Gastroschisis: Antenatal Sonographic Predictors of Adverse Neonatal Outcome

Objectives. The aim of this review was to identify clinically significant ultrasound predictors of adverse neonatal outcome in fetal gastroschisis.Methods. A quasi-systematic review was conducted in PubMed and Ovid using the key terms “gastroschisis,” “predictors,” “outcome,” and “ultrasound.”Results. A total of 18 papers were included. The most common sonographic predictors were intra-abdominal bowel dilatation (IABD), intrauterine growth restriction (IUGR), and bowel dilatation not otherwise specified (NOS). Three ultrasound markers were consistently found to be statistically insignificant with respect to predicting adverse outcome including abdominal circumference, stomach herniation and dilatation, and extra-abdominal bowel dilatation (EABD).Conclusions. Gastroschisis is associated with several comorbidities, yet there is much discrepancy in the literature regarding which specific ultrasound markers best predict adverse neonatal outcomes. Future research should include prospective trials with larger sample sizes and use well-defined and consistent definitions of the adverse outcomes investigated with consideration given to IABD.

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OP06.10: The association between suboptimal fetal abdominal circumference growth velocity and adverse neonatal outcome in appropriate-for-gestational-age neonates

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.17748 ◽

2017 ◽

Vol 50 ◽

pp. 66-66

Author(s):

M. Hendrix ◽

S. van Kuijk ◽

D. Kramer ◽

D. Gavilanes ◽

S. Al Nasiry ◽

...

Keyword(s):

Gestational Age ◽

Growth Velocity ◽

Neonatal Outcome ◽

Abdominal Circumference ◽

Adverse Neonatal Outcome ◽

Appropriate For Gestational Age

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Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital

Journal of Fatima Jinnah Medical University ◽

10.37018/qbhp7754 ◽

2021 ◽

Vol 15 (1) ◽

pp. 18-22

Author(s):

Erum Saboohi ◽

Nighat Seema ◽

Abdulah Hadi Hassan

Keyword(s):

Risk Factors ◽

Antenatal Care ◽

Preterm Delivery ◽

Neonatal Outcome ◽

Neonatal Outcomes ◽

P Value ◽

Medical College ◽

Adverse Neonatal Outcome ◽

Adverse Neonatal Outcomes ◽

Nicu Admission

Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome. Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant. Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001). Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.

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Is There a Benefit of Antenatal Corticosteroid When Given < 48 Hours Before Delivery?

10.21203/rs.3.rs-921511/v1 ◽

2021 ◽

Author(s):

Yoav Siegler ◽

Naphtali Justman ◽

Gal Bachar ◽

Roy Lauterbach ◽

Yaniv Zipori ◽

...

Keyword(s):

Primary Outcome ◽

Neonatal Outcome ◽

Neonatal Morbidity ◽

Time Interval ◽

Outcome Study ◽

Antenatal Corticosteroid ◽

Time Intervals ◽

Corticosteroid Administration ◽

Adverse Neonatal Outcome ◽

Adverse Neonatal Outcomes

Abstract Objective We assessed the association between a short Antenatal Corticosteroid Administration-to-Birth Interval and neonatal outcome. Study design: A retrospective study between 2010- 2020. Eligible cases were singleton preterm live-born neonates born between 24 0/7 and 33 6/7 weeks of gestation and were initiated an ACS course of Betamethasone. We divided the first 48 hours following 1st ACS administration to four-time intervals and compared each time interval to those born more than 48 hours following ACS administration. The primary outcome was a composite of adverse neonatal outcome, including neonatal mortality or any major neonatal morbidity. Results A total of 200 women gave birth less than 48 hours from receiving the first betamethasone injection, and 172 women gave birth within 2-7 days (48-168 hours) from ACS administration. Composite adverse neonatal outcome was higher for neonates born less than 12 hours from initial ACS administration compared to neonates born 2-7 days from first betamethasone injection (55.45% vs. 29.07%, OR 3.45 95% CI [2.02-5.89], p.value<0.0001). However, there was no difference in composite adverse neonatal outcomes between neonates born 12-48 hours following ACS administration and those born after 2-7 days. That was also true after adjusting for confounders. Conclusions 12-24 hours following ACS Administration may be sufficient in reducing the same risk of neonatal morbidities as > 48 hours following ACS administration. It may raise the question regarding the utility of the second dose of ACS.

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The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis

Global Pediatric Health ◽

10.1177/2333794x211019699 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110196

Author(s):

Wubet Alebachew Bayih ◽

Metadel Yibeltal Ayalew ◽

Melaku Tadege ◽

Maru Mekie ◽

Teklehaimanot Kiros ◽

...

