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1
Said, Aboayesh, and Dimitrie Nanu. "Diagnosis and treatment in premature births." Romanian Medical Journal 62, no. 3 (September 30, 2015): 298–302. http://dx.doi.org/10.37897/rmj.2015.3.17.
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Definition. Preterm birth means that birth occurs between 20 and 37 weeks of amenorrhea complete. (ACOG – July 2014) In Romania, the declaration of pregnancy is made starting with 24 weeks of gestation. Outstanding progresses in the recovery of newborns weighing less than 1,000 grams (the US and Japan recovered newborns weighing 500 g and less) allowed international forums reconsider criteria for definition of prematurity (see abortion classifications). For performant neonatal departments, the presence of signs of life (beating heart, pulsation of the umbilical cord, muscle contracture to external stimuli) are sufficient to use resuscitation and recovering the product of conception.
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Mudrov, V. A., A. M. Ziganshin, A. G. Yashchuk, L. A. Dautova, and R. Sh Badranova. "Possibilities for diagnosis and prediction of preterm labor at the present stage." Kazan medical journal 102, no. 1 (February 10, 2021): 47–59. http://dx.doi.org/10.17816/kmj2021-47.
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Preterm birth is one of the main causes of perinatal morbidity and mortality, which does not tend to decrease in rate. The risk of death in premature babies is 2535 times higher than that of full-term babies, and stillbirths are registered 813 times more often than in timely delivery. To date, there are no effective ways to prevent preterm birth. Therefore, the timeliness of therapy, which largely determines the outcome of pregnancy in general, depends on the effectiveness of assessing the likelihood of their development. At the International Federation of Gynecology and Obstetrics (FIGO) Congress (2018), preterm birth is identified as a problem that has not yet been solved at the current stage of science and technology development. The result of the unsolved problems is a situation wherein the modern world over the past 60 years there has been no decrease in the premature birth rate, which is 9.5% of births and annually ends with the birth of 15,000,000 premature babies. The study aimed to research modern methods of diagnosis and prediction of spontaneous preterm birth. An analytical method was used in the study: a detailed systematic analysis of modern domestic and foreign literature on the diagnosis and prognosis of preterm birth. We used eLibrary, Scopus, PubMed, MEDLINE, ScienceDirect, Cochrane Library bibliographic databases (until August 2020). The article deals with the diagnosis and prediction of preterm birth probability, which will optimize the management of patients from the risk group and, in the future, will reduce the rate of perinatal morbidity and mortality of premature babies. Despite a significant number of researches devoted to the study of possibilities for diagnosing and predicting spontaneous preterm birth, currently, there are no methods with absolute diagnostic value. Most -existing studies indicate that when assessing the probability of preterm birth, a comprehensive approach should be preferred taking into account the results of several main and additional methods.
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Ciana, G., M. C. Fertz, V. Pecile, and S. Demarini. "Premature Birth with Complicated Perinatal Course Delaying Diagnosis of Prader-Willi Syndrome." Case Reports in Pediatrics 2011 (2011): 1–3. http://dx.doi.org/10.1155/2011/981941.
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Prader-Willi syndrome in the newborn is essentially characterized by marked hypotonia, feeding difficulties, hypogonadism, and possible characteristic facial features. However, diagnosis at this age may be particularly difficult, and dysmorphic features may be subtle or absent. Prematurity can furthermore delay clinical features recognition and typical complications due to preterm birth may contribute to divert the diagnosis. We describe a preterm baby with a complicated perinatal course later diagnosed as PWS.
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Fatyhova, N. R., R. G. Gamirova, and L. E. Ziganshina. "Very premature babies and west’s syndrome." Kazan medical journal 95, no. 1 (February 15, 2014): 11–18. http://dx.doi.org/10.17816/kmj1447.
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Aim. To compare the prevalence of West’s syndrome in very preterm babies and in babies with prematurity of 1-2 degrees. Methods. Both retrospective and prospective study including 241 preterm babies who received out-patient or in-patient aid for different neurological disorders. Inclusion criteria for the first group were diagnosis of a neurological disorder, gestational age less than 31 weeks and birth weight not exceeding 1500 grams. Inclusion criteria for the second group were diagnosis of a neurological disorder, gestational age of 32-37 weeks and birth weight ranging from 1501 to 2500 grams. Results. Severe central nervous system damage, including such conditions as spastic quadriplegia (126 out of 157 1 stgroup babies, 80.3%, and 40 out of 84 2 ndgroup babies, 47.6%, р 0.001), developmental delay of cognitive functions (123 out of 157 1 stgroup babies, 78.3%, and 40 out of 84 1 stgroup babies, 47.6%, р 0,001) were more common in the first group. West’s syndrome was diagnosed in 22 (14%) of cases in 1 stgroup, in 3 (3.6%) of cases in 2 ndgroup (HR=4.4, 95% CI [1.28; 15.16], χ 2=6.42, р=0.01). In 21 (95.5%) of West’s syndrome cases, modified hypsarrhythmia was diagnosed by video electroencephalogram monitoring. Severe cerebral hypoxia of higher degrees, periventricular leukomalacia and hypoplasia of the corpus callosum were more common in 1 stgroup babies. Conclusion. Our study showed that the prevalence of West’s syndrome in very premature infants with neurological disorders was 4.4 times higher compared to babies with prematurity of 1-2 degrees. There was an association between West’s syndrome in preterm babies and such cerebral disorders as severe cerebral hypoxia of 3 rddegree, periventricular leukomalacia and hypoplasia of the corpus callosum.
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Wyszynski, Diego F., Wendy J. Carman, Alan B. Cantor, John M. Graham, Liza H. Kunz, Anne M. Slavotinek, Russell S. Kirby, and John Seeger. "Pregnancy and Birth Outcomes among Women with Idiopathic Thrombocytopenic Purpura." Journal of Pregnancy 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/8297407.
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Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy.Methods. A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, and major congenital anomalies.Results. Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery. Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live births were preterm.Conclusions. The results of this study provide further evidence that cause and duration of maternal ITP are important determinants of the outcomes of pregnancy.
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Zhuk, S., and O. Schurevska. "Threat of premature birth: psycho-social aspects." HEALTH OF WOMAN, no. 6(112) (July 29, 2016): 86–89. http://dx.doi.org/10.15574/hw.2016.112.86.
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The objective: to study the psychological characteristics of women’s status in one of the most common complications of pregnancy - the threat of termination of pregnancy, depending on the level of stress load. Patients and methods. We have studied the psychological status (the Holmes-Rahe level of psychosocial stress, the Spielberg-Hanin level of anxiety, V.I.Dobryakov’s related to a pregnancy test, diagnosis of psychological defense mechanisms, assessment of quality of life) 60 pregnant women with threat of premature birth in the third trimester of pregnancy. Surveyed women were divided into 2 groups: group 1 included 30 pregnant women – forced migrant of Donetsk and Lugansk area and 2 group – 30 pregnant women who resided in Kiev. Results. At the same clinical picture of the threat of premature birth we detected discrepancy between the subjective assessment of their condition in women – forced migrants: a high level of situational and personal anxiety, decrease in physical (physical functioning, role-physical functioning) and psychological (social functioning, role emotional functioning) health, doubtful and pathological subtypes of gestational dominant. This creates prerequisites for complications of pregnancy, childbirth and postpartum future period and requires the participation of psychologists in the work with this category of patients. Conclusion. So, revealed a discrepancy between the objective clinical signs similar obstetric pathology (on the example of threatened abortion) in pregnant women with different levels of stress load and their subjective evaluation of their condition that affects their psychological status. This should be reflected in individually tailored therapy and be mainstreamed into the work of obstetricians and gynecologists with these patients, and requires mandatory participation of psychologists in the work with this category of patients. Key words: pregnancy, the threat of premature birth, stress, psychological status.
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Tayman, Cuneyt, Ufuk Cakır, Mehmet Buyuktiryaki, Utku Serkant, Serife Oğuz, and Halit Halil. "Serum Endocan Level as a Predictive Marker for Hemodynamically Significant Patent Ductus Arteriosus in Very Low Birth Weight İnfants." American Journal of Perinatology 34, no. 13 (May 22, 2017): 1312–17. http://dx.doi.org/10.1055/s-0037-1603509.
