scholarly journals Comparison of Respiratory Outcome between the Surfactant without Endotracheal Tube Intubation and the Intubation-Surfactant-Extubation Techniques in Extremely Low Gestational Age Neonates with Respiratory Distress Syndrome

Perinatology ◽  
2021 ◽  
Vol 32 (3) ◽  
pp. 125
Author(s):  
Teahyen Cha ◽  
Jiyoon Jeong ◽  
Byong Sop Lee ◽  
Ellen Ai-Rhan Kim ◽  
Ki-Soo Kim ◽  
...  
2021 ◽  
pp. 8-14
Author(s):  
P. Swathi ◽  
K. Radhikajyothi

BACKGROUND: Preterm birth remains a major health issue worldwide. Preterm delivery affects over 7–12% of births in India and is responsible for up to 75% of neonatal deaths. Despite advances in medical technology, the prevalence of preterm birth is increasing. Discovery of antenatal corticosteroid for fetal maturation and its adoption into clinical practice highlights several fascinating and universal truths about science and medicine. The challenge in human studies is to demonstrate antenatal corticosteroid administration in pregnancy contributes to developmental programming and how this is manifested in later life. The World Health Organization recommends the use of one course of antenatal steroids for all pregnant women between 26 and 35 weeks of gestation who are at risk of preterm delivery within 7 days. Both, the American College of Obstetricians and Gynaecologists and the Royal College of Obstetricians and Gynaecologists recommend their use between 24 and 34 weeks of gestation (1). The use of antenatal steroids after 34 or 35 weeks of gestation is not recommended unless there is evidence of fetal pulmonary immaturity. Despite this, antenatal steroids are widely used globally across all gestational periods. In a diverse country like India, diversity in clinical practice is a reality. Hence, the present research study intends to study the maternal and perinatal outcomes with antenatal corticosteroid administration in preterm deliveries at Government district hospital, Nandyal in South India. AIMS AND OBJECTIVES Ÿ To determine the incidence of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To determine the severity of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To compare the neonatal mortality among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS with those whose mothers did not receive ACS. Ÿ To determine the effectiveness of antenatal corticosteroid administration in preventing early neonatal respiratory distress syndrome in early preterm labour versus late preterm labour. Ÿ To determine the effectiveness of ACS administration in preventing neonatal complications with respect to the mode of delivery. METHODOLOGY: Study was conducted at Government District Hospital, Nandyal from 01/01/2019 to 30/10/2019. A structured questionnaire was prepared under guidance of thesis guide. All pregnant women with gestational age between 28 completed weeks to 37 completed weeks, presenting in OPD either in labour or getting admitted due to any other maternal medical complication, are initially assessed thoroughly to estimate the gestational age by history, LMP, early USG, and clinical examination. They are given a course of ACS if they were not expecting delivery within next 1 hour, after explaining the benets and risks of ACS as per recommendations of Federation of International st Gynecology and Obstetrics. Those who did not receive ACS or those who delivered within 24hrs of administration of 1 dose of ACS were considered as subjects in NACS group. Those who received ACS were considered as subjects in ACS group. After delivery, the neonate is followed up in NICU until discharged or until 7 days whichever is shorter. Mother is followed up for any clinical signs of infection, until she is discharged. Data is analyzed scientically. RESULTS: In Antenatal corticosteroids group (ACS), there were 36 subjects within 20 years, 43 subjects between 20-25 years, 29 subjects between 25-30 years, 25 subjects between 30-35 years. In No Antenatal corticosteroids group (NACS), there were 32 subjects within 20 years, 49 subjects between 20-25 years, 25 subjects between 25-30 years, 10 subjects between 30-35 years. Study observed that Antenatal corticosteroids group had lower incidence of Respiratory distress syndrome compared to No Antenatal corticosteroids group (12.07% versus 23.28%). Antenatal corticosteroids group had lower incidence of severe Respiratory distress syndrome compared to No Antenatal corticosteroids group (21.3 % versus 33.33%) among those who had Respiratory Distress Syndrome. Antenatal corticosteroids group had fewer admissions to NICU than No Antenatal corticosteroids group (20.69% versus 33.62%). Antenatal corticosteroids group had lower mortality than No Antenatal corticosteroids group (12.07 % versus 22.41%). Antenatal corticosteroids group had 35 % less chances of Respiratory distress syndrome compared to No Antenatal corticosteroids group. In No Antenatal corticosteroids group, subjects who underwent vaginal delivery had 10% less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. In Antenatal corticosteroids group, subjects who underwent vaginal delivery had 14.29 % less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. Antenatal corticosteroids group had maternal infection rate comparable to No Antenatal Corticosteroids group. CONCLUSION: Use of antenatal corticosteroids was found to be benecial in pregnant women with Gestational age of 28 completed weeks to less than 37 completed weeks at Government District hospital, Nandyal. Antenatal corticosteroids did not have statistically signicant adverse effects (i.e. increased rate of infection) in mothers.


