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Sample records for asphyxia neonatorum

  1. 窒息新生儿脑干诱发电位的检测价值%The Value of Brainstem Auditory Evoked Potential in Asphyxia Neonatorum

    Institute of Scientific and Technical Information of China (English)

    李秋玲

    2011-01-01

    围生期窒息后可引起听神经通路细胞的缺血/再灌注损伤,从而影响听觉功能.脑干听觉诱发电位可反映脑神经和脑听觉通路不同部位所引起的生物电活动,因其客观、准确、重复性好、无损伤性、受干扰因素少而受到儿科工作者重视.对可能累及到中枢神经系统功能失调及听力障碍的儿科疾病具有早期诊断和判断预后的临床参考价值.%The ischemic reperfusion of injury of nerve cell in auditory pathway can be caued by perinatal asphyxia. And the injury can affect hearing. Brainstem auditory evoked potential can reflect the bioelectric activity of cranial nerves and cerebral auditory pathway. Because it have not only good objectivity, precision and reproducibility , but also it have no damage and few interference factors, brainstem auditory evoked potential was thought highly by pediatrician. It has the clinical reference value of early diagnosis and the judgment of prognosis in pediatrie disease of central dysautonomia and dysacusis.

  2. Acne neonatorum and familial hyperandrogenism.

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    Bekaert, C; Song, M; Delvigne, A

    1998-01-01

    We report a case of acne neonatorum developed in a boy since birth. His mother and his aunt had different signs of hyperandrogenism including acne and hirsutism. This case illustrates the correlation between acne neonatorum and familial hyperandrogenism. It shows the importance of the family history and the eventual clinical and serological presence of hyperandrogenism in the mother when confronted with acne neonatorum. PMID:9669129

  3. Preventing Ophthalmia Neonatorum

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    Dorothy L Moore

    2015-01-01

    Full Text Available The use of silver nitrate as prophylaxis for neonatal ophthalmia was instituted in the late 1800s to prevent the devastating effects of neonatal ocular infection with Neisseria gonorrhoeae. At that time – during the preantibiotic era – many countries made such prophylaxis mandatory by law. Today, neonatal gonococcal ophthalmia is rare in Canada, but ocular prophylaxis for this condition remains mandatory in some provinces/ territories. Silver nitrate drops are no longer available and erythromycin, the only ophthalmic antibiotic eye ointment currently available for use in newborns, is of questionable efficacy. Ocular prophylaxis is not effective in preventing chlamydial conjunctivitis. Applying medication to the eyes of newborns may result in mild eye irritation and has been perceived by some parents as interfering with mother-infant bonding. Physicians caring for newborns should advocate for rescinding mandatory ocular prophylaxis laws. More effective means of preventing ophthalmia neonatorum include screening all pregnant women for gonorrhea and chlamydia infection, and treatment and follow-up of those found to be infected. Mothers who were not screened should be tested at delivery. Infants of mothers with untreated gonococcal infection at delivery should receive ceftriaxone. Infants exposed to chlamydia at delivery should be followed closely for signs of infection.

  4. 头位脐带绕颈不同分娩方式与新生儿窒息的关系%Different Delivery Modes of Nuchal Cord Cephalic Presentation and Asphyxia Neonatorum

    Institute of Scientific and Technical Information of China (English)

    邢玲玲

    2012-01-01

    目的 探讨不同分娩方式对头位脐带绕颈的处理对新生儿窒息的影响.方法 选择我院2009年9月至2011年9月单胎头位脐带绕颈足月妊娠产妇共280例,上述病例均无产科合并症、相关并发症.根据分娩方式不同分为阴道分娩组和剖宫产组.阴道分娩组均在局麻下行左侧会阴侧切分娩.剖宫产组均在持续硬膜外麻醉下实施剖宫产术.其中阴道分娩组160例;剖宫产组120例.观察脐带绕颈不同分娩方式对新生儿窒息及胎儿宫内窘迫发生的影响.结果 阴道分娩组胎儿宫内窘迫发生率显著高于剖宫产组,差异有统计学意义(P<0.05);阴道分娩组新生儿窒息发生率与剖宫产组比较,差异无统计学意义(P>0.05).结论 根据脐带绕颈情况选择合适的分娩方式,脐带绕颈1周妊娠病例可建议实施自然分娩,脐带绕颈>2周的可建议实施剖宫产进行分娩.%Objective To discuss the effect of different delivery modes for pregnancy with nuchal cord cephalic presentation on neonatal asphyxia. Methods 280 term pregnancy women( all without obstetric complications )with nuchal cord cephalic presentation from Sep. 2009 to Sep. 2011 were divided into vaginal delivery group and cesarean section group according to their delivery mode. Vaginal delivery group( n - 160 ) was performed left lateral episiotomy under local anesthesia,while cesarean section group( n - 120 )was performed under continuous epidural anesthesia. Effect of different modes of delivery on neonatal asphyxia and intrauterine fetal distress was observed. Results The incidence of fetal distress in vaginal delivery group was obviously higher than that in cesarean section group, the difference had statistical significance^ P 0.05 ). Conclusion The delivery mode can be chosen according to nuchal cord situations. Natural delivery can be chosen in case of 1 circle of nuchal cord, while cesarean section is suggested for the situation of > 2 circles.

  5. Is noma neonatorum a presentation of ecthyma gangrenosum in the newborn?

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    Freeman, Alexandra F; Mancini, Anthony J; Yogev, Ram

    2002-01-01

    Noma neonatorum was suggested as a distinct entity characterized by a gangrenous process of the nose, oral cavity, eyelids and perineum that was almost universally fatal in premature infants with Pseudomonas sepsis. We report the first case of noma neonatorum in a 26-week-gestation twin born in the United States. Our case is consistent with previous descriptions of noma neonatorum; however, we question the distinction between noma neonatorum and a neonatal presentation of ecthyma gangrenosum.

  6. Noma Neonatorum From Multidrug-Resistant Pseudomonas aeruginosa: An Underestimated Threat?

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    Raimondi, Francesco; Veropalumbo, Claudio; Coppola, Clara; Maddaluno, Sergio; Ferrara, Teresa; Cangiano, Giancarlo; Capasso, Letizia

    2015-09-01

    We present the case of an extremely low birth weight infant with diffuse gingival noma, initially misdiagnosed as thrush. Multidrug-resistant Pseudomonas aeruginosa strain was cultured and treated with systemic and local colistin with complete healing. Noma neonatorum from multidrug-resistant pathogens may appear in neonatal intensive care units. Old antibiotics may help.Noma (cancrum oris) is a devastating gangrenous disease that leads to destruction of facial tissue with significant morbidity and mortality in children and young adults. Noma has virtually disappeared from Europe and North America, but it is still common among children and young adults in India, Africa, and South America. Noma is a polymicrobial opportunistic infection related to malnutrition and immune dysfunction. In the neonate, a similar but distinct condition, known as "noma neonatorum" was described in 1977, in which gangrenous lesions involve the mucocutaneous junctions of oral, nasal, and anal area, and, occasionally, the eyelids and the scrotum. The neonatal disease has been linked to Pseudomonas aeruginosa, prematurity, and low birth weight. There is no established treatment, and mortality is almost inevitable in the few reported cases. In this study, we present the first European case of noma neonatorum from a multidrug-resistant strain of P aeruginosa.

  7. The use of toxoid for the prevention of tetanus neonatorum. Final report of a double-blind controlled field trial.

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    Newell, K W; Dueñas Lehmann, A; LeBlanc, D R; Garces Osorio, N

    1966-01-01

    With a view to determining the effectiveness of a method for the control of tetanus neonatorum which would be independent of medical examination or care, a double-blind field trial covering 1618 women was conducted between 1961 and 1966 in a rural area of Colombia with an estimated existing tetanus neonatorum death rate of 11.6 per 100 births. The study group was given 1-3 injections of 1 ml of an aluminium-phosphate-adsorbed tetanus toxoid more than 6 weeks apart, and the control group a similar number of injections of an influenza-virus vaccine.There was no statistically significant difference between those in the two groups given one injection. Those in the control group given 2 or 3 injections had a tetanus neonatorum death rate of 7.8 deaths per 100 births, and the corresponding subjects in the study group had none. This difference is unlikely to have occurred by chance.

  8. Neonatal asphyxia: A study of 210 cases

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    Hülya Üzel

    2012-06-01

    Full Text Available Objectives: Perinatal asphyxia remains an importantcause of neonatal morbidity and mortality. The aim of thisstudy was to investigate antenatal, natal, and postnatalrisk factors of neonatal asphyxia, relationship with knownrisk factors and stage of Sarnat and Sarnat scores, theeffect of risk factors on hospital discharge and survival forneonates with perinatal asphyxia.Materials and methods: In this study, we retrospectivelyanalyzed the hospital records of 210 patients diagnosedas perinatal asphyxia. The patients’ demographic characteristics,antepartum, intrapartum, and postpartum riskfactors and Sarnat and Sarnat clinical staging criteria ofnewborns were analyzed.Results: The risk factors for asphyxia were detectedantepartum period in 67.7% of newborns, intrapartum in91% and potpartum in of 29.5% of neonates. When caseswere examined according to the studied years, perinatalasphyxia ratio was the most frequent in 2007 as 28.1%.With a decline over the years, frequency dropped to %21in 2010. The number of patients with stage 3 and mortalityrate were significantly decreased over the years (p<0.05.Conclusions: Less preventable intrapartum causes ofbirth asphyxia are seen more frequently. Early detectionof risk factors together with appropriate prenatal, nataland postnatal care provision, reduced emergency caesareansections and will decrease considerably decreasefrequency of perinatal asphyxia. We think that followingup neonates who needed intensive care in neonatal unitssufficiently equipped will decrease complications due toasphyxia. J Clin Exp Invest 2012; 3(2: 194-198

  9. Klebsiella pneumonia: An unusual cause of ophthalmia neonatorum in a healthy newborn.

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    Kumar, Jaya B; Silverstein, Evan; Wallace, David K

    2015-12-01

    Ophthalmia neonatorum is one of the most common infections during the neonatal period. Chlamydia trachomatis and Neisseria gonorrhoea must be ruled out, given their high virulence and systemic complications. We describe a case of ophthalmia neonatroum from Klebsiella pneumonia. Gram-negative organisms have been reported in hospital-acquired conjunctivitis (HAC), but we are unaware of any published reports of K. pneumonia conjunctivitis in an otherwise healthy full-term infant born in the United States who has received prophylaxis. It is important to promptly identify and treat Klebsiella conjunctivitis because it can lead to severe complications. PMID:26691043

  10. A Swine Model of Neonatal Asphyxia

    OpenAIRE

    Cheung, Po-Yin; Gill, Richdeep S.; Bigam, David L.

    2011-01-01

    Annually more than 1 million neonates die worldwide as related to asphyxia. Asphyxiated neonates commonly have multi-organ failure including hypotension, perfusion deficit, hypoxic-ischemic encephalopathy, pulmonary hypertension, vasculopathic enterocolitis, renal failure and thrombo-embolic complications. Animal models are developed to help us understand the patho-physiology and pharmacology of neonatal asphyxia. In comparison to rodents and newborn lambs, the newborn piglet has been proven ...

  11. A Survey on Ophthalmia Neonatorum in Benin City, Nigeria (Emphasis on gonococcal ophthalmia

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    Enabulele Onaiwu

    2003-08-01

    Full Text Available The purpose of the study was to investigate the incidence of gonococcal ophthalmia neonatorum considering its ability to lead to childhood blindness through corneal ulceration and scarification. Eye swabs were obtained from 330 neonates of 1-5 days in the hospitals of study. Of these, 248 yielded growth and six bacterial genera were identified using standard techniques. Staphylococcus aureus was the most prevalent (60.5% while Neisseria gonorrhoeae accounted for 1.7%. Susceptibility patterns of bacterial isolates to four antibiotics were determined using Disk-diffusion tests. Staphylococcus aureus and Neisseria gonorrhoeae showed 62.5 and 100% susceptibility to Erythromycin while 66.7% of Escherichia coli and Klebsiella and 62.5% of Pseudomonas aeruginosa were susceptible to Gentamicin. The incidence of gonococcal ophthalmia neonatorum for the period of study was 8.9 (cases per 1,000 live births. Prevention is through ocular prophylaxis by the application of either 1% silver nitrate ophthalmic solution or 0.5% erythromycin ointment to the neonates? eyes some hours after birth. This would help to preserve vision and reduce to the barest minimum the incidence of childhood blindness.

  12. Nondrowning Asphyxia in Veterinary Forensic Pathology: Suffocation, Strangulation, and Mechanical Asphyxia.

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    McEwen, B J

    2016-09-01

    Asphyxia in a forensic context refers to death by rapid cerebral anoxia or hypoxia due to accidental or nonaccidental injury. Death due to nondrowning asphyxia can occur with strangulation, suffocation, and mechanical asphyxia, each of which is categorized based on the mechanism of injury. Individuals dying due to various types of asphyxia may or may not have lesions, and even those lesions that are present may be due to other causes. The interpretation or opinion that death was due to asphyxia requires definitive and compelling evidence from the postmortem examination, death scene, and/or history. Beyond the postmortem examination, pathologists may be faced with questions of forensic importance that revolve around the behavioral and physiological responses in animals subjected to strangulation, suffocation, or mechanical asphyxia to determine if the animal suffered. While there is no prescriptive answer to these questions, it is apparent that, because of physiological and anatomical differences between humans and animals, for some mechanisms of asphyxia, consciousness is maintained for longer periods and the onset of death is later in animals than that described for people. Veterinary pathologists must be cognizant that direct extrapolation from the medical forensic literature to animals may be incorrect. This article reviews the terminology, classification, mechanisms, and lesions associated with asphyxial deaths in companion animals and highlights significant comparative differences of the response to various types of asphyxia in animals and people. PMID:27084399

  13. Relationship between neonatal asphyxia and meconium-stained amniotic fluid%新生儿窒息与羊水粪染的临床研究

    Institute of Scientific and Technical Information of China (English)

    郑日华; 谢晓丹; 方妙君

    2013-01-01

    Objective To investigate the relationship between neonatal asphyxia and meconiumstained amniotic fluid.Methods Seventy-seven cases of neonatal asphyxia from January 2010 to December 2011 were selected to annlyze the feature of amniotic fluid.All the newborn were single fetus and mature.Results The rate of meconium-stained was 76.6%,and meconium-stained amniotic fluid Ⅲ played a main role in severe asphyxia of newborn.Conclusions There is a certain relationship between neonatorum asphyxia and meconium-stained amniotic fluid,and the therapy to the meconium-stained amniotic fluid is important.%目的 探讨新生儿窒息和羊水粪染的相关性.方法 选取2010年1月至2011年12月汕头大学医学院第二附属医院分娩的单胎、头位孕37~42周的77例窒息新生儿,对其羊水性状进行分析.结果 新生儿窒息组羊水粪染率为76.6%,新生儿重度窒息组中羊水Ⅲ度粪染比例高.结论 羊水粪染与新生儿窒息有一定的相关性,应重视羊水粪染的母儿处理.