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Background Diagnosis and treatment of patent ductus arteriosus (PDA) in premature infants is still an important problem for clinicians. Echocardiography is the gold standard for determination of PDA based on clinical and hemodynamic significance. Clinical decision making may be aided by measuring circulating biomarkers such as natriuretic and endothelial propeptides. We aimed to investigate the significance of serum endocan and B-type natriuretic peptide (BNP) in the diagnosis and follow-up of hemodynamically significant PDA (hsPDA) in very low birth weight infants. Materials and Methods In this study, 84 premature infants with gestation age less than 32 weeks were included. Forty-two premature infants with hsPDA were determined as the study group and 42 premature infants without PDA were assigned as the control group. Blood samples were collected and analyzed for serum endocan and pro-BNP levels. Results Serum levels of pro-BNP and endocan in the study group at the time of diagnosis of PDA were found to be significantly higher than the control group, and the levels decreased significantly after medication. Multivariate regression analysis showed that birth weight and the presence of PDA were significantly correlated with serum endocan levels. The cutoff values of pro-BNP and endocan for PDA prediction were 290 pg/mL and 506 ng/mL, respectively. Conclusion Endocan and pro-BNP assays have clinical importance in the diagnosis, initiation therapy, and follow response to therapy in very low birth weight infants with hsPDA.
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Bakalli, Ilirjana, Elmira Kola, Robert Lluka, Ermela Celaj, Durim Sala, Inva Gjeta, Sashenka Sallabanda, and Dea Klironomi. "Surgical congenital anomalies in Albania: incidence, prenatal diagnosis and outcome." World Journal of Pediatric Surgery 2, no. 1 (February 2019): e000012. http://dx.doi.org/10.1136/wjps-2018-000012.
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IntroductionSignificant progress has been made in the diagnosis and management of congenital anomalies (CA). In our study, we aimed to evaluate prenatal diagnosis, trend of surgical CA, mortality rate and the factors affecting their prognosis in our country.MethodsWe enrolled in our study all children with CA who underwent surgery from January 2008 to December 2017. We compared prenatal diagnosis, incidence and mortality for two 5-year periods: the first period in 2008–2012 and the second period in 2013–2017.ResultsDuring the study period, a total of 321 cases with CA were presented, with an incidence of 0.69–1.18 per 1000 live births. Intestinal, anal and esophageal atresia remain the most important CAs (23%, 18% and 16%), followed by diaphragmatic hernia and gastroschisis (10% and 7%). Comparing the incidence for the two periods, we did not find statistical differences (p=0.73), but the mortality rate has been reduced from 31.4% during the first period to 24.6% during the second period (p=0.17). Prenatal diagnosis has increased: 28% in the second period compared with 10% in the first period (p<0.001), without significantly affecting the prognosis (p=0.09). Birth of premature babies resulted in a significantly negative predictive factor for the prognosis of these anomalies (p=0.0002).ConclusionIncidence of CA has not changed over the years in our country. Advances in intensive care, surgical techniques and parenteral nutrition made in recent years have significantly increased the survival of neonates born with surgical CA. Birth of premature babies was a significantly negative predictive factor for the prognosis of these anomalies.
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Sarabia Alcocer, Betty, Baldemar Ake Canche, Lidia Maria Maas Ortegon, Roman Alberto Perez Balan, Carlos Armando Chan Keb, Rafael Manuel de Jesus Mex Alvarez, Patricia Margarita Garma Quen, Tomas Joel Lopez Gutierrez, and Karen Felix Guzman. "RISK FACTORS OF NEONATAL SEPSIS." International Journal of Advanced Research 8, no. 12 (December 31, 2020): 508–14. http://dx.doi.org/10.21474/ijar01/12177.
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Objectives:To identify the risk factors of neonatal sepsisduring the period from January 2017 to December 2019. Methods:A cross-sectional, retrospective study, observational, descriptive; the record of 106 newborns diagnosed with sepsis were reviewed. We excluded 15 were included in the data collection, diagnosis of early and late neonatal sepsis, maternal age, number of gestation, prenatal care, premature birth, diagnosis of UTI diagnosis of chorioamnionitis, premature rupture of membrane (s RPM ), sex product, invasive procedures, product weight and route of obtaining the product. Results:Of the 1401 patients obtained alive, 191 obtained diagnosis of neonatal sepsis and an incidence of 6.49% of early neonatal sepsis was obtained. The main risk factor associated with early neonatal sepsis has been the way of obtaining caesarean with 52.74%, the low birth weight with 32.96% and multiparity an incidence of 34.06% and there were no significant differences between sexes as the man / femalerelationship was 1.02.However if a significant importance in the delivery / caesarean relationship was obtained0.89. There was only one death recorded. Conclusions:The main risk factors associated with early neonatal sepsis are obtained via caesarean section, low birth weight and multiparity, male sex was the most affected but with no significant differences, the IVU, PROM, maternal age less to 18 years and the lack of prenatal care they had similar incidence. Only one late neonatal sepsis and death was obtained. I do not chorioamnionitis data was obtained.
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Morse, Alan R., and Ellen Trief. "Diagnosis and Evaluation of Visual Dysfunction in Premature Infants with Low Birth Weight." Journal of Visual Impairment & Blindness 79, no. 6 (June 1985): 248–51. http://dx.doi.org/10.1177/0145482x8507900603.
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Visual impairment of many kinds is common in premature infants with low birth weight. The infant's visual system is quite plastic in the early stages, and early screening may help to discover treatable pathology. Clinical techniques are available that are not used in the routine examination given by the pediatrician. These include optokinetic nystagmus, preferential looking, and visually evoked potential. If such techniques were more widely employed where visual impairment is suspected, nonsurgical remedial intervention might be more successful.
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Ilyas, Sana, Sana Waqar, Asim Khurshid, and Muhammad Sohail Arshad. "Congenital heart diseases in premature newborns." Professional Medical Journal 28, no. 08 (August 1, 2021): 1178–82. http://dx.doi.org/10.29309/tpmj/2021.28.08.6126.
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Objective: To determine the frequency of congenital heart diseases (CHD) in newborns admitted with prematurity. Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Neonatology Children’s Hospital & The Institute of Child Health, Multan. Period: August 2019 to January 2020. Material & Methods: A total of 155 preterm infants ≤36 weeks gestation were included. In preterm newborns of either gender, echocardiography was done by hospital Pediatric Cardiologist. Patient’s name, age, gestational age, weight, sex, date, serial number, registration number and echocardiographic results were entered in pre-designed performa. The outcome variable was frequency of congenital heart disease in preterm newborns. Results: Congenital heart disease was detected in 34.8% (n = 54) preterm infants. Nine percent (n=14) were < 1.5 kg, 45.2% (n=70) between 1.5 – 2.0 kg and 45.8% (n=71) were > 2.0 kg in weight. Most frequent lesion was Ventricular Septal Defect (VSD) in 19 (35%) infants followed by patent ductus arteriosus (PDA) in 15 (28%) infants. Atrial Septal Defect (ASD) was seen in 6 (11%) preterm infants. Frequency of CHD was significantly higher (p-value < 0.001) in babies delivered at ≤32 weeks and those infants with with birth weight <1.5 kg. Conclusion: The study highlights the association of congenital heart diseases in premature and low birth weight neonates. So, every preterm and low birth weight neonate must undergo echocardiography to screen for CHD so that earlier diagnosis may be made for earlier intervention.
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Perepelitsa, S. A., and E. F. Smerdova. "Differential Diagnosis of Congenital Pneumonia in Newborns with Low and Extremely Low Body Weight (Morphological Study)." General Reanimatology 14, no. 4 (September 2, 2018): 4–14. http://dx.doi.org/10.15360/1813-9779-2018-4-4-14.
