In Reply: α-Fetoprotein Normal Values

PEDIATRICS ◽  
1989 ◽  
Vol 83 (4) ◽  
pp. 640-640
Author(s):  
GORDON B. GALE ◽  
DENNIS O'CONNOR ◽  
JEN-YIH CHU
Keyword(s):  
Gestational Age ◽  
Normal Values ◽  
Premature Neonate ◽  
Neonates And Infants

We would like to thank Caglar et al for providing further information about normal values of α-fetoprotein in neonates and infants. Although the number of serum α-fetoprotein values in the premature neonate is still limited, the table referred to by them further illustrates that normal values in neonates and infants are different from adult normals. The values vary with both gestational age and postnatal age of the infants. Physicians who interpret α-fetoprotein values in neonates and infants need to keep this information in mind.

Reference Values for Transverse Cerebellar Diameter Throughout Gestation

2002 ◽  
Vol 5 (5) ◽  
pp. 489-494 ◽  
Author(s):  
Halit Pinar ◽  
Sarah H. Burke ◽  
Carol W. Huang ◽  
Don B. Singer ◽  
C. James Sung
Keyword(s):  
Reference Values ◽  
Growth Curve ◽  
Gestational Age ◽  
Normal Values ◽  
Growth Restriction ◽  
Reliable Indicator ◽  
Transverse Diameter ◽  
Reliable Parameter ◽  
Gestational Week ◽  
Duration Of Gestation

The transverse cerebellar diameter (TCD) is well established in the ultrasound literature as a reliable parameter for estimating the duration of gestation. In cases of growth restriction the cerebellum is usually spared, making TCD a reliable indicator of gestational age even when other parameters fall off the appropriate growth curve. The purpose of this study is to establish normal values for the transverse diameter of the cerebellum in pathology specimens, and to determine if these values correlate with those obtained by ultrasound. We examined 96 specimens ranging from 14 to 42 weeks gestational age and found that our values correlate well with those published in the ultrasound literature. Mean TCD with 2 standard deviations for each gestational week were determined as reference values.

Umbilical Morphology: Normal Values for Neonatal Periumbilical Skin Length

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 47-49
Author(s):  
Aengus S. O'Marcaigh ◽  
Lora B. Folz ◽  
Virginia V. Michels
Keyword(s):  
Regression Analysis ◽  
Birth Weight ◽  
Gestational Age ◽  
Normal Values ◽  
The Other ◽  
Male And Female ◽  
Rieger Syndrome ◽  
Neonatal Diagnosis ◽  
Robinow Syndrome ◽  
Aarskog Syndrome

Malformations of the umbilicus are a feature of many dysmorphic syndromes including Rieger syndrome, Robinow syndrome, and Aarskog syndrome. The characteristic umbilical malformation in Rieger syndrome consists of redundant periumbilical skin which extends along the cord for an excessive distance. Although the measurement of umbilical skin length plays an important role in the neonatal diagnosis of Rieger syndrome, normal values for this measurement in healthy neonates have not been established. Umbilical skin length was measured in 104 healthy neonates. The length to which the umbilical skin extended along the cranial aspect of cord (mean 11.53 mm, SD 3.58) was significantly longer than the umbilical skin length along the caudal aspect (mean 8.71 mm, SD 2.89) (P < .05). Multiple regression analysis revealed a significant association between age and umbilical skin length. Birth weight, length, and gestational age were not significantly associated with umbilical skin length when adjusted for the other three variables. No significant differences in umbilical skin length were observed between male and female groups. The above normal values should aid in the neonatal diagnosis of Rieger syndrome, and furthermore it is recommended that cranial umbilical skin length measurement be included in the examination of the dysmorphic child.

SPONTANEOUS ADVERSE DRUG REACTION REPORTS FOR NEONATES AND INFANTS IN THE UK 2001–2010

2015 ◽  
Vol 101 (1) ◽  
pp. e1.43-e1
Author(s):  
Dan Hawcutt ◽  
Hannah Maqsood ◽  
Simon Gomberg ◽  
Andrew Riordan ◽  
Mark Turner
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Gestational Age ◽  
Spontaneous Reporting ◽  
Swine Flu ◽  
Yellow Card ◽  
Neisseria Meningitides ◽  
Spontaneous Adverse Drug Reaction ◽  
The Uk ◽  
Neonates And Infants

