Analysis of Pathology in Premature Infants in Obstetrics and Gynecology Clinic at St George University Hospital, Plovdiv between 2013 and 2015

Introduction: Premature birth is now one of the most profound prenatal problems worldwide because of the high morbidity and mor-tality it is associated with at the beginning of life. Advances in prenatal medicine over the past decades have led to a significant improve-ment of neonatal survival in risk groups of newborns. Infants of gestational age of 22-25 weeks represent the greatest medical, social, and ethical dilemma in neonatology. Most of these newborns need intensive care to survive, and most infants born between 28 and 32 weeks of gestation require special care. Those born 34 to 36 weeks’ gestation also have higher rates of short-term morbid premature birth-related conditions such as respiratory distress syndrome (RDS) and intraventricular hemorrhage (IVH) than their peers born at term. Aim: To carry out an analysis of morbidity during the neonatal period in premature babies. Materials and methods: A retrospective triennial study was conducted on 598 premature newborns. Results: The results of the study show that morbidity rate in premature born infants is high. The most frequent reasons for admission to the neonatal intensive care unit are the other forms of respiratory distress syndrome (45%). Respiratory distress syndrome (RDS) was observed in 23.41% of the prematurity, 10.7% of them were suspected of having other pathology, and 20.9% of premature neonates  manifested no complications in the neonatal period. There was a significant difference in the diagnosis of newborns after birth (p=0.0001, r=0.58), with the newborns with RDS demonstrating the most complications in the neonatal period. Conclusions: The conclusions to be drawn from the analysis of the data are as follows: there is wide comorbidity in the prematurity of RDS. Lower gestational age strongly correlates with the development of RDS. If no corticosteroid therapy is administered the risk of developing hyaline membrane disease increases. There is extremely high probability of neonatal mortality in children with hyaline membrane disease. There is significant difference between the primary diagnosis and the condition of the child at discharge from the medical establishment. Adequate and specialized prenatal care is essential when trying to reduce the incidence of preterm birth.

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

Voprosy praktičeskoj pediatrii ◽

10.20953/1817-7646-2020-6-94-102 ◽

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

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Neonatal outcome in new-borns admitted in NICU of tertiary care hospital in central India: a 5-year study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20182512 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1364 ◽

Cited By ~ 3

Author(s):

Jyotsna Verma ◽

Shweta Anand ◽

Nawal Kapoor ◽

Sharad Gedam ◽

Umesh Patel

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Distress Syndrome ◽

Perinatal Asphyxia ◽

Hyaline Membrane Disease ◽

Low Birth Weight Babies ◽

Hyaline Membrane

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.Methods: This retrospective study was done on 1424 neonates who were admitted at LN Medical College and JK Hospital, Bhopal in neonatal intensive care unit (NICU) in the Department of Paediatrics from January 2013-December 2017.Results: 1424 newborns admitted within 24 hours of birth were included in the study. About 767 were male neonates, (Male: female1.16:1). The low birth weight babies were 54% in our study. Among the various causes of NICU admission, Respiratory distress was present in 555 (39%) of neonates, Respiratory distress syndrome (Hyaline membrane disease) being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 24% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 2.5%. The neonatal mortality was found to be 11% in our study. Prematurity with Respiratory distress syndrome (Hyaline membrane disease) and perinatal asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates.Conclusions: Present study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore, a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.

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STUDIES ON HYALINE MEMBRANE DISEASE

PEDIATRICS ◽

10.1542/peds.32.1.10 ◽

1963 ◽

Vol 32 (1) ◽

pp. 10-24

Author(s):

Clara M. Ambrus ◽

David H. Weintraub ◽

Donal Dunphy ◽

John E. Dowd ◽

John W. Pickren ◽

...

Keyword(s):

Placebo Group ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Plasminogen Activator ◽