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The purpose of the study is a comprehensive assessment of morphological changes in the placenta and lungs to detect early signs of congenital pneumonia in extremely premature infants.Materials and methods. Protocols of post-mortem examinations of 23 preterm newborns died from severe respiratory failure were analyzed. The average gestational age of the newborns was 26.4±2.7 weeks and the body weight at birth was 972.4±355.8 grams. In the sample, 78.3% of infants had an extremely low birth weight (ELBW). At birth, all newborns presented severe asphyxia. Newborn underwent several types of respiratory therapy since birth: Mechanical ventilation was performed in 65.2% of newborns since their birth, non-invasive ventilation was performed in 26.1% of cases, and 8.7% of patients underwent oxygenotherapy through a facial mask. In all cases, there was an unfavorable course of the neonatal period, a progressive deterioration of newborns' condition, and a lethal outcome. A comprehensive histological examination of the placenta and the lungs of deceased premature newborn infants was performed.Results. Congenital infections of different localizations remain the leading cause of death.Congenital pneumonia and generalized infections are clinically manifested at birth by severe perinatal hypoxia and respiratory failure. In the case of congenital pneumonia, the morphological patterns are polymorphic and characterize the severity of lung damage. For some newborns, these patterns include accumulation of exudates and fibrin, segmented leukocytes, fragments of basophilic coccal microflora, and a large number of colony forming bacilli, and desquamated alveolocytes with a deformed nucleus are visualized in the deformed lumen of the alveoli and bronchi. Diffuse lymphoid-leukocyte infiltration in the septa and respiratory parts of the lungs are typical for other infants. Histological examination find lumpy or lamellar eosinophilic hyaline membranes in alveoli in specimens from these newborns. Diffuse, focal or confluent segmentonuclear infiltration in various lung structures is commonly combined with hyaline membranes of various localizations and sizes. Hyaline membranes were detected in 93.5% of cases.Conclusion. Very early preterm delivery is associated with intrauterine pneumonia and systemic infection in extremely premature infants. Early clinical and laboratory signs of intrauterine infectious lung include severe perinatal hypoxia, very low Apgar score and laboratory test findings (hypoxaemia and decompensated metabolic lactate acidosis) that are resistant to standard resuscitation measures. Hypoxemia and decompensated metabolic acidosis persisting during the first hours of postnatal life indicate the severity of intrauterine lung damage and require a rapid change of treatment aimed at normalization of lung function, prevention of complications in the respiratory system, hemostasis and central nervous system. Clinicians should be better informed about the features of early postnatal adaptation of extremely premature infants with congenital pneumonia to provide appropriate treatment.
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Rook, Olivia. "Supporting preterm children." Early Years Educator 21, no. 8 (December 2, 2019): 46. http://dx.doi.org/10.12968/eyed.2019.21.8.46.
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While premature birth is a risk factor, not a diagnosis, for difficulties later in life, it is becoming increasingly important that teachers are aware of it. A new, free e-learning resource is now addressing this need.
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Fujioka, Tao, Masaki Nii, and Yasuhiko Tanaka. "A premature low-birth-weight infant with congenital complete atrioventricular block and myocarditis successfully treated by staged pacemaker implantation." Cardiology in the Young 26, no. 5 (April 13, 2016): 1029–32. http://dx.doi.org/10.1017/s1047951116000433.
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AbstractCongenital complete atrioventricular block is a known lethal condition. Although antenatal diagnosis and the technical advances of pacemaker treatment have reduced its mortality, treatment of premature babies with significant myocardial damage remains a challenge. In this paper, we report the case of a premature low-birth-weight infant with congenital complete atrioventricular block and extremely low ventricular rate, fetal hydrops, and myocarditis who was successfully treated with staged permanent pacemaker implantation.
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Cowan, Judith, and Charles Kerr. "Reproductive patterns and thalassaemia major." Journal of Biosocial Science 18, no. 3 (July 1986): 285–95. http://dx.doi.org/10.1017/s0021932000016254.
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SummaryA study of families affected by thalassaemia major demonstrated that before antenatal diagnosis became an option, premature curtailment of reproduction was the most common parental response to their understanding of the genetic implications of the diagnosis. Subsequently parents of younger patients used antenatal diagnosis to meet or almost meet their birth expectations. There was no evidence that antenatal diagnosis contributed to any process of ‘compensating’ for existing affected offspring.
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Saling, Erich, and Jürgen Lüthje. "A simple program for prevention of premature birth, and some regrettable contradictions." Journal of obstetrics and women's diseases 64, no. 2 (June 15, 2015): 76–83. http://dx.doi.org/10.17816/jowd64276-83.
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Prematurity and late abortions are still major problems of modern obstetrics. An important cause is ascending genital infection, which can often be prevented by very early diagnosis of vaginal milieu disturbances by the patients themselves. In cases of recurrent late abortions or early preterm births, an operative total cercix occlusion is probably the most effective method currently available.
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Sandeva, Milena, and Petar Uchikov. "Analysis of Pathology in Premature Infants in Obstetrics and Gynecology Clinic at St George University Hospital, Plovdiv between 2013 and 2015." Folia Medica 63, no. 1 (February 28, 2021): 88–96. http://dx.doi.org/10.3897/folmed.63.e52203.
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Introduction: Premature birth is now one of the most profound prenatal problems worldwide because of the high morbidity and mor-tality it is associated with at the beginning of life. Advances in prenatal medicine over the past decades have led to a significant improve-ment of neonatal survival in risk groups of newborns. Infants of gestational age of 22-25 weeks represent the greatest medical, social, and ethical dilemma in neonatology. Most of these newborns need intensive care to survive, and most infants born between 28 and 32 weeks of gestation require special care. Those born 34 to 36 weeks’ gestation also have higher rates of short-term morbid premature birth-related conditions such as respiratory distress syndrome (RDS) and intraventricular hemorrhage (IVH) than their peers born at term. Aim: To carry out an analysis of morbidity during the neonatal period in premature babies. Materials and methods: A retrospective triennial study was conducted on 598 premature newborns. Results: The results of the study show that morbidity rate in premature born infants is high. The most frequent reasons for admission to the neonatal intensive care unit are the other forms of respiratory distress syndrome (45%). Respiratory distress syndrome (RDS) was observed in 23.41% of the prematurity, 10.7% of them were suspected of having other pathology, and 20.9% of premature neonates manifested no complications in the neonatal period. There was a significant difference in the diagnosis of newborns after birth (p=0.0001, r=0.58), with the newborns with RDS demonstrating the most complications in the neonatal period. Conclusions: The conclusions to be drawn from the analysis of the data are as follows: there is wide comorbidity in the prematurity of RDS. Lower gestational age strongly correlates with the development of RDS. If no corticosteroid therapy is administered the risk of developing hyaline membrane disease increases. There is extremely high probability of neonatal mortality in children with hyaline membrane disease. There is significant difference between the primary diagnosis and the condition of the child at discharge from the medical establishment. Adequate and specialized prenatal care is essential when trying to reduce the incidence of preterm birth.
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Guillen, Juan, Stacey Ramey, and Prabhu Satya Parimi. "Congenital Adhesion Band Presenting as Intestinal Perforation in an Extremely Low Birth Weight Infant." American Journal of Perinatology Reports 11, no. 01 (January 2021): e1-e4. http://dx.doi.org/10.1055/s-0040-1722729.
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AbstractA 231/7-week-old and 560-g-weighing premature male infant was evaluated on day of life 33 for increased frequency of bradycardias, bilious residual, and an increase in abdominal girth. Physical examination was notable for distended and mild tender abdomen. Investigations revealed pneumoperitoneum with dilated bowel loops and a normal acid–base balance. An urgent exploratory laparotomy demonstrated isolated jejunal perforation with an adhesive band extending from the omentum to the base of the mesentery. A segmental jejunal resection followed by an end-to-end anastomosis was performed. The diagnosis of intestinal perforation was inconsistent with focal spontaneous intestinal perforation and necrotizing enterocolitis. Decision to perform exploratory laparotomy led to diagnosis of congenital adhesion band, a rare clinical condition, and the patient had a favorable outcome. This premature infant made an excellent recovery and the upper gastrointestinal (GI) study demonstrated that the anastomotic site was intact. He is currently tolerating advancing enteral feeds.
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Karapetyan, Tamara E., Natalya A. Lomova, Valeria R. Yusubova, and Shota G. Gvenetadze. "Bacterial vaginosis in pregnancy: a current view on diagnosis and therapy (literature review)." Gynecology 21, no. 5 (October 15, 2019): 30–34. http://dx.doi.org/10.26442/20795696.2019.5.190667.
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Bacterial vaginosis (BV) is the most prevalent lower genital tract disease in women of reproductive age (both pregnant and non-pregnant) and the most common cause of vaginal discharge and foul odor from the genital tract. To date, there is a lot of literature describing many different approaches to the diagnosis and treatment of BV during pregnancy. BV is common, and its precise prevalence varies widely depending on the patient population. Studies confirm that the prevalence of BV among pregnant women is the same as in the population of non-pregnant women, and ranges from 6 to 32%. The link between BV and a patient’s ethnicity, smoking, sexual behavior and douching was established. BV is more prevalent among African American women, smokers, sexually active women compared to virgins and those who use douching. Diagnosis of BV is based on clinical symptoms and the results of microbiological examination. Diagnostic criteria are the same for pregnant and non-pregnant women. If BV is confirmed, treat-ment is indicated. In most international guidelines on sexually transmitted infections, the use of either metronidazole 500 mg orally 2 times a day for 7 days, or clindamycin 300 mg orally 2 times a day for 7 days are recommended for the prevention of adverse obstetric outcomes. BV is considered as the risk factor for adverse obstetric outcomes, such as premature birth, premature rupture of membranes, spontaneous abortion, chorioamnionitis and postpartum infections, such as endometritis and infectious compli-cations in the area of the postoperative wound after cesarean section. Pregnant women with symptoms of BV are advised to be screened and treated to eliminate the symptoms. Treatment with oral or local antibiotics is acceptable to achieve recovery (cure) in pregnant women with a symptomatic course of BV and a low risk of adverse obstetric outcomes. Women without symptoms of BV and women without identified risk factors for preterm birth should not be routinely screened and treated for BV, while patients with an increased risk for premature birth may benefit from routine screening and treatment for BV.
