NEONATAL OUTCOMES OF EBSTEIN'S ANOMALY IN A TERTIARY NEONATAL INTENSIVE CARE UNIT

Author(s):  
Anju Singh
2020 ◽  
pp. 63-67
Author(s):  
A.A. Malska ◽  
◽  
O.B. Kurilyak ◽  

This article presents a rare case of combination of Ebstein's anomaly with critical aortic coarctation in a newborn baby, who was admitted to the neonatal intensive care unit of the Regional Children's Hospital needed urgent surgical correction. Purpose — to conduct a literature review of the clinical cases of association of Ebstein's abnormality with critical aortic coarctation in newborns and to present a clinical case of such a rare combination in a newborn boy. Clinical case. A newborn boy was admitted to the neonatal intensive care unit of the Lviv Regional Children's Hospital OHMATDYT, on the second day after his birth with an established diagnosis of Ebstein's anomaly. On admission, the child's general condition was moderate. On ausculation: rhythmic heart tones, tachycardia (heart rate 160 bpm), loud S2 above the pulmonary artery and loud 4/6 systolic murmur across the left sternal border and under the left scapula. The weakened pulsation of the femoral arteries was determined. On Echocardiographic examination: critical aortic coarctation and Ebstein's abnormality have been diagnosed, which is an extremely rare combination. Clinically on the 6th day of the child's life condition significantly worsened: respiratory and cardiovascular failure increased, diuresis decreased, urea and creatinine levels increased. The child was urgently transferred to the intensive care unit to the pediatric cardiac surgery center, where a surgical correction of aortic coarctation was successfully carried out. Surgical correction of Ebstein's anomaly was not performed. Conclusions. The presented clinical case is extremely rare, despite the combination of Ebstein's anomaly and aortic coartation in the neonatal period is not described in the literature, specialists of ultrasound diagnostics should closely monitor the protocol of echocardiographic examination and conduct it in full to diagnose the pathology and perform a timely surgical correction. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Ebstein's anomaly, critical aortic coarcia, newborns.


2020 ◽  
Vol 112 (6) ◽  
pp. 515-522
Author(s):  
Nuriye Emiroğlu ◽  
Fatma Hilal Yılmaz ◽  
Ramazan Keçeci ◽  
Mehmet Yücel ◽  
Nazlı Dilay Gültekin ◽  
...  

Author(s):  
Emine Öztürk ◽  
Şükrü Yıldız

Objective: The aim of this study was to determine whether pregnant women who developed maternal hypoglycemia during the 75 g Oral Glucose Test (OGT) were at an increased risk for adverse obstetric and neonatal outcomes. Methods: This case-control study was conducted from computer-based medical records of women who delivered in a tertiary center between January 2015 and December 2018. OGT had been performed with 75 gr glucose for gestational diabetes screening at 24-28 weeks of gestation. The pregnants with 1st-hour blood glucose levels less than 90 mg/dl (low GT) were matched with normoglycemic patients according to age, body mass index (BMI), gravida and gestational weeks. Obstetric and neonatal outcomes were assessed. Results: Of the 1249 pregnant women included in the study, 62 (4.9%) were in the Low GT group. Admission to the neonatal intensive care unit (NICU) showed a rate of 3.48 increase in the Low GT group (95% confidence interval: 1.05-11.47, p=0.04). There was no difference between the two groups in the other obstetric and neonatal parameters such as: preeclampsia, preterm delivery, birth weight, and weight gained during pregnancy and the 5-minute Apgar scores adjusted for gestational age (SGA) of the fetus. Conclusion: Low 75 g OGT results are significantly associated with increased risk of neonatal intensive care unit (NICU) admissions.


Author(s):  
Nuria Infante-Torres ◽  
Milagros Molina-Alarcón ◽  
Angel Arias-Arias ◽  
Julián Rodríguez-Almagro ◽  
Antonio Hernández-Martínez

To evaluate the association between prolonged second stage of labor and the risk of adverse neonatal outcomes with a systematic review and meta-analysis. PubMed, Scopus and EMBASE were searched using the search strategy “Labor Stage, Second” AND (length OR duration OR prolonged OR abnormal OR excessive). Observational studies that examine the relationship between prolonged second stage of labor and neonatal outcomes were selected. Prolonged second stage of labor was defined as 4 h or more in nulliparous women and 3 h or more in multiparous women. The main neonatal outcomes were 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, neonatal sepsis and neonatal death. Data collection and quality assessment were carried out independently by the three reviewers. Twelve studies were selected including 266,479 women. In nulliparous women, a second stage duration greater than 4 h increased the risk of 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit and neonatal sepsis and intubation. In multiparous women, a second stage of labor greater than 3 h was related to 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, meconium staining and composite neonatal morbidity. Prolonged second stage of labor increased the risk of 5 min Apgar score <7 and admission to the Neonatal Intensive Care Unit in nulliparous and multiparous women, without increasing the risk of neonatal death. This review demonstrates that prolonged second stage of labor increases the risk of neonatal complications in nulliparous and multiparous women.


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