scholarly journals Anatomical tracheal parameters in premature neonates with birth body weight less than 1000 g for effective and safe administration of surfactant

Author(s):  
A. V. Mostovoy ◽  
D. A. Zhakota ◽  
A. L. Karpova ◽  
N. Yu. Karpov ◽  
L. N. Karpov ◽  
...  

Objective. To evaluate anatomical tracheal parameters of fetus and premature infant for clarifying the permissible and safe depth of insertion and «thin catheter» diameter during minimally invasive administration of surfactant.Material and methods. Autopsy examination of fetuses and newborns with extremely low birth weight, who died during their first 168 hours of life. The study describes only 26 cases, respiratory system malformations are excluded. The authors measured the distance from the glottis to the bifurcation, the perimeter of the trachea under the ligaments, in the middle part and at the level of the bifurcation with the calculation of the trachea diameter.Results. The average body weight was 684.6 ± 160.8 g, gestational age varied from 21 to 33 weeks and averaged 25 weeks. The distance from the glottis to the bifurcation was 34.31 ± 5.28 mm, and the diameter in the upper, middle and lower thirds was 3.53 ± 0.64 mm, 3.41 ± 0.63 and 3.69 ± 0.78 mm respectivelyApplication of the results: registration of these indicators when choosing a catheter for minimally invasive administration of a surfactant and the depth of its introduction into the trachea in newborns with extremely low body weight will help to avoid such complications, as one-lung administration of surfactant and its regurgitation from the trachea during the procedure, thereby increasing the efficiency and safety of the methodConclusion. The length and diameter of trachea in neonates with extremely low birth weight in the early neonatal period depend on anthropometric values and gestational age at birth, mean length is 34.31±5.28 mm.

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.


1985 ◽  
Vol 110 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Takeki Hirano ◽  
Jaideep Singh ◽  
Gopal Srinivasan ◽  
Rosita Pildes

Abstract. Because the concentrations of serum free thyroxine (FT4) and thyroid hormone binding globulin (TBG) have not been fully evaluated in preterm infants at the immediate post-natal period, we studied the longitudinal changes of serum FT4 and TBG, along with thyroxine (T4) and thyroid stimulating hormone (TSH), at birth (cord blood), 2 days, 1 week and 2 weeks of age in 7 infants with birth body weight ≦ 1000 g, 7 infants with body weight 1001 to 1350 g, 11 infants with body weight 1351 to 2499 g, and 11 full-term infants. Free T4 concentrations were measured by Corning Medical radio-immunoassay (RIA) kit. The infants with extremely low birth weight (ELBW) (body weight ≦ 1000 g) showed precipitous declines of total T4 and, to a lesser extent, of FT4 concentrations at 1 and 2 weeks of age. These post-natal T4 and FT4 decreases in ELBW neonates have not previously been reported. The clinical significance of this finding remains, speculative, but it may be due to metabolic or nutritional problems related to extreme prematurity itself. This study suggests that measurement of FT4 is a useful adjunct to the assessment of ELBW infants with wery low T4 values, if done between 1 to 2 weeks af age, and could be used as a primary hypothyroid screening tool instead of T4 measurements, provided that an FT4 assay is developed that uses the elute of blood spotted on filter paper.


2018 ◽  
Vol 52 (21) ◽  
pp. 1386-1396 ◽  
Author(s):  
Margie H Davenport ◽  
Victoria L Meah ◽  
Stephanie-May Ruchat ◽  
Gregory A Davies ◽  
Rachel J Skow ◽  
...  

