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Preterm and blood transfusion

Clare L Whitehead, Susan P Walker, Stephen Tong
Circulating nucleic acids have revolutionized prenatal diagnosis in the last decade, allowing non-invasive screening for single gene or chromosomal defects using a single sample of maternal blood. In addition to deoxyribonucleic acids (DNA), ribonucleic acids (RNA) from the placenta are released into the maternal blood from early in pregnancy and may reflect changes in gene expression occurring within the placenta. Measuring circulating RNA may therefore provide insights into the placental transcriptome without the need for invasive testing...
October 6, 2016: Prenatal Diagnosis
Aaron E Pritchard, Beth H Shaz
CONTEXT: -Transfusion-associated graft-versus-host disease is a rare, often fatal complication of cellular blood product transfusion. The requirement that at-risk groups receive irradiated products reduces the incidence of transfusion-associated graft-versus-host disease. A comprehensive survey of irradiation practices has not been performed since 1989; meanwhile, new indications for irradiation have emerged. OBJECTIVE: -To assess current irradiation practices at College of American Pathologists member institutions...
October 2016: Archives of Pathology & Laboratory Medicine
Alexandra H Wallace, Stuart R Dalziel, Brett R Cowan, Alistair A Young, Kent L Thornburg, Jane E Harding
OBJECTIVE: To compare long-term cardiovascular outcomes in survivors of fetal anaemia and intrauterine transfusion with those of non-anaemic siblings. DESIGN: Retrospective cohort study. SETTING: Auckland, New Zealand. PARTICIPANTS: Adults who received intrauterine transfusion for anaemia due to rhesus disease (exposed) and their unexposed sibling(s). EXPOSURE: Fetal anaemia requiring intrauterine transfusion...
September 23, 2016: Archives of Disease in Childhood
C Gale, M J Hyde, N Modi
OBJECTIVE: Randomised controlled trials, a gold-standard approach to reduce uncertainties in clinical practice, are growing in cost and are often slow to recruit. We determined whether methodological approaches to facilitate large, efficient clinical trials were acceptable to UK research ethics committees (RECs). DESIGN: We developed a protocol in collaboration with parents, for a comparative-effectiveness, randomised controlled trial comparing two widely used blood transfusion practices in preterm infants...
September 14, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Eran Weiner, Hadas Miremberg, Ehud Grinstein, Letizia Schreiber, Shimon Ginath, Jacob Bar, Michal Kovo
BACKGROUND: The mechanisms involved in bleeding in cases of placenta previa (PP) and the effect on pregnancy outcome is unclear. OBJECTIVES: We aimed to compare pregnancy outcome and placental histopathology in pregnancies complicated with symptomatic (bleeding) vs. non-symptomatic PP, and to study the effects of the co-existence of histopathological retro-placental hemorrhage (RPH) in cases of symptomatic PP on neonatal and maternal outcomes. STUDY DESIGN: Labor and maternal characteristics, neonatal outcome and placental histopathology lesions of pregnancies with PP, delivered between 24 and 42weeks, during 2009-2015, were reviewed...
October 2016: Early Human Development
Antonio Del Vecchio, Caterina Franco, Flavia Petrillo, Gabriele D'Amato
Based on small studies and not on statistically valid clinical trials, guidelines for neonatal transfusions remain controversial and practices vary greatly. Premature infants and critically ill neonates in the neonatal intensive care unit (NICU) often require blood transfusions and extremely preterm neonates receive at least one red blood cell transfusion during their hospital stay. Transfusions to neonates convey both benefits and risks and consequently it is imperative to establish specific guidelines to improve practice and avoid unnecessary transfusions...
September 2016: American Journal of Perinatology
Patrick D Carroll, Robert D Christensen, Vickie L Baer, Mark J Sheffield, Erick Gerday, Sarah J Ilstrup
BACKGROUND: Our previous retrospective study suggested that red blood cell (RBC) transfusion of preterm neonates can be associated with an increase in bilirubin, but this has not been tested prospectively. STUDY DESIGN AND METHODS: We studied neonates before and after RBC transfusions, recording serial bilirubin levels and whether they qualified for phototherapy. Because lysed RBCs release plasma-free hemoglobin (Hb), a precursor to bilirubin, we also measured plasma free Hb and bilirubin from the donor blood...
