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 ◽  
...  

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.

Author(s):  
Sylvia Kirchengast ◽  
Beda Hartmann

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.


2020 ◽  
Vol 1 (3) ◽  
pp. 11-17
Author(s):  
P. E. Khodkevich ◽  
K. V. Кulikova ◽  
V. V. Gorev ◽  
I. A. Deev

Over the past decade, an increase in the survival rate of children born with low birth weight, very low birth weight, and extremely low birth weight has been observed in Russian Federation, which is due to transition to new live birth criteria. Premature infants are exposed to a number of adverse factors that have a negative impact on the development of organs and systems, which, in turn, can lead to the occurrence of acute and chronic diseases in various age periods. Therefore, neonatologists and pediatricians are dealing with a new cohort of small children who have particular features of physical and neuropsychological development which may lead to severe debilitating diseases. This review article surveys previous studies evaluating the echographic characteristics of structural and functional development of the urinary, cardiovascular and endocrine systems as a function of body weight at birth and gestational age, and in different age periods.


Author(s):  
A. V. Migali ◽  
K. A. Kazakova ◽  
Yu. S. Akoyev ◽  
V. M. Studenikin ◽  
M. A. Varichkina ◽  
...  

Innovative technologies in the reanimation and intensive therapy permitted to improve the survival of premature infants, including those with extremely low birth weight infants. There are considered various issues of practical medical care for very-low-birth weight infants in the first three years of life. The special attention is given to patients with bronchopulmonary dysplasia (BPD). There is briefly presented the own authors’ experience of the observation for premature infants in conditions of a multidisciplinary team care approach. There were described such important aspects of the mentioned category of patients as neurodietology/nutritional rehabilitation, compliance with aseptic environmental conditions, the correction of visual and hearing impairment, treatment of neurological deficit, especially neuropharmacology, treatment of paroxysmal disorders and epilepsy.


2019 ◽  
Vol 66 (4) ◽  
pp. 403-411
Author(s):  
Surjit Damon Jeetoo ◽  
Johan Smith ◽  
Richard Denys Pitcher

Abstract Background Very low birth weight (VLBW) and extremely low birth weight (ELBW) neonates are particularly susceptible to the adverse effects of ionizing radiation. There are limited data on radiographic practice among this population in resource-limited environments. Aim To estimate cumulative effective dose (ED) from diagnostic imaging in VLBW (1000–1500 g) and ELBW (<1000 g) neonates in a resource-limited setting. Method A retrospective analysis of all diagnostic imaging examinations performed on ELBW and VLBW neonates born in a large South African public-sector tertiary-level hospital from January through June 2015. Data were stratified by birth weight and imaging examination. The ED was estimated according to the method of Puch-Kapst. Non-parametric t-tests compared the number of radiographs and ED in VLBW and ELBW neonates, at 5% significance. Results Three hundred and ninety-three neonates with median birth weight 1130 (IQR: 930–1340) g were included; 265 (67%) were VLBW and 128 (33%) ELBW; 48 (12%) died at a median of 7 (IQR: 2–17) days. A median of 2 (IQR: 1–5) radiographs were performed per neonate, with median ED 28.8 (IQR: 14.4–90.8) μSv. The median radiographic exposures for VLBW and ELBW neonates were 1 (IQR: 1–4) and 4 (IQR: 2–9), respectively, (p < 0.0001) with median ED 14.4 (IQR: 14.4–70.4) μSv and 71.2 (IQR: 28.8–169.3) μSv, respectively, (p < 0.0001). Radiographic exposure for VLBW neonates was lower than previously documented for this population. Conclusion Neonatal radiographic practice in resource-limited settings has the potential to contribute to the discourse on international best practice.


2020 ◽  
Vol 16 (8) ◽  
pp. 549-553
Author(s):  
Susi Araújo Alves ◽  
Emanuela Virginia Cavalcante ◽  
Narjara Tiane Melo ◽  
Ana Corina Lima ◽  
Eduardo Just e Silva ◽  
...  

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