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Kosyakova, Olga V., and Olesya N. Bespalova. "Prevention and therapy of threatened preterm birth in multiple pregnancy." Journal of obstetrics and women's diseases 68, no. 4 (October 5, 2019): 55–70. http://dx.doi.org/10.17816/jowd68455-70.
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Preterm birth in multiple pregnancy is an important medical, economic and social problem. Currently, more than half of twins are born prematurely, which puts them at high risk of developing neonatal diseases causing lifelong disability and social maladjustment. In this regard, reducing the frequency of preterm multiple births is an important task of modern obstetrics. Improving perinatal outcomes of multiple pregnancies can only be achieved using the most effective measures that have a good evidence base. At the same time, numerous studies on the effectiveness of therapeutic interventions aimed at prolonging multiple pregnancies have reported contradictory results. This review included most of the randomized controlled trials of methods for the prevention and treatment of threatening preterm birth in multiple pregnancies, as available in PubMed, Google Academy, Elibrary, and the Cochrane Central Register of Controlled Trials. Thus far, studies on the use of bed rest, prophylactic tocolysis, most of the progestins, and cervical cerclage in multiple pregnancy have shown no efficacy in reducing the risk of premature birth. However, encouraging data were obtained on improving neonatal outcomes of multiple pregnancies using vaginal progesterone and an obstetric pessary, but these results require additional confirmation in larger multicenter randomized studies. Further clinical trials are needed to develop algorithms for timely diagnosis and adequate treatment of threatened preterm birth in case of multiple pregnancy, including the use of the most rational preventive and therapeutic methods that have a high evidence level.
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Rzepka, Rafał, Barbara Dołęgowska, Aleksandra Rajewska, Daria Sałata, Marta Budkowska, Sebastian Kwiatkowski, and Andrzej Torbé. "Diagnostic Potential of Evaluation of SDF-1αand sRAGE Levels in Threatened Premature Labor." BioMed Research International 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/2719460.
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Preterm birth remains the most prevalent cause of neonatal morbidity. This study aimed to evaluate the diagnostic value of SDF-1α, resistin, secretory RAGE (sRAGE), and endogenous secretory RAGE (esRAGE) in preterm labor. A total of 211 pregnant women participated in the study. Group A contained 72 women between 22 and 36 weeks of gestation, with premature labor, who finally had preterm birth. Group B contained 66 women in labor between 37 and 41 weeks of gestation. Women in group A had lower SDF-1αand sRAGE levels than those in group B. Moreover, in group A, SDF-1αand sRAGE levels were correlated with the latency period from the occurrence of premature labor symptoms until delivery. Sensitivity and specificity of studied parameters for prediction of preterm birth were 95% and 40% for SDF-1αand 51.3% and 93.5% for sRAGE, respectively. The prognostic value of plasma SDF-1αand sRAGE levels was comparable with that of cervical length ultrasound measurement and serum C-reactive protein levels. We conclude that SDF-1αand sRAGE appear to play a major role in the diagnosis of preterm birth and its evaluation could be convenient and useful for predicting preterm birth.
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Кузибаева, R. Kuzibaeva, Хадарцева, and K. Khadartseva. "The structure and incidence of preterm birth in nulliparous women." Journal of New Medical Technologies. eJournal 9, no. 2 (July 6, 2015): 0. http://dx.doi.org/10.12737/10811.
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The article presents current views on the problem of preterm birth, various mechanisms of development and approaches to early diagnosis and prevention. Ultrasound plays a leading role in the examination of pregnant women, because of its relative simplicity, invasiveness, safety for mother and fetus. Ultrasound assessment of the cervix should be considered highly informative and prognostically valuable in the diagnosis of threatened abortion. Transvaginal measurement of cervical length is carried out for the prediction of parturition in pregnant women, who are not related to the risk of a premature birth. Ultrasound assessment of the cervix, as a screening technique is used in the Tula region for early diagnosis, accurate forecasting and perinatal outcomes, due to the large number of etiological factors and the lack of a specific method of timely diagnosis. Various risk factors are taken into account in nulliparous women who are associated with idiopathic preterm birth, prenatal rupture of membranes and termination of pregnancy for medical reasons. Preterm birth is a major cause of perinatal morbidity and mortality of newborns in nulliparous, despite the improvement in perinatal outcome in recent years.
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Mello, Rosane Reis de, Kátia Silveira da Silva, Maura Calixto Cecherelli de Rodrigues, Geórgia Chalfun, Rachel Carvalho Ferreira, and Juliana Verçosa Rocha Delamônica. "Predictive factors for neuromotor abnormalities at the corrected age of 12 months in very low birth weight premature infants." Arquivos de Neuro-Psiquiatria 67, no. 2a (June 2009): 235–41. http://dx.doi.org/10.1590/s0004-282x2009000200012.
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BACKGROUND: The increase in survival of premature newborns has sparked growing interest in the prediction of their long-term neurodevelopment. OBJECTIVE: To estimate the incidence of neuromotor abnormalities at the corrected age of 12 months and to identify the predictive factors associated with altered neuromotor development in very low birth weight premature infants. METHOD: Cohort study. The sample included 100 premature infants. The outcome was neuromotor development at 12 months classified by Bayley Scale (PDI) and neurological assessment (tonus, reflexes, posture). A multivariate logistic regression model was constructed. Neonatal variables and neuromotor abnormalities up to 6 months of corrected age were selected by bivariate analysis. RESULTS: Mean birth weight was 1126g (SD: 240). Abnormal neuromotor development was presented in 60 children at 12 months corrected age. CONCLUSION: According to the model, patients with a diagnosis including bronchopulmonary dysplasia, hypertonia of lower extremities, truncal hypotonia showed a 94.0% probability of neuromotor involvement at 12 months.
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Mbodji, Aissatou, Mouhamadou Wade, Mamour Gueye, Mame D. Ndiaye, Aliou D. Dia, Mouhamed Sene, Pahté Sow, Aminata T. Gueye, and Magatte Mbaye. "Amniotic band syndrome: a new case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 7 (June 28, 2021): 2864. http://dx.doi.org/10.18203/2320-1770.ijrcog20212682.
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Amniotic band syndrome is a pathology affecting the extremities of the fetus. It is uncommon with rates around 1 per 10,000 births. The pathophysiology is poorly understood until now with several theories reported in the literature. The diagnosis is most often made at birth. We reported a case of a 40 year old patient with no particular history who had consulted for spontaneous premature rupture of membranes in a 20 weeks pregnancy. The diagnostic of amniotic band syndrome was made after the delivery with amputation of a limb, amniotic syndactilia and deformation of the right foot in equinovarus.
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Smith, Amanda E., Amy McKenney, Laura Rabinowitz, and Anirudha Das. "Diagnosis of Neonatal Herpes Simplex Infection from the Placenta." Case Reports in Pediatrics 2020 (November 20, 2020): 1–4. http://dx.doi.org/10.1155/2020/8898612.
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Due to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neonatologist was informed of positive immunohistochemistry for the virus on the fifth day of life by the pathologist. Pathological examination of the placenta had revealed subacute necrotizing inflammation with stromal cell necrosis suggestive of intrauterine infection, possibly ascending due to prolonged rupture of membranes. To the best of our knowledge, this is the first case wherein placental pathology indicated exposure to HSV in utero before the infant presented with signs or symptoms of neonatal HSV resulting in a favorable outcome for the infant. Due to the variability of presentation of intrauterine HSV infection, pathological examination of the placenta in the first 2–5 days of life in premature infants can provide clues to the diagnosis of neonatal HSV which may significantly impact the outcome.
