation. We then achieved successful surgical repair when the baby was aged 7 months...
July 2016: World Journal for Pediatric & Congenital Heart Surgery
Christian L Hermansen, Anand Mahajan
Newborn respiratory distress presents a diagnostic and management challenge. Newborns with respiratory distress commonly exhibit tachypnea with a respiratory rate of more than 60 respirations per minute. They may present with grunting, retractions, nasal flaring, and cyanosis. Common causes include transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia, sepsis, pneumothorax, persistent pulmonary hypertension of the newborn, and delayed transition. Congenital heart defects, airway malformations, and inborn errors of metabolism are less common etiologies...
December 1, 2015: American Family Physician
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