Premature Infants ◽

Distress Syndrome ◽

Hyaline Membrane Disease ◽

Blood Coagulation Factors ◽

Plasminogen Activator Activity ◽

Hyaline Membrane

In the serum of normal prematures and premature infants with respiratory distress syndrome, plasminogen was absent. In mature newborns plasminogen levels were low, as compared to adults. In the euglobulin fraction of plasma, plasminogen level was highest in mature newborns, lower in healthy prematures, and lowest in prematures with respiratory distress syndrome. Antiplasmin level was exceptionally high in about a fourth of the premature infants with or without respiratory distress syndrome. Plasminogen activator activity was found more often in the blood of infants with respiratory distress syndrome than in normal infants. This may be due to the liberation of tissue activators as a consequence of hypoxia. Because of the absence of the substrate (plasminogen), this activator level may have no significance. Tissue activator activity was found in the lungs of premature infants whether they died of hyaline membrane disease or from other causes. Forty-five infants with respiratory distress were treated in a therapeutic study. Twelve were treated in a preliminary series and 33 in a randomizd, double-blind investigation. Of the latter, 11 were treated with placebo, and 5 (45%) survived; 8 were treated with streptokinase activated human plasmin and 2 (25%) survived; 14 were treated with urokinase activated human plasmin and 12 (86%) survived. Among the infants who died, no definite hyaline membrane disease was found by histopathologic examination in two of the placebo group, one in the streptokinase-plasmin treated group, and the two who died in the urokinase-plasmin group. No significant side-effects of plasmin therapy were seen. Although considerable fibrinolytic and plasminogen-activator activity was generated in many treated patients, there was no significant fall in blood coagulation factors. Intracerebral hemorrhage, which appears to occur often in patients who die with hyaline membrane disease, was not more frequent in the plasmintreated group than in the placebo group.

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The Magnitude and Risk Factors of Acute Respiratory Distress Syndrome among Newborn Admitted To Neonatal Intensive Care Unit at Benghazi Medical Center

Asian Journal of Medicine and Health ◽

10.9734/ajmah/2021/v19i1230416 ◽

2021 ◽

pp. 41-61

Author(s):

Munera Awad Radwan ◽

Najia Abdelati El-Mansori ◽

Mufeda Ali Elfergani ◽

Mohanad Abdulhadi Lawgali

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Medical Center ◽

Female Gender ◽

Hyaline Membrane Disease ◽

Hyaline Membrane

Background: Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS) is the most common lung condition affecting premature babies. The inadequate amount of surfactant causes alveoli to collapse when the baby breathes out. It is hard for your baby to re-inflate the collapsed alveoli when he breathes. The lack of surfactant and resulting inflammation is called. Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS). Aim of the Study: To determine the magnitude of Hyaline membrane disease or respiratory distress syndrome and identify the risk factors and complication among newborn babies in neonatal intensive care unit at Benghazi medical center (BMC). Materials and Methods: Case series study. The study was conducted during the period between March 2017 to March 2018 of HMD cases at Benghazi medical center. A convenient sample of 120 cases diagnosed as HMD. Studied variables include the following; gestational age, birth weight, gender, type of pregnancy and type of delivery also the data for mothers such as (diabetes mellitus, preeclampsia hypothyroidism, receiving of Dexamethasone injection and premature rupture of membrane). Also investigation and treatment and finally the outcomes of babies. Statistical Methods: Data were analyzed with SPSS version 17, analysis of associations was made with application Chi - square test for categorical variables comparison, was applied for test of association P <0.25. P was considered statistically significant if ≤ 0.05. Results: Female gender was predominant (52%). Most of cases of HMD were between 1000 -2000 kg. Among the 120 cases we have (15%) sever HMD and the majority of cases have moderate –to sever Hyaline membrane disease 39 (32.5%) whereas very sever HMD were observed in nearly 27% of cases. The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis, all these were found to be very common risk factors of HMD. Pearson chi-square test p value highly significant of female gender with complications of HMD. Our results observed more than half of babies were died. Conclusion: The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis all these were found to be very common risk factors of HMD. Also we concluded that the cases had premature rupture of membrane, which identified as risk factors of hyaline membrane disease. Furthermore, we concluded that highly significant of female gender with complications of HMD, such as Pneumothorax, bronco pulmonary, dysplasia, intra ventricular hemorrhage and congenital heart diseases were common co- morbidities with respiratory distress syndrome, all these could be have an association with the development of hyaline membrane disease, finally we observed more than half of babies were died this is a warning sign for health services.

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Association between Thyroid Stimulating Hormone and Respiratory Distress Syndrome of Newborn in the Preterm Infants

10.21203/rs.3.rs-40381/v1 ◽

2020 ◽

Author(s):

Young Jin Kim ◽

Byoung Kook Kim ◽

Yong Hyuk Kim

Keyword(s):

Thyroid Hormone ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Distress Syndrome ◽

Control Group ◽

Lower Serum ◽

Significant Difference ◽

Serum Tsh ◽

Tsh Levels

Abstract Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T3 and fT4 level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T3 and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT4) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.