  14. Clinicoradiological correlation in birth asphyxia

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    Basavaraj Patil

    2015-06-01

    Full Text Available Background: Hypoxic Ischemic Encephalopathy (HIE is the most dreaded neurological disease of the new-born. Assessment of severity of HIE would help proper parent counseling and early institution of stimulation therapy for better development of the infant. Methods: This study was conducted between December 2012 and May 2014. 37 term neonates with perinatal asphyxia were the subjects. The cranial ultrasound, EEG and MRI findings of these babies are analysed and correlated with each other and with clinical staging and the neurological condition of the babies at discharge. Results: Among the 37 neonates, 21 were of HIE stage 2 and 16 were of stage 3. Sensitivity of EEG in detecting abnormality in the neurological condition according to our study is 76.9%, specificity 87.5%, positive predictive value 76.9%, negative predictive value 87.5%. Sensitivity of severe pattern of injury in MRI brain in detecting abnormality in neurological condition according to our study is 76.9%, specificity 91.6%, positive predictive value 83.3%, negative predictive value 88%. Involvement of both basal ganglia and cortex in MRI brain had statistically significant correlation with abnormal neurological condition at discharge in our study (P = 0.04. Conclusion: An abnormal EEG and MRI brain in a term new-born with Hypoxic Ischemic Encephalopathy (HIE is associated with poor neurological outcome. Involvement of basal ganglia/thalamus and cortex together in the MRI are predictors of abnormal outcome. [Int J Res Med Sci 2015; 3(3.000: 560-567

  15. Compression asphyxia from a human pyramid.

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    Tumram, Nilesh Keshav; Ambade, Vipul Namdeorao; Biyabani, Naushad

    2015-12-01

    In compression asphyxia, respiration is stopped by external forces on the body. It is usually due to an external force compressing the trunk such as a heavy weight on the chest or abdomen and is associated with internal injuries. In present case, the victim was trapped and crushed under the falling persons from a human pyramid formation for a "Dahi Handi" festival. There was neither any severe blunt force injury nor any significant pathological natural disease contributing to the cause of death. The victim was unable to remove himself from the situation because his cognitive responses and coordination were impaired due to alcohol intake. The victim died from asphyxia due to compression of his chest and abdomen. Compression asphyxia resulting from the collapse of a human pyramid and the dynamics of its impact force in these circumstances is very rare and is not reported previously to the best of our knowledge.

  16. Perinatal asphyxia in the term newborn

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    Roberto Antonucci

    2014-06-01

    Full Text Available Despite the important advances in perinatal care in the past decades, asphyxia remains a severe condition leading to significant mortality and morbidity. Perinatal asphyxia has an incidence of 1 to 6 per 1,000 live full-term births, and represents the third most common cause of neonatal death (23% after preterm birth (28% and severe infections (26%. Many preconceptional, antepartum and intrapartum risk factors have been shown to be associated with perinatal asphyxia. The standard for defining an intrapartum hypoxic-ischemic event as sufficient to produce moderate to severe neonatal encephalopathy which subsequently leads to cerebral palsy has been established in 3 Consensus statements. The cornerstone of all three statements is the presence of severe metabolic acidosis (pH < 7 and base deficit ≥ 12 mmol/L at birth in a newborn exhibiting early signs of moderate or severe encephalopathy. Perinatal asphyxia may affect virtually any organ, but hypoxic-ischemic encephalopathy (HIE is the most studied clinical condition and that is burdened with the most severe sequelae. The feasibility of providing neuroprotection after HIE has been proven by hypothermia therapy, which is able to reduce the risk of death or major neurodevelopmental disability. Many promising neuroprotective agents might contribute to reduce hypoxic-ischemic brain injury through different mechanisms of action, but further studies are required to confirm their efficacy. The prognosis is dependent on the severity of the perinatal asphyxia. Only a minority of infants with severe HIE survive without handicap. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  17. A case report of Traumatic Asphyxia

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    B Sah

    2015-06-01

    Full Text Available Traumatic asphyxia is a condition presenting with cervicofacial cyanosis and edema, subconjunctival hemorrhage, and petechial hemorrhages of the face, neck, and upper chest that occurs due to a compressive force to the thoracoabdominal region.In this case report a 52 years old lady who was brought to the mortuary because of death due to traumatic asphyxia as a result of being stampeded by her own cows upon her chest was discussed. Congestion on both the conjunctiva, cyanosis on chin and adjacent upper left side of neck found with a well demarcated area observed between the cyanosed area over face and the normal area of neck. Hematoma was present in the chin and the adjacent neck region.Apart from quickly eliminating organ pathologies and initiation of supportive therapy in a case of traumatic asphyxia, possibility of formation of hematoma in neck after few hours of getting injured should also be considered, as this type of hematoma may contribute to the cause of death.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12777 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 51-55

  18. First Attempt to Implement Ophthalmia Neonatorum Prophylaxis in Angola: Microorganisms, Efficacy, and Obstacles

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    Isabel Alexandre

    2015-01-01

    Full Text Available Purpose. To determine the efficacy of povidone-iodine (P-I prophylaxis for ophthalmia neonatorum (ON in Angola and to document maternal prevalence and mother-to-child transmission rates. Methods. Endocervical samples from mothers n=317 and newborn conjunctival smears n=245 were analysed by multiplex polymerase chain reaction (PCR for Chlamydia trachomatis (CT, Neisseria gonorrhoeae (NG, and Mycoplasma genitalium (MG. Newborns were randomized into a noninterventional group and an interventional group that received a drop of P-I 2.5% bilaterally after conjunctival smear collection. Mothers were trained to identify signs of ON and attend a follow-up visit. Results. Forty-two newborns had ocular pathology, and 11 (4.4% had clinical signs of ON at the time of delivery. Maternal PCR was positive for MG n=19, CT n=8, and NG n=2. Six newborns were positive for CT n=4, MG n=2, and NG n=1. Mother-to-child transmission rates were 50% for CT and NG and 10.5% for MG. Only 16 newborns returned for follow-up. Conclusions. Lack of maternal compliance prevented successful testing of prophylactic P-I efficacy in ON prevention. Nevertheless, we documented the prevalence and mother-to-child transmission rates for CT, NG, and MG. These results emphasize the need to develop an effective Angolan educational and prophylactic ON program.

  19. Correlation between Nonreassuring Patterns in Fetal Cardiotocography and Birth Asphyxia

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    Fatemeh Abbasalizadeh

    2015-07-01

    Full Text Available Objective: Cardiotocography is a tool for assessing the fetus during labor and identification the risk of asphyxia. Abnormal cardiotocography can induce stress on the physician and mother and can result in their deciding to terminate the pregnancy and the complications of an emergency cesarean section. The purpose of this study was the evaluation of the correlation between non-reassuring patterns in fetal cardiotocography and birth asphyxia. Materials and methods: In a cross-sectional analytic study, 324 term pregnant women were included, and the association between non-reassuring patterns in cardiotocography (fetal tachycardia, fetal bradycardia, absent or minimal baseline variability, and absence of acceleration and periodic or episodic deceleration and birth asphyxia were assessed. Results: Birth asphyxia existed in 10 newborns; in all cases mild hypoxic ischemic encephalopathy was observed. Within the non-reassuring cardiotocography patterns, baseline fetal heart variability and periodic or episodic deceleration had a significant relationship with birth asphyxia. Most asphyxia cases had occurred in absent and minimal baseline fetal heart rate (FHR variability (R = 0.49, P < 0.001. In periodic or episodic decelerations, most asphyxia cases occurred in recurrent late decelerations with normal baseline variability and variable decelerations with shoulders or overshoots (R = 0.42, P = 0.014. Conclusion: With regard to the findings of the present study, we can use non-reassuring cardiotocographic patterns, especially absent and minimal baseline FHR variability and periodic or episodic decelerations, in prediction of birth asphyxia. But it seems that most birth asphyxias occur in normal cardiotocographs.

  20. Correlation between Nonreassuring Patterns in Fetal Cardiotocography and Birth Asphyxia

    OpenAIRE

    Fatemeh Abbasalizadeh; Shamci Abbasalizadeh; Shabnam Pouraliakbar; Parvin Bastani

    2015-01-01

    Objective: Cardiotocography is a tool for assessing the fetus during labor and identification the risk of asphyxia. Abnormal cardiotocography can induce stress on the physician and mother and can result in their deciding to terminate the pregnancy and the complications of an emergency cesarean section. The purpose of this study was the evaluation of the correlation between non-reassuring patterns in fetal cardiotocography and birth asphyxia. Materials and methods: In a cross-sectional anal...

  1. ASPHYXIA AND DEVELOPMENTAL OUTCOME IN HIGH RISK INFANTS

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    Valentina DUKOVSKA

    2010-04-01

    Full Text Available Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE.The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.

  2. Asphyxia from the eyes of the neonatologist

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    Paolo Gancia

    2014-06-01

    Full Text Available The perinatal asphyxia occurs at a frequency of 4-6‰ in developed countries The hypoxic-ischemic encephalopathy (HIE has an incidence of 0.5-2‰, and is a frequent cause of death and severe disability. Cerebral hypothermia is a well-established therapy of HIE, and its benefits have been described by systematic reviews and meta-analyses of numerous controlled clinical trials. Authors describe their experience in implementation of cerebral hypotermia in a Neonatal Intensive Care Unit, the creation of a network to perform neurophysiologic study of asphyxiated infants ≥ 35 weeks gestation, potential hypothermia candidates. Neurodevelopmental prognosis of HIE infants is of paramount importance for parents. To improve the quality of prognosis and communication with the parents, two studies have been undertaken. First, EEG and magnetic resonance imaging (MRI relationships analysis showed that the severity of the background EEG is associated with the severity and location of MRI lesion patterns in infants treated with hypothermia because of HIE. The second study aims to elucidate the relationships between MRI patterns and neurodevelopmental assessment by Griffiths scales. We found that neuroimaging findings correlate significantly with overall neurodevelopmental assessment at 12 and 24 months of life; in particular, this correlation is significant for the loco-motor and psycho-social sides. These instrumental data, with the EEG evaluation and clinical data, allow the neonatologist to predict quite precisely the neurological outcome of an infant. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  3. Asphyxia from the eyes of the obstetrician

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    Alessandra Meloni

    2014-06-01

    Full Text Available Nowadays it is well recognized that there are multiple potential pathways causing hypoxic-ischemic events that may lead to cerebral palsy in term infants. The signs and symptoms of neonatal encephalopathy may range from mild to severe, depending on nature and timing of brain injury. The incidence of cerebral palsy has not changed over the last 30 years and one of the obstetricians’challenge is how to recognize babies at intrapartum risk both before and during labour. A detailed description of prepartum and intrapartum risk factors is available. A close surveillance of labour and intrapartum time should be mandatory as the valuation of all available data from obstetrical examination, cardiotocography, ultrasound and labour progression to reach the correct diagnosis with the lowest possible rate of error. The close monitoring should not exclude a humanized and compliant attitude versus labouring women and their families. We analysed the Cagliari Neonatal Intensive Care Unit (NICU activity during the last four years considering 22 asphyxiated babies (coming from 9 different hospitals who underwent hypothermia treatment. The main result was that the need to resuscitation procedures at birth correlates with adverse outcomes. Asphyxia still remains a matter of great concern also as medico legal claims. Considering that neonatal encephalopathy is a heterogeneous condition, it is unlikely that it will be eradicated. However, a comprehensive evaluation of all risk factors and of intrapartum surveillance available tools may reduce as much as possible adverse events.Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  4. Brain pertechnetate SPECT in perinatal asphyxia

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    Sfakianakis, G.; Curless, R.; Goldberg, R.; Clarke, L.; Saw, C.; Sfakianakis, E.; Bloom, F.; Bauer, C.; Serafini, A.

    1984-01-01

    Single photon emission computed tomography of the brain was performed in 6 patients with perinatal asphyxis aged 8-26 days. A single-head (LFOV) commercial SPECT system (Picker) was used and data were acquired 2-3 hr after an IV injection of 1-2 mCi Tc-99m-pertechnetate (360/sup 0/ rotation, 60 views, 64 x 64 matrix, 50K cts/view). Reconstruction in three planes was performed using MDS software (Hanning medium resolution filter, with or without attenuation correction using Sorenson's technique). For each clinical study, a ring type phantom source was used to identify the level of reconstruction noise in the tomographic planes. Abnormalities were found in all patients studied, 3 central (moderate intensity), 2 peripheral (1 severe, 1 moderate) and 1 diffuse (mild intensity). Despite use of oral perchlorate (50 mg) in one patient the choroid plexus was visible. Since attenuation correction tended to amplify noise, the clinical studies were interpreted both with and without this correction. All 3 patients with central lesions were found abnormal on early (1-4 mo) neurologic follow-up examination, whereas the others were normal. No correlation was found between SPECT and 24 hr blood levels of CPK, ammonia, base excess, or the Apgar scores. Ct scans were reported abnormal (3 diffuse, 1 peripheral, 1 central and 1 questionable). Planar scintigrams obtained immediately after SPECT were normal (2), questionable (2) and abnormal (2). Follow-up SPECT brain scintigrams in two of the patients showed partial resolution. SPECT of the brain appears promising in perinatal asphyxia but long-term correlation with patient development is necessary.