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Sathiamoorthi, Saraniya, Ryan D. Frank, and Brian G. Mohney. "Incidence and clinical characteristics of congenital nasolacrimal duct obstruction." British Journal of Ophthalmology 103, no. 4 (June 6, 2018): 527–29. http://dx.doi.org/10.1136/bjophthalmol-2018-312074.
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Background/aimsThe literature on the prevalence and demographics of congenital nasolacrimal duct obstruction (CNLDO) is 30–70 years old and largely comprises small sample sizes. This study provides epidemiological findings of this common disorder from the largest cohort reported to date.MethodsThe medical records of all children (<5 years of age) residing in Olmsted County, Minnesota, when diagnosed with CNLDO from 1 January 1995 through 31 December 2004, were reviewed.ResultsOf 17 713 newborns born during the 10-year study period, 1998 were diagnosed with CNLDO, yielding a birth prevalence of one in nine live births. The diagnosis was made in approximately 90% by a primary care physician, at a median age of 5 weeks, with no gender predilection. Compared with the reference population, CNLDO was associated with premature birth (p=0.005) and was more prevalent among Caucasians (p<0.001). Two-thirds of patients initially presented with discharge alone, 18% with tearing alone and 15% with both discharge and tearing.ConclusionsIn this large population-based cohort, CNLDO occurred in one in nine live births with no gender predilection. Prematurity and Caucasian race were associated with the development of CNLDO. Mucopurulent discharge was a much more common feature than tearing at initial presentation.
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Ahmad, Kaashif Aqeeb, Monica Michelle Bennett, Samiya Fatima Ahmad, Reese Hunter Clark, and Veeral Nalin Tolia. "Morbidity and mortality with early pulmonary haemorrhage in preterm neonates." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 1 (January 27, 2018): F63—F68. http://dx.doi.org/10.1136/archdischild-2017-314172.
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ObjectiveThere are no large studies evaluating pulmonary haemorrhage (PH) in premature infants. We sought to quantify the clinical characteristics, morbidities and mortality associated with early PH.DesignData were abstracted from the Pediatrix Clinical Data Warehouse, a large de-identified data set. For incidence calculations, we included infants from 340 Pediatrix United States Neonatal Intensive Care Units from 2005 to 2014 without congenital anomalies. Infants <28 weeks’ gestation with PH within 7 days of birth were then matched with two controls for birth weight, gestational age, gender, antenatal steroid exposure, day of life 0 or 1 intubation and multiple gestation.ResultsFrom 596 411 total infants, we identified 2799 with a diagnosis of PH. Peak incidence was 86.9 cases per 1000 admissions for neonates born at 24 weeks’ gestation. We then identified 1476 infants <28 weeks’ gestation with an early PH diagnosis at ≤7 days of age of which 1363 (92.3%) were successfully matched. Patients with early PH had significantly higher exposure to poractant alfa (35.4% vs 28%), diagnosis of shock (63.7% vs 51%) and grade IV intraventricular haemorrhage (20.8% vs 6%). Patients with PH also had significantly higher mortality rates at 7 days of age (40.6% vs 18.9%), 30 days of age (54% vs 28.8%) and prior to discharge (56.9% vs 33.7).ConclusionIn this large cohort of premature infants, we found PH to be common among the most premature babies. Early PH was associated with significant morbidity and mortality in excess of 50%. A renewed focus on the underlying pathophysiology and prevention of PH is warranted.
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Rzepka, Rafał, Barbara Dołęgowska, Aleksandra Rajewska, and Sebastian Kwiatkowski. "On the Significance of New Biochemical Markers for the Diagnosis of Premature Labour." Mediators of Inflammation 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/251451.
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Preterm labour is defined as a birth taking place between 22nd and 37th weeks of gestation. Despite numerous studies on the aetiology and pathogenesis of preterm labour, its very cause still remains unclear. The importance of the cytokines and acute inflammation in preterm labour aetiology is nowadays well-proven. However, chronic inflammation as an element of the pathogenesis of premature labour is still unclear. This paper presents a literature review on the damage-associated molecular patterns (DAMPs), receptors for advanced glycation end products (RAGE), negative soluble isoforms of RAGE, chemokine-stromal cell-derived factor-1 (SDF-1) and one of the adipokines, resistin, in the pathogenesis of preterm labour. We conclude that the chronic inflammatory response can play a much more important role in the pathogenesis of preterm delivery than the acute one.
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Borschova, A. A., G. M. Pertceva, and N. A. Alekseeva. "ISTHMIC-CERVICAL INSUFFICIENCY IN THE STRUCTURE OF THE REASONS FOR MORTARING OF PREGNANCY." Medical Herald of the South of Russia 11, no. 1 (March 30, 2020): 34–40. http://dx.doi.org/10.21886/2219-8075-2020-11-1-34-40.
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Objective: to identify the main causes that contribute to the occurrence of ischemic-cervical insufficiency.Materials and methods: a retrospective analysis of the course of pregnancy, childbirth, outcomes for the fetus in 158 women with ischemic-cervical insufficiency was performed. All pregnant women, except for general clinical examination, underwent transvaginal ultrasound examination of the cervix.Results: of 158 women with isthmic-cervical insufficiency, there were 71 first-born (44.94 %), and 87 second-born (55.06 %). In the history of these women, 64 (40.51 %) had inflammatory processes of the female genitals, 38 (24.05 %) had extragenital pathology (cardiovascular diseases), 36 (22.78 %) were obese, 13 (8.23 %) had cervical erosion, and only 7 (4.43 %) had a favorable history. The diagnosis of ICN was established by a combination of data from vaginal and transvaginal ultrasound examination of the cervix. Correction of this pathology was carried out by applying a pessary to the cervix. Conclusion: we did not find a statistically significant difference between the occurrence, causes, and manifestation of clinical data in both first-and second-generation women. Among the causes of PPI, both in the first and second clinical groups, inflammatory diseases of the female genitals, cardiovascular pathology and obesity predominate. Early diagnosis of PPI reduces the risk of premature birth, reduces the percentage of premature birth, and contributes to the birth of children during full-term pregnancy.
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Haque, Gazi Mohammad Imranul, and Probir Kumar Sarkar. "Diagnosis and Management of Patent Ductus Arteriosus in Newborn: An Update." Dhaka Shishu (Children) Hospital Journal 36, no. 1 (March 26, 2021): 61–66. http://dx.doi.org/10.3329/dshj.v36i1.52643.
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Patent ductus arteriosus is one of the common congenital acyanotic heart disease in neonates, especially in preterm. Patent ductus arteriosus (PDA) is a congenital condition, characterized by a persistent connection between the aorta and the pulmonary artery. Patency of Ductus Arteriosus is essential for fetal survival. Patent ductus arteriosus is one of the most common clinical findings and most frequent source of complications in premature infant. After birth, in term infants, the ductus usually closes within the first day of life, starting with functional closure followed by anatomical closure with vascular remodeling. The persistence of the PDA in preterm infant is inversely related to gestational age and birth weight. The incidence of Patent Ductus Arteriosus is 31% in preterm infant weighing 501 to 1500 gm and gestational age 29 weeks. The treatment options available are conservative medical management, pharmacological therapy or surgical ligation. Conservative medical management involves fluid restriction; watchful waiting and ventilator support.
DS (Child) H J 2020; 36(1) : 61-66
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Akhmetgaliev, A. R., I. F. Fatkullin, A. A. Munavirova, and F. I. Fatkullin. "Algorithm to identify the signs of threatened preterm labour." Kazan medical journal 98, no. 1 (February 15, 2017): 132–36. http://dx.doi.org/10.17750/kmj2017-132.
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Aim. To develop the algorithm of identification the signs of threatened preterm labour based on statistical and clinical comparison of modern available diagnostic tests: ultrasound cervicometry and express test-systems for measuring placental α1-microglobulin in cervical secretion.Methods. The analysis of case histories of patients with a diagnosis of «threatened preterm labor» was performed.Results. Total of 12 patients had premature labour accounting for 14.12%. In 8 of them placental α1-microglobulin in cervical secretion was positive and only in 5 patients cervical length was ≤20 mm according to ultrasound cervicometry. 4 patients with premature birth (ranging from 48 hours to 7 days) had false-negative test results. 7 (8.2%) patients had a false-positive result of placental α1-microglobulin test, and these patients subsequently had term birth. The sensitivity of the test for placental α1-microglobulin as a marker of premature birth was 66.67%, specificity 95.9%, specificity of ultrasound cervicometry - 47.9%, and sensitivity - 41.7%. Use of the combination of both tests can significantly reduce hyperdiagnosis of threatened preterm labour.Conclusion. Females with short cervix according to ultrasound cervicometry should reasonably be tested for placental α1-microglobulin in cervical discharge; positive result of this test will be found in those whose probability to give preterm labour during the next 14 days reaches 72.72%, and high prognostic value of a negative test result allows observing the patients in outpatient setting.
