scholarly journals Should Echocardiographic Evaluation Be Performed Routinely in the First 72 Hours in Extremely Low Birth Weight Babies?

2021 ◽  
pp. 1-6
Author(s):  
Ruya Çolak ◽  
Senem Alkan Ozdemir ◽  
Ezgi Yangin Ergon ◽  
Ferit Kulali ◽  
Oguz Han Kalkanli ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Clinical Signs ◽  
Extremely Low Birth Weight ◽  
Average Birth Weight ◽  
Mortality And Morbidity ◽  
Echocardiographic Evaluation ◽  
Low Birth Weight Babies

Objective: Hemodynamically significant patent ductus arteriosus(hsPDA) is resulting in severe mortality and morbidity in infants with extremely low birth weight(ELBW). In our study, we aimed to evaluate the necessity of performing routine echocardiography(ECHO) in the first 72hours in ELBW infants.Study Design:This study was planned retrospectively and observationally.Between June2016 and December2018,36 patients diagnosed with hemodynamically significant PDA(hsPDA) who were hospitalized in the neonatal intensive care unit(NICU),with ≤28Gw or ≤1000g were included in this study.These babies were routinely performed ECHO for PDA between 24-72hours,although they were asymptomatic in the period from June2016 to December2017(n:23).Between January2018 and December2018, patients without PDA symptoms were expected to complete 72hours for routine PDA screening (n:13).The patients were divided into 2 groups as early ECHO group(EEG)(n=23) and late ECHO group (LEG)(n=13).In the presence of at least one of the clinical signs of systemic hypoperfusion and/or pulmonary hyperperfusion, symptomatic PDA was accepted and closure treatment was  applied with ibuprofen(n: 23) or paracetamol(n: 5).While the two groups were compared in terms of demographic features,ECHO findings,and the state of taking closure therapy,patients receiving closure therapy were compared in terms of mortality and premature morbidity.Results:The average birth weight of 36 patients was 855.9(± 241.5)g, and the average week of birth was 26.4(± 2.1)Gw.It was observed that the two groups were similar in terms of demographic characteristics.Although the findings of ECHO and treatment rates were similar between the two groups,it was observed that the EEG had earlier closure treatment(p = 0.03). In patients receiving closure treatment, performing early(n:17)and late(n:11) echocardiography showed no statistical difference in the long-term results.Conclusion:Performing early ECHO without symptoms in infants with ELBW may provoke the clinician to give PDA closure treatment earlier. In infants with ELBW,unnecessary closure treatment can be prevented by closely monitoring the symptoms of PDA and performing ECHO when necessary.

scholarly journals Mortality and morbidity of very low birth weight and extremely low birth weight babies in neonatal period

2019 ◽  
Vol 6 (2) ◽  
pp. 645
Author(s):  
Saroj Kumar Tripathy ◽  
Kripasindhu Chatterjee ◽  
Narendra Behera
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Neonatal Morbidity ◽  
Hyaline Membrane Disease ◽  
Extremely Low Birth Weight ◽  
Childhood Disability ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Low Birth Weight Babies

Background: Preterm birth is one of the major clinical problems in neonatology as it is commonly associated with perinatal mortality, serious neonatal morbidity and in some cases, it leads to childhood disability. The objective of this study was to find out the outcomes of VLBW and ELBW babies in the form of mortality and morbidity in neonatal period.Methods: A cross sectional study was conducted in SNCU, MKCG Medical College, Berhampur, Odisha between 2011 to 2013. All babies with birth weight less than 1500gm, admitted between days 1 to day 7 of life were enrolled in the study. Babies were broadly divided in to two groups i.e.VLBW group (weight 1000-1499gm) and ELBW group (weight<1000gm). Details of antenatal history, sociodemographic profile and birth history including significant events were noted. Outcome measures included were death, cured and with sequelae.Results: Total number of babies enrolled in this study were two hundred twelve (n=212) and following observations were made. Mortality of ELBW babies was 61.11% and that of VLBW babies was 26.41%. Death rate in babies with weight range 500-749gm, 750-999gm, 1000-1249gm and 125-1499gm was 87.50%, 53.57%, 30.76% and 20.97% respectively. It was found that morbidities such as RDS, HIE, shock and hypoglycemia are significantly higher in ELBW babies as compared to VLBW babies.Conclusions: Extremely low birth weight babies have shown high mortality and morbidity compared to very low birth weight babies and its related death multiply when associated with complications like hyaline membrane disease, hypoxic ischemic encephalopathy, and sepsis.

scholarly journals SIMPLE: A Novel Scoring System for Predicting Hemodynamically Significant Patent Ductus Arteriosus Without Echocardiographic Evaluation in Extremely Low Birth Weight Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Ilker Gonen ◽  
Aslan Babayigit ◽  
Helen Bornaun ◽  
Beril Yasa ◽  
Seyma Memur ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Scoring System ◽  
Ductus Arteriosus ◽  
Clinical Findings ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Echocardiographic Evaluation ◽  
Patent Ductus

