Diagnosis of Fetal Esophageal Atresia by Prenatal MRI and Analysis of Prognostic Factors

2020 ◽  
Vol 10 (11) ◽  
pp. 2693-2698
Author(s):  
Peng An ◽  
Ping Song ◽  
Kun An ◽  
Xinyi Liu ◽  
Yanting Zhang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Poor Prognosis ◽  
Prenatal Ultrasound ◽  
Type I ◽  
Cardiovascular Malformation ◽  
Mri Features ◽  
Prognosis Group ◽  
Ultrasound Features

Objective To investigate the value of prenatal ultrasound and MRI in the diagnosis of types I and III fetal esophageal atresia (EA), in addition to analyzing the factors related to prognosis. Methods The clinical data regarding six cases of type I and 39 cases of type III EA, with the diagnosis confirmed by postnatal autopsy, MRI, CT, or surgical operation from November 2012 to January 2018, were retrospectively analyzed. Moreover, the prenatal ultrasound and MRI features were summarized. According to the prognosis, 45 fetuses with EA were divided into study (poor prognosis) and control (better prognosis) groups. Logistic regression was used to analyze the prognostic factors. Results The imaging features of 45 EA cases were as follows: Ultrasound features of fetal EA: polyhydramnios (AFI ≥ 25), continuously absent stomach bubble (rechecked 48 hours later), and reduced or no fetal swallowing over 30 minutes; the measured values for fetal head circumference (HC), abdominal circumference (AC), and estimated fetal weight (EFW) were lower than expected according to the clinical gestational age. MRI features: appearance of line-like long T1 and long T2 signals from the fetal neck to the esophagus at the upper mediastinal spinal anterior area; esophageal disconnection, sagging, or the appearance of a visible blind-ended pouch, and disappearance of the stomach bubble. Three cases (6.67%, 3/45) were diagnosed accurately by prenatal ultrasound, while 45 cases (100%, 45/45) were diagnosed accurately by MRI after prenatal ultrasound suggested EA. The incidences of complex cardiovascular malformation, low birth weight ( < 1200 g), EA type (type I), hypoproteinemia, and an esophageal deletion length > 5 cm were significantly higher in the poor prognosis group than those in the better prognosis group ( P < 0 05). Conclusions Due to interference factors such as fetal movement, excessive skin thickness, skeleton, and surrounding tissues and organs, only 6.67% of types I and III EA were directly diagnosed by prenatal ultrasound in the present study. The risk factors for poor prognosis of EA were complex cardiovascular malformation, low birth weight, EA type, hypoproteinemia, and esophageal deletion length > 5 cm; when these ultrasound features were found, performing MRI to diagnose EA and predict prognosis was valuable.

Diagnosis of Fetal Esophageal Atresia by Prenatal MRI and Analysis of Prognostic Factors

2020 ◽  
Vol 10 (11) ◽  
pp. 2693-2698
Author(s):  
Peng An ◽  
Ping Song ◽  
Kun An ◽  
Xinyi Liu ◽  
Yanting Zhang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Poor Prognosis ◽  
Prenatal Ultrasound ◽  
Type I ◽  
Cardiovascular Malformation ◽  
Mri Features ◽  
Prognosis Group ◽  
Ultrasound Features

Objective To investigate the value of prenatal ultrasound and MRI in the diagnosis of types I and III fetal esophageal atresia (EA), in addition to analyzing the factors related to prognosis. Methods The clinical data regarding six cases of type I and 39 cases of type III EA, with the diagnosis confirmed by postnatal autopsy, MRI, CT, or surgical operation from November 2012 to January 2018, were retrospectively analyzed. Moreover, the prenatal ultrasound and MRI features were summarized. According to the prognosis, 45 fetuses with EA were divided into study (poor prognosis) and control (better prognosis) groups. Logistic regression was used to analyze the prognostic factors. Results The imaging features of 45 EA cases were as follows: Ultrasound features of fetal EA: polyhydramnios (AFI ≥ 25), continuously absent stomach bubble (rechecked 48 hours later), and reduced or no fetal swallowing over 30 minutes; the measured values for fetal head circumference (HC), abdominal circumference (AC), and estimated fetal weight (EFW) were lower than expected according to the clinical gestational age. MRI features: appearance of line-like long T1 and long T2 signals from the fetal neck to the esophagus at the upper mediastinal spinal anterior area; esophageal disconnection, sagging, or the appearance of a visible blind-ended pouch, and disappearance of the stomach bubble. Three cases (6.67%, 3/45) were diagnosed accurately by prenatal ultrasound, while 45 cases (100%, 45/45) were diagnosed accurately by MRI after prenatal ultrasound suggested EA. The incidences of complex cardiovascular malformation, low birth weight ( < 1200 g), EA type (type I), hypoproteinemia, and an esophageal deletion length > 5 cm were significantly higher in the poor prognosis group than those in the better prognosis group ( P < 0 05). Conclusions Due to interference factors such as fetal movement, excessive skin thickness, skeleton, and surrounding tissues and organs, only 6.67% of types I and III EA were directly diagnosed by prenatal ultrasound in the present study. The risk factors for poor prognosis of EA were complex cardiovascular malformation, low birth weight, EA type, hypoproteinemia, and esophageal deletion length > 5 cm; when these ultrasound features were found, performing MRI to diagnose EA and predict prognosis was valuable.

