Placenta Pathology From Term Born Neonates With Normal or Adverse Outcome

2021 ◽  
pp. 109352662098060
Author(s):  
Peter GJ Nikkels ◽  
Annemieke CC Evers ◽  
Ewoud Schuit ◽  
Hens AA Brouwers ◽  
Hein W Bruinse ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Study Groups ◽  
Term Infants ◽  
Neonatal Deaths ◽  
Terminal Villi ◽  
Normal Term ◽  
Low Weight ◽  
Normal Outcome ◽  
Level 3 ◽  
Chronic Villitis

Background The incidence of umbilical cord or placental parenchyma abnormalities associated with mortality or morbidity of term infants is lacking. Methods Placentas of 55 antepartum stillbirths (APD), 21 intrapartum stillbirths (IPD), 12 neonatal deaths (ND), and 80 admissions to a level 3 neonatal intensive care unit (NS) were studied and compared with 439 placentas from neonates from normal term pregnancies and normal outcome after vaginal delivery (NPVD) and with 105 placentas after an elective caesarian sections (NPEC). Results NPVD and NPEC placentas showed no or one abnormality in 70% and placentas from stillbirth showed two or more abnormalities in 80% of cases. APD placentas more frequently had a low weight and less formation of terminal villi. Hypercoiling was more often present in all study groups. Severe chronic villitis was almost exclusively present in APD placentas. Chorioamnionitis was significantly more frequent in APD, IPD and NS placentas and funisitis was more often observed in IPD and NS placentas. Conclusion Multiple placental abnormalities are significantly more frequent in placentas from term neonates with severe perinatal morbidity and mortality. These placental abnormalities are thought to be associated with disturbed oxygen transfer or with inflammation.

scholarly journals Mean platelet volume (MPV) as a diagnostic marker in neonatal sepsis

2019 ◽  
Vol 6 (3) ◽  
pp. 1036
Author(s):  
Prathyusha . ◽  
Shreekrishna G. N. ◽  
Sinchana Bhat ◽  
Sahana P.
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Diagnostic Marker ◽  
Tertiary Care ◽  
Study Groups ◽  
Care Hospital ◽  
Neonatal Deaths ◽  
Significant Difference ◽  
Group B

Background: Neonatal sepsis is a frequent and important cause of morbidity and mortality which accounts for one quarter of neonatal deaths. There are very few studies done in India to evaluate the role of MPV as diagnostic marker of neonatal sepsis.Methods: Prospective case control study in a tertiary care hospital. Neonates > 30 weeks gestation admitted to neonatal intensive care unit during the study period of 1 year with clinically suspected were included in the study. Neonates with Septic screen positive and culture positive sepsis were included in group A and normal neonates were included in Group B. MPV was done for all the subjects and values more than 10.2fl was considered positive. Newborns with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 17.0.Results: 106 neonates were included in the study. MPV showed statistically significant difference between the study groups (mean 12.8±1.52, 10.82±1.20 respectively) at a cut of value of 10.2fl and a sensitivity of 93%, specificity of 84 % with a positive predictive value of 83% and negative predictive value of 94%.Conclusions: MPV can be used as an adjuvant marker along with established septic screen to ensure early diagnosis and treatment of neonatal sepsis with no additional expense.

Late-onset pubic-phallic idiopathic edema in premature recovering infants

2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Bengt-Ola S. Bengtsson ◽  
John P. van Houten
Keyword(s):  
Neonatal Intensive Care ◽  
Chart Review ◽  
Late Onset ◽  
Expectant Management ◽  
Retrospective Chart Review ◽  
Extremely Low Birth Weight ◽  
Genital Area ◽  
Level 3 ◽  
Prolonged Observation ◽  
Idiopathic Edema

AbstractObjectiveSeveral cases of isolated localized edema of the genital area in extremely low birth weight (ELBW) infants within the last 5 years prompted a search for possible explanations and a search of the literature.Study designA retrospective chart review of all cases of localized genital area edema in our 16-bed community level-3 neonatal intensive care unit (NICU) between January 2007 and December 2017.ResultsA total of six patients with localized edema of the genital area were found. Among the six cases, five provided descriptions of time of onset. Only one case had a plausible etiology [inguinal hernia (IH)].ConclusionsTo our knowledge, this entity is not well described in the literature. Etiologies are speculative. Prolonged observation in the NICU by virtue of ELBW-status suggests that there are no detrimental effects, the condition does not appear to preclude discharge and cautious expectant management and reassurance are therefore in order.