ObjectiveWe aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if published in English, Spanish or French, and contained information on the relevant population (pregnant women without contraindication to exercise), intervention (subjective/objective measures of frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’)), comparator (no exercise or different frequency, intensity, duration, volume, type or trimester of exercise) and outcomes (preterm birth, gestational age at delivery, birth weight, low birth weight (<2500 g), high birth weight (>4000 g), small for gestational age, large for gestational age, intrauterine growth restriction, neonatal hypoglycaemia, metabolic acidosis (cord blood pH, base excess), hyperbilirubinaemia, Apgar scores, neonatal intensive care unit admittance, shoulder dystocia, brachial plexus injury, neonatal body composition (per cent body fat, body weight, body mass index (BMI), ponderal index), childhood obesity (per cent body fat, body weight, BMI) and developmental milestones (including cognitive, psychosocial, motor skills)).ResultsA total of 135 studies (n=166 094) were included. There was ‘high’ quality evidence from exercise-only randomised controlled trials (RCTs) showing a 39% reduction in the odds of having a baby >4000 g (macrosomia: 15 RCTs, n=3670; OR 0.61, 95% CI 0.41 to 0.92) in women who exercised compared with women who did not exercise, without affecting the odds of growth-restricted, preterm or low birth weight babies. Prenatal exercise was not associated with the other neonatal or infant outcomes that were examined.ConclusionsPrenatal exercise is safe and beneficial for the fetus. Maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes.


PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 886-887
Author(s):  
Linda C. Eaves ◽  
Harry Klonoff ◽  
Henry G. Dunn

In the printing of our article on the subject in the January issue of Pediatrics (45:9, 1970) the wording of a sentence on page 10 was unfortunately changed in such a manner as to distort the personal communication we had received from Dr. Ruth Griffiths in London, England. As printed, the sentence is: "It does not seem admirable to try and meaningful to correct such D.Q. figures according to gestational age at birth." The statement we wished to make was: "It does not seem advisable to try and correct such D.Q. figures according to gestational age at birth."


2003 ◽  
Vol 58 (6) ◽  
pp. 299-304
Author(s):  
Marinice Duarte da Ponte ◽  
Sérgio Tadeu Martins Marba

PURPOSE: This study aims to characterize the peri-intraventricular hemorrhages in the neonatal period in very low birth weight newborns in 2 institutions that provide neonatal tertiary assistance. METHOD: This was a comparative and observational study in 2 neonatal intensive care units, the Maternity Hospital of Campinas and the "Centro de Atenção Integrada à Saúde da Mulher" of the State University of Campinas, from December 01, 1998 to November 30, 1999. We examined 187 newborns for peri-intraventricular hemorrhages, using transfontanel ultrasound (76 and 11 respectively at the first and second unit), and classified them into 4 grades. We observed their gender, intrauterine growth, weight, and gestational age at birth. RESULTS: We diagnosed 34 cases of peri-intraventricular hemorrhages (13 and 21, respectively), and both groups differed as to the birth weight and the adequacy of weight to the gestational age at birth. There was no difference in the prevalence or extent of peri-intraventricular hemorrhages among cases. There was a statistically significant occurrence of lower birth weight at gestational ages of less than 30 weeks. CONCLUSIONS: The prevalence of peri-intraventricular hemorrhages in our study was compared to that reported in the world literature. Although the cases of the second institution had a smaller mean birth weight, the prevalence of peri-intraventricular hemorrhages was similar to that at the first institution, probably because in the first one, 69% of the gestational ages of the neonates with hemorrhage were less than 30 weeks as compared to 48% in the second one. We stress the importance of the ultrasonographic method for diagnosing peri-intraventricular hemorrhages in very low birth weight newborns.


Author(s):  
Nevin Tuten ◽  
Onur Guralp ◽  
Koray Gok ◽  
Abdullah Tuten ◽  
Altay Gezer

