scholarly journals Morphofunctional features of platelets in premature newborns with very low and extremely low body weight

2021 ◽  
Vol 12 (2) ◽  
pp. 35-41
Author(s):  
Anastasia V. Budalova ◽  
Natalia V. Kharlamova ◽  
Galina N. Kuzmenko
Keyword(s):  
Body Weight ◽  
Platelet Count ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Distress Syndrome ◽  
Premature Newborns ◽  
Intrauterine Growth

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.

scholarly journals Investigation Into the Current Situation and Analysis of the Factors Influencing Extrauterine Growth Retardation in Preterm Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Ting Zhao ◽  
Hui-Ming Feng ◽  
Bayier Caicike ◽  
Yan-Ping Zhu
Keyword(s):  
Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Retardation ◽  
Distress Syndrome ◽  
Factors Influencing ◽  
Extrauterine Growth Retardation ◽  
Growth Indicators

Objective: This study aims to explore the occurrence of extrauterine growth retardation (EUGR) in preterm infants with a gestational age of <34 weeks, at discharge, and the factors influencing the occurrence of EUGR.Method: A retrospective analysis of 691 preterm infants with a gestational age of less than 34 weeks, born in our hospital over the past 3 years. At discharge, the growth indicators head circumference, weight, and length were used to divide the infants into an EUGR group (n = 255) and the non-EUGR group (n = 436). The occurrence of EUGR and its influencing factors were then analyzed.Results: Of the 691 preterm infants evaluated for inclusion in the study, 255 cases (36.9%) met the requirements of EUGR at discharge. The different growth indicators used, i.e., weight, length, and head circumference, classified the infants differently. The incidence of EUGR using these measures was 30.2% (209), 27.9% (193), and 23.2% (161), respectively. The results of a univariate analysis showed that gestational age, birth weight, intrauterine growth retardation (IUGR), maternal gestational hypertension, age at which the infant commenced feeding, duration of the application of an invasive ventilator, length of hospital stay, nosocomial infection, respiratory and gastrointestinal diseases, symptomatic patent ductus arteriosus, and the early onset of neonatal sepsis were correlated with the occurrence of EUGR. Further logistic multivariate regression analysis revealed that low gestational age, low birth weight, complicated IUGR, respiratory distress syndrome, and necrotizing enterocolitis were independent risk factors for EUGR in preterm infants with a gestational age <34 weeks.Conclusion: In preterm infants with a gestational age <34 weeks in our hospital, there is a high incidence of EUGR, which is affected by factors such as the gestational age, birth weight, IUGR, respiratory distress syndrome, necrotizing enterocolitis, and other factors.

scholarly journals OBSESTRIC AND PERINATAL OUTCOMES OF PRETERM LABOR IN WOMEN LIVING WITH HIV

2019 ◽  
Vol 11 (3) ◽  
pp. 16-22 ◽  
Author(s):  
E. N. Kravchenko ◽  
O. A. Yakovlevа ◽  
L. V. Kuklina
Keyword(s):  
Hiv Infection ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Labor ◽  
Intrauterine Growth Retardation ◽  
Distress Syndrome ◽  
Perinatal Outcomes ◽  
Intrauterine Growth ◽  
Women Living With Hiv ◽  
Living With Hiv

The objective of the present study is to reveal characteristics of the course of gestation and perinatal outcomes of preterm, labor associated with human immunodeficiency viral infection. Materials and methods. Retrospective case control study with the participation of 76 pregnant HIV-positive women with preterm labor (main group) and their 76 newborns was held. Comparison group consisted of 198 pregnant women without HIV-infection and their 198 newborns. HIV-infection verification was conducted in accordance with the standard procedure regulated by the Order of the Ministry of Health of the Russian Federation. Results. Antenatal chemoprophylaxis with antiretroviral drugs was used in 92,1% of infected patients. In the vast majority of cases (89,4%) the therapy was conducted with the combination of drugs: Combivir (zidovudine 300 mg + lamivudine 150 mg) taken 1 tablet twice daily combined with Kaletra (lopinavir 200 mg + ritonavir 25 mg) taken 2 tablets twice daily. Initiation of ART vary depending on the HIV infection date: in the first trimester of pregnancy, 48,9% of pregnant were intended to treat, in the second trimester — 36,2%, in the third — 6,4%. 7,9 patients did not receive treatment. Intranatal chemoprophylaxis of prevention of mother-to-child transmission was held in 69 (90,8%) HIV-infected patients. HIV-infection was detected in 2 (2,6%) newborns from mothers who did not receive etiotropic treatment. Common complications of gestation under HIV-infection include anemia (61,8%) and intrauterine growth retardation (34,2%), during labor — meconium in the amniotic fluid (31,6%). Respiratory distress syndrome occurred in 6 (7,6%) newborns, cerebral ischemia was diagnosed in 86,8% of newborns, respiratory distress — in 7,9%. Respiratory distress prophylaxis was conducted in 46% cases only. Conclusion. The course of gestation in women living with HIV with preterm labor was complicated by iron-deficiency anemia, intrauterine growth retardation, meconium in the amniotic fluid; cerebral ischaemia and respiratory distress syndrome most commonly occurred in newborns.