ANALYSIS OF FETAL AND NEONATAL DEATHS IN 4117 CONSECUTIVE BIRTHS

PEDIATRICS ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 184-192
Author(s):  
HERBERT C. MILLER
Keyword(s):  
Cause Of Death ◽  
Premature Infants ◽  
Neonatal Death ◽  
Causes Of Death ◽  
Neonatal Period ◽  
Full Term ◽  
Maternal Complications ◽  
Term Infants ◽  
Neonatal Deaths ◽  
Postmortem Examinations

An analysis of the significant causes of death in 4117 consecutive births was made; there were 66 fetal deaths and 85 neonatal deaths. A significant cause of death was determined in 51 fetuses and 56 live-born infants. Eighty-five per cent of the live-born infants who weighed over 1000 gm. at birth and had postmortem examinations had causes of death which were considered to be significant. Almost half of the live-born premature infants with birth weights between 1000 and 2500 gm. were considered to have had more than one significant cause of death. The so-called significant causes of death among live-born infants differed from those determined for fetuses dying before birth. Among the former, pathologic conditions in the infants were determined four times more frequently than in those dying before birth and, in the latter, maternal complications of pregnancy and labor were diagnosed as significant causes of death five times more frequently than in infants dying in the neonatal period. Hyaline-like material in the lung was considered to be the most frequent significant cause of death in live-born premature infants; congenital malformation and anoxia resulting from complications of labor were the most frequently determined significant causes of death in live-born full term infants. No differences were found in the significant causes of death in premature and full term fetuses. Anoxia resulting from accidental and unexpected interruption of the blood flow in the placenta and umbilical cord and from dystocia was the most frequently determined significant cause of death in both groups. A plea has been made for the adoption by obstetricians, pathologists and pediatricians of a formal uniform plan of classifying the causes of fetal and neonatal death which would divest current efforts to determine the cause of death of as much vague terminology and arbitrary opinion as possible.

Placental Lesions Associated With Cerebral Palsy and Neurologic Impairment Following Term Birth

2000 ◽  
Vol 124 (12) ◽  
pp. 1785-1791 ◽  
Author(s):  
Raymond W. Redline ◽  
Mary Ann O'Riordan
Keyword(s):  
Cerebral Palsy ◽  
Labor And Delivery ◽  
Placental Pathology ◽  
Term Infants ◽  
Additional Lesion ◽  
Nucleated Red Blood Cells ◽  
Neurologic Impairment ◽  
Retrospective Comparison ◽  
Abruptio Placenta ◽  
Chronic Villitis

Abstract Objective.—The aim of this study was to determine the association of placental findings with cerebral palsy and related forms of neurologic impairment (NI) following birth at ≥37 weeks gestation (term). Design.—In a retrospective comparison, placentas from 40 term infants with NI ascertained on the basis of clinicopathologic review for medicolegal consultation were compared with placentas from 176 consecutive meconium-stained term infants at low risk for NI. Results.—After stratification for severity, 9 lesions were significantly increased in placentas from infants with NI: 5 lesions generally considered to occur within days of the time of labor and delivery (meconium-associated vascular necrosis, severe fetal chorioamnionitis, chorionic vessel thrombi, increased nucleated red blood cells, and findings consistent with abruptio placenta) and 4 lesions generally believed to have their onset long before labor and delivery (diffuse chronic villitis, extensive avascular villi, diffuse chorioamnionic hemosiderosis, and perivillous fibrin). Findings independently associated with NI by logistic regression in this descriptive study were severe fetal chorioamnionitis (odds ratio [OR], 13.2; 95% confidence interval [CI], 1.2–144); extensive avascular villi (OR, 9.0; 95% CI, 1.6–51); and diffuse chorioamnionic hemosiderosis (OR, 74.8; 95% CI, 6.3–894). The risk of NI increased as a function of the number of lesions present (OR, 10.1; 95% CI, 5.1–20 for each additional lesion), particularly when lesions generally considered to occur near the time of labor and those believed to occur well before labor were found in the same placenta (OR, 94.2; 95% CI, 11.9–747). Conclusions.—These findings suggest that placental pathology can contribute to an understanding of the mechanisms that contribute to NI at term.

scholarly journals Accuracy of real-time delivery room resuscitation documentation

2018 ◽  
Vol 105 (2) ◽  
pp. 222-224 ◽  
Author(s):  
Claire E Fishman ◽  
Danielle D Weinberg ◽  
Ashley Murray ◽  
Elizabeth E Foglia
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Real Time ◽  
Vital Sign ◽  
Gold Standard ◽  
Neonatal Intensive Care ◽  
Video Recording ◽  
Neonatal Resuscitation ◽  
Delivery Room ◽  
Level 3