Objective: To investigate the accuracy of fetal weight estimation made by the last prenatal ultrasound measurement in low birth weight newborns (<2500 g). Study Design: A total of 1082 women were evaluated in this retrospective cohort study. Demographic and clinical information of the mother and newborn and obstetric ultrasonography measurements and findings performed in the last week before birth were recorded. Accuracy of fetal weight estimation and parameters affecting it was investigated. Results: Accurate estimation rates were lower in the term compared to the preterm delivery group; and in the SGA group compared to the AGA group (respectively, p=0.016, p=0.032). Accurate estimation rates (p=0.182) were comparable between the 500-1500 g and 1501-2500 g subgroups. The multiple linear regression analysis showed that gestational age at birth, birth weight, examination during labor, and duration between examination to delivery were statistically significant for the accurate estimation(p=0.001) Conclusions: Accurate estimation rates were lower in the term compared to the preterm delivery group, and in the SGA group compared to the AGA group. The factors affecting accurate estimation were found to be gestational age at birth, birth weight, examination during labor, and duration between examination to delivery.Keywords: Accurate estimation rate, Duration between examination to delivery, Examination during


2019 ◽  
Vol 44 (5) ◽  
pp. 897-906 ◽  
Author(s):  
Maja Gilarska ◽  
Anke Raaijmakers ◽  
Zhen-Yu Zhang ◽  
Jan A. Staessen ◽  
Elena Levtchenko ◽  
...  

Background: A number of studies examined the association between preterm delivery and kidney size and function later in life. However, the number of cases in published cohort studies is low. This study was aimed at performing a multicenter collaboration to pool data to obtain more accurate results to quantify the extent of renal impairment in former extremely low birth weight (ELBW; <1,000 g) children. Methodology: We performed a subject-level meta-analysis to pool data from Cracow (64 cases/34 controls) and Leuven (93 cases/87 controls). We assessed and analyzed cystatin C, estimated glomerular filtration rate (eGFR), ultrasound kidney length, and blood pressure (BP) in 11-year-old ELBW children compared with controls born at term. The prevalence of hypertension (HT) and prehypertension (preHT) in both groups was also analyzed. Results: The study group comprised 157 former ELBW children (gestational age 23–33 weeks and birth weight 430–1,000 g) and 123 children born at term. Former ELBW children had lower mean eGFR (100.62 ± 16.53 vs. 111.89 ± 15.26 mL/min/1.73 m2; p < 0.001), smaller absolute kidney length (8.56 ± 0.78 vs. 9.008 ± 0.73 cm; <0.001), and higher systolic (111.8 ± 9.8 vs. 107.2 ± 9.07 mm Hg; p = 0.01) and diastolic (68.6 ± 6.8 vs. 66.3 ± 7.7 mm Hg; p = 0.03) BP. Smaller renal size in former ELBW children was positively associated with lower birth weight, shorter gestational age, and severity of perinatal complications (intraventricular hemorrhage, length of stay, mechanical ventilation, and oxygen therapy). Conclusion: ELBW is associated with lower eGFR and a high frequency of preHT and HT.


Author(s):  
Daniel Nakhla ◽  
Alla Kushnir ◽  
Rafat Ahmed ◽  
Vineet Bhandari ◽  
Krystal Hunter ◽  
...  

Background: Extremely low birth weight (ELBW) infants often receive transfusions of packed red blood cells. Long-term outcomes of infants treated with liberal versus restricted transfusion criteria have been evaluated with conflicting results. Clinicians incorporate a reticulocyte count (RC) in their transfusion decisions. There is a lack of information on reference ranges for RCs in growing ELBW infants and whether infant’s chronologic age or corrected gestational age generates a specific trend in the RCs. Objective: Our aim was to evaluate the levels of RCs obtained from ELBW infants over the course of the initial hospitalization. Study Design: A retrospective chart review of ELBW infants treated in the neonatal intensive care unit and had RCs performed. We analyzed the RCs to observe trends based on the chronologic age and corrected gestational age. Results: A total of 738 RCs were analyzed. A positive trend in RCs that reached a peak at 32-34 weeks corrected gestational age and then experienced a downward trend was observed. Conclusions: Our report examines a very common hematologic test that is theoretically helpful but is in need of guidelines concerning the appropriate frequency of testing and its utility in making transfusion decisions in ELBW infants.


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