September 7, 2016: Transfusion
Rani A Bashir, Vineet Bhandari, Sakeer Vayalthrikkovil, Yacov Rabi, Amuchou Soraisham, Selphee Tang, Essa Al Awad, Abhay Lodha
AIM: To compare preterm infants with no bronchopulmonary dysplasia (BPD), BPD with chorioamnionitis (BPDC) and BPD with no chorioamnionitis (BPDNC) for the association with neurodevelopmental disability (NDD) at three years corrected age. METHODS: Demographic and outcome data of infants with birthweight (BW) ≤1250 g born during two epochs (1995-2000 and 2002-2007 with an interim washout period of one year) were compared on the basis of whether they had BPD, chorioamnionitis or both...
November 2016: Acta Paediatrica
Mehmet Ozgur Akkurt, And Yavuz, Serenat Eris Yalcin, Iltac Akkurt, Ozerk Turel Turan, Yakup Yalcin, Mekin Sezik
AIM: To investigate short- and long-term outcomes in women undergoing cesarean myomectomy (CM) Methods: This was a retrospective study that explored short-term outcomes of women, who underwent cesarean operations with or without myomectomies (CM controls) in a single tertiary centre throughout a 6-year-period. For long-term outcomes, the mean duration of follow-up was 6.3 ± 1.0 years. RESULTS: There were no differences among the CM (n= 91) and control groups (n = 60) considering mean change in hemoglobin and hematocrit levels, hemorrhage, as well as requirement for blood transfusions with a slightly increased operative time...
August 23, 2016: Journal of Maternal-fetal & Neonatal Medicine
Masayuki Ochiai, Hiroaki Kurata, Hirosuke Inoue, Koichi Tanaka, Yuki Matsushita, Junko Fujiyoshi, Yoshifumi Wakata, Kiyoko Kato, Tomoaki Taguchi, Hidetoshi Takada
BACKGROUND: The substantial risk of iron overload is not routinely monitored in most of the neonatal intensive care units (NICUs) in Japan; however, blood transfusion is an essential strategy for successfully treating preterm low-birth-weight infants. OBJECTIVE: The aim of this study was to investigate the iron status and clinical features of infants with a birth weight of <1,500 g, i.e. very-low-birth-weight infants (VLBWIs). METHODS: This prospective observational study enrolled 176 (82...
August 23, 2016: Neonatology
Qi Lu, Shupeng Cheng, Min Zhou, Jialin Yu
BACKGROUND: Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups. METHODS: Risk factors associated with NEC were investigated using a retrospective case-control design. Patients with Bell's Stage NEC≥II were divided into three groups based on GA: I, <34 weeks; II, ≥34 weeks but <37 weeks; III, ≥37 weeks. Each case was paired with two GA- and weight-matched controls...
June 22, 2016: Pediatrics and Neonatology
Michael Tchirikov, Zhaxybay Sh Zhumadilov, Gauri Bapayeva, Michael Bergner, Michael Entezami
OBJECTIVE: To determine if intrauterine intraumbilical supplementation with amino acids (AA) and glucose can improve neonatal outcome of severe growth restricted human fetuses (IUGR). METHODS: Prospective pilot study of intrauterine treatment of severe IUGR fetuses [n=14, 27 weeks of gestation (range 23-31)] with cerebroplacental ratio <1, with long-term intraumbilical AA and glucose supplementation (10% of feto-placental blood volume/day) using a perinatal port system alone (n=5) or combined with hyperbaric oxygenation (n=1, HBO) vs...
August 17, 2016: Journal of Perinatal Medicine
Amira El-Messidi, Nicholas Czuzoj-Shulman, Andrea R Spence, Haim Arie Abenhaim
BACKGROUND: Worldwide, tuberculosis remains a major health concern, with an estimated 9.6 million people infected in the year 2014, of which one-third were women. Tuberculosis is estimated to be even more prevalent in pregnant women than the general population. To date there is conflicting evidence on the maternal and neonatal complications of tuberculosis in pregnancy OBJECTIVE: To determine the trends in the incidence of tuberculosis in pregnancy and to examine the associations between tuberculosis in pregnancy and maternal and fetal complications...