ObjectiveTo assess the accuracy of real-time delivery room resuscitation documentation.DesignRetrospective observational study.SettingLevel 3 academic neonatal intensive care unit.ParticipantsFifty infants with video recording of neonatal resuscitation.Main outcome measuresVital sign assessments and interventions performed during resuscitation. The accuracy of written documentation was compared with video gold standard.ResultsTiming of initial heart rate assessment agreed with video in 44/50 (88%) records; the documented heart rate was correct in 34/44 (77%) of these. Heart rate and oxygen saturation were documented at 5 min of life in 90% of resuscitations. Of these, 100% of heart rate and 93% of oxygen saturation values were correctly recorded. Written records accurately reflected the mode(s) of respiratory support for 89%–100%, procedures for 91%–100% and medications for 100% of events.ConclusionReal-time documentation correctly reflects interventions performed during delivery room resuscitation but is less accurate for early vital sign assessments.

Admission of Term Infants to Neonatal Intensive Care: A Population-Based Study

Birth ◽  
2007 ◽  
Vol 34 (4) ◽  
pp. 301-307 ◽  
Author(s):  
Sally K. Tracy ◽  
Mark B. Tracy ◽  
Elizabeth Sullivan
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Population Based ◽  
Term Infants ◽  
Population Based Study

scholarly journals Textronic Solutions Used for Premature Babies: A Review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Karolina Wilgocka ◽  
Ewa Skrzetuska ◽  
Izabella Krucińska ◽  
Witold Sujka
Keyword(s):  
Neonatal Intensive Care ◽  
Continuous Monitoring ◽  
Developed Countries ◽  
Health Condition ◽  
Perinatal Medicine ◽  
Premature Babies ◽  
Substantial Problem ◽  
Low Weight ◽  
Prematurity Rate ◽  
Huge Challenge

Abstract Premature birth is considered to be a substantial problem in perinatal medicine, which in the vast majority of cases (>60%), concerns African and South Asian countries. Nevertheless, prematurity is a global problem and is faced by both less-developed (where 12% of babies are prematurely born) and well-developed countries (with 9% prematurity rate) [1, 2]. The percentage of children born prematurely, i.e., before the 37th week of pregnancy, was 8.7% in Europe, while, in Poland, it was 7.34% [3]. Care of prematurely born babies is a huge challenge for parents and medical staff in the neonatal intensive care unit. Preterm infants, because of their low weight and gestational age, are prone to health problems and even death. For this reason, continuous monitoring of health parameters plays an important role. It is achieved by the use of various sensors that are inserted in infants’ garments. Sensor systems monitor an infant’s health condition, and then the data are transmitted to doctors or parents. This article is for illustrative purposes, aimed at presenting solutions such as the use of sensors for monitoring infants’ physiological parameters.

PERIPHERAL CIRCULATORY RESPONSE TO FEEDING IN THE NEWBORN INFANT

PEDIATRICS ◽  
1971 ◽  
Vol 47 (2) ◽  
pp. 378-383
Author(s):  
Alice C. Yao ◽  
C. Göran Wallgren ◽  
Sachchida N. Sinha ◽  
John Lind
Keyword(s):  
Vascular Resistance ◽  
Venous Occlusion ◽  
Term Infants ◽  
Significant Drop ◽  
Circulatory Response ◽  
Control Value ◽  
Limb Perfusion ◽  
Normal Term ◽  
Regional Vascular Resistance ◽  
Umbilical Arterial Catheter

The peripheral circulatory response to feeding was studied in 39 normal term infants, age ranging from 24 hours to 9 days. Blood flow to calf of left leg was measured by the venous occlusion plethysmographic method before and half hourly after feeding for 3 to 3½ hours. Arterial pressure was monitored in nine infants via an umbilical arterial catheter simultaneously and regional vascular resistance to flow in the leg calculated. Changes in pulse rate, and skin and rectal temperatures were also monitored. A significant drop in the calf perfusion averaging 49% of the control value was observed at the 30 minutes postprandial recording. This was due to an increased regional vascular resistance and blood pressure remained unchanged during the time of study. As a rule, a superseding hyperperfusion of the limb overshooting the control value by 40 to 50% occurred 1½ to 3 hours after feeding. This was comparable to the hyperkinetic phase described in adult man and other species after meals. The early postprandial vasoconstriction in the leg seems unique to the newborn. It is suggested that having the early circulatory demand provoked by feeding is relatively bigger in the newborn than in the adult and is met partly at the expense of lower limb perfusion.

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