scholarly journals Prognostic Factors for Behavioral Problems and Psychiatric Disorders in Children Born Very Preterm or Very Low Birth Weight

2016 ◽  
Vol 37 (1) ◽  
pp. 88-102 ◽  
Author(s):  
Louise Linsell ◽  
Reem Malouf ◽  
Samantha Johnson ◽  
Joan Morris ◽  
Jennifer J. Kurinczuk ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Psychiatric Disorders ◽  
Behavioral Problems ◽  
Very Low Birth Weight ◽  
Very Preterm

scholarly journals Clinical Features and Prognostic Factors of Acute Ischemic Stroke Related to Malignant Gastrointestinal Tumor

2021 ◽  
Vol 12 ◽  
Author(s):  
Yating Liu ◽  
Xin Li ◽  
Feixue Song ◽  
Xin Yan ◽  
Zhijian Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Prognostic Factors ◽  
Acute Ischemic Stroke ◽  
Malignant Tumor ◽  
Poor Prognosis ◽  
Good Prognosis ◽  
Imaging Features ◽  
Prognosis Group ◽  
D Dimer

Objectives: To analyze the clinical and imaging features of acute ischemic stroke (AIS) related to gastrointestinal malignant tumor, and to explore the prognostic factors.Methods: Clinical data of consecutive patients with gastrointestinal malignant tumor complicated with AIS admitted to the Department of Neurology and Oncology in Lanzhou University Second Hospital from April 2015 to April 2019 were retrospectively analyzed. Patients were divided into good prognosis (mRS 0–2) and poor prognosis (mRS &gt; 2) based on a 90-day mRS score after discharge. The multivariate logistic regression model was used to analyze the prognostic factors.Results: A total of 68 patients were enrolled with an average age of 61.78 ± 6.65 years, including 49 men (72.06%). There were 18 patients in the good prognosis group and 50 patients in the poor prognosis group. The univariate analysis showed that Hcy, D-dimer, thrombin–antithrombin complex (TAT), and three territory sign in magnetic resonance imaging (MRI) were the risk factors for poor prognosis. Multivariate analysis showed that increased D-dimer (OR 4.497, 95% CI 1.014–19.938) and TAT levels (OR 4.294, 95% CI 1.654–11.149) were independent risk factors for the prognosis in such patients.Conclusion: Image of patients with gastrointestinal malignant tumor-related AIS is characterized by three territory sign (multiple lesions in different vascular supply areas). Increased TAT and D-dimer levels are independent prognostic risk factors. TAT is more sensitive to predict prognosis than D-dimer.

scholarly journals Prognostic factors for success in the Kangaroo Mother Care method for low birth weight babies

2015 ◽  
Vol 55 (3) ◽  
pp. 142 ◽  
Author(s):  
Rina Pratiwi ◽  
Muhammad Sholeh Kosim ◽  
Noor Wijayahadi
Keyword(s):  
Heart Rate ◽  
Prognostic Factors ◽  
Weight Gain ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Maternal Education ◽  
Education Level ◽  
Kangaroo Mother Care ◽  
Low Birth Weight Babies