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Wheeler, Sarahn, Elisabeth Nigrini, Andrew Satin, Michael Johnston, Ernest Graham, and Irina Burd. "525: Peripheral glucose levels at birth and diagnosis of periventricular white matter injury in premature neonates." American Journal of Obstetrics and Gynecology 208, no. 1 (January 2013): S225. http://dx.doi.org/10.1016/j.ajog.2012.10.691.
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Tarricone, Fabio, Antonio Brunetti, Domenico Buongiorno, Nicola Altini, Vitoantonio Bevilacqua, Antonio Del Vecchio, and Flavia Petrillo. "Intelligent Neonatal Sepsis Early Diagnosis System for Very Low Birth Weight Infants." Applied Sciences 11, no. 1 (January 4, 2021): 404. http://dx.doi.org/10.3390/app11010404.
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Neonatal sepsis is a critical pathology that particularly affects the neonates in intensive care, especially if they are preterm and low birth weight, with an incidence varying between 1and 40% according to the onset (early or late) of the disease. Prompt diagnostic and therapeutic interventions could reduce the high percentage of mortality that characterises this pathology, especially in the premature and low weight neonates. The HeRO score analyses the heart rate variability and represents the risk of contracting sepsis because of the hospitalization in the neonatal intensive care unit up to 24 h before the clinical signs. However, it has been demonstrated that the HeRO score can produce many false-positive cases, thus leading to the start of unnecessary antibiotic therapy. In this work, the authors propose an optimised artificial neural network model able to diagnose sepsis early based on the HeRO score along with a series of parameters strictly connected to the risk of neonatal sepsis. The proposed methodology shows promising results, outperforming the diagnostic accuracy of the only HeRO score and reducing the number of false positives, thus revealing itself to be a promising tool for supporting the clinicians in the daily clinical practice.
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Borodynia, V. I., and O. A. Svyatchenko. "Передчасне відшарування плаценти коней (діагностика, лікування)." Scientific Messenger of LNU of Veterinary Medicine and Biotechnologies 19, no. 82 (November 4, 2017): 16–20. http://dx.doi.org/10.15421/nvlvet8204.
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In case of a premature placenta abruption, diagnostics should be done quickly, because it affects survival and viability of a foal. Premature detachment of the placenta in the mares, which occurs before or during birth, is not a common parable. This pathological condition ranges from 5 to 10% of all cases of abortion, the birth of dead fetuses and perinatal mortality in horses. The general condition of a mare usually is without any abnormalities. Clinical obstetric examination includes vaginal and sonographic study. When conducting a vaginal examination, it is possible to see an open cervix and placenta bulging in a vagina. Sonography of an uterus enables to determine location of the placenta abruption and its volume. Typical symptoms of a premature abruption of a placenta in mares become visible only when foaling. For foaling with placenta previa typical is absence of ejection of amniotic fluid (allantois fluid) at the beginning of the second stage of foaling as chorioallantois remains intact. Fetus, all shells and fluids that are contained in a holistic chorioallantois, come out at once. In afterbirth of mares with premature placental abruption changes in structure of membranes are clearly observed. This pathological condition may significantly influence the unborn foal in the neonatal period. For mares, foaling with a diagnosis of premature placental abruption does not pose any danger. One of the most important factors in treatment is immediate dissection of chorioallantois and evacuating the fetus.
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Ramaswamy, Mamatha, Victor Anthony Skrinska, Rola Fayez Mitri, and Ghassan Abdoh. "Diagnosis of Carnitine Deficiency in Extremely Preterm Neonates Related to Parenteral Nutrition: Two Step Newborn Screening Approach." International Journal of Neonatal Screening 5, no. 3 (August 31, 2019): 29. http://dx.doi.org/10.3390/ijns5030029.
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Currently, there is no evidence in the literature to support the routine supplementation of all parenterally fed premature infants with l-carnitine. In our study, we found that about 8.56% of extremely preterm neonates are diagnosed with carnitine deficiency secondary to malnutrition, either due to reduced stores at birth or related to total parenteral nutrition (TPN). Our two step approach of performing newborn screening (NBS) again at 32 weeks gestational age (GA) equivalent helps to diagnose 81.4% more preterm babies with carnitine deficiency—who would otherwise be missed—and supplement them with l-carnitine for optimal growth. We performed a retrospective cohort study to diagnose carnitine deficiency related to malnutrition in two groups: those presenting at birth and those presenting later in life. We found that there was a statistically significant difference in the median GA and birth weight (BW) between the two groups, but there was no difference in the free carnitine levels.
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Palomo-Carrión, Rocío, Rita Pilar Romero-Galisteo, Helena Romay-Barrero, Inés Martínez-Galán, Cristina Lirio-Romero, and Elena Pinero-Pinto. "How Does the Cause of Infantile Hemiparesis Influence Other Conditioning Factors? A Preliminary Study in a Spanish Population." Children 8, no. 5 (April 22, 2021): 323. http://dx.doi.org/10.3390/children8050323.
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Infantile hemiparesis may be associated with significant morbidity and may have a profound impact on a child’s physical and social development. Infantile hemiparesis is associated with motor dysfunction as well as additional neurologic impairments, including sensory loss, mental retardation, epilepsy, and vision, hearing, or speech impairments. The objective of this study was to analyze the association between the cause of infantile hemiparesis and birth (gestational age), age of diagnosis, and associated disorders present in children with infantile hemiparesis aged 0 to 3 years. An observational and cross-sectional study was performed. A simple and anonymous questionnaire was created ad hoc for parents of children diagnosed with infantile hemiparesis aged between 0 and 3 years about the situation regarding the diagnosis of hemiparesis, birth, cause of hemiparesis, and presence of other associated disorders. Perinatal stroke (60.1%) was the most common cause of hemiparesis, and the most typical associated disorder was epilepsy (34.2%), with the second largest percentage in this dimension corresponding to an absence of associated disorders (20.7%). The most frequent birth was “no premature” (74.1%). The mean age of diagnosis of infantile hemiparesis was registered at 8 months (IQR: 0–36). Knowing the possible association between different conditioning factors and the cause of infantile hemiparesis facilitates the prevention of severe sequelae in children and family, implementing an early comprehensive therapeutic approach in children with infantile hemiparesis.
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Adnan, Muhammad Luthfi. "WANITA USIA 26 TAHUN, MULTIGRAVIDA HAMIL 35 MINGGU DENGAN DIAGNOSIS INFEKSI SALURAN KEMIH." JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia 7, no. 2 (March 18, 2020): 54–59. http://dx.doi.org/10.53366/jimki.v7i2.51.
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Urinary tract infection (UTI) is a disease caused by bacteria that attack theurinary tract. Pregnant women are one of the risk factors for the occurrenceof UTI and are at risk of causing premature birth and low birth weight (LBW).This case report describes multigravida women with G3P1A1Ah1 with agestational age of 35 weeks less 2 days with complaints of tightness,frequent urination at night and lower back pain. The patient has a history ofcesarean section at the birth of the first child and the incidence of UTI beforemarriage. Blood pressure: 102/71 mmHg with pulse 90 times / minute. FH29 cm with EFW ± 2790 grams, right back, head presentation, had enteredthe pelvis with a 4/5 decline, His palpitations were not palpable, fetal heartrate was 135x / minute and irregular rhythm. On laboratory examinationshows the results of hemoglobin (Hb) examination of 12.8 g / dL and leukocytes exceed the normal threshold (5000-15000 / mm3). The patient isthen given calcium lactate, iron fumarate to maintain pregnancy andamoxicillin to treat UTI in patients. Patients are also educated to maintainthe cleanliness of genital organs to prevent further infection and advise ifwant to start family plan program, patient can use Intrauterine Device (IUD)as contraception.
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Chisholm, Karen M., Mary E. Norton, Anna A. Penn, and Amy Heerema-McKenney. "Classification of Preterm Birth With Placental Correlates." Pediatric and Developmental Pathology 21, no. 6 (May 14, 2018): 548–60. http://dx.doi.org/10.1177/1093526618775958.
