scholarly journals Investigation of the relationship between umbilical cord pH and intraventricular hemorrhage of infants delivered preterm

2019 ◽  
Vol 65 (5) ◽  
pp. 647-656
Author(s):  
Ali Mazouri ◽  
Mahtab Massahi ◽  
Nasrin Khalesi ◽  
Ladan Younesi asl ◽  
Mandana Kashaki
Keyword(s):  
Umbilical Cord ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Blood Gases ◽  
Blood Gas ◽  
The Third ◽  
The Relationship ◽  
Type Of Delivery ◽  
Control Study

SUMMARY OBJECTIVE: We measured the level of pH gases in premature infants at birth, and examined the relationship between brain ultrasonography on the third and seventh day after birth. A case-control study conducted at the Neonatal Intensive Care Unit (NICU) of Shahid Akbar Abadi Hospital, Iran, during the years 2016-2017. METHODS: All premature infants who were admitted to NICU were enrolled in the current study. At birth, a blood gas sample was taken from the umbilical cord of the infants. On the third and seventh day after birth, an ultrasound of the brain of each neonate was performed by a radiologist. The umbilical cord was evaluated for blood gases in 72 neonates (mostly boys). RESULTS: Sixty-six newborns had normal sonography, and 16.7% (12 cases) had anomalies. A total of 75% of the 8 infants with intravenous bleeding were girls, which were significantly different from those in the non-hemodynamic group (62.5% male) (P 0.049). However, the type of delivery, mean weight, height, head circumference, the circumference of the chest, and Apgar score did not differ between the two groups. Mean pH, HCO3– and PCO2 in umbilical cord blood gas samples were not significantly different between the two groups with or without intraventricular hemorrhage (IVH). Although it was not related to gender and type of delivery in newborns CONCLUSION: Blood gases do not help in determining the occurrence of IVH in infants. Nevertheless, it is associated with immaturity and fetal age.

scholarly journals Relationship between intraventricular hemorrhage and acute kidney injury in premature infants and its effect on neonatal mortality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mountasser M. Al-Mouqdad ◽  
Roya Huseynova ◽  
Thanaa M. Khalil ◽  
Yasmeen S. Asfour ◽  
Suzan S. Asfour
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Neonatal Mortality ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Direct Relationship ◽  
Kidney Injury ◽  
Study Population ◽  
The Relationship

AbstractIntraventricular hemorrhage (IVH) and acute kidney injury (AKI) are important neonatal morbidities in premature infants. This study aimed to investigate the relationship between IVH and AKI in premature infants and whether this association affects the incidence of neonatal mortality. Infants [gestational age (GA) ≤ 32 weeks; birth weight (BW) < 1500 g] were retrospectively evaluated in a large tertiary neonatal intensive care unit. Of 710 premature infants, 268 (37.7%) developed AKI. Infants with IVH were more likely to have AKI than those without IVH. Infants with severe IVH had a higher incidence of AKI than infants with mild IVH. Infants younger than 28 weeks with IVH were more likely to have AKI than those without IVH. An association between IVH grades and AKI stages was observed in the overall study population, in infants with GA < 28 weeks, and in infants with GA between 28 and 32 weeks. Mortality was increased 1.5 times in infants with IVH and AKI compared with that in infants with IVH but without AKI. Furthermore, mortality was increased in infants with IVH and AKI compared with infants without IVH or AKI. This study shows a direct relationship between the severity of IVH and the degree of AKI; both IVH and AKI increase the incidence of neonatal mortality.

The Relationship Between Head Circumference and the Development of Communicating Hydrocephalus in Infants Following Intraventricular Hemorrhage

PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 74-77 ◽  
Author(s):  
Rowena Korobkin
Keyword(s):  
Clinical Sign ◽  
Premature Infants ◽  
Gestational Age ◽  
Head Circumference ◽  
Intraventricular Hemorrhage ◽  
Clinical Status ◽  
Clinical Deterioration ◽  
Communicating Hydrocephalus ◽  
Sudden Appearance ◽  
The Relationship

Rapidly enlarging head circumference is a standard clinical sign of progressive hydrocephalus in an infant. Six neonates 29 to 36 weeks gestational age, with intraventricular hemorrhage, confirmed by ventricular tap, had head circumferences measured at intervals from birth. The sudden appearance of rapidly expanding head size, not associated with changing clinical status, occurred 9 to 20 days after the estimated time of hemorrhage in all of the infants. Air ventriculography within three days of abnormal acceleration of head circumference growth demonstrated moderately to severely dilated ventricles. The ventricles were probably enlarging slowing from the time of hemorrhage because there was no associated clinical deterioration in the infants coincident with the rapid increase in head circumference. After intraventncular hemorrhage, enlarging head circumference appears to be an insensitive sign of hydrocephalus in premature infants.