Categories of intrauterine growth retardation

1993 ◽  
Vol 5 (4) ◽  
pp. 203-212 ◽  
Author(s):  
Roger A Fay ◽  
David A Ellwood
Keyword(s):  
Soft Tissue ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Large Scale ◽  
Intrauterine Growth Retardation ◽  
Low Birthweight ◽  
Ponderal Index ◽  
Intrauterine Growth ◽  
Different Types

Originally all low birthweight infants were considered to be premature. When prematurity was redefined in terms of gestational age (SGA) and not preterm. With the large scale collection of obstetric data the distributions of birthweight at different gestational ages were described and from these, infants who were SGA could be defined. SGA became synonymous with terms such as growth retardation, but it soon became appearent that the two were not necessarily interchangeable. Scott and Usher found that it was the degree of soft tissue wasting rather than birthweight that related to poor perinatal outcome. Miller and Hassanein stated that: “birthweight by itself is not a valid measure of fetal growth impairment”. They used Rorher’s Ponderal Index (weight (g) × 100/length (cm)) to diagnose the malnourished or excessively wasted infants with reduced soft tissue mass. Most studies of intrauterine growth retardation (IUGR) still use low birthweight for gestational age centile as their only definition of IUGR or only study infants who have a low birthweight. Altman and Hytten expressed disquiet about this definition and stated: “There is now an urgent need to establish true measures of fetal growth from which deviations indicating genuine growth retardation can be derived” and that “it is particularly important that some reliable measures of outcome should be established”. In large series of term deliveries published recently, two groups of IUGR infants with different growth patterens have been identified. These studies confirm that birthweight alone is inadequate to define the different types of IUGR. They established that low Ponderal Index (PI) is a measure of IUGR associated with an increased incidence of perinatal problems and that it is time to re-evaluate IUGR in terms of the different types of aberrant fetal growth.

MATERNAL AND PERINATAL OUTCOMES WITH ANTENATAL CORTICOSTEROID ADMINISTRATION IN PRETERM DELIVERIES AT GOVERNMENT DISTRICT HOSPITAL, NANDYAL- AN OBSERVATIONAL STUDY

2021 ◽  
pp. 8-14
Author(s):  
P. Swathi ◽  
K. Radhikajyothi
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
District Hospital ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids ◽  
Corticosteroid Administration ◽  
Antenatal Steroids ◽  
Government District

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.

Respiratory distress syndrome in neonates with extremely low body weight: non-invasive respiratory therapy in the early neonatal period

2020 ◽  
Vol 15 (6) ◽  
pp. 94-102
Author(s):  
O.V. Zavyalov ◽  
◽  
V.V. Marenkov ◽  
A.A. Dementyev ◽  
I.N. Pasechnik ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Body Weight ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Respiratory Therapy ◽  
Non Invasive ◽  
Early Neonatal Period