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Premature birth lacks a widely accepted classification that unites features of the clinical presentation with placental pathology. To further explore associations between the clinical categories of preterm birth and placental histology, 109 infants with gestational age <34 weeks and birth weight <2000 g were selected and, based on electronic records, were classified into preterm birth categories of preterm labor, prelabor premature rupture of membranes, preeclampsia, indicated preterm birth for maternal factors (other than preeclampsia), indicated preterm birth for fetal factors, and the clinical diagnosis of abruption. Corresponding placentas were analyzed for gross and microscopic variables, with findings grouped into categories of amniotic fluid infection, lymphocytic inflammation, maternal vascular malperfusion, and fetal vascular malperfusion. Placental features of maternal vascular malperfusion were pervasive in all preterm birth categories and were commonly associated with amniotic fluid infection and lymphocytic inflammation. Features of maternal vascular malperfusion were significantly associated with preterm birth due to preeclampsia, and amniotic fluid infection was highly associated with prelabor preterm rupture of membranes. Findings of lymphocytic inflammation were significantly increased in cases of abruption. Laminar decidual necrosis was present in all cases of abruption. Placentas from multiple gestations had significantly less histologic findings compared to singletons. Given that 75% of placentas demonstrated at least 1 feature of maternal vascular malperfusion despite different clinical presentations, seemingly different pathologies such as ascending amniotic fluid infection or lymphocytic inflammation may be mechanistically related to processes established early in pregnancy. The concept of “uterine ischemia” may be too simplistic to account for all of the changes attributed to maternal vascular malperfusion in the preterm placenta.
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Khasanov, A. A., L. D. Egamberdieva, F. F. Minnullina, and L. M. Mukhametzyanova. "Mature teratoma in pregnancy and in the postpartum period." Practical medicine 19, no. 1 (2021): 91–95. http://dx.doi.org/10.32000/2072-1757-2021-1-91-95.
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Ovarian tumors are detected in 2-3% of pregnant women. They may cause complications such as torsion of the tumor or appendages, rupture of the capsule, threat of termination of pregnancy or premature birth, obstruction of the birth canal, risk of tumor malignancy. Patients with mature teratomas most often have no or few symptoms, hence complicated diagnostics. The bimanual examination and the ultrasound method are not so effective due to the pregnancy. The tumor markers are not so meaningful in the differential diagnosis of malignant diseases, which complicates the choice of treatment tactics. That is why we present the clinical cases of pregnancies with a mature teratoma. The correct differential diagnosis of complications of ovarian tumors with diseases such as endometritis and other inflammatory diseases are very important.
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Machado, Ângela, Gustavo Rocha, Ana Isabel Silva, Nuno Alegrete, and Hercília Guimarães. "Fraturas Ósseas em uma Unidade de Cuidados Intensivos Neonatais." Acta Médica Portuguesa 28, no. 2 (April 30, 2015): 204. http://dx.doi.org/10.20344/amp.5660.
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<strong>Introduction:</strong> Fractures during the neonatal period are rare. Some fractures, especially long bones, may occur during birth. Moreover, neonates hospitalized in the Neonatal Intensive Care Unit have an increased risk of fractures for several reasons.<br /><strong>Objective:</strong> To evaluate the incidence and characterize fractures in newborns admitted in a tertiary Neonatal Intensive Care Unit.<br /><strong>Material and Methods:</strong> A retrospective analysis of the newborns admitted to the Neonatal Intensive Care Unit with a diagnosis at discharge of one or more bone fractures from January 1996 to June 2013.<br /><strong>Results: </strong>Eighty neonates had one or more fractures. In 76 (95%) infants the fractures were attributed to birth injury. The most common fracture was the clavicle fracture in 60 (79%) neonates, followed by skull fracture in 6 (8%). In two (2.5%) neonates, extremely low birth weight infants, fractures were interpreted as resulting from osteopenia of prematurity. Both had multiple fractures, and one of them with several ribs.<br /><strong>Conclusion: </strong>A change in obstetric practices allied to improvement premature neonate’s care contributed to the decreased incidence of fractures in neonatal period. But in premature infants the diagnosis may be underestimated, given the high risk of fracture that these infants present.
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Nair, Jayasree, and Vasantha Kumar. "Liver Failure and Conjugated Hyperbilirubinemia in a Preterm Neonate: Role of Early IVIG and Exchange Transfusion." American Journal of Perinatology Reports 08, no. 02 (April 2018): e95-e98. http://dx.doi.org/10.1055/s-0038-1649339.
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AbstractNeonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging. The infant underwent intensive phototherapy along with four exchange transfusions (ET) and two courses of intravenous immunoglobulins (IVIG). The clinical goals were to keep total bilirubin values ≤ 20 mg/dL in this premature neonate and to minimize the risk of bilirubin-induced neurologic dysfunction and decompensated liver failure. Abnormal iron studies and later magnetic resonance imaging were suggestive of GALD. Liver functions improved over time with normal neurodevelopmental assessment at 3 years of age. To conclude, in infants with NLF soon after birth, earlier consideration of IVIG/ET in the first few days may be beneficial. Larger multicenter data analyses are required to formulate treatment guidelines and indications for phototherapy, ET, and IVIG in sick neonates with NLF.
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Ercan, Fedi, Nefise Nazli Yenigul, and Emre Baser. "Measurement of the Uterocervical Angle for Predicting the Latent Period in Pregnancy Exhibiting Premature Membrane Rupture." Gynecologic and Obstetric Investigation 86, no. 1-2 (2021): 200–208. http://dx.doi.org/10.1159/000515224.
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<b><i>Objectives:</i></b> The duration of the latent period is uncertain in preterm premature rupture of membranes (PPROM). This time estimate provides information on the time of the corticosteroid to be applied and the time of delivery of the pregnant women. Here, we used transvaginal sonography to determine the relationship between the uterocervical angle (UCA) and PPROM latency and the risk for neonatal complications. <b><i>Design:</i></b> This is a prospective cohort study of 80 singleton pregnancies with PPROM. <b><i>Participants/Materials, Setting, and Methods:</i></b> This prospective cohort study was conducted at a tertiary center with a total of 80 singleton pregnancies with PPROM. The UCA and cervical length were measured in the first evaluation of PPROM in patients between 24 and 34 weeks of age. The study population was subdivided into 2 groups: group 1 (<i>n</i> = 27) included women who gave birth within 10 days after a PPROM diagnosis and group 2 (<i>n</i> = 53) included women who gave birth later than this. Our aim was latency prediction (more or less than 10 days) in PPROM patients undergoing regular UCA monitoring. <b><i>Results:</i></b> Of the women in group 1, 74.1% (<i>n</i> = 20) had spontaneous births and 7.4% (<i>n</i> = 2) had induced births because of clinical chorioamnionitis. Of the women in group 2, 71.6% (<i>n</i> = 38) had spontaneous births and 7.6% (<i>n</i> = 4) had induced births because of clinical chorioamnionitis (<i>n</i> = 3) or poor fetal condition (<i>n</i> = 1). We drew receiver operating characteristic curves to explore whether the UCA predicted birth within 10 days of PPROM. The area under the curve was 0.894 (<i>p</i> < 0.001). The optimal UCA cutoff was 108°, with 93% sensitivity and 85% specificity. <b><i>Limitations:</i></b> First, the sample size was small; it would have been better to have more patients. Second, we measured the UCA only once. Third, patients were not categorized by parity. <b><i>Conclusions:</i></b> The UCA, measured by the transvaginal route, can successfully predict latent period in PPROM. Measuring the UCA can be useful to determine the time of corticosteroid administration and to inform patients about the time of birth.
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Shliakhtsitsava, Ksenya, Emily Myers, and Irene Su. "Reproductive Concerns Among Female Leukemia and Lymphoma Survivors with the History of Adverse Pregnancy Outcomes after Cancer Treatment." Blood 132, Supplement 1 (November 29, 2018): 5893. http://dx.doi.org/10.1182/blood-2018-99-110590.