AimsThe UK Medicines and Healthcare products Regulatory Agency (MHRA) runs a national spontaneous reporting system (Yellow Card Scheme [YCS]) to collect ‘suspected' adverse drug reaction (ADR) data. We aim to describe the Yellow card reports received for patients aged ≤1 year for a 10 year period and assess their utility.MethodsData on all ADRs reported via the YCS in Infants aged ≤1 years from the years 2001–10 were supplied by the MHRA.ResultsIn total, 3217 suspected ADRs were reported to the YCS between 2001–10 for infants age ≤1 year (Neonates n=97, vaccinations n=2673, infant [neither neonate nor vaccine] n=477). Overall only 0.88 YC per day were received by the MHRA with a male preponderance (Male 50.3%, Female 45.7%); only 25 (0.8%) YC reports stated a gestational age for the affected infant. The medications most frequently reported as suspected of causing an ADR were Swine Flu Vaccine (neonates n=8), Neisseria meningitides (vaccinations n=693) and oseltamivir (infants n=37). Reports associated with vaccinations followed the expected trends. ADRs highlighted by regulators for neonatal and infant populations are not represented in the YCs received by the regulator.Conclusions The frequency of YCS reports for those ≤1 year is low, with less than 1 per day overall. Neonates are poorly represented, and recording of gestational age is very limited. The YCS appears to be more effective for spontaneous reporting of vaccination-related ADRs in infants than for other medications. Action is required to improve reporting of suspected ADRs that affect neonates and infants.

Tracheostomy in the Extremely Premature Neonate: A Multi-Institutional Study

2020 ◽  
Vol 162 (4) ◽  
pp. 559-565
Author(s):  
Kevin D. Pereira ◽  
Kevin Shaigany ◽  
Karen B. Zur ◽  
Carolyn M. Jenks ◽  
Diego A. Preciado ◽  
...  
Keyword(s):  
Lung Disease ◽  
Premature Infants ◽  
Gestational Age ◽  
Chronic Lung Disease ◽  
Neonatal Intensive Care ◽  
Premature Neonate ◽  
Neurodevelopmental Outcomes ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
The Mean

Objective (1) To describe characteristics associated with tracheostomy placement and (2) to describe associated in-hospital morbidity in extremely premature infants. Study Design Pooled retrospective analysis of charts. Setting Academic children’s hospitals. Subjects and Methods The patient records of premature infants (23-28 weeks gestational age) who underwent tracheostomy between January 1, 2012, and December 31, 2017, were reviewed from 4 academic children’s hospitals. Demographics, procedural morbidity, feeding, respiratory, and neurodevelopmental outcomes at the time of transfer from the neonatal intensive care unit (NICU) were obtained. The contribution of baseline characteristics to mortality, neurodevelopmental, and feeding outcomes was also assessed. Results: The charts of 119 infants were included. The mean gestational age was 25.5 (95% confidence interval, 25.2-25.7) weeks. The mean birth weight was 712 (671-752) g. Approximately 50% was African American. The principal comorbidity was chronic lung disease (92.4%). Overall, 60.5% of the infants had at least 1 complication. At the time of transfer, most remained mechanically ventilated (94%) and dependent on a feeding tube (90%). Necrotizing enterocolitis increased the risk of feeding impairment ( P = .002) and death ( P = .03). Conclusions Tracheostomy in the extremely premature neonate is primarily performed for chronic lung disease. Complications occur frequently, with skin breakdown being the most common. Placement of a tracheostomy does not seem to mitigate the systemic morbidity associated with extreme prematurity.

Reactivity of amniotic fluid alpha-fetoprotein with concanavalin A in relation to gestational age: clinical implications.

1980 ◽  
Vol 26 (12) ◽  
pp. 1656-1659 ◽  
Author(s):  
K Toftager-Larsen ◽  
E Kjaersgaard ◽  
J C Jacobsen ◽  
B Nørgaard-Pedersen
Keyword(s):  
Amniotic Fluid ◽  
Clinical Significance ◽  
Concanavalin A ◽  
Gestational Age ◽  
Normal Values ◽  
Alpha Fetoprotein ◽  
Clinical Implications ◽  
Fetal Malformation ◽  
Average Decrease ◽  
Normal Outcome

Abstract We used concanavalin A crossed-line affinity immunoelectrophoresis to determine the percentage of concanavalin A nonreactive alpha-fetoprotein in amniotic fluid samples from pregnancies with normal and abnormal fetuses. In 167 samples from pregnancies with a normal outcome and normal values for total alpha-fetoprotein concentration in amniotic fluid the percentage decreased from a median value of 27.4% in the 13th week to 8.5% in the 21st week of gestation, and a statistically significant (p < 0.001) average decrease of 1.7% per week was found from the 14th to the 19th week. A similar average decrease (2.2%) was found in 22 pregnancies from which two or more samples were obtained. The clinical significance of this decrease is discussed. Of 108 samples from patients with above-normal values for total alpha-fetoprotein and a normal outcome, seven had a total alpha-fetoprotein above recommended cut-off values, and only one of these had a low percentage of concanavalin A nonreactive alpha-fetoprotein. In contrast, for all 27 samples from pregnancies with a severe fetal malformation this percentage was low, even in one case where the total alpha-fetoprotein concentration was below the recommended cut-off value.