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Complicated delivery in a patient with acute respiratory distress syndrome on Coronavirus disease 2019 infection

10.22541/au.160646412.24677267/v1 ◽

2020 ◽

Author(s):

Alexis Bikfalvi ◽

Aleksandar Dabetic ◽

Moira Robertson

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Caesarean Section ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Hyaline Membrane Disease ◽

Invasive Ventilation ◽

Hyaline Membrane ◽

Return Home

A 39-year-old parturient contracted COVID-19 at 28 weeks of gestation and later developed ARDS requiring emergent caesarean section, intubation and 11 days of invasive ventilation. Her infant also required intubation due to hyaline membrane disease, he was not infected by COVID-19. Both evolved well and could return home.

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Air Leak in Neonatal Respiratory Distress Syndrome

Anaesthesia and Intensive Care ◽

10.1177/0310057x8401200108 ◽

1984 ◽

Vol 12 (1) ◽

pp. 41-45 ◽

Cited By ~ 9

Author(s):

P. D. Sly ◽

J. H. Drew

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Hyaline Membrane Disease ◽

Maternity Hospital ◽

Assisted Ventilation ◽

Air Leak ◽

Mechanical Ventilators ◽

Hyaline Membrane ◽

Neonatal Respiratory Distress

A review of 9401 consecutive live births at the Mercy Maternity Hospital, Melbourne, was performed to determine the incidence of air leak in those with respiratory distress syndrome. Respiratory distress was detected in 552 (5.9%) infants and hyaline membrane disease was the most common cause occurring in 238 (2.5%) infants. Air leak developed in 22% of infants with respiratory distress, 8% had pulmonary interstitial emphysema alone, 14% had pneumomediastinum or pneumothorax and 7% had emphysema with pneumomediastinum or pneumothorax. Mortality increased from 12% in infants without air leak to 31% (p < 0.001) in infants with air leak. Ninety-five per cent of air leak developed in infants with hyaline membrane, and these were smaller, less mature and sicker than those without air leak. Eighty-seven per cent of air leak developed in infants treated with assisted ventilation and was commoner with mechanical ventilators with a more rapid rise in inspiratory pressure.

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A Comparison of Leak Synchronized Nasal SIMV Methods and Leak Compensated Nasal SIMV in Newborns with Respiratory Distress Syndrome

The Journal of Pediatric Academy ◽

10.51271/jpea-2021-0094 ◽

2021 ◽

pp. 18-21

Author(s):

Ahmet Özdemir ◽

Mustafa Ali Akın ◽

Osman Baştug ◽

Tamer Güneş

Keyword(s):

Blood Pressure ◽

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Distress Syndrome ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Significant Difference

The aim of the present study was to compare the efficacy of leak compensated nasal SIMV (LCnSIMV) and leak synchronized nasal SIMV (LSnSIMV) modes in order to reduce the need for endotracheal intubation and associated complications in newborns with respiratory distress. This randomized, prospective study was conducted on 50 infants (25 per group) with gestational age below 34 weeks and/or below 2000 grams who have been admitted to NICU of Erciyes University Hospital because of respiratory distress syndrome (RDS) and need for mechanical ventilation. Infants with congenital heart disease, nasopharyngeal pathology (coanal atresia and cleft palate-lip) were excluded. Infants monitored on mechanical ventilator after surfactant were randomly assigned to LCnSIMV and LSnSIMV groups before extubation. SPO2/FiO2 (S/F), peak heart rate (PHR), respiration rate per minute (RRM), and arterial blood pressure (aBP) values of patients were recorded. Gestational age, birth weight, gender, RDS, patent ductus arteriosus (PDA) requiring treatment, presence of intraventricular bleeding (IVH), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) were recorded. The patients enrolled in the study were female by 48% and male by 52%. There was not any statistically significant difference between groups for gender, postnatal age and birth weight. There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for non-invasive ventilation period and re-intubation rate (p=0.04 and p=0.03, respectively). There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for SpO2 and S/F rates at 60 minutes (p=0.03 and p=0.01, respectively). There was not any difference between groups for blood pressure, PDA, IVH, ROP, BPD, NEC, sepsis and air leak. It may be appropriate to prefer the LSnSIMV method in patients with respiratory distress syndrome who need non-invasive ventilation in the pre-extubation period by considering the patient-ventilator compliance for positive effect in terms of mechanical clinical variables.

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