Standardized Evaluation of Cord Gases in Neonates at Risk for Hypoxic Ischemic Encephalopathy

2021 ◽  
Author(s):  
Elizabeth Blecharczyk ◽  
Lucy Lee ◽  
Krista Birnie ◽  
Arun Gupta ◽  
Alexis Davis ◽  
...  
Keyword(s):  
At Risk ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Care Pathway ◽  
Clinical Care ◽  
Blood Gases ◽  
Hypoxic Ischemic Encephalopathy ◽  
Blood Gas ◽  
Clinical Care Pathway ◽  
Ischemic Encephalopathy

BACKGROUND: Umbilical-cord acidemia may indicate perinatal asphyxia and places a neonate at increased risk for hypoxic ischemic encephalopathy (HIE). Our specific aim was to develop a standardized clinical care pathway, ensuring timely identification and evaluation of neonates with umbilical-cord acidemia at risk for HIE. METHODS: A standardized clinical care pathway to screen inborn neonates ≥36 weeks with abnormal cord blood gases (a pH of ≤7.0 or base deficit of ≥10) for HIE was implemented in January 2016. Abnormal cord blood gases resulted in a direct notification from the laboratory to an on-call physician. Evaluation included a modified Sarnat examination, postnatal blood gas, and standardized documentation. The percentage of neonates in which physician notification, documented Sarnat examination, and postnatal blood gas occurred was examined for 6 months before and 35 months after implementation. RESULTS: Of 203 neonates with abnormal cord gases in the post–quality improvement (QI) period, physician notification occurred in 92%. In the post-QI period, 94% had a documented Sarnat examination, and 94% had postnatal blood gas, compared with 16% and 11%, respectively, of 87 neonates in the pre-QI period. In the post-QI period, of those evaluated, &gt;96% were documented within 4 hours of birth. In the post-QI period, 15 (7.4%) neonates were cooled; 13 were in the NICU at time of identification, but 2 were identified in the newborn nursery and redirected to the NICU for cooling. CONCLUSIONS: A standardized screening pathway in neonates with umbilical-cord acidemia led to timely identification and evaluation of neonates at risk for HIE.

Prematurity and Intraventricular Hemorrhage

2019 ◽  
pp. 19-29
Author(s):  
Catherine A. Mazzola ◽  
Tatiana Huk Sikorskyj
Keyword(s):  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Imaging Modality ◽  
Treatment Options ◽  
Infantile Hydrocephalus ◽  
Cerebrospinal Fluid Diversion ◽  
Radiologic Imaging ◽  
Evidence Based Guidelines ◽  
Symptoms And Signs

Intraventricular hemorrhage caused by bleeding in the germinal matrix is a complication often seen in premature infants. Variations in cerebral blood flow may lead to rupture of the fragile, immature blood vessels due to their inability to autoregulate or accommodate changes in cerebral perfusion. Post-hemorrhagic hydrocephalus (PHH) may lead to significant neurologic compromise and can be diagnosed by assessing for symptoms and signs of infantile hydrocephalus, followed by radiologic imaging. Treatment options may include temporary and permanent cerebrospinal fluid diversion. Head ultrasound is a common imaging modality used for hydrocephalus surveillance in infants during their postnatal hospital stay in the neonatal intensive care unit. Evidence-based guidelines for the treatment of PHH have been published by the Joint Guidelines Committee of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

Intraventricular Hemorrhage: An Update

1993 ◽  
Vol 8 (4) ◽  
pp. 157-176 ◽  
Author(s):  
Karl C.K. Kuban ◽  
Joseph J. Volpe
Keyword(s):  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Single Agent ◽  
Survival Rates ◽  
Pharmacological Interventions ◽  
Germinal Matrix ◽  
Vascular Integrity ◽  
The Matrix ◽  
Prenatal Interventions

Although the incidence of intraventricular hemorrhage (IVH) has decreased in recent years, the increasing survival rates for the smallest premature infants indicate that the lesion will continue to be a major problem in neonatal intensive care facilities. We review prenatal, perinatal, and postnatal variables that have been associated with enhanced risk of IVH and address some of the methodological limitations of previously reported studies. The neuropa-thology is characterized by bleeding into the subependymal germinal matrix, with subsequent rupture into the lateral ventricle. The pathogenesis of IVH relates to intravascular, vascular, and extravascular factors. Intravas-cular factors are those that relate primarily to control of blood flow and pressure in the microcirculation of the germinal matrix. Vascular factors relate to the microcirculation of the matrix, the site of initial bleeding. A maturation-dependent alteration of vascular integrity and a vulnerability of matrix vessels to injury appear important. Extravascular factors include those relevant to mesenchy-mal and glial support for matrix vessels and to local fibrino-lytic activity in the germinal matrix. Prognosis in the setting of IVH relates to the mechanisms of brain injury, the most important of which is pcriventricular hemorrhagic infarction, often inappropriately called grade IV IVH and often associated with subsequent motor and cognitive deficits. Prevention of IVH remains the most important goal. Prenatal interventions include prevention of premature birth, transportation of premature infants to a tertiary facility in utero rather than after birth, possibly prenatal administration of phenobarbital or vitamin K, and optimal management of labor and deliver. Postnatal interventions include careful newborn resuscitation, correction or prevention of major hemodynamic disturbances, and correction of abnormalities of coagulation. Postnatal pharmacological interventions that have been studied in detail include phenobarbital, indomethacin, ethamsylate, and vitamin E. No single agent among this group has been shown consistently to lead to a decrease in incidence and severity of IVH.