Transillumination of the Skull in Premature Infants

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 658-664 ◽  
Author(s):  
Herbert M. Swick ◽  
M. Douglas Cunningham ◽  
Lloyd K. Shield
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Premature Infants ◽  
Gestational Age ◽  
Simple Technique ◽  
Normal Values ◽  
Progressive Increase ◽  
Anterior Fontanelle ◽  
The Central Nervous System ◽  
Standard Techniques

Transillumination of the Skull in Premature Infants Transillumination of the skull in infants is a simple technique which can be used to detect several major abnormalities of the central nervous system. The usefulness of transillumination has been limited, however, by the lack of standard techniques for its performance and by the absence of normal values, especially in premature infants. In healthy premature infants, there is a progressive increase in transillumination with increasing gestational age over three sites—the anterior fontanelle, the frontotemporal fossa, and the parieto-occipital eminence.

Upper Airway Measurements During Inspiration and Expiration in Infants

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 73-77
Author(s):  
Tania R. Gunn ◽  
Shirley L. Tonkin
Keyword(s):  
Head Circumference ◽  
Normal Values ◽  
Upper Airway ◽  
Normal Variation ◽  
Term Neonates ◽  
X Ray ◽  
Posterior Airway Space ◽  
Healthy Infants ◽  
Neonates And Infants ◽  
Cephalometric Measurements

Accurate measurements of the upper airway of the infant are important but are difficult to obtain reliably because of the normal variation that occurs during respiration. X-ray films of the lateral upper airway were obtained during inspiration and expiration in healthy infants, by using as a timing device a respiration monitor which was wired to the x-ray machine and was attached to the abdominal wall of the infant. Cephalometric measurements were made of 44 "normal" full-term neonates and 29 infants at 6 weeks of age. Despite significant differences in head circumference between the sexes, only the nasion to sella length was significantly longer in the boys (P < .01). The lateral upper airway measurements were independent of weight, head circumference, and sex in the neonates and infants at 6 weeks of age but were significantly smaller during inspiration than expiration (P < .01). The measurements progressively increased from the middle to the posterior airway space at both ages. The middle airway space behind the caudal end of the hard palate was smaller during inspiration at 6 weeks of age compared to the neonate (P < .01). During expiration, the posterior airway space was larger at 6 weeks compared to the neonate (P < .01). The method described in this report enables reliable roentgenographic measurements to be made of the upper airway of the infant; normal values for the changes during inspiration and expiration are provided. This may assist in the evaluation of infants with suspected upper airway obstruction.

Direct measurement of static chest wall compliance in animal and human neonates

1988 ◽  
Vol 65 (3) ◽  
pp. 1093-1098 ◽  
Author(s):  
G. M. Davis ◽  
A. L. Coates ◽  
A. Papageorgiou ◽  
M. A. Bureau
Keyword(s):  
Chest Wall ◽  
Face Mask ◽  
Premature Neonate ◽  
Lung Compliance ◽  
Pulmonary Mechanics ◽  
Chest Wall Compliance ◽  
Wall Compliance ◽  
The Mean ◽  
Dynamic Lung Compliance ◽  
Neonates And Infants

The measurement of pulmonary mechanics has been developed extensively for adults, and these techniques have been applied directly to neonates and infants. However, the compliant chest wall of the infant frequently predisposes to chest wall distortion, especially when there is a low dynamic lung compliance (CL,dyn). We describe a technique of directly measuring the static chest wall compliance (Cw,st), developed initially in the newborn lamb and subsequently applied to the premature neonate with chest wall distortion. The mean CL,dyn in seven intubated newborn lambs in normoxia was 2.45 +/- 0.41 ml.cmH2O-1.kg-1, whereas Cw,st was 11.81 +/- 0.25 ml.cmH2O-1.kg-1. These values did not change significantly in seven animals breathing through a tight-fitting face mask or with hypercapnia-induced tachypnea. For the eight premature infants the mean CL,dyn was 1.35 +/- 0.36 ml.cmH2O-1.kg-1, whereas the mean Cw,st was 3.16 +/- 1.01 ml.cmH2O-1.kg-1. This study shows that, under relaxed conditions when measurements of static compliance are performed, the chest wall is more compliant than the lung. The measurement of Cw,st may thus be used to determine the contribution of the respiratory musculature in stabilizing the chest wall.

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