2021 ◽  
Vol 12 (2) ◽  
pp. 35-41
Author(s):  
Anastasia V. Budalova ◽  
Natalia V. Kharlamova ◽  
Galina N. Kuzmenko

Background. Currently, the development of medicine in the field of perinatology is aimed at improving the quality of medical care for newborns, especially those born prematurely. Premature newborns are most likely to develop hemorrhagic disorders, which often aggravates their condition and determines high morbidity and mortality. On modern hematological analyzers, it has become possible to evaluate a larger number of blood parameters, including platelet parameters, however, there are a small number of studies devoted to the study of platelet parameters in premature newborns. The aim was to study the morphofunctional features of platelets in premature newborns with very low and extremely low body weight. Materials and methods. The study included 78 newborns born at 2534 weeks of gestation, with a body weight of less than 1500 grams. On the 3rd5th day of life, a clinical blood test was performed on the Advia 2120i hematological analyzer (Siemens), with the determination of platelet parameters: PLT, 103 cells/l, PCT, %, PDW, %, Large Plt, 103 cells/l, MPC, g/dl, MRM, pg. Results. In newborns with ELBW, a decrease in the number and granularity of platelets in the blood, an increase in the average dry mass of platelets was found. Newborns with intrauterine growth retardation have a reduced platelet count and reduced thrombocrit. In premature newborns with a gestational age of 2527 weeks, blood circulation of platelets with a reduced volume was established, and in newborns who were born at a gestational age of 3234 weeks with increased granularity. In the absence of antenatal prevention of respiratory distress syndrome in newborns, there is a decrease in thrombocrit, the number of platelets, including large forms in the blood. In premature newborns born in a state of severe asphyxia, a decrease in platelet granularity was noted. The use of high concentrations of O2 in the oxygen-air mixture during respiratory therapy leads to a decrease in the number of platelets in the blood. Conclusions. Factors determining the morphofunctional state of platelets in premature newborns were established: the presence of a full course of antenatal prevention of respiratory distress syndrome of newborns, gestational age, the severity of asphyxia at birth, as well as the concentration of O2 in the oxygen-air mixture used in respiratory therapy. Newborns with ELBW have a reduced platelet count, low-granulated platelets, and an increased average dry platelet mass. Newborns with intrauterine growth retardation have a reduced number of platelets and thrombocrit in the blood. The revealed morphofunctional features of platelets allow us to clarify the nature of changes in the platelet link of hemostasis in premature newborns for the timely prevention of complications during the underlying disease.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Abolfazl Khoshdel ◽  
Soleiman Kheiri ◽  
Peyman Omidvari ◽  
Fahimeh Moradi ◽  
Majid Hamidi ◽  
...  

Cytokine polymorphisms may contribute to the prevalence of respiratory distress syndrome. The present study was done to investigate the frequency of interleukin- (IL-) 10 and tumor necrosis factor- (TNF-) α gene polymorphisms and their association with the risk of RDS in preterm infants. One-hundred and nineteen patients with RDS and 119 healthy preterm infants were enrolled. PCR restriction fragment length polymorphism was used to determine the frequency of IL-10 and TNF-α genotypes at -1082 A and -308 A, respectively. One-hundred and nineteen out of 238 infants had RDS (50%). The age of the mothers and gestational age ranged 17–45 (mean: 28.6±5.3) years and 24–34 (mean: 34.3±2.38) weeks, respectively. Totally, 23 deaths were recorded in the RDS group. Incidence of TNF-α-308 A/A and TNF-α-308 G/A was 84% and 16%, respectively. TNF-a-308 G/G was not found in both groups. Prevalence of IL-10-1082 G/G and IL-10-1082 G/A variants was 65.5% and 34.5%, respectively. IL-10-1082 A/A was not found in both groups. The incidence of the allele G in the IL-10-1082 polymorphism was lower in RDS group (P<0.05). We found that the risk of RDS was correlated to sex, gestational age, and IL-10-1082.


Author(s):  
Zenaw Ayele ◽  
Mekonnen Tadesse ◽  
Zelalem Tazu

Introduction: Respiratory distress syndrome (RDS) is not only the most common respiratory disorder in premature infants but also the main cause of neonatal mortality. Methods: Competing risk framework was used to examine and identify potential prognostic factors of the health status of preterm infants with respiratory distress syndrome. Preterm infants with RDS admitted to the neonatal intensive care units (NICUs) of selected hospitals in Ethiopia were followed for 28 days and only neonates with complete cases were included in the analysis. The Fine-Gray or sub-distribution hazard model was used to identify significant prognostic factors. Three outcome variables (death due to RDS, death due to other causes and discharged alive) were considered. Results: The Fine-Gray model fit results revealed that anemia, multiple pregnancies, birth-weight and gestational age were the prognostic factors significantly associated with the death of neonates due to Respiratory distress syndrome problem while Pneumonia, meningitis, anemia and gestational age of neonates were the significant prognostic factors for death of neonates due to other causes. Moreover, pneumonia, birth weight and gestational age were identified as the prognostic factors associated with neonates being discharged alive. Conclusion: Offering intensive and adequate treatments for neonates with lowest birth-weights and gestational age may be useful to reduce neonatal mortality and increase the incidence of being discharged alive.


2005 ◽  
Vol 192 (1) ◽  
pp. 199-207 ◽  
Author(s):  
Curtis A. Parvin ◽  
Lawrence A. Kaplan ◽  
John F. Chapman ◽  
Timothy G. McManamon ◽  
Ann M. Gronowski

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