scholarly journals Music Therapy With Premature Infants and Their Caregivers in Colombia – A Mixed Methods Pilot Study Including a Randomized Trial

2014 ◽  
Vol 14 (2) ◽  
Author(s):  
Mark Ettenberger ◽  
Helen Odell-Miller ◽  
Cátherine Rojas Cárdenas ◽  
Sergio Torres Serrano ◽  
Mike Parker ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Weight Gain ◽  
Pilot Study ◽  
Music Therapy ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Qualitative Data ◽  
State Trait Anxiety Inventory ◽  
The Relationship ◽  
Length Of Hospitalization

This article reports the results of a three-arm mixed methods pilot study of music therapy with premature infants and their caregivers in a Neonatal Intensive Care Unit (NICU) in Bogotá, Colombia. The study included 19 medically stable babies born between the 30th and 37th week of gestation and their caregivers. Two intervention groups were compared with a control group.The objectives were to find out whether music therapy could help the neonates to stabilize their physiological states and help mothers to reduce anxiety and strengthen the relationship with their baby.The data collection included the babies´ weight gain, heart rate, oxygen saturation, size, cephalic perimeter and length of hospitalization. Mothers filled out the State-Trait Anxiety Inventory (STAI-C) and the Mother-to-Infant Bonding Scale (MIBS) before the first and after the last intervention. Thematic analysis was used to analyze the qualitative data obtained through questionnaires.A trend towards an increased weight gain for both intervention groups and a shorter length of hospitalization for one of the intervention groups was noticed. Anxiety and bonding in mothers appears not to follow linear trends, as new challenges arise for parents at different stages during hospitalization. Mothers stated that music therapy was helpful for them, their baby and their relationship with the baby. Mothers across the groups think that music therapy should be a regular offer in the NICU and that music therapy helps to humanize the NICU environment.

Anesthesia for Premature Infants and Micropremies

2019 ◽  
Author(s):  
Elaine Ng
Keyword(s):  
Intensive Care ◽  
Inguinal Hernia ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Anesthetic Management ◽  
Collaborative Approach ◽  
Careful Planning ◽  
Anesthetic Agents ◽  
Time Of Presentation

Advances in medicine has led to the increased survival of micropremies and premature infants. The anesthetic management for these patients has unique considerations and should only be provided by experts at specialized pediatric centers. Technical procedures and monitoring can be challenging due to their small size. Related to the physiology and immaturity of the airway, respiratory, cardiac and neurologic systems, there is an increased perioperative risk that may be related to hypoxemia and apnea and rapid desaturation, reversal of intracardiac shunts, and intraventricular hemorrhage. Immature renal and hepatic systems are related to decreased drug metabolism and demand careful and accurate administration of medications. The patients are prone to hypothermia and hypoglycemia. In addition, there may be congenital anomalies, syndromes, or other metabolic issues that may not have been fully worked up at the time of presentation for anesthesia. Emerging information related to potential neurotoxicity related to exposure to anesthetic agents has led to continual research and understanding of these mechanisms in order to provide the safest care. A meticulous approach, careful planning, and collaborative approach with the multidisciplinary neonatal team are essential to ensure the best possible outcome for this unique patient population.  This review contains 3 figures, 4 tables, and 36 references. Keywords: inguinal hernia repair, micropremies, prematurity, neonatal anesthesia, neurotoxicity, neonatal intensive care, necrotizing enterocolitis, preterm infants

TP53 rs28934571 polymorphism increases the prognostic risk in hepatocellular carcinoma

2021 ◽  
Author(s):  
Yichao Zhao ◽  
Chaoqian Zhu ◽  
Qing Chang ◽  
Jie Yang ◽  
Yuanguang Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Case Control Study ◽  
Case Control ◽  
Homologous Gene ◽  
The Third ◽  
The Relationship ◽  
Diagnostic Indicator ◽  
Control Study

Aim: Hepatocellular carcinoma (HCC) is considered to be the third leading cause of cancer death. The homologous gene of TP53 is significant in the occurrence and development of cancer. This study explored the relationship between TP53 rs28934571 polymorphism and HCC risk in Guangxi, China. Materials & methods: We first screened the association through bioinformatics. Additionally, a case–control study was performed to further verify the relationship between gene polymorphism and HCC risk after collecting clinical characteristics. Results: Results showed that allele A on TP53 rs28934571 was a risk factor for HCC and mutation from C to A on TP53 rs28934571 would increase the risk of poor prognosis of HCC. Conclusion: Therefore, the study concluded that TP53 rs28934571 may become a diagnostic indicator in judging the prognosis of HCC.

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