Keyword(s):

Neonatal Outcome ◽

Birth Outcome ◽

Meta Analysis ◽

Neonatal Outcomes ◽

Data Bases ◽

Substance Users ◽

Adverse Neonatal Outcome ◽

Pooled Prevalence ◽

Adverse Neonatal Outcomes ◽

International Data

Background. Substances mainly khat, alcohol and cigarette are used during pregnancy in Ethiopia. However, to this date, there is no pooled evidence about the burden of adverse neonatal outcomes among the substance users during pregnancy in the country. Methods. Eligible primary studies were accessed from 4 international data bases (Google Scholar, Science Direct, Scopus, and PubMed). The required data were extracted from these studies and then exported to stata version 14 for analysis. Subgroup analyses were conducted for evidence of heterogeneity. Results. A total of 2298 neonates were included from 7 studies. Among these neonates, 530(23.06%) were those whose mothers used substance during pregnancy (exposed group) whereas 1768 neonates were those whose mothers didn’t use substance during pregnancy (controls group). The pooled prevalence of adverse neonatal outcome among the exposed mothers was 38.32% (95% CI: 29.48%, 47.16%; I2 = 76.3%) whereas it was 16.29% (95% CI: 9.45%, 23.13%) among the controls. Adverse neonatal outcome was most burdensome among cigarette smokers 45.20% (95% CI: 37.68%, 52.73%; I2 = .00%) when compared with khat chewers 34.00% (95% CI: 20.87%, 47.13%) and alcohol drinkers 38.47% (95% CI: 17.96%, 58.98%). Low birth weight 42.00% (95% CI: 18.01%, 65.99%; I2 = 91.8%) was the most common adverse birth outcome. Conclusion. It was found that adverse neonatal outcomes were much more burdensome among antenatal substance users than the controls. Therefore, mothers should be enabled to quit using substance before pregnancy. Besides, strict comprehensive screening of every pregnant mother should be made at antenatal care clinics for early identification and management of antenatal substance use.

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Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

American Journal of Perinatology ◽

10.1055/s-0039-1683439 ◽

2019 ◽

Vol 37 (05) ◽

pp. 503-510

Author(s):

Emily S. Miller ◽

Yinglei Lai ◽

Jennifer Bailit ◽

Uma M. Reddy ◽

Ronald J. Wapner ◽

...

Keyword(s):

Vaginal Delivery ◽

Study Design ◽

Neonatal Outcome ◽

Secondary Analysis ◽

Perinatal Outcomes ◽

Obstetric Outcomes ◽

Adverse Neonatal Outcome ◽

Operative Vaginal Delivery ◽

Adverse Neonatal Outcomes ◽

Observational Cohort

Abstract Objective This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.

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Tools & Resources: Impairment and Disability Web Sites

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1999.novdec03 ◽

1999 ◽

Vol 4 (6) ◽

pp. 5-6

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Interpersonal Relationships ◽

Web Sites ◽

Outpatient Psychotherapy ◽

Obsessive Compulsive ◽

Not Otherwise Specified ◽

Cluster B Personality Disorders ◽

Clinically Significant ◽

And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

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Neonatal Outcome of Macrosomia

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v40i2.28917 ◽

2020 ◽

Vol 40 (2) ◽

pp. 114-119

Author(s):

Subhash Chandra Shah ◽

Anusmriti Guragain ◽

Shreejana Pandey ◽

Ajaya Kumar Dhakal

Keyword(s):

Maternal Age ◽

Neonatal Outcome ◽

Tertiary Care ◽

Public Health Problem ◽

Pregnancy Induced Hypertension ◽

Factors Associated ◽

Adverse Neonatal Outcome ◽

Induced Hypertension ◽

Appropriate For Gestational Age ◽

Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

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Disorders of Development

The Oxford Handbook of Clinical Psychology ◽

10.1093/oxfordhb/9780195366884.013.0025 ◽

2010 ◽

pp. 551-574

Author(s):

V. Mark Durand

Keyword(s):

Pervasive Developmental Disorders ◽

Developmental Disorders ◽

Early Adulthood ◽

Learning Disorders ◽

Future Research ◽

Hyperactivity Disorder ◽

Asperger Disorder ◽

Oppositional Defiant ◽

Assessment And Treatment ◽

Clinically Significant

Disorders of development include a range of problems first evidenced in childhood. Although most disorders have their origins in childhood, a few fully express themselves before early adulthood. This chapter describes the nature, assessment, and treatment of the more common disorders that are revealed in a clinically significant way during a child’s developing years. The disorders of development affect a range of functioning, from single skills deficits to more pervasive problems that negatively impact a child’s ability to function. Included is coverage of several disorders usually diagnosed first in infancy, childhood, or adolescence, including attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, learning disorders, communication and related disorders, pervasive developmental disorders (including autistic disorder and Asperger disorder), and intellectual disabilities. Recommendations for future research on the potential for advancing knowledge regarding spectrums within some of these disorders, as well as recommendations for treatment, are outlined.

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Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

Global Pediatric Health ◽

10.1177/2333794x211018350 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110183

Author(s):

Maleda Tefera ◽

Nega Assefa ◽

Kedir Teji Roba ◽

Letta Gedefa

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Neonatal Outcome ◽

Birth Asphyxia ◽

Public Hospitals ◽

Obstructed Labor ◽

Eastern Ethiopia ◽

Adverse Neonatal Outcome ◽

Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

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