  5. Metabolic effects of perinatal asphyxia in the rat cerebral cortex.

    Science.gov (United States)

    Souza, Samir Khal; Martins, Tiago Leal; Ferreira, Gustavo Dias; Vinagre, Anapaula Sommer; Silva, Roselis Silveira Martins da; Frizzo, Marcos Emilio

    2013-03-01

    We reported previously that intrauterine asphyxia acutely affects the rat hippocampus. For this reason, the early effects of this injury were studied in the cerebral cortex, immediately after hysterectomy (acute condition) or following a recovery period at normoxia (recovery condition). Lactacidemia and glycemia were determined, as well as glycogen levels in the muscle, liver and cortex. Cortical tissue was also used to assay the ATP levels and glutamate uptake. Asphyxiated pups exhibited bluish coloring, loss of movement, sporadic gasping and hypertonia. However, the appearance of the controls and asphyxiated pups was similar at the end of the recovery period. Lactacidemia and glycemia were significantly increased by asphyxia in both the acute and recovery conditions. Concerning muscle and hepatic glycogen, the control group showed significantly higher levels than the asphyxic group in the acute condition and when compared with groups of the recovery period. In the recovery condition, the control and asphyxic groups showed similar glycogen levels. However, in the cortex, the control groups showed significantly higher glycogen levels than the asphyxic group, in both the acute and recovery conditions. In the cortical tissue, asphyxia reduced ATP levels by 70 % in the acute condition, but these levels increased significantly in asphyxic pups after the recovery period. Asphyxia did not affect glutamate transport in the cortex of both groups. Our results suggest that the cortex uses different energy resources to restore ATP after an asphyxia episode followed by a reperfusion period. This strategy could sustain the activity of essential energy-dependent mechanisms. PMID:23196669

  6. Circulatory responses to asphyxia differ if the asphyxia occurs in utero or ex utero in near-term lambs.

    Directory of Open Access Journals (Sweden)

    Kristina S Sobotka

    Full Text Available A cornerstone of neonatal resuscitation teaching suggests that a rapid vagal-mediated bradycardia is one of the first signs of perinatal compromise. As this understanding is based primarily on fetal studies, we investigated whether the heart rate and blood pressure response to total asphyxia is influenced by whether the animal is in utero or ex utero.Fetal sheep were instrumented at ∼ 139 days of gestation and then asphyxiated by umbilical cord occlusion until mean arterial blood pressure decreased to ∼ 20 mmHg. Lambs were either completely submerged in amniotic fluid (in utero; n = 8 throughout the asphyxia or were delivered and then remained ex utero (ex utero; n = 8 throughout the asphyxia. Heart rate and arterial blood pressure were continuously recorded.Heart rate was higher in ex utero lambs than in utero lambs. Heart rates in in utero lambs rapidly decreased, while heart rates in ex utero lambs initially increased following cord occlusion (for ∼ 1.5 min before they started to decrease. Mean arterial pressure initially increased then decreased in both groups.Heart rate response to asphyxia was markedly different depending upon whether the lamb was in utero or ex utero. This indicates that the cardiovascular responses to perinatal asphyxia are significantly influenced by the newborn's local environment. As such, based solely on heart rate, the stage and severity of a perinatal asphyxic event may not be as accurate as previously assumed.

  7. A Study on Birth Asphyxia at Tertiary Health Centre

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    Ekta A Dalal

    2013-08-01

    Methodology: This was the cross sectional study conducted in the tertiary care centre of Ahmedabad on the full term babies with birth asphyxia. The maternal, fetal and newborn correlates were recorded according to predesigned proforma. Results: There were total 401 (6.6% babies born with apgar score of less than 7 at one minute and among them, 320 (79.8% were full term babies and 81 (20.2% were preterm babies. Among the babies 52.5% were male, 56.9% were primigravida, and only 41.9% had antenatal care present, 42.2% had MSL and 47.2% were small for date babies. Conclusion: Birth asphyxia is common the babies of the mother who had not received proper antenatal care. Maternal anaemia, primipara, meconium stained liquor babies have more chances of getting birth asphyxia. [Natl J Med Res 2013; 3(4.000: 374-376

  8. Perinatal asphyxia: CNS development and deficits with delayed onset

    Directory of Open Access Journals (Sweden)

    Mario eHerrera-Marschitz

    2014-03-01

    Full Text Available Perinatal asphyxia constitutes a prototype of obstetric complications occurring when pulmonary oxygenation is delayed or interrupted. The primary insult relates to the duration of the period lacking oxygenation, leading to death if not re-established. Re-oxygenation leads to a secondary insult, related to a cascade of biochemical events required for restoring proper function. Perinatal asphyxia interferes with neonatal development, resulting in long-term deficits associated to mental and neurological diseases with delayed clinical onset, by mechanisms not yet clarified.In the experimental scenario, the effects observed long after perinatal asphyxia have been explained by over expression of sentinel proteins, such as poly(ADP-ribose polymerase-1 (PARP-1, competing for NAD+ during re-oxygenation, leading to the idea that sentinel protein inhibition constitutes a suitable therapeutic strategy. Asphyxia induces transcriptional activation of pro-inflammatory factors, in tandem with PARP-1 overactivation, and pharmacologically induced PARP-1 inhibition also down-regulates the expression of proinflammatory cytokines. Nicotinamide has been proposed as a suitable PARP-1 inhibitor. Its effect has been studied in an experimental model of global hypoxia in rats. In that model, the insult is induced by immersing rat foetuses into a water bath for various periods of time. Following asphyxia, the pups are delivered, treated, and nursed by surrogate dams, pending further experiments. Nicotinamide rapidly distributes into the brain following systemic administration, reaching steady state concentrations sufficient to inhibit PARP-1 activity for several hours, preventing several of the long-term consequences of perinatal asphyxia, supporting the idea that it constitutes a lead for exploring compounds with similar or better pharmacological profiles.

  9. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    BACKGROUND: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies. METHODS: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate...... neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat. RESULTS: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3...

  10. Asphyxia: a rare cause of death for motor vehicle crash occupants.

    Science.gov (United States)

    Conroy, Carol; Stanley, Christina; Eastman, A Brent; Vaughan, Teresa; Vilke, Gary M; Hoyt, David B; Pacyna, Sharon; Smith, Alan

    2008-03-01

    Motor vehicle related trauma is one of the leading causes of traumatic death. Although most of these deaths are because of severe blunt force trauma, there are people without severe injury who die of asphyxia related to the motor vehicle collision. There were 37 deaths because of motor vehicle related asphyxia in San Diego County during 1995-2004. Almost half (48.6%) of these deaths were because of compression asphyxia, 29.7% were positional asphyxia deaths, and 16.2% died of a combination of compression and positional asphyxia. We were unable to classify the mechanism of asphyxia for the remaining 5.4% of asphyxia deaths. Almost all occupants dying from asphyxia were involved in rollover crashes and may have been incapacitated by obesity, drug or alcohol intoxication, or blunt force trauma. Compression asphyxia deaths occurred both from vehicle crush with intrusion into the passenger compartment and from ejection of the occupant and subsequent crushing by the vehicle. Positional asphyxia occurred in positions interfering with normal respiration, including inversion. None of the occupants had injury severe enough to result in death at the scene if they had not first died of asphyxia. This study suggests classifying the mechanism of asphyxia for these fatalities may be a challenge to forensic pathologists who seldom see these rare deaths.

  11. Long-Term Cognitive Outcomes of Birth Asphyxia and the Contribution of Identified Perinatal Asphyxia to Cerebral Palsy.

    Science.gov (United States)

    Pappas, Athina; Korzeniewski, Steven J

    2016-09-01

    Neonatal encephalopathy among survivors of presumed perinatal asphyxia is recognized as an important cause of cerebral palsy (CP) and neuromotor impairment. Recent studies suggest that moderate to severe neonatal encephalopathy contributes to a wide range of neurodevelopmental and cognitive impairments among survivors with and without CP. Nearly 1 of every 4 to 5 neonates treated with hypothermia has or develops CP. Neonatal encephalopathy is diagnosed in only approximately 10% of all cases. This article reviews the long-term cognitive outcomes of children with presumed birth asphyxia and describes what is known about its contribution to CP. PMID:27524454

  12. Quality of general movements in term infants with asphyxia

    NARCIS (Netherlands)

    van Iersel, Patricia A. M.; Bakker, Saskia C. M.; Jonker, Arnold J. H.; Hadders-Algra, Mijna

    2009-01-01

    Background: Perinatal asphyxia may result in a developmental disorder. A recently developed non-invasive toot to investigate brain function at an early age is the assessment of general movements (GMs). Aim: To evaluate relationships between perinatal risk factors and the quality of GMs in the neonat

  13. Arterial blood gas analysis and electrolyte determination in neonates with asphyxia

    Institute of Scientific and Technical Information of China (English)

    Zi-Mei Sun

    2015-01-01

    Objective:To explore the value of arterial blood gas analysis and electrolyte determination in the diagnosis of neonatal asphyxia.Methods: A total of 100 neonates with asphyxia who were admitted in our department from March, 2013 to March, 2014 were included in the study and divided into the mild asphyxia group and the severe asphyxia group according to Apgar scoring. Moreover, 50 normal neonates were served as the control group and used for comparative analysis. AVL blood-gas analyzer was used to detect the levels of pH, PaO2, HCO3-, BE, PaCO2, K+, Na+, Cl-, and Ca2+.Results:The concentrations of pH, PaO2, HCO3-, and BE in the severe asphyxia group were significantly lower than those in the mild asphyxia group and the control group, while PaCO2 level was significantly higher than that in the mild asphyxia group and the control group. The comparison of the various indicators between the control group and the mild asphyxia group was not statistically significant. The comparison of serum K+, Na+,and Cl- levels among the control group, the mild asphyxia group, and the severe asphyxia group was not statistically significant. The serum Ca2+ level in the severe asphyxia group was significantly lower than that in the mild asphyxia group and the control group, while the comparison between the mild asphyxia group and the control group was also statistically significant.Conclusions:Blood gas analysis and electrolyte determination to the arterial blood in neonates can compensate for the insufficiency of Apgar scoring and provide an objective evidence for the diagnosis of neonatal asphyxia and the estimation of severity degree. Clinical combination with Apgar scoring is of great significance in enhancing the diagnosis of neonatal asphyxia and the accuracy of severity evaluation.

  14. Cerebellar cytokine expression in a rat model for fetal asphyctic preconditioning and perinatal asphyxia

    DEFF Research Database (Denmark)

    Vlassaks, Evi; Brudek, Tomasz; Pakkenberg, Bente;

    2014-01-01

    was decreased 96 h postfetal asphyxia. When applied as preconditioning stimulus, fetal asphyxia attenuates the cerebellar cytokine response. These results indicate that sublethal fetal asphyxia may protect the cerebellum from perinatal asphyxia-induced damage via inhibition of inflammation.......Asphyctic brain injury is a major cause of neuronal inflammation in the perinatal period. Fetal asphyctic preconditioning has been shown to modulate the cerebral inflammatory cytokine response, hereby protecting the brain against asphyctic injury at birth. This study was designated to examine...... the effects of perinatal asphyxia and fetal asphyctic preconditioning on the inflammatory cytokine response in the cerebellum. Fetal asphyxia was induced at embryonic day 17 by clamping the uterine vasculature for 30 min. At term birth, global perinatal asphyxia was induced by placing the uterine horns...

  15. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    OpenAIRE

    P Benson Ham; Pinkal Patel; Linda J. Wise; Christian Walters; Stansfield, Brian K.

    2015-01-01

    Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO) and discuss the role of cardiac biomarkers, echocardiography, electrocardiog...

  16. Somatosensory evoked potentials and outcome in perinatal asphyxia.

    OpenAIRE

    Gibson, N A; Graham, M.; Levene, M I

    1992-01-01

    Somatosensory evoked potentials (SEP) can be measured in the term newborn infant and given an index of function in the areas of the brain most likely to be damaged in perinatal asphyxia. We studied the median nerve SEP in 30 asphyxiated term infants over the course of their encephalopathy and until discharge from the neonatal unit. Three types of response were noted: normal waveform, abnormal waveform, or absence of cortical response. Follow up of the survivors was undertaken at a mean age of...