The aim of this study was to evaluate the efficacy of non-invasive respiratory therapy using the method of dual positive airway pressure (DuoPAP) via nasal prongs performed in the intensive care unit and neonatal intensive care unit in premature newborns with extremely low body weight and respiratory distress syndrome in the early neonatal period. We conducted a retrospective analysis of 55 medical records of premature newborns treated in the intensive care unit of the Perinatal Center at S.S. Yudin City Clinical Hospital during the first 7 days of their life. We included patients treated between January 2018 and December 2019. All newborns had extremely low body weight (850 ± 149 g); mean gestational age was 28 ± 4 weeks; Apgar score at the first minute of life varied between 3 and 6; Silverman Anderson score (severity of respiratory disorders) was between 3 and 5 s. Standard examination was performed in accordance with current protocols developed by Russian and foreign specialists in neonatal medicine. A specially developed clinical protocol of the study was approved by the local ethics committee. Study participants were divided into 3 groups according to their type of spontaneous respiratory efforts, target level of preductal saturation, and Silverman Anderson score. Patients in Group I received synchronized intermittent mandatory ventilation (SIMV); patients in Group II received ventilation using DuoPAP via nasal prongs (if it was ineffective, we considered SIMV via tube); patients in group III received ventilation using DuoPAP only. In this study, we have identified indications and contraindications for initial and prolonged respiratory therapy with DuoPAP and developed main practical recommendations for effective and safe application of DuoPAP. The efficacy and safety of non-invasive respiratory therapy with DuoPAP via nasal prongs in extremely premature infants with respiratory distress syndrome in the early neonatal period is primarily determined by the newborn’s readiness for active spontaneous and productive respiratory movements, but not only by the compensated parameters of the acid-base state and gas composition of the capillary blood. The assessment of feasibility and limitations of non-invasive respiratory therapy with DuoPAP is an important step towards developing a clinical protocol for respiratory therapy in the early neonatal period in a neonatal intensive care unit; it will help to reduce the use of invasive lung ventilation. Key words: premature newborns, non-invasive respiratory therapy, respiratory distress syndrome, extremely low body weight

Intrauterine growth retardation risk detection for fetuses of unknown gestational age

1982 ◽  
Vol 144 (6) ◽  
pp. 709-714 ◽  
Author(s):  
John S. Sholl ◽  
Diana Woo ◽  
Jonathan M. Rubin ◽  
Chin-Chu Lin ◽  
Atef H. Moawad
Keyword(s):  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Intrauterine Growth ◽  
Risk Detection

scholarly journals Frequency of neonatal complications after premature delivery

2013 ◽  
Vol 3 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Gordana Grgić ◽  
Elvira Brkičević ◽  
Dženita Ljuca ◽  
Edin Ostrvica ◽  
Azur Tulumović
Keyword(s):  
Body Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Intracranial Hemorrhage ◽  
Premature Infants ◽  
Apgar Score ◽  
Distress Syndrome ◽  
Premature Delivery ◽  
Average Body ◽  
Average Body Weight

Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group), while 300 infants were born in time (37-42 weeks of gestation-control group).Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

Drs. Redding and Pereira Reply

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 486-486
Author(s):  
Ralph A. Redding ◽  
Celina Pereira
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Scoring System ◽  
Confidence Limit ◽  
Distress Syndrome ◽  
Premature Newborns

We thank Dr. Graham for his interest in our paper and for his constructive criticisms. However, there may be a problem in semantics in regard to his first criticism, for what we did "compare" were premature newborns with or without respiratory distress syndrome of similar gestational ages (30 to 33 weeks and 34 to 37 weeks respectively). Dubowitz et al. claim a 95% confidence limit of two weeks utilizing their total scoring system, which we also used.

HUMAN FETAL GROWTH RETARDATION: I. CLINICAL FEATURES OF SAMPLE WITH INTRAUTERINE GROWTH RETARDATION

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 547-558
Author(s):  
J. Urrusti ◽  
P. Yoshida ◽  
L. Velasco ◽  
S. Frenk ◽  
A. Rosado ◽  
...  
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Fetal Growth Retardation ◽  
Neonatal Deaths ◽  
Intrauterine Growth ◽  
Normal Term

Intrauterine growth was assessed in a series of 128 cases. Thirty-six infants were small for gestational age, and showed the usual signs of intrauterine growth retardation (IUM). The head circumference of these infants was small, with reference to normal term babies (FT) and comparable to premature infants, appropriately sized for a gestational age (ACA) five weeks less than that of the IUM's. There were 12 neonatal deaths, three among IUM infants within 24 hours and nine in the low birth weight AGA group within 72 hours. The mothers of these three groups of infants were similar with respect to age, weight, height, nutritional patterns, and prior pregnancy histories.

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