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Abstract Introduction Due to advances in cancer treatment the majority of young adults diagnosed with leukemia or lymphoma become long-term survivors. These individuals have been shown to have higher pregnancy risks as a result of cancer and treatment exposure. Adverse pregnancy outcomes including miscarriage and premature delivery may impact survivor's reproductive concerns after cancer. We hypothesized that reproductive-aged female leukemia and lymphoma survivors who experienced miscarriage or premature birth after cancer would have higher reproductive concerns as compared to female leukemia and lymphoma survivors who did not have an adverse pregnancy outcome after cancer. Methods This is a retrospective cohort study of young adult female leukemia and lymphoma survivors with at least one pregnancy after cancer, who are participants of the Reproductive Window study. Study participants were recruited between March 2015 and December 2017 from population-based cancer registries (California and Texas), physician and advocacy group referrals. Eligible women were age 18 to 40 at enrollment, age 15-35 at cancer diagnosis, and had at least one ovary. Enrolled participants answered a questionnaire on pregnancy outcomes and reproductive concerns using the Reproductive Concerns After Cancer (RCAC) Scale. The exposure was adverse pregnancy outcome (miscarriage or premature birth). The outcomes were RCAC subscales measuring concerns regarding becoming pregnant in the future and personal and offspring health. Subscale scores were dichotomized at 3, with >3 indicating moderate to severe reproductive concerns. Logistic regression models were used to test the association between an adverse pregnancy outcome (miscarriage or preterm birth) and RCAC subscales of interest, while adjusting for confounding Results 76 participants, mean age 34.3±3.9 years and mean years since cancer diagnosis 12.0± 5.8 years were included. The majority of participants were white (80%), completed college (72%) and were partnered (87%). Thirty eight percent of participants reported an adverse pregnancy outcome after cancer (18% miscarriage, 21% premature delivery). Thirty-two percent reported moderate to severe concerns about becoming pregnant in the future, 60% regarding offspring health, and 46% over personal health. History of miscarriage after cancer, but not preterm birth, was associated with higher concerns about becoming pregnant. In a multivariable model that adjusted for Hispanic ethnicity, current age, and live birth after cancer, participants who experienced a miscarriage after cancer were more likely to have moderate to high concerns about becoming pregnant in the future (adjusted OR 4.1, 95% CI 1.05-15.5, p=0.042) compared to participants with no history of miscarriage. Neither adverse pregnancy outcomes was associated with concerns about offspring or personal health. Conclusions In the cohort of young adult female leukemia and lymphoma survivors, experiencing a miscarriage after cancer was associated with higher concerns regarding becoming pregnant in the future. Additional research is needed to determine whether interventions such as preconception counseling with consideration of prior cancer treatments may help manage these concerns and improve pregnancy outcomes. Disclosures No relevant conflicts of interest to declare.
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Souza, Alex Sandro Rolland, Adriane Farias Patriota, Gláucia Virgínia de Queiroz Lins Guerra, and Brena Carvalho Pinto de Melo. "Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes." Revista da Associação Médica Brasileira 62, no. 3 (June 2016): 269–75. http://dx.doi.org/10.1590/1806-9282.62.03.269.
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SUMMARY Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.
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Tyutyunnik, V. L., N. E. Kan, N. A. Lomova, and M. K. Medzhidova. "THERAPY OF UROGENITAL INFECTIONS DURING PREGNANCY." Medical Council, no. 2 (December 30, 2017): 62–65. http://dx.doi.org/10.21518/2079-701x-2017-2-62-65.
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Urogenital infections (UGI) remain one of the urgent problems of obstetrics and gynecology. In the period of gestation, the UGI may cause such complications as chorioamnionitis, intrauterine growth retardation and intrauterine and intrapartum infection of the fetus, spontaneous abortions, premature birth, purulent-septic complications in the postpartum period. According to the literature, UGI in pregnant women have a high prevalence and often occur in a latent form, complicating timely diagnosis and subsequent treatment.
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Kirpekar, M., M. M. Abiri, C. Hilfer, and R. Enerson. "Ultrasound in the diagnosis of systemic candidiasis (renal and cranial) in very low birth weight premature infants." Pediatric Radiology 16, no. 1 (January 1986): 17–20. http://dx.doi.org/10.1007/bf02387499.
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Nastase, Leonard, Luiza Radulescu, Monica Luminita Luminos, Maria Madalina Merisescu, Gheorghita Jugulete, and Silvia Maria Stoicescu. "Severe Modifications of Biological Markers in Late Neonatal Sepsis in a Very Low Birth Weight Due to Candida lusitaniae." Revista de Chimie 70, no. 2 (March 15, 2019): 393–97. http://dx.doi.org/10.37358/rc.19.2.6923.
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Neonatal sepsis is a major cause of neonatal mortality and morbidity in preterm, very low birth weight infants. Coagulase-negative staphylococcus and Candida spp. are among the most common causes of single infections and coinfections in neonates. Candida lusitaniae is rarely reported as an opportunistic pathogen in very low birth weight neonates. Early diagnosis and appropriate antifungal therapy can prevent morbidity and mortality in preterms especially in coinfections. Necrotizing enterocolitis is one of the most catastrophic gastrointestinal emergencies in premature infants in the intensive care neonatal unit, especially in preterm infants. Currently, the pathogenesis of necrotizing enterocolitis is believed to have multifactorial causes. We present the case of a very low birth weight preterm who developed necrotizing enterocolitis and sepsis caused by a coinfection of Coagulase-negative Staphylococcus and Candida lusitaniae.
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Karki, Bipin, Varsha Verma, Ritesh Shrestha, and Suchita Shrestha Joshi. "Allergic proctocolitis causing hematochezia in preterm twins." Nepal Mediciti Medical Journal 1, no. 1 (December 1, 2020): 23–26. http://dx.doi.org/10.3126/nmmj.v1i1.34477.
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Allergic colitis due to cow’s milk or soy protein in commercially prepared infant formula or due to ingestion of breast-milk of mothers who are ingesting cow’s milk is a known cause of colitis occurring in infants. Allergic colitis can occur within days, weeks or months of birth and should be considered as a differential diagnosis in any infant presenting with hematochezia. Typically, there is a significant delay in the onset of milk allergy in premature infants compared to full term infants. We report a case of premature twin neonates who presented with profuse rectal bleeding during second week of life. The infants had been feeding expressed breast milk since birth and the nursing mother had been drinking cow’s milk. The infants had pneumatosis coli suggestive of inflammation of the colon while biochemical and hematological markers of inflammation were normal. Expressed breast milk was re-introduced after eliminating dairy from mother’s diet for 5 days. The infants were fed on mother’s milk and top up of hydrolyzed infant formula as required. Both the twins remained well.
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., Bharti, and Sumit Chawla. "Perinatal outcome in hypertensive disorder of pregnancy in a rural community of Haryana." International Journal Of Community Medicine And Public Health 6, no. 10 (September 26, 2019): 4267. http://dx.doi.org/10.18203/2394-6040.ijcmph20194478.
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Background: Pregnancy in hypertension may complicate pregnancies with variable incidence among different settings. Pregnancies complicated with hypertensive disorders are associated with increased risk of adverse fetal, neonatal and maternal outcome including preterm birth, intrauterine growth retardation (IUGR), perinatal death etc. The present study was undertaken to study the perinatal outcome of hypertension in pregnancy in a rural block of Haryana.Methods: This cross-sectional study was carried out in the all the 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Pregnancy outcome was followed-up by contacting the health worker of respective sub-center or mother. Information regarding stillbirth, abortion, maturity, birth weight, mode of delivery and early neonatal death was collected. Appropriate statistical tests were used for analysis.Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Hypertension in pregnancy is significantly associated with premature births still births (6.7% vs 1.4%; p=0.003), low birth weight (26.7% vs 4.9%; p=0.000) and early neonatal deaths (8.3% vs 2.8%; p=0.017).Conclusions: Perinatal mortality is significantly high in mothers with hypertensive disorders. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.
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Kajiwara, Kazuhiro, Tomohiro Tanemoto, Chie Nagata, and Aikou Okamoto. "Prenatal Diagnosis of Isolated Agnathia-Otocephaly: A Case Report and Review of the Literature." Case Reports in Obstetrics and Gynecology 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/8512351.
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Agnathia is a rare disease characterized by the absence of a mandible. Few cases of prenatally diagnosed isolated agnathia have been reported. We present a case report and review of the literature of prenatally diagnosed agnathia. A 38-year-old woman (gravida 0, para 0) was referred to our hospital at 28 weeks and 3 days of gestation for fetal evaluation because of polyhydramnios and suspected facial anomalies. Three-dimensional ultrasonography and MRI indicated agnathia. Premature rupture of the membranes occurred before the parents could reach a decision on the postnatal treatment. We performed emergency cesarean section on the second day of the 33rd week of gestation. The neonate was deemed nonresuscitable and he died of airway obstruction shortly after birth. Because agnathia is associated with very poor prognosis, accurate prenatal diagnosis and detailed counseling should be promptly provided before unexpected delivery to the parents for the determination of postnatal treatment.