Aim: To develop a novel clinical scoring system for predicting hemodynamically significant patent ductus arteriosus (hsPDA) in extremely low birth weight (ELBW) infants.Methods: A prospective observational study was conducted among ELBW infants born in the study center during a 6-month period. Fourteen items were selected on a literature review basis and weighed by severity on an arbitrary 1–4 scale, the sum of which represented the Scoring preterm Infants for PDA cLinically without Echocardiographic evaluation (SIMPLE) score. The SIMPLE scores were compared at several time points during the first 3 days of life between two groups of patients: those with an hsPDA at echocardiography and those without.Results: A total of 48 ELBW infants were enrolled, of which 30 infants developed hsPDA. The SIMPLE scores of the infants with hsPDA were significantly greater than those of the infants who did not develop hsPDA. Cut-off SIMPLE scores that were significantly associated with detection of symptomatic hsPDA at each evaluation time point were identified.Conclusions: SIMPLE is the first scoring system that depends on the risk factors and clinical findings of ELBW infants for early prediction of hsPDA. It is simple, objective and easy to perform, and it does not require any additional tests and/or echocardiographic evaluation. We suggest that SIMPLE can be used as a screening tool for determining the need for echocardiographic evaluation in ELBW infants in order to minimize the number of unnecessary pediatric cardiology consultations.

scholarly journals Changes in the outcome of extremely low birth weight infants less than 500 grams in the First Department of Obstetrics and Gynecology, Semmelweis University

2015 ◽  
Vol 156 (10) ◽  
pp. 404-408 ◽  
Author(s):  
Péter Varga ◽  
Judit Jeager ◽  
Ágnes Harmath ◽  
Botond Berecz ◽  
Tímea Kollár ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Survival Rate ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Extremely Low Birth Weight ◽  
Obstetrics And Gynecology ◽  
Low Birth Weight Infants ◽  
Mortality And Morbidity

Introduction: The mortality and morbidity of extremely low birth weight infants (birth weight below 1000 grams) are different from low birth weight and term infants. The Centers for Disease Control statistics from the year 2009 shows that the mortality of preterm infants with a birth weight less than 500 grams is 83.4% in the United States. In many cases, serious complications can be expected in survivals. Aim: The aim of this retrospective study was to find prognostic factors which may improve the survival of the group of extremely low birth weight infants (<500 grams). Method: Data of extremely low birth weight infants with less than 500 grams born at the 1st Department of Obstetrics and Gynecology, Semmelweis University between January 1, 2006 and June 1, 2012 were analysed, and mortality and morbidity of infants between January 1, 2006 and December 31, 2008 (period I) were compared those found between January 1, 2009 and June 1, 2012 (period II). Statistical analysis was performed with probe-t, -F and -Chi-square. Results: Survival rate of extremely low birth weight infants less than 500 grams in period 1 and II was 26.31% and 55.17%, respectively (p = 0.048), whereas the prevalence of complications were not significantly different between the period examined. The mean gestational age of survived infants (25.57 weeks) was higher than the gestational age of infants who did not survive (24.18 weeks) and the difference was statistically significant (p = 0.0045). Conclusions: Education of the team of the Neonatal Intensive Care Unit, professional routine and technical conditions may improve the survival chance of preterm infants. The use of treatment protocols, conditions of the Neonatal Intensive Care Unit and steroid prophylaxis may improve the survival rate of extremely low birth weight infants. Orv. Hetil., 2015, 156(10), 404–408.

Prevalence and predictors of adverse outcomes in neonatal seizures

2021 ◽  
pp. 1-7
Author(s):  
K. Famra ◽  
P. Barta ◽  
A. Aggarwal ◽  
B.D. Banerjee
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Birth Asphyxia ◽  
Adverse Outcomes ◽  
Neonatal Seizures ◽  
Clinical Practices ◽  
Inborn Errors ◽  
Mortality And Morbidity ◽  
Low Birth Weight Babies

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.

Reticulocyte Count: The Forgotten Factor in Transfusion Decisions for Extremely Low Birth Weight Infants

2021 ◽  
Author(s):  
Daniel Nakhla ◽  
Alla Kushnir ◽  
Rafat Ahmed ◽  
Vineet Bhandari ◽  
Krystal Hunter ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Reticulocyte Count ◽  
Retrospective Chart Review ◽  
Extremely Low Birth Weight ◽  
Positive Trend ◽  
Reference Ranges ◽  
Low Birth Weight Infants ◽  
Packed Red Blood Cells

Objective Extremely low birth weight (ELBW) infants often receive transfusions of packed red blood cells (PRBCs). 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 (GA) generates a specific trend in the RCs. 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 (NICU) and had RCs performed. We analyzed the RCs to observe trends based on the chronologic age and corrected GA. Results A total of 738 RCs were analyzed. A positive trend in RCs that reached a peak at 32 to 34 weeks' corrected GA and then experienced a downward trend was observed. Conclusion 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. Key Points

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