August 13, 2016: American Journal of Obstetrics and Gynecology
Yu-Cheng Wang, Oi-Wa Chan, Ming-Chou Chiang, Peng-Hong Yang, Shih-Ming Chu, Jen-Fu Hsu, Ren-Huei Fu, Reyin Lien
BACKGROUND: Red blood cell (RBC) transfusion is often considered a life-saving measure in critically ill neonates. The smallest and least mature infants tend to receive the largest amount of transfusions. RBC transfusion itself has also been suggested as an independent risk factor of poor clinical outcome in critical patients. Our aim is to study if there are associations between RBC transfusion and in-hospital mortality, short-term morbidities, and late neurodevelopmental outcome in extremely low birth weight (ELBW) preterm infants...
July 5, 2016: Pediatrics and Neonatology
J Banerjee, T S Leung, N Aladangady
BACKGROUND AND OBJECTIVE: The objective of the study was to investigate the splanchnic blood flow velocity and oximetry response to blood transfusion in preterm infants according to postnatal age. MATERIALS AND METHODS: Preterm infants receiving blood transfusion were recruited to three groups: 1-7 (group 1; n = 20), 8-28 (group 2; n = 21) and ≥29 days of life (group 3; n = 18). Superior mesenteric artery (SMA) peak systolic (PSV) and diastolic velocities were measured 30-60 min pre- and post-transfusion using Doppler ultrasound scan...
August 10, 2016: Vox Sanguinis
C Dollat, C Pierron, A Keslick, E Billoir, A François, P-H Jarreau
In France since 2002, the single-donor transfusion protocol, using four pediatric units from the same adult donor's packed red blood cells (PRBCs) in multiply transfused newborns, is recommended in preterm neonates to reduce the risks of infection and alloimmunization. This protocol is controversial, however, because it causes the transfusion of stored blood, which could have adverse consequences. Before the new recommendations of the French Haute Autorité de santé (National authority for health) in 2015, we conducted a national practice survey in 63 neonatal intensive care units (NICU) and a retrospective study of the characteristics of 103 children transfused within our unit, to better target beneficiaries...
September 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
José Francisco López-Catzín, Patricia Berenice Bolado-García, Gonzalo Jesús Gamboa-López, Carolina Elizabeth Medina-Escobedo, Leydi Rubí Cambranes-Catzima
BACKGROUND: Treating anemia of prematurity is transfused red blood cells and the use of erythropoiesis-stimulating agents. The aim of this article is to determine the correlation between the number of blood transfusions and the use of recombinant human erythropoietin in preterm infants with anemia. METHODS: A correlation study was performed in 80 cases of patients with anemia treated with transfusions and erythropoietin, were randomized into two groups: one was treated with transfusions (T) and one with transfusions and erythropoietin (E)...
September 2016: Revista Médica del Instituto Mexicano del Seguro Social
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
Xiao-Yue Dong, Xiao-Fan Sun, Meng-Meng Li, Zhang-Bing Yu, Shu-Ping Han
OBJECTIVE: To investigate the influence of delayed cord clamping (DCC) on preterm infants with a gestational age of <32 weeks. METHODS: Ninety preterm infants with a gestational age of <32 weeks delivered naturally from January to December, 2015 were enrolled and randomly divided into DCC group (46 infants) and immediate cord clamping (ICC) group (44 infants). The routine blood test results, total amount of red blood cell transfusion, blood gas parameters, mean arterial pressure, bilirubin peak, total time of phototherapy, and incidence rates of necrotizing enterocolitis, late-onset sepsis, intracranial hemorrhage, retinopathy, and bronchopulmonary dysplasia were compared between the two groups...
July 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Sharon Anderson
BACKGROUND: Increasingly, evidence supports enteral probiotics are an important risk-reduction strategy for necrotizing enterocolitis (NEC) among very low birth-weight and extremely low birth-weight preterm infants. Yet, the majority of providers remain reluctant to implement practice changes. PURPOSE: The aim of this study was to better understand the discrepancy between the available evidence and clinical practice regarding the use of probiotics and other NEC prevention strategies in New Jersey...
August 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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