  17. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    P. Benson Ham

    2015-05-01

    Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

  18. Clinical study of umbilical artery blood gas analysis and Apgar score in evaluation of neonatal asphyxia%脐动脉血气分析和Apgar评分评估新生儿窒息的临床探讨

    Institute of Scientific and Technical Information of China (English)

    余燕红; 陈影; 陈少君

    2014-01-01

    目的:探讨脐动脉血气分析及Apgar评分在评估新生儿窒息中的临床意义。方法选择2012年3月~2013年3月广东省肇庆市第二人民医院分娩的84例新生儿作为研究对象,其中34例窒息新生儿为观察组,50例正常新生儿为对照组。分析两组新生儿出生时Apgar评分及脐动脉血血气分析与脏器损伤的关系,脐动脉血pH值与出生1 min Apgar评分的关系。结果观察组中,pH值<7.2者占38.2%,对照组中pH值<7.2者占16.0%,脐动脉血pH值较低的患儿,Apgar评分也较低,同时窒息的发生率较高,差异均有统计学意义(P<0.05)。结论评估新生儿窒息不能没有血气分析的结果,脐动脉血气分析比Apgar评分对评估新生儿窒息更具客观性,两者结合,能反映胎儿宫内缺氧缺血程度,为临床正确及时诊断新生儿窒息提供可靠的科学依据。%Objective To discuss the clinical significance of umbilical artery blood gas analysis and Apgar score in e-valuation of clinical significance in newborns with asphyxia. Methods 84 newborns from March 2012 to March 2013 in the Second People's Hospital of Zhaoqing City in Guangdong Province were selected as study objects, of which 34 newborns with asphyxia were as observation group, and 50 normal newborns were as control group. The relation be-tween the Apgar score at the time of birth, umbilical artery blood gas analysis and visceral injury, and the relation be-tween umbilical arterial pH and Apgar score in 1 min after birth were analyzed. Results In the asphyxia group, new-borns with pH <7.2 accounted for 38.2%, and in the control group, newborns with pH <7.2 accounted for 16.0%, um-bilical artery blood pH value was lower in children who with low Apgar score, at the same time, the rate of asphyxia neonatorum was higher, the differentese were statistically significant (P< 0.05) . Conclusion Assessment of neonatal asphyxia can not be done without blood gas analysis

  19. Evaluation and prognosis of neonates with asphyxia treated by hypothermia

    Directory of Open Access Journals (Sweden)

    Abdollah Jannatdoust

    2015-04-01

    Full Text Available Background: Asphyxia is a perinatal accident with a high mortality rate, therapeutic hypothermia in both head or whole body was suggested as effective therapeutic methods. In this study, we compare these methods in neonates with asphyxia. Methods and Materials: 16 neonates with asphyxia in two hospitals including Alzahra(head hypothermia and Taleghani hospital (total body hypothermia went under the therapeutic hypothermia for 72 hours. Maintaining temperature controlled by several sensors precisely. Body cooling were performed on the trunk and limbs of the neonates. Temperature and vital signs controlled every 1 hour and biochemistry, and coagulation tests were performed regularly, early and late complications of patients including developmental disorders, were evaluated. Comparing two groups was performed using Chi square and Mann Whitney U test, on the software SPSS16 , p less than 0.05 was significant. Results: 16 cases with gestation age of 38 ± 2weeks were enrolled. Of 9 cases by head cooling 1 patient died and 2 patients got mild developmental disorders. Of the 7 newborns of whole body cooling trail, 3 died and 1 got minor developmental disorders and one case showed major.. Feeding time (head group 5±2 , body group 8±5 days and also discharge time (head group 15±8 days and body group 14±5 days had no significant differences . Conclusion: It seems head hypothermia method is associated with a lower mortality than the whole body method. In the above sample size, the differences were not statistically significant. Performing these procedures on larger samples could be approval.

  20. Cardiovascular Alterations and Multiorgan Dysfunction After Birth Asphyxia.

    Science.gov (United States)

    Polglase, Graeme R; Ong, Tracey; Hillman, Noah H

    2016-09-01

    The cardiovascular response to asphyxia involves redistribution of cardiac output to maintain oxygen delivery to critical organs such as the adrenal gland, heart, and brain, at the expense of other organs such as the gut, kidneys and skin. This redistribution results in reduced perfusion and localized hypoxia/ischemia in these organs, which, if severe, can result in multiorgan failure. Liver injury, coagulopathy, bleeding, thrombocytopenia, renal dysfunction, and pulmonary and gastrointestinal injury all result from hypoxia, underperfusion, or both. Current clinical therapies need to be considered together with therapeutic hypothermia and cardiovascular recovery. PMID:27524448

  1. Correlation between serumβ2 microglobulin and early kidney injury post neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    Jun-Xia Liu; Hui-Qin Wang; Na Zhang; Wei-Na Lu; Xin Zhang

    2016-01-01

    Objective:To investigate serumβ2 microglobulin and neonatal asphyxia early renal damage correlation.Methods:A total of 84 suffocation full-term newborns in our hospital from 2012 March to 2014 November. According to the Apgar standards, divided into severe asphyxia group (n=36) and mild asphyxia group (n=48), and selected 40 cases of full-term newborn, observed blood and urinaryβ2-MG, albumin (Alb) blood urea nitrogen (BUN), creatinine (Cr) level.Results:severe asphyxia groupβ2-MG (6.02±0.96) mg/L was the highest, followed by mild asphyxia group, lowest in the control group; severe asphyxia group Alb, BUN and Cr were (22.15±6.17) mg/L, (10.01±1.84) mmol/L and (120.16±28.13)μmol/L, significantly higher than the mild asphyxia group and the control group; Mild asphyxia group and the control group Alb, BUN and Cr were not statistically significant; three groups birth 48 h,β2-MG, Alb, serum BUN and Cr showed significant differences, in which the severe asphyxia groupβ2-MG, Alb, BUN and Cr were the highest, and lowest in the control group; Severe asphyxia group was the highestβ2-MG, (7.12±1.32) mg/L; serumβ2-MG were positively associated with urineβ2-MG.Conclusion: Serumβ2-2 microglobulin in judging neonatal asphyxia early renal damage is more sensitive, and has clinical practical value.

  2. Virtopsy versus autopsy in unusual case of asphyxia: case report.

    Science.gov (United States)

    Aquila, I; Falcone, C; Di Nunzio, C; Tamburrini, O; Boca, S; Ricci, P

    2013-06-10

    We report the case of a 70-year-old woman found dead in her apartment in the South of Italy in February 2011. The detailed data showed that the victim was affected by familiar-type paranoid schizophrenia. This finding was confirmed by the discovery of antipsychotic and tricyclic antidepressant drugs in the house and the deposition of her psychiatric therapist. Before the autopsy, a multislice computed tomography (MSCT) scanning of the thoracic and facial maxillo-cervical area was performed that has allowed anatomical identification and diagnosis of a mechanical obstruction as the cause of death. The autopsy has showed the presence of materials obstructing the trachea totally. Histological and toxicological investigations were carried out on the victim. The toxicological investigation has shown the presence of metabolites of tricyclic antidepressants and antipsychotics in the blood and urine. The histology showed the presence of foreign-origin materials (starch fibres) inside the pulmonary alveolus. The cause of death was asphyxia due to obstruction by food-origin material. In this case the radiological data have been compared with the autopsy and toxicological and histological data. The comparison of results has shown that MSCT scanning may aid in identification of occlusion and then in determination of the cause of death. In conclusion, MSCT scanning can be proposed in the cases of suspected asphyxia, as the screening procedure of first instance to produce preliminary information useful to rapidly develop the successive autopsy performance. PMID:23582265

  3. Effect of therapeutic hypothermia on chromosomal aberration in perinatal asphyxia

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    Bahubali D Gane

    2016-01-01

    Full Text Available Introduction: Perinatal asphyxia is a major cause for neonatal mortality and morbidity around the world. The reduction of O2results in the generation of reactive oxygen species which interact with nucleic acid and make alteration in the structure and functioning of the genome. We studied the effect of therapeutic hypothermia on chromosomes with karyotyping. Subjects and Methods: Babies in the hypothermia group were cooled for the first 72 h, using gel packs. Rectal temperature of 33–34°C was maintained. Blood sample was collected after completion of therapeutic hypothermia for Chromosomal analysis. It was done with IKAROS Karyotyping system, Metasystems, based on recommendations of International system of human cytogenetic nomenclature. Results: The median chromosomal aberration was lower in hypothermia [2(0-5] than control group [4(1-7] and chromatid breakage was commonest aberration seen. Chromosomal aberration was significantly higher in severe encephalopathy group than moderate encephalopathy group. Conclusion: We conclude that the TH significantly reduces DNA damage in perinatal asphyxia.

  4. Current Controversies in Newer Therapies to Treat Birth Asphyxia

    Directory of Open Access Journals (Sweden)

    Pia Wintermark

    2011-01-01

    Full Text Available Despite major advances in monitoring technology and knowledge of fetal and neonatal pathophysiology, neonatal hypoxic-ischemic encephalopathy (HIE remains one of the main causes of severe adverse neurological outcome in children. Until recently, there were no therapies other than supportive measures. Over the past several years, mild hypothermia has been proven to be safe to treat HIE. Unfortunately, this neuroprotective strategy seems efficient in preventing brain injury in some asphyxiated newborns, but not in all of them. Thus, there is increasing interest to rapidly understand how to refine hypothermia therapy and add neuroprotective or neurorestorative strategies. Several promising newer treatments to treat birth asphyxia and prevent its devastating neurological consequences are currently being tested. In this paper, the physiopathology behind HIE, the currently available treatment, the potential alternatives, and the next steps before implementation of these other treatments are reviewed.

  5. A Rare and Serious Syndrome That Requires Attention in Emergency Service: Traumatic Asphyxia

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    Gultekin Gulbahar

    2015-01-01

    Full Text Available Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature.

  6. Gastroesophageal manometry and 24-hour double pH monitoring in neonates with birth asphyxia

    Institute of Scientific and Technical Information of China (English)

    Mei Sun; Wei-Lin Wang; Wei Wang; De-Liang Wen; Hui Zhang; Yu-Kun Han

    2001-01-01

    @@ INTRODUCTION Birth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.

  7. The Behaviour of Protein Carbonyls in Newborns with Birth Respiratory Distress and Asphyxia

    OpenAIRE

    Zaharie, Gabriela; Antonia POPESCU; BLAGA, LIGIA; Melinda MATYAS

    2009-01-01

    Objective: A prospective study was carried out in premature newborns with respiratory distress syndrome (RDS) and asphyxia at birth in order to identify and analyze the effects of RDS on proteins. Material and Methods: Protein peroxidation was studied using the Reznick spectrophotometric method. The study group included 14 premature newborns with respiratory distress and asphyxia at birth. The control group included 13 newborns that were born on term, eutrophic and healthy. The determinations...

  8. Electroencephalogram abnormalities in full term infants with history of severe asphyxia

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    Susanti Halim

    2016-11-01

    Full Text Available ingtool used to determine developmental and electrical problemsin the brain. A history of severe asphyxia is a risk factor for thesebrain problems in infants.Objective To evaluate the prevalence of abnormal EEGs infull term neonates and to assess for an association with severeasphyxia, hypoxic ischemic encephalopathy (HIE, and spontaneousdelivery.Methods This cross-sectional study was conducted at thePediatric Outpatient Department of Sanglah Hospital, Denpasar,from November 2013 to January 2014. Subjects were fullterminfants aged 1 month who were delivered and/or hospitalized atSanglah Hospital. All subjects underwent EEG. The EEGs wereinterpreted by a pediatric neurology consultant, twice, with aweek interval between readings. Clinical data were obtainedfrom medical records. Association between abnormal ECG andsevere asphyxia were analyzed by Chi-square and multivariablelogistic analyses.Results Of 55 subjects, 27 had a history of severe asphyxia and 28were vigorous babies. Forty percent (22/55 of subjects had abnormalEEG findings, 19/22 of these subjects having history of severeasphyxia, 15/22 had history of hypoxic-ischemic encephalopathy(HIE, and 20/22 were delievered vaginally. There were strongcorrelations between the prevalence of abnormal EEG and historyof severe asphyxia, HIE, and spontaneous delivery.Conclusion Prevalence of abnormal EEG among full-term neonatesreferred to neurology/growth development clinic is around40%, with most of them having a history of severe asphyxia. AbnormalEEG is significantly associated to severe asphyxia, HIE, andspontaneous delivery.

  9. Connexin Hemichannel Blockade Is Neuroprotective after Asphyxia in Preterm Fetal Sheep

    Science.gov (United States)

    Davidson, Joanne O.; Drury, Paul P.; Green, Colin R.; Nicholson, Louise F.; Bennet, Laura; Gunn, Alistair J.

    2014-01-01

    Asphyxia around the time of preterm birth is associated with neurodevelopmental disability. In this study, we tested the hypothesis that blockade of connexin hemichannels would improve recovery of brain activity and reduce cell loss after asphyxia in preterm fetal sheep. Asphyxia was induced by 25 min of complete umbilical cord occlusion in preterm fetal sheep (103–104 d gestational age). Connexin hemichannels were blocked by intracerebroventricular infusion of mimetic peptide starting 90 min after asphyxia at a concentration of 50 µM/h for one hour followed by 50 µM/24 hour for 24 hours (occlusion-peptide group, n = 6) or vehicle infusion for controls (occlusion-vehicle group, n = 7). Peptide infusion was associated with earlier recovery of electroencephalographic power after asphyxia compared to occlusion-vehicle (p<0.05), with reduced neuronal loss in the caudate and putamen (p<0.05), but not in the hippocampus. In the intragyral and periventricular white matter, peptide administration was associated with an increase in total oligodendrocyte numbers (p<0.05) and immature/mature oligodendrocytes compared to occlusion-vehicle (p<0.05), with a significant increase in proliferation (p<0.05). Connexin hemichannel blockade was neuroprotective and reduced oligodendrocyte death and improved recovery of oligodendrocyte maturation in preterm fetuses after asphyxia. PMID:24865217

  10. Traumatic asphyxia due to blunt chest trauma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Sertaridou Eleni

    2012-08-01

    Full Text Available Abstract Introduction Crush asphyxia is different from positional asphyxia, as respiratory compromise in the latter is caused by splinting of the chest and/or diaphragm, thus preventing normal chest expansion. There are only a few cases or small case series of crush asphyxia in the literature, reporting usually poor outcomes. Case presentation We present the case of a 44-year-old Caucasian man who developed traumatic asphyxia with severe thoracic injury and mild brain edema after being crushed under heavy auto vehicle mechanical parts. He remained unconscious for an unknown time. The treatment included oropharyngeal intubation and mechanical ventilation, bilateral chest tube thoracostomies, treatment of brain edema and other supportive measures. Our patient’s outcome was good. Traumatic asphyxia is generally under-reported and most authors apply supportive measures, while the final outcome seems to be dependent on the length of time of the chest compression and on the associated injuries. Conclusion Treatment for traumatic asphyxia is mainly supportive with special attention to the re-establishment of adequate oxygenation and perfusion; treatment of the concomitant injuries might also affect the final outcome.