Background Low birth weight (LBW) is closely related to neonatal morbidity and mortality. Management of LBW infants in developing countries remains limited, due to the low availability of incubators. The Kangaroo Mother Care (KMC) method has been shown to be effective for newborns, especially LBW infants, in which skin-to-skin contact may be conducive for infants’ weight gain, thermoregulation, and heart rate stability.Objective To determine the prognostic factors for KMC success in LBW babies.Methods This cohort study included LBW infants at Dr. Kariadi General Government Hospital, Semarang, by a consecutive sampling method. Success of KMC was assessed by infant weight gain, as well as stabilization of temperature, heart rate, and respiration. Prognostic factors for KMC success that we assessed were birth weight, gestational age, KMC duration, age at KMC onset and maternal education level. Statistical analyses used were Chi-square and relative risk (RR) tests.Results Of 40 LBW infants, 24 were successful in KMC. Birth weight ≥ 1500 grams (RR 0.4; 95%CI 0.23 to 0.73; P=0.001)], gestational age ≥ 34 weeks (RR 0.94; 95%CI 0.46 to 1.89; P=1.00), KMC duration ≥ 65 minutes (RR 1.44; 95%CI 0.76 to 2.75; P= 0.215), high maternal education level (RR 1.25; 95%CI 0.76 to 2.04; P=0.408), and age at KMC onset >10 days (RR 2.69; 95%CI 1.14 to 6.32; P=0.003), were factors that related to the successful of KMC.Conclusion Age at KMC onset > 10 days was a prognostic factor for KMC success in low birth weight babies.

Developmental Outcome of Very Low Birth Weight Infants with Intraventricular Hemorrhage

1993 ◽  
Vol 77 (3) ◽  
pp. 894-894 ◽  
Author(s):  
Anna J. Whitehead
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Poor Prognosis ◽  
Very Low Birth Weight ◽  
Ventricular Dilatation ◽  
Developmental Outcome ◽  
Low Birth Weight Infants

Analyses of data from 20 infants confirmed that ventricular dilatation in VLBW preterm infants carries poor prognosis for development, but not IVH alone.

scholarly journals Biliary atresia in a preterm and extremely low birth weight infant: a case report and literature review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuki Kawano ◽  
Koichiro Yoshimaru ◽  
Yasuyuki Uchida ◽  
Keisuke Kajihara ◽  
Yukihiro Toriigahara ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Biliary Atresia ◽  
Very Low Birth Weight ◽  
Relevant Literature ◽  
Extremely Low Birth Weight ◽  
Optimal Timing ◽  
Type I ◽  
Donor Liver Transplantation

Abstract Background Biliary atresia in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants is rarely reported, and the optimal timing of Kasai portoenterostomy (KPE) in these cases remains unclear. Case presentation We report a case of biliary atresia in a preterm female infant of 24 weeks of gestation who weighed 824 g. She underwent exploratory laparotomy and intraoperative cholangiography at 58 days of age (weight, 1336 g). Despite the diagnosis of biliary atresia with a type I cyst, we could only perform gallbladder drainage at that time due to the unstable intraoperative condition. While we waited for her body weight to increase, KPE was performed at 122 days of age (corrected age: 16 days), when the patient weighed 2296 g. Although she initially became jaundice-free, her liver function deteriorated due to cholangitis, and she developed decompensated cholestatic liver cirrhosis. Living donor liver transplantation was successfully performed at 117 days after KPE, and the postoperative course was uneventful. The timing of KPE is difficult to determine and a review of the relevant literature revealed that a poor prognosis in VLBW and ELBW infants with BA. Conclusions Early KPE and careful postoperative follow-up, including liver transplantation is important for the improvement of outcomes.

scholarly journals Neonatal Hyperbilirubinemia: A Retrospective Study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hina Abbas ◽  
Sabih ul Hassan ◽  
Kulsoom Arif ◽  
Sambreen Zameer ◽  
Naseem Ahmed ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Blood Group ◽  
Serum Bilirubin ◽  
Neonatal Hyperbilirubinemia ◽  
Age Group ◽  
East Asians ◽  
Preterm Babies

Background: Neonatal Hyperbilirubinemia is a common problem encountered in neonates and often requires admission and treatment.Almost 60% of the term babies and 80% of the preterm babies develop jaundice. East Asians have higher baseline neonatal bilirubin levelsthan whites and are predisposed to the development of severe neonatal hyperbilirubinemia. .Objectives: To determine the important prognostic factors in Neonatal Hyperbilirubinemia and to correlate variables with severity ofpresentation.Material and Methods: A retrospective study was conducted in the Paediatrics Unit 3 of Civil Hospital Karachi from June to November2017 on admitted patients below one month of age with clinically diagnosed jaundice. Total and indirect serum bilirubin levels, and data ofgender, age, birth weight, blood group incompatibility, and breast feeding were obtained.Results: Of 255 cases, 80% were resolved. Phototherapy was the most common method of treatment (in 91.8% of cases). Males slightlyoutnumbered females (1.39:1). 6.3% of jaundiced neonates died; 3.5% developed kernicterus before death. Low birth weight wasobserved in 50.2% of cases while preterm gestation was seen in 39.2% of cases.Conclusion: Important prognostic factors for Hyperbilirubinemia were presence of kernicterus, anemia, age group of the infant, severityof hyperbilirubinemia and the therapy provided.

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