  11. Connexin hemichannel blockade is neuroprotective after asphyxia in preterm fetal sheep.

    Directory of Open Access Journals (Sweden)

    Joanne O Davidson

    Full Text Available Asphyxia around the time of preterm birth is associated with neurodevelopmental disability. In this study, we tested the hypothesis that blockade of connexin hemichannels would improve recovery of brain activity and reduce cell loss after asphyxia in preterm fetal sheep. Asphyxia was induced by 25 min of complete umbilical cord occlusion in preterm fetal sheep (103-104 d gestational age. Connexin hemichannels were blocked by intracerebroventricular infusion of mimetic peptide starting 90 min after asphyxia at a concentration of 50 µM/h for one hour followed by 50 µM/24 hour for 24 hours (occlusion-peptide group, n = 6 or vehicle infusion for controls (occlusion-vehicle group, n = 7. Peptide infusion was associated with earlier recovery of electroencephalographic power after asphyxia compared to occlusion-vehicle (p<0.05, with reduced neuronal loss in the caudate and putamen (p<0.05, but not in the hippocampus. In the intragyral and periventricular white matter, peptide administration was associated with an increase in total oligodendrocyte numbers (p<0.05 and immature/mature oligodendrocytes compared to occlusion-vehicle (p<0.05, with a significant increase in proliferation (p<0.05. Connexin hemichannel blockade was neuroprotective and reduced oligodendrocyte death and improved recovery of oligodendrocyte maturation in preterm fetuses after asphyxia.

  12. Somatostatin modulates generation of inspiratory rhythms and determines asphyxia survival.

    Science.gov (United States)

    Ramírez-Jarquín, Josué O; Lara-Hernández, Sergio; López-Guerrero, Juan J; Aguileta, Miguel A; Rivera-Angulo, Ana J; Sampieri, Alicia; Vaca, Luis; Ordaz, Benito; Peña-Ortega, Fernando

    2012-04-01

    Breathing and the activity of its generator (the pre-Bötzinger complex; pre-BötC) are highly regulated functions. Among neuromodulators of breathing, somatostatin (SST) is unique: it is synthesized by a subset of glutamatergic pre-BötC neurons, but acts as an inhibitory neuromodulator. Moreover, SST regulates breathing both in normoxic and in hypoxic conditions. Although it has been implicated in the neuromodulation of breathing, neither the locus of SST modulation, nor the receptor subtypes involved have been identified. In this study, we aimed to fill in these blanks by characterizing the SST-induced regulation of inspiratory rhythm generation in vitro and in vivo. We found that both endogenous and exogenous SST depress all preBötC-generated rhythms. While SST abolishes sighs, it also decreases the frequency and increases the regularity of eupnea and gasping. Pharmacological experiments showed that SST modulates inspiratory rhythm generation by activating SST receptor type-2, whose mRNA is abundantly expressed in the pre-Bötzinger complex. In vivo, blockade of SST receptor type-2 reduces gasping amplitude and consequently, it precludes auto-resuscitation after asphyxia. Based on our findings, we suggest that SST functions as an inhibitory neuromodulator released by excitatory respiratory neurons when they become overactivated in order to stabilize breathing rhythmicity in normoxic and hypoxic conditions.

  13. Long lasting cerebellar alterations after perinatal asphyxia in rats.

    Science.gov (United States)

    Campanille, Verónica; Saraceno, G Ezequiel; Rivière, Stéphanie; Logica, Tamara; Kölliker, Rodolfo; Capani, Francisco; Castilla, Rocío

    2015-07-01

    The developing brain may be particularly vulnerable to injury before, at and after birth. Among possible insults, hypoxia suffered as a consequence of perinatal asphyxia (PA) exhibits the highest incidence levels and the cerebellar circuitry appears to be particularly susceptible, as the cellular makeup and the quantity of inputs change quickly during days and weeks following birth. In this work, we have used a murine model to induce severe global PA in rats at the time of birth. Short-term cerebellar alterations within this PA model have been previously reported but whether such alterations remain in adulthood has not been conclusively determined yet. For this reason, and given the crucial cerebellar role in determining connectivity patterns in the brain, the aim of our work is to unveil long-term cerebellum histomorphology following a PA insult. Morphological and cytological neuronal changes and glial reaction in the cerebellar cortex were analyzed at postnatal 120 (P120) following injury performed at birth. As compared to control, PA animals exhibited: (1) an increase in molecular and granular thickness, both presenting lower cellular density; (2) a disarrayed Purkinje cell layer presenting a higher number of anomalous calbindin-stained cells. (3) focal swelling and marked fragmentation of microtubule-associated protein 2 (MAP-2) in Purkinje cell dendrites and, (4) an increase in glial fibrillary acidic protein (GFAP) expression in Bergmann cells and the granular layer. In conclusion, we demonstrate that PA produces long-term damage in cellular histomorphology in rat cerebellar cortex which could be involved in the pathogenesis of cognitive deficits observed in both animals and humans.

  14. Long lasting cerebellar alterations after perinatal asphyxia in rats.

    Science.gov (United States)

    Campanille, Verónica; Saraceno, G Ezequiel; Rivière, Stéphanie; Logica, Tamara; Kölliker, Rodolfo; Capani, Francisco; Castilla, Rocío

    2015-07-01

    The developing brain may be particularly vulnerable to injury before, at and after birth. Among possible insults, hypoxia suffered as a consequence of perinatal asphyxia (PA) exhibits the highest incidence levels and the cerebellar circuitry appears to be particularly susceptible, as the cellular makeup and the quantity of inputs change quickly during days and weeks following birth. In this work, we have used a murine model to induce severe global PA in rats at the time of birth. Short-term cerebellar alterations within this PA model have been previously reported but whether such alterations remain in adulthood has not been conclusively determined yet. For this reason, and given the crucial cerebellar role in determining connectivity patterns in the brain, the aim of our work is to unveil long-term cerebellum histomorphology following a PA insult. Morphological and cytological neuronal changes and glial reaction in the cerebellar cortex were analyzed at postnatal 120 (P120) following injury performed at birth. As compared to control, PA animals exhibited: (1) an increase in molecular and granular thickness, both presenting lower cellular density; (2) a disarrayed Purkinje cell layer presenting a higher number of anomalous calbindin-stained cells. (3) focal swelling and marked fragmentation of microtubule-associated protein 2 (MAP-2) in Purkinje cell dendrites and, (4) an increase in glial fibrillary acidic protein (GFAP) expression in Bergmann cells and the granular layer. In conclusion, we demonstrate that PA produces long-term damage in cellular histomorphology in rat cerebellar cortex which could be involved in the pathogenesis of cognitive deficits observed in both animals and humans. PMID:26116983

  15. Using uterine activity to improve fetal heart rate variability analysis for detection of asphyxia during labor.

    Science.gov (United States)

    Warmerdam, G J J; Vullings, R; Van Laar, J O E H; Van der Hout-Van der Jagt, M B; Bergmans, J W M; Schmitt, L; Oei, S G

    2016-03-01

    During labor, uterine contractions can cause temporary oxygen deficiency for the fetus. In case of severe and prolonged oxygen deficiency this can lead to asphyxia. The currently used technique for detection of asphyxia, cardiotocography (CTG), suffers from a low specificity. Recent studies suggest that analysis of fetal heart rate variability (HRV) in addition to CTG can provide information on fetal distress. However, interpretation of fetal HRV during labor is difficult due to the influence of uterine contractions on fetal HRV. The aim of this study is therefore to investigate whether HRV features differ during contraction and rest periods, and whether these differences can improve the detection of asphyxia. To this end, a case-control study was performed, using 14 cases with asphyxia that were matched with 14 healthy fetuses. We did not find significant differences for individual HRV features when calculated over the fetal heart rate without separating contractions and rest periods (p  >  0.30 for all HRV features). Separating contractions from rest periods did result in a significant difference. In particular the ratio between HRV features calculated during and outside contractions can improve discrimination between fetuses with and without asphyxia (p  <  0.04 for three out of four ratio HRV features that were studied in this paper). PMID:26862891

  16. Clinical significance of determination of serum cortisol and insulin levels in neonates with asphyxia

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical significance of the changes of serum cortisol and insulin levels in neonates with asphyxia. Methods: Serum cortisol levels were determined with CLIA and serum insulin levels with RIA in 38 neonates with asphyxia (mild degree 20, advanced 18) and 30 controls. Results: 1) In mild cases, serum insulin levels were significantly higher than those in controls (p<0.01) and serum cortisol levels were very significantly higher (p<0.001). 2) In advanced cases, both serum insulin and cortisol levels were very significantly higher than those in the controls (p<0.001). Conclusion: Hypoxia in the neonates with asphyxia is a very severe stress and will induce hypersecretion of cortisol and hyperglycemia which is detrimental to the patients. However hypersecretion of insulin will result in hypoglycemia, which is also very damaging. Physicians in charge should be aware of these possibilities and deal with them appropriately

  17. Perinatal risk factors for neonatal asphyxia in Vali-e-Asr hospital, Tehran-Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Nayeri

    2012-01-01

    Full Text Available Background: Asphyxia is a medical condition in which placental or pulmonary gas exchange is impaired or they cease all together, typically producing a combination of progressive hypoxemia and hypercapnea. Objective: In addition to regional differences in its etiology; it is important to know its risk factors. Materials and Methods: This is a case-control study, all neonates born from May 2002 to September 2005 in Vali-e-Asr Hospital were studied. 9488 newborns were born of which 6091 of the live patients were hospitalized in NICU. 546 newborns were studied as case and control group. 260 neonates (48% were female and 286 neonates (52% were male. Among the neonates who were admitted, 182 of them were diagnosed with asphyxia and twice of them (364 newborns were selected as a control group. The variables consist of; gestational age, type of delivery, birth weight, prenatal care, pregnancy and peripartum complications and neonatal disorders. Results: Our studies showed that 35 (19.2% patients had mild asphyxia, 107 (58.8% had moderate asphyxia and 40 (22% were diagnosed as severe asphyxia. Mean maternal age was 34.23±4.29yr; (range: 23-38 yr; and mean of parity was 2±1.2; (range: 1-8. Risk factors in our study included emergent Caesarian Section, preterm labor (<37w, low birth weight (<2500g, 5 minute Apgar (less than 6, need for resuscitation, nuchal cord, impaired Biophysical Profile, neonatal anemia, and maternal infertility. Conclusion: All risk factors listed above play a role in asphyxia. The majority of these factors are avoidable by means of good perinatal care

  18. Asphyxia-related risk factors and their timing in spastic cerebral palsy

    DEFF Research Database (Denmark)

    Nielsen, Lene F.; Schendel, Diana; Grove, Jakob;

    2008-01-01

    Objective To investigate the association of asphyxia-related conditions (reducing blood flow or blood oxygen levels in the fetus) with spastic cerebral palsy (CP) considering different gestational age groups and the timing of risk. Design Population-based case-control study. Setting Danish Cerebral...... Palsy Register in eastern Denmark and Danish Medical Birth Register. Population or Sample 271 singletons with spastic CP and 217 singleton controls, frequency matched by gestational age group, born 1982-1990 in eastern Denmark. Methods Data were abstracted from medical records, and a priori asphyxia...

  19. PERINATAL ASPHYXIA-CLINICAL PROFILE IN M R A MEDICAL COLLEGE AMBEDKAR NAGAR UTTAR PRADESH

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    Bhavana

    2014-10-01

    Full Text Available BACKGROUND: Perinatal asphyxia is a condition during the first and second stage of labour in which impaired gas exchange leads to fetal hypoxia and hypercarbia. Perinatal asphyxia is a common cause of mortality and morbidity in neonatal intensive care units. Although many studies are there but no such study was available from the studied area. So this study was conducted to know the clinical correlations of perinatal asphyxia in this area. AIMS: This study was conducted to study various maternal and neonatal risk factors for perinatal asphyxia and to study the various clinical features of perinatal asphyxia with special reference to central nervous system and to grade the encephalopathy as per Sarnat and Sarnat staging. SETTINGS: Neonatal intensive care unit of MRA Medical College Ambedkar Nagar. DESIGN: Observational study. MATERIAL AND METHODS: Neonates admitted in NICU with history of perinatal asphyxia as per the definition by WHO. RESULTS: Various feto-maternal factors were associated with asphyxiated neonates. Those observed to be significantly associated with asphyxia (in decreasing order of risk included no antenatal check-ups (50%, home delivery (40%,fetal distress (25%, meconium stained liquor (23.3%, prolonged labour (20%, prolonged rupture of membranes(16.7% antepartum haemorrhage (13.3%,severe anemia (10%, eclampsia(8.3%,premature rupture of membrane (6.6%, obstructed labour (5%.In many of the cases more than one risk factor was associated. Of the total 120 asphyxiated neonates 80 (66.6% had encephalopathy. As per Sarnat and Sarnat staging 24(20% were in stage 1, 36(30% were in stage 2 and 20(16.6% were in stage 3 of Hypoxic Ischemic Encephalopathy. Other than neurological dysfunction symptoms which were also associated in asphyxiated newborn were feeding difficulties(75%, respiratory distress (25%, meconium aspiration syndrome(13.3%,acute renal Failure(8.3%,apnea(4.2%. CONCLUSION: Perinatal asphyxia is a common cause of morbidity

  20. Brain and Cognitive-Behavioural Development after Asphyxia at Term Birth

    Science.gov (United States)

    de Haan, Michelle; Wyatt, John S.; Roth, Simon; Vargha-Khadem, Faraneh; Gadian, David; Mishkin, Mortimer

    2006-01-01

    Perinatal asphyxia occurs in approximately 1-6 per 1000 live full-term births. Different patterns of brain damage can result, though the relation of these patterns to long-term cognitive-behavioural outcome remains under investigation. The hippocampus is one brain region that can be damaged (typically not in isolation), and this site of damage has…

  1. Therapeutic Hypothermia Modifies Perinatal Asphyxia-Induced Changes of the Corpus Callosum and Outcome in Neonates

    NARCIS (Netherlands)

    Alderliesten, Thomas; de Vries, Linda S.; Khalil, Yara; van Haastert, Ingrid C.; Benders, Manon J. N. L.; Koopman-Esseboom, Corine; Groenendaal, Floris

    2015-01-01

    What Is Known about this Subject? Diffusion-weighted MRI has demonstrated changes in the corpus callosum of term neonates with perinatal asphyxia. The severity of cerebral changes demonstrated using diffusion-weighted MRI is difficult to assess without measuring values of the Apparent Diffusion Coef

  2. Positional Asphyxia: Death Due to Unusual Head-Down Position in a Narrow Space.

    Science.gov (United States)

    Chaudhari, Vinod Ashok; Ghodake, Dattatray G; Kharat, Rajesh D

    2016-06-01

    Death due to a head-down position with hyperflexion of the neck is a rare event. A person accidentally falling into a narrow space and remaining in an upside-down position with no timely recovery may experience positional or postural asphyxia. It is a critical condition arising out of particular body positions, leading to mechanical obstruction of respiration. The precipitating factors are intoxication due to alcohol, drugs, obesity, psychiatric illnesses, and injuries. A 30-year-old unmarried woman, weighing 82 kg and with a body mass index of 31.24, was found in a narrow space between the bed and the wall in a naked state and in a head-down position with hyperflexion of the neck. The distribution of lividity was consistent with the position of the body at the scene. Blood was oozing from the mouth and nostrils, and signs of asphyxia were present. The toxicological analyses of viscera, blood, and urine were negative for alcohol, drugs, and poisons. Glucose levels in the blood (86 mg/dL) as well as urine and vitreous humor levels (68 mg/dL) were within normal limits. On microscopic examination, there were no findings of coronary atherosclerosis, whereas the brain and lung were edematous. After meticulous examination, we ruled out sexual assault, autoerotic asphyxia, epilepsy, psychiatric illness, diabetes, toxicity, and coronary artery disease. Death was attributed to the accidental fall of the obese individual being stuck in a narrow space, resulting in positional asphyxia. It is imperative to recognize the precipitating or risk factors before labeling positional asphyxia as a cause of death.

  3. Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case–control study

    Science.gov (United States)

    Lindqvist, Pelle G; Silva, Aldo T; Gustafsson, Sven A; Gidlöf, Sebastian

    2016-01-01

    Objective Vitamin D deficiency causes not only skeletal problems but also muscle weakness, including heart muscle. If the fetal heart is also affected, it might be more susceptible to fetal distress and birth asphyxia. In this pilot study, we hypothesised that low maternal vitamin D levels are over-represented in pregnancies with fetal distress/birth asphyxia. Design and setting A population-based nested case–control study. Patients Banked sera of 2496 women from the 12th week of pregnancy. Outcome measures Vitamin D levels were analysed using a direct competitive chemiluminescence immunoassay. Vitamin D levels in early gestation in women delivered by emergency caesarean section due to suspected fetal distress were compared to those in controls. Birth asphyxia was defined as Apgar caesarean section due to suspected fetal distress (n=53, 43.6±18 nmol/L) compared to controls (n=120, 48.6±19 nmol/L, p=0.04). Birth asphyxia was more common in women with vitamin D deficiency (n=95) in early pregnancy (OR 2.4, 95% CI 1.1 to 5.7). Conclusions Low vitamin D levels in early pregnancy may be associated with emergency caesarean section due to suspected fetal distress and birth asphyxia. If our findings are supported by further studies, preferably on severe birth asphyxia, vitamin D supplementation/sun exposure in pregnancy may lower the risk of subsequent birth asphyxia. PMID:27660312

  4. The murderer is the bed: an unusual case of death by traumatic asphyxia in a hotel folding bunk bed.

    Science.gov (United States)

    Domènech, Mercè Subirana; Alcázar, Helena Martínez; Pallarès, Antoni Aguilar; Vicente, Ignasi Galtés; García, Josep Castellà; Gutiérrez, Claudina Vidal; Muñiz, Jordi Medallo

    2012-07-10

    This paper presents the first referenced case on a death by traumatic asphyxia in a folding bunk bed. A middle-aged man was found dead in a hotel room trapped into a lower folding bunk bed where he had been sleeping after a party. The autopsy showed signs of asphyxia and excluded signs of struggle and sexual intercourse. Toxicological analyses revealed alcohol intoxication. A differential diagnosis of the manner of death including a technical study of the bed which contributed to understand the circumstances of death was made. The medico-legal investigation of the case strongly supported the hypothesis of an accidental death by traumatic asphyxia. PMID:22361389

  5. Therapeutic hypothermia modifies perinatal asphyxia-induced changes of the corpus callosum and outcome in neonates.

    Directory of Open Access Journals (Sweden)

    Thomas Alderliesten

    Full Text Available WHAT IS KNOWN ABOUT THIS SUBJECT?: Diffusion-weighted MRI has demonstrated changes in the corpus callosum of term neonates with perinatal asphyxia. The severity of cerebral changes demonstrated using diffusion-weighted MRI is difficult to assess without measuring values of the Apparent Diffusion Coefficient (ADC. WHAT IS NEW?: ADC values of the anterior part of the corpus callosum are slightly higher than of the posterior part in full term infants with perinatal asphyxia. Low ADC values of the corpus callosum were associated with an adverse outcome in infants with perinatal asphyxia. In infants treated with hypothermia lower ADC values than with normothermia were associated with a poor outcome, supporting neuroprotective effects of hypothermia.Using MRI, changes can be detected in the corpus callosum (CC following perinatal asphyxia which are associated with later neurodevelopmental outcome.To study the association between the apparent diffusion coefficient of water (ADC in the CC on MRI in neonates with perinatal asphyxia and neurodevelopmental outcome at 18 months of age.Of 121 infants 32 (26% died and 13 (11% survived with an adverse neurological outcome. Sixty-five (54% received therapeutic hypothermia. MRI was performed within 7 days after birth using a 1.5 T or 3.0 T system, and ADC values were measured in the anterior and posterior CC. The association between ADC and composite outcome (death or abnormal neurodevelopment was analyzed for both normothermia and hypothermia cases using receiver operating characteristics.ADC values of the posterior CC were lower than of the anterior part (mean difference 0.050 x 10-3 mm2/s, p<0.001. Field strength did not affect ADC values. ADC values of the posterior part of the CC were significantly lower in infants with basal ganglia/thalamus or near total brain injury (p<0.001. Lower ADC values were associated with an adverse outcome, but cut-off levels were lower after hypothermia (1.024 x 10-3 mm2/s vs 0

  6. Tau protein as a biomarker for asphyxia: A possible forensic tool?

    Science.gov (United States)

    Salama, Mohamed; Mohamed, Wael M Y

    2016-06-01

    Asphyxial death has been a problem for forensic investigations due to the absence of a validated biomarker for the diagnosis of this event. Recently, research on brain affection by asphyxia raised hopes on the possible use of CNS markers for asphyxia. The cytoskeletal proteins seem to be attractive targets as they are vulnerable to hypoxia and can be affected in asphyxial deaths. Tau, an important cytoskeletal protein, showed affection in many neurodegenerative disorders and recently in some acute incidences like trauma and brain ischemia. In this report we show the affection of the normal pattern of tau and pathological aggregates of tau in the case of brain hypoxia. This may give new clues to asphyxial death investigations.

  7. [The influence of perinatal asphyxia on the occurrence of respiratory distress syndrome in preterm labor].

    Science.gov (United States)

    Krasomski, G; Broniarczyk, D

    1994-10-01

    During the period 1985-1992, the influence of perinatal asphyxia on the frequency of RDS was investigated in preterm neonates. Two thousand one hundred and sixty-eight premature infants born alive without congenital malformations weighing from 900 g to 2500 g were in the investigated group. The frequency of the occurrence of RDS and its most severe form--hyaline membrane disease (HMD)--was evaluated depending on state at birth in the first and fifth minute of life. The clinical diagnosis of HMD was verified during the postmortem examination. The state at birth was evaluated using Apgar score. In the statistical analysis, the F-Snedecor variance test was used. During this study, the influence of perinatal asphyxia on the occurrence of RDS, and particularly its most severe form--HMD, was evaluated. PMID:7729713

  8. Immediate Remote Ischemic Postconditioning Reduces Brain Nitrotyrosine Formation in a Piglet Asphyxia Model.

    Science.gov (United States)

    Rocha-Ferreira, Eridan; Rudge, Brogan; Hughes, Michael P; Rahim, Ahad A; Hristova, Mariya; Robertson, Nicola J

    2016-01-01

    Remote ischemic postconditioning (RIPostC) is a promising therapeutic intervention that could be administered as an alternative to cooling in cases of perinatal hypoxia-ischemia (HI). In the current study we hypothesized that RIPostC in the piglet model of birth asphyxia confers protection by reducing nitrosative stress and subsequent nitrotyrosine formation, as well as having an effect on glial immunoreactivity. Postnatal day 1 (P1) piglets underwent HI brain injury and were randomised to HI (control) or HI + RIPostC. Immunohistochemistry assessment 48 hours after HI revealed a significant decrease in brain nitrotyrosine deposits in the RIPostC-treated group (p = 0.02). This was accompanied by a significant increase in eNOS expression (p piglet model of neonatal asphyxia, which appears to be mediated by modulation of nitrosative stress, despite glial activation.

  9. Age, transvestism, bondage, and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia.

    Science.gov (United States)

    Blanchard, R; Hucker, S J

    1991-09-01

    Autoerotic asphyxia is the practice of self-inducing cerebral anoxia, usually by hanging, strangulation, or suffocation, during masturbation. This study investigated the relationships between: asphyxiators' ages; two paraphilias commonly accompanying autoerotic asphyxia, bondage and transvestism; and various other types of simultaneous sexual behaviour. Subjects were two concurrent series totalling 117 males aged 10-56 who died accidentally during autoerotic asphyxial activities. Data concerning sexual paraphernalia at the scene of death or among the deceased's effects were extracted from coronors' files using standardised protocols. Anal self-stimulation with dildos, etc., and self-observation with mirrors or cameras were correlated with transvestism. Older asphyxiators were more likely to have been simultaneously engaged in bondage or transvestism, suggesting elaboration of the masturbatory ritual over time. The greatest degree of transvestism was associated with intermediate rather than high levels of bondage, suggesting that response competition from bondage may limit asphyxiators' involvement in a third paraphilia like transvestism. PMID:1958948

  10. Use of brain lactate levels to predict outcome after perinatal asphyxia

    DEFF Research Database (Denmark)

    Leth, H; Toft, P.B.; Peitersen, Birgit;

    1996-01-01

    Perinatal asphyxia is an important cause of neurological disability, but early prediction of outcome can be difficult. We performed proton magnetic resonance spectroscopy (MRS) and global cerebral blood flow measurements by xenon-133 clearance in 16 infants with evidence of perinatal asphyxia....... Cerebral blood flow was determined daily in the first 3 days after birth in seven cases. Proton MRS was performed in 11 infants within the first week (mean 3.7 days), the rest within the first month (mean 22.2 days), and all had a scan around 3 months of age. Four infants died neonatally, three showed...... min-1), (p = 0.02) and outcome. The diagnostic and prognostic implications of early MRS and CBF are predictive of poor outcome in severely asphyxiated infants...

  11. Copeptin concentration in cord blood in infants with early-onset sepsis, chorioamnionitis and perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Aebi Christoph

    2011-05-01

    Full Text Available Abstract Background Vasopressin is one of the most important physiological stress and shock hormones. Copeptin, a stable vasopressin precursor, is a promising sepsis marker in adults. In contrast, its involvement in neonatal diseases remains unknown. The aim of this study was to establish copeptin concentrations in neonates of different stress states such as sepsis, chorioamnionitis and asphyxia. Methods Copeptin cord blood concentration was determined using the BRAHMS kryptor assay. Neonates with early-onset sepsis (EOS, n = 30, chorioamnionitis (n = 33 and asphyxia (n = 25 were compared to a control group of preterm and term (n = 155 neonates. Results Median copeptin concentration in cord blood was 36 pmol/l ranging from undetectable to 5498 pmol/l (IQR 7 - 419. Copeptin cord blood concentrations were non-normally distributed and increased with gestational age (p Conclusions Copeptin concentrations were strongly related to factors associated with perinatal stress such as birth acidosis, asphyxia and vaginal delivery. In contrast, copeptin appears to be unsuitable for the diagnosis of EOS.

  12. Predictive value of brain-specific proteins in serum for neurodevelopmental outcome after birth asphyxia.

    Science.gov (United States)

    Nagdyman, Nicole; Grimmer, Ingrid; Scholz, Tristess; Muller, Christian; Obladen, Michael

    2003-08-01

    Brain-specific proteins have been used to detect cerebral injury after birth asphyxia. Previous investigations suggest that serum protein S-100beta, brain-specific creatine kinase (CK-BB), and neuron-specific enolase (NSE) are capable of identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated. We examined serum protein S-100beta, NSE, and CK-BB at 2, 6, 12, and 24 h after birth in 29 asphyxiated infants and 20 control infants. Neurodevelopmental follow-up examinations were performed at 20 mo of age using the German revision of the Griffiths scales for developmental assessment. Elevated concentrations of serum protein S-100beta, NSE, and CK-BB within 24 h after asphyxia did not correlate with long-term neurodevelopmental delay. We conclude that serum protein S-100beta, NSE, and CK-BB, sampled on the first day of life, is of limited value in predicting severe brain damage after birth asphyxia.

  13. Evaluation of utilization of antenatal services by mothers of babies with severe birth asphyxia

    Institute of Scientific and Technical Information of China (English)

    H. A. A. Ugboma; C. N. Onyearugha

    2011-01-01

    Objective:To evaluate the utilization of antenatal services by mothers of babies delivered with severe birth asphyxia at the University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt, Nigeria. Methods: A case control study of the utilization of antenatal services by 97 mothers of newborns with severe birth asphyxia delivered at UPTH from 1st February to 31st October 2009 compared with mothers of newborns with normal Apgar scores was done. Relevant pregnancy, birth, family and social history was obtained by personal interviews and referral to case notes. Results:Significantly more of the mothers of babies with normal Apgar score booked early(4 months or less) and had up to 8 or more antenatal visits prior to delivery than mothers of asphyxiated babies 86 (88.6 % ) vs 68(70.2 %), P = 0. 002 ; 93 (95.7 % ) vs 68 ( 70. 2 % ), P = 0.001 respectively. Significantly more subjects 56 (57.7 % ) than the controls 45 (46.4 % ) were primiparous, P= 0. 04. Also, significantly more subjects 19 (19.5%) suffered delay prior to intervention in labour than the controls 5 (5.1 %),P= 0. 004. Conclusion: Primiparity, delayed booking, inadequate antenatal visits and late intervention in labour have been identified as significant contributors to severe birth asphyxia.

  14. Antenatal dexamethasone after asphyxia increases neural injury in preterm fetal sheep.

    Directory of Open Access Journals (Sweden)

    Miriam E Koome

    Full Text Available BACKGROUND AND PURPOSE: Maternal glucocorticoid treatment for threatened premature delivery dramatically improves neonatal survival and short-term morbidity; however, its effects on neurodevelopmental outcome are variable. We investigated the effect of maternal glucocorticoid exposure after acute asphyxia on injury in the preterm brain. METHODS: Chronically instrumented singleton fetal sheep at 0.7 of gestation received asphyxia induced by complete umbilical cord occlusion for 25 minutes. 15 minutes after release of occlusion, ewes received a 3 ml i.m. injection of either dexamethasone (12 mg, n = 10 or saline (n = 10. Sheep were killed after 7 days recovery; survival of neurons in the hippocampus and basal ganglia, and oligodendrocytes in periventricular white matter were assessed using an unbiased stereological approach. RESULTS: Maternal dexamethasone after asphyxia was associated with more severe loss of neurons in the hippocampus (CA3 regions, 290 ± 76 vs 484 ± 98 neurons/mm(2, mean ± SEM, P<0.05 and basal ganglia (putamen, 538 ± 112 vs 814 ± 34 neurons/mm(2, P<0.05 compared to asphyxia-saline, and with greater loss of both total (913 ± 77 vs 1201 ± 75/mm(2, P<0.05 and immature/mature myelinating oligodendrocytes in periventricular white matter (66 ± 8 vs 114 ± 12/mm(2, P<0.05, vs sham controls 165 ± 10/mm(2, P<0.001. This was associated with transient hyperglycemia (peak 3.5 ± 0.2 vs. 1.4 ± 0.2 mmol/L at 6 h, P<0.05 and reduced suppression of EEG power in the first 24 h after occlusion (maximum -1.5 ± 1.2 dB vs. -5.0 ± 1.4 dB in saline controls, P<0.01, but later onset and fewer overt seizures. CONCLUSIONS: In preterm fetal sheep, exposure to maternal dexamethasone during recovery from asphyxia exacerbated brain damage.

  15. ASPHYXIA, INTRACRANIAL HEMORRHAGES AND BRAIN EDEMA OF RISK CHILDREN IN THE ADVISORY INSTITUTE IN BITOLA FROM 1989-1994

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    M. ILIEVSKA,

    1997-09-01

    Full Text Available 3986 files have been examined in the Advisory Institute for a five year period in relation to the present risk factors in the pre, peri and postnatal period, the occurrence of asphyxia, I.H. (intracranial hemorrhages and brain edema and their outcome for the children. There were 958 or 32% risk children, out of them 206 or 22% were with asphyxia, 25 or 3% were with brain edema and 14 or 1,5% were with intracranial hemorrhages.The analysis for the risk factors shows that 119 of them were abortive , and from them 15% were born with asphyxia; 124 were SFD and 21% of them with asphyxia; 272 children weighed over 4500 gr., 7% of them with asphyxia and 0.4% with I.H., there were 68 twins, 12% of them with asphyxia. Out of the children with no risk registered, 6 were born with I.H., or 0,2%.Mothers under the age of 18 gave birth to 13% children with asphyxia; treated for sterility and anemia during pregnancy 15%; with increased blood pressure 14%; and 5% with maintained pregnancy.The highest delivery risk is present with children born with vacuum extraction (30% or every third child is with asphyxia and 3% with I.H. and with children delivered by caesarean section (14% with asphyxia.As for the position of the fetus-Citus pedalicus gave 55% children with asphyxia, and Situs pelvicus 12%.The worst damage is suffered by infants with premature amnion disruption (62% are with asphyxia; with the umbilical cord round the neck-56% with asphyxia and 6% with I.H.; and with muddled amniotic fluid and placenta pelvia-50%.The order of risk factors related to asphyxia, I.H. and brain edema is as follows: the first is premature amnion disruption, then follows the umbilical cord round the neck, the muddled amniotic fluid, and placenta previa and Citus pedalicus-which are obstetric problems. The next are the vacuum extraction and S.C. As for the gestatory period the order is as follows: first the abortive, then the twins and hypertrofic infants. The outcome of the

  16. Magnesium sulphate and cardiovascular and cerebrovascular adaptations to asphyxia in preterm fetal sheep.

    Science.gov (United States)

    Galinsky, Robert; Davidson, Joanne O; Drury, Paul P; Wassink, Guido; Lear, Christopher A; van den Heuij, Lotte G; Gunn, Alistair J; Bennet, Laura

    2016-03-01

    Magnesium sulphate is a standard therapy for eclampsia in pregnancy and is widely recommended for perinatal neuroprotection during threatened preterm labour. MgSO4 is a vasodilator and negative inotrope. Therefore the aim of this study was to investigate the effect of MgSO4 on the cardiovascular and cerebrovascular responses of the preterm fetus to asphyxia. Fetal sheep were instrumented at 98 ± 1 days of gestation (term = 147 days). At 104 days, unanaesthetised fetuses were randomly assigned to receive an intravenous infusion of MgSO4 (n = 6) or saline (n = 9). At 105 days all fetuses underwent umbilical cord occlusion for 25 min. Before occlusion, MgSO4 treatment reduced heart rate and increased femoral blood flow (FBF) and vascular conductance compared to controls. During occlusion, carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. After occlusion, fetal heart rate was lower and carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. Femoral arterial waveform height and width were increased during MgSO4 infusion, consistent with increased stroke volume. MgSO4 did not alter the fetal neurophysiological or nuchal electromyographic responses to asphyxia. These data demonstrate that a clinically comparable dose of MgSO4 increased FBF and stroke volume without impairing mean arterial pressure (MAP) or carotid blood flow (CaBF) during and immediately after profound asphyxia. Thus, MgSO4 may increase perfusion of peripheral vascular beds during adverse perinatal events. PMID:26077461

  17. CT cold areas in both putamens in cases with history of perinatal asphyxia

    International Nuclear Information System (INIS)

    CT bilaterally showed a cold area in the putamen of 5 infants with cerebral palsy who had had asphyxia at birth. The etiology was discussed, and 4 of the cases were clinically studied. All four patients had convulsive tetraplegia, or convulsive bilateral paralysis with the element of athetosis. Three of them had a history of infantile epilepsy, accompanied by abnormal ocular movement. Two patients with tetraplegia showed marked hypotonia of the trunk in ventral support (Landau). Impairment of the bilateral putamens in the abnormal muscle tone was inferred. (Chiba, N.)

  18. PERINATAL ASPHYXIA AS POTENTIAL SOURCE OF CHILDREN WITH DEVELOPMENTAL PSYCHO-MOTOR DIFFICULTIES

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    Elizabeta ZISOVSKA

    1997-09-01

    Full Text Available Besides the great improvement of aostetrics and neanatal intensive care, certain percentage of new born children suffer from perinatal asphyxia (PA and that is one of the first reasons for hypoxic and ischemic brain damage which leads to neuro-developing handicap. In order to show how strong is the correaltion between PA and permanent sequele, an early, precise and prompt diagnosis of asphyxia and its influence on neonatal brain is neccessary.This study presents answers to the following issues.1.Which parameters define precisely the perinatal asphyxia?2.How great is the PA incidence on our material?3.What is the percentage of postasphyxic encephalopathy (PAE in the group of asphyxic new born children?4.Which of these children bear high risk for developmental psycho-motor difficulties?MaterialThe new born children delivered on time in the Clinic of Gynecology and Obstetrics.Methods1.Early diagnosis of PA according to the score consisted of high specific, sensitivity and positive and predictive value2.Consequent neurological check-ups and PAE cathegori-zation for seven days3.Ultrasound examination of CNS through big fontanelle4.Lab analysesResults5.639 successive new born children delivered on time were examined. The included scouring system covers APGAR score at the 5th minute, cardiotocographic record, base deficit in ABS, meconium around the amniotic water. According to this system, 81 child passed the PA , i.e., 14,3/ 1.000 new born children delivered on time. Out of them, 54 have signs of PAE (9,5/1000 new born children delivered on time, i.e., 66,6% of all asphyxia new born children. Classification has been made according to the PAE grade: 34 children survived the first grade (62,9%, 11 children survived the second grade (20,4% and 9 new born children survived the third grade (16,7%. According to data in literature and long year studies of this issue, the children from the group who passed the second and the third grade of PAE have the risk

  19. CT cold areas in both putamens in cases with history of perinatal asphyxia

    Energy Technology Data Exchange (ETDEWEB)

    Ishizaki, Asayo; Maruyama, Hiroshi (Tokyo Women' s Medical Coll. (Japan))

    1982-12-01

    CT bilaterally showed a cold area in the putamen of 5 infants with cerebral palsy who had had asphyxia at birth. The etiology was discussed, and 4 of the cases were clinically studied. All four patients had convulsive tetraplegia, or convulsive bilateral paralysis with the element of athetosis. Three of them had a history of infantile epilepsy, accompanied by abnormal ocular movement. Two patients with tetraplegia showed marked hypotonia of the trunk in ventral support (Landau). Impairment of the bilateral putamens in the abnormal muscle tone was inferred.

  20. Novel Approaches to Neonatal Resuscitation and the Impact on Birth Asphyxia.

    Science.gov (United States)

    Te Pas, Arjan B; Sobotka, Kristina; Hooper, Stuart B

    2016-09-01

    Historically, recommendations for neonatal resuscitation were largely based on dogma, but there is renewed interest in performing resuscitation studies at birth. The emphasis for resuscitation following birth asphyxia is administering effective ventilation, as adequate lung aeration leads not only to an increase in oxygenation but also increased pulmonary blood flow and heart rate. To aerate the lung, an initial sustained inflation can increase heart rate, oxygenation, and blood pressure recovery much faster when compared with standard ventilation. Hyperoxia should be avoided, and extra oxygen given to restore cardiac function and spontaneous breathing should be titrated based on oxygen saturations. PMID:27524447

  1. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

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    Andreas CHIABI

    2013-08-01

    Full Text Available How to Cite This Article: Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, Tchokoteu PF, Doh A. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013 Summer; 7(3:46-54.ObjectiveThe World Health Organization (WHO estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates.Materials & MethodsThis study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors.ResultsThe prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour,prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% hada satisfactory outcome.ConclusionThe incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal  visits through informing and communicating with pregnant women should be reinforced. References1. World Health Organisation. Perinatal mortality: a listingof

  2. Perinatal asphyxia reduces dentate granule cells and exacerbates methamphetamine-induced hyperlocomotion in adulthood.

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    Tomoyasu Wakuda

    Full Text Available BACKGROUND: Obstetric complications have been regarded as a risk factor for schizophrenia later in life. One of the mechanisms underlying the association is postulated to be a hypoxic process in the brain in the offspring around the time of birth. Hippocampus is one of the brain regions implicated in the late-onset dopaminergic dysfunction associated with hypoxic obstetric complications. METHODOLOGY/PRINCIPAL FINDINGS: We used an animal model of perinatal asphyxia, in which rat pups were exposed to 15 min of intrauterine anoxia during Cesarean section birth. At 6 and 12 weeks after birth, the behavior of the pups was assessed using a methamphetamine-induced locomotion test. In addition, the histopathology of the hippocampus was examined by means of stereology. At 6 weeks, there was no change in the methamphetamine-induced locomotion. However, at 12 weeks of age, we found an elevation in methamphetamine-induced locomotor activity, which was associated with an increase of dopamine release in the nucleus accumbens. At the same age, we also found a reduction of the dentate granule cells of the hippocampus. CONCLUSIONS/SIGNIFICANCE: These results suggest that the dopaminergic dysregulation after perinatal asphyxia is associated with a reduction in hippocampal dentate granule cells, and this may partly contribute to the pathogenesis of schizophrenia.

  3. Effect of Marine Collagen Peptides on Physiological and Neurobehavioral Development of Male Rats with Perinatal Asphyxia

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    Linlin Xu

    2015-06-01

    Full Text Available Asphyxia during delivery produces long-term deficits in brain development. We investigated the neuroprotective effects of marine collagen peptides (MCPs, isolated from Chum Salmon skin by enzymatic hydrolysis, on male rats with perinatal asphyxia (PA. PA was performed by immersing rat fetuses with uterine horns removed from ready-to-deliver rats into a water bath for 15 min. Caesarean-delivered pups were used as controls. PA rats were intragastrically administered with 0.33 g/kg, 1.0 g/kg and 3.0 g/kg body weight MCPs from postnatal day 0 (PND 0 till the age of 90-days. Behavioral tests were carried out at PND21, PND 28 and PND 90. The results indicated that MCPs facilitated early body weight gain of the PA pups, however had little effects on early physiological development. Behavioral tests revealed that MCPs facilitated long-term learning and memory of the pups with PA through reducing oxidative damage and acetylcholinesterase (AChE activity in the brain, and increasing hippocampus phosphorylated cAMP-response element binding protein (p-CREB and brain derived neurotrophic factor (BDNF expression.

  4. The Behaviour of Protein Carbonyls in Newborns with Birth Respiratory Distress and Asphyxia

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    Gabriela ZAHARIE

    2009-12-01

    Full Text Available Objective: A prospective study was carried out in premature newborns with respiratory distress syndrome (RDS and asphyxia at birth in order to identify and analyze the effects of RDS on proteins. Material and Methods: Protein peroxidation was studied using the Reznick spectrophotometric method. The study group included 14 premature newborns with respiratory distress and asphyxia at birth. The control group included 13 newborns that were born on term, eutrophic and healthy. The determinations were carried out using venous blood. Statistical data analyses were performed using Statistica software. The comparisons between groups (study and controls were performed by applying parametric and non-parametric tests according with the type of distribution. Results: Statistically significant correlations were found between the value of protein carbonyls (PC and the weight of premature newborns in the case group (p < 0.05, as well as between the PC value and the presence of respiratory distress due to surfactant deficiency in the study group. The average PC value in the study group was higher in the third day as compared with the first day. The PC value was significantly higher in the control group as compared with study group. Conclusion: The results of our study revealed that the respiratory distress in the premature newborn and oxygen therapy stimulate the peroxidation of proteins.

  5. Pressure passive cerebral blood flow and breakdown of the blood-brain barrier in experimental fetal asphyxia

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Tweed, W A;

    1979-01-01

    reaching CBF values up to 6 times normal at normal MABP of about 60 to 70 mmHg, and severe ischemia reaching CBF values close to zero in large cortical areas at MABP of 30 mmHg. CVP remained essentially unchanged at 10--15 mmHg. The severe and prolonged asphyxia rendered the blood-brain barrier leaky...

  6. Diagnostic and prognostic value of asphyxia, Sarnat's clinical classification, and CT-scan in perinatal brain damage

    International Nuclear Information System (INIS)

    A retrospective review was made of 145 babies, excluding those with congenital heart disease or chromosome aberration, admitted for CT scanning. The study was done to determine the diagnostic and prognostic value of CT findings, as well as the presence of asphyxia and the clinical stage based on the Sarnat's classification, in perinatal brain damage. The patients had a minimum follow up of 2 years for the evaluation of neurologic manifestations, such as cerebral palsy, epilepsy and mental retardation. Among babies weighing 2,000 g or more at birth, neonatal asphyxia was significantly correlated with neurologic prognosis. In addition, both clinical stages and CT findings were significantly correlated with neurologic prognosis, irrespective of birth weight. The correlation between clinical stages and CT findings was significant, irrespective of body weight, however, a significant correlation between clinical stages and neonatal asphyxia was restricted to those weighing 2,000 g or more. These findings suggest that the presence of asphyxia, clinical stages and CT findings are complementary in the diagnosis and prognosis evaluation of perinatal brain damage. (N.K.)

  7. Atrial fibrillation in rats induced by rapid transesophageal atrial pacing during brief episodes of asphyxia: A new in vivo model

    DEFF Research Database (Denmark)

    Haugan, K.; Lam, Henrik Rye; Knudsen, C. B.;

    2004-01-01

    Non-pharmacological in vivo models of atrial fibrillation (AF) have been developed in large animals only. We aimed to develop and characterize a new small animal non-pharmacological in vivo model of AF. AF was induced by transesophageal atrial burst pacing during 35 seconds periods of asphyxia...

  8. Analysis of Obstetric Factors of Neonatal Asphyxia%新生儿窒息的产科因素分析

    Institute of Scientific and Technical Information of China (English)

    庞正钰; 杨妹; 孙艳萍; 林怡; 黄蓉

    2015-01-01

    目的:探讨新生儿窒息的产科危险因素,分析如何有效降低新生儿窒息发生率和病死率,提高人口素质。方法对2011~2012年间在我院住院分娩的病历、统计资料进行回顾性分析,对新生儿不同性别、产式、孕周、产妇产龄等新生儿窒息影响因素进行比较,找出新生儿窒息的主要原因。结果新生儿窒息率为5.09%;男、女新生儿窒息发生率和病死率无显著性差异;新生儿窒息的前三位原因是:早产、脐带绕颈、妊娠高血压疾病,分别占56.23%、19.15%和12.46%;早产是新生儿窒息和死亡的首位原因;阴道助产、高龄分娩都会增加新生儿窒息的风险。结论加强围产保健,积极预防早产,是降低新生儿窒息的关键。为了母婴健康,应鼓励适龄婚育,才是提高人口素质的有效措施。%Objective To explore the factors of neonatal asphyxia obstetric risk, to reduce the incidence and mortality rate of neonatal asphyxia, and to improve the quality of the population.Methods Medical records and statistical data of hospitalization and delivery from 2011 to 2012 in the hospital were retrospectively analyzed.The newborns′different genders, birth type, gestational age, maternal age and asphyxia were compared, to find out the main causes of neonatal asphyxia.Results The rate of neonatal asphyxia was 5.09%;male and female, the incidence of neonatal asphyxia and mortality had no significant difference;the first three causes of neonatal asphyxia were pre-mature birth, umbilical cord around the neck, pregnancy induced hypertension, accounting for 56.23%, 19.15%and 12.46%;premature was the first cause of neonatal asphyxia and death;vaginal instrumental delivery and advanced age delivery can increase neonatal asphyxia.Conclusion Strengthening perinatal health care and preventing premature delivery is the key to reduce neonatal asphyxia.For maternal and child health, marriage and

  9. STUDY OF CORD BLOOD NUCLEATED RED BLOOD CELLS/100 WBC COUNT AS A PREDICTOR OF PERINATAL ASPHYXIA AND ITS SEVERITY

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    Goutami Ratna

    2015-11-01

    Full Text Available Perinatal asphyxia is a major cause of neonatal mortality and chronic neurologic disability amongst survivors. There is no single parameter to define perinatal asphyxia. Recent studies have established a correlation between cord blood nucleated red blood cell count and severity of perinatal asphyxia. AIMS AND OBJECTIVES To evaluate the utility of cord blood nucleated red blood cell/100 WBC count in early identification of perinatal asphyxia and in predicting its severity. MATERIALS AND METHOD This is a case-control study with a total number of 100 subjects, out of which 50 are asphyxiated/case group and the other 50 are non-asphyxiated/control group, which include neonates born in Gandhi Hospital in the Department of Obstetrics and Gynecology. Immediately after birth, umbilical cord blood is collected and a thin blood smear slide is prepared which is stained with Leishman stain for NRBC count. The NRBC count of the case group and the control group is compared. The results were analyzed statistically. RESULTS The mean NRBC count in case group was 38.3 and that in control group was 5.24 with significant rise in cord blood NRBC/100 WBC count in case group compared to controlled group with p value <0.001. Increase in NRBC/100 WBC count was also associated with increased severity of HIE in case group. CONCLUSION In conditions where blood gas analyzers are not easily available, cord blood NRBC count can be used as a cheaper and reliable alternative to predict perinatal asphyxia and to assess its severity.

  10. Metabolic Changes Following Perinatal Asphyxia: Role of Astrocytes and Their Interaction with Neurons.

    Science.gov (United States)

    Logica, Tamara; Riviere, Stephanie; Holubiec, Mariana I; Castilla, Rocío; Barreto, George E; Capani, Francisco

    2016-01-01

    Perinatal Asphyxia (PA) represents an important cause of severe neurological deficits including delayed mental and motor development, epilepsy, major cognitive deficits and blindness. The interaction between neurons, astrocytes and endothelial cells plays a central role coupling energy supply with changes in neuronal activity. Traditionally, experimental research focused on neurons, whereas astrocytes have been more related to the damage mechanisms of PA. Astrocytes carry out a number of functions that are critical to normal nervous system function, including uptake of neurotransmitters, regulation of pH and ion concentrations, and metabolic support for neurons. In this work, we aim to review metabolic neuron-astrocyte interactions with the purpose of encourage further research in this area in the context of PA, which is highly complex and its mechanisms and pathways have not been fully elucidated to this day.

  11. Metabolic Changes Following Perinatal Asphyxia: Role of Astrocytes and Their Interaction with Neurons.

    Science.gov (United States)

    Logica, Tamara; Riviere, Stephanie; Holubiec, Mariana I; Castilla, Rocío; Barreto, George E; Capani, Francisco

    2016-01-01

    Perinatal Asphyxia (PA) represents an important cause of severe neurological deficits including delayed mental and motor development, epilepsy, major cognitive deficits and blindness. The interaction between neurons, astrocytes and endothelial cells plays a central role coupling energy supply with changes in neuronal activity. Traditionally, experimental research focused on neurons, whereas astrocytes have been more related to the damage mechanisms of PA. Astrocytes carry out a number of functions that are critical to normal nervous system function, including uptake of neurotransmitters, regulation of pH and ion concentrations, and metabolic support for neurons. In this work, we aim to review metabolic neuron-astrocyte interactions with the purpose of encourage further research in this area in the context of PA, which is highly complex and its mechanisms and pathways have not been fully elucidated to this day. PMID:27445788

  12. Prematurity, asphyxia and congenital malformations underrepresented among neonates in a tertiary pediatric hospital in Vietnam

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    Kruse Alexandra Y

    2012-12-01

    Full Text Available Abstract Background Estimated 17,000 neonates (≤ 28 days of age die in Vietnam annually, corresponding to more than half of the child mortality burden. However, current knowledge about these neonates is limited. Prematurity, asphyxia and congenital malformations are major causes of death in neonates worldwide. To improve survival and long term development, these vulnerable neonates need access to the specialized neonatal care existing, although limited, in lower middle-income countries like Vietnam. The aim of this study was to describe these conditions in a specialized Vietnamese hospital, compared to a Danish hospital. Methods We performed a comparative observational study of all neonates admitted to a tertiary pediatric hospital in South Vietnam in 2009–2010. The data were prospectively extracted from the central hospital registry and included basic patient characteristics and diagnoses (International Classification of Diseases, 10th revision. Prematurity, asphyxia and designated congenital malformations (oesophageal atresia, gastroschisis, omphalocoele, diaphragmatic hernia and heart disease were investigated. In a subgroup, the prematurity diagnosis was validated using a questionnaire. The hospitalization ratio of each diagnosis was compared to those obtained from a Danish tertiary hospital. The Danish data were retrieved from the neonatal department database for a ten-year period. Results The study included 5763 neonates (missing Conclusion Our findings suggest the investigated diagnoses were underrepresented in the Vietnamese study hospital. In contrast, relatively mild diagnoses were frequent. These results indicate the use of specialized care may not be optimal. Pre-hospital selection mechanisms were not investigated and additional studies are needed to optimise utilisation of specialized care and improve neonatal survival.

  13. Maturation of the mitochondrial redox response to profound asphyxia in fetal sheep.

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    Paul P Drury

    Full Text Available UNLABELLED: Fetal susceptibility to hypoxic brain injury increases over the last third of gestation. This study examined the hypothesis that this is associated with impaired mitochondrial adaptation, as measured by more rapid oxidation of cytochrome oxidase (CytOx during profound asphyxia. METHODS: Chronically instrumented fetal sheep at 0.6, 0.7, and 0.85 gestation were subjected to either 30 min (0.6 gestational age (ga, n = 6, 25 min (0.7 ga, n = 27 or 15 min (0.85 ga, n = 17 of complete umbilical cord occlusion. Fetal EEG, cerebral impedance (to measure brain swelling and near-infrared spectroscopy-derived intra-cerebral oxygenation (ΔHb = HbO(2 - Hb, total hemoglobin (THb and CytOx redox state were monitored continuously. Occlusion was associated with profound, rapid fall in ΔHb in all groups to a plateau from 6 min, greatest at 0.85 ga compared to 0.6 and 0.7 ga (p<0.05. THb initially increased at all ages, with the greatest rise at 0.85 ga (p<0.05, followed by a progressive fall from 7 min in all groups. CytOx initially increased in all groups with the greatest rise at 0.85 ga (p<0.05, followed by a further, delayed increase in preterm fetuses, but a striking fall in the 0.85 group after 6 min of occlusion. Cerebral impedance (a measure of cytotoxic edema increased earlier and more rapidly with greater gestation. In conclusion, the more rapid rise in CytOx and cortical impedance during profound asphyxia with greater maturation is consistent with increasing dependence on oxidative metabolism leading to earlier onset of neural energy failure before the onset of systemic hypotension.

  14. Brain caspase-3 and intestinal FABP responses in preterm and term rats submitted to birth asphyxia

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    R.L. Figueira

    2016-01-01

    Full Text Available Neonatal asphyxia can cause irreversible injury of multiple organs resulting in hypoxic-ischemic encephalopathy and necrotizing enterocolitis (NEC. This injury is dependent on time, severity, and gestational age, once the preterm babies need ventilator support. Our aim was to assess the different brain and intestinal effects of ischemia and reperfusion in neonate rats after birth anoxia and mechanical ventilation. Preterm and term neonates were divided into 8 subgroups (n=12/group: 1 preterm control (PTC, 2 preterm ventilated (PTV, 3 preterm asphyxiated (PTA, 4 preterm asphyxiated and ventilated (PTAV, 5 term control (TC, 6 term ventilated (TV, 7 term asphyxiated (TA, and 8 term asphyxiated and ventilated (TAV. We measured body, brain, and intestine weights and respective ratios [(BW, (BrW, (IW, (BrW/BW and (IW/BW]. Histology analysis and damage grading were performed in the brain (cortex/hippocampus and intestine (jejunum/ileum tissues, as well as immunohistochemistry analysis for caspase-3 and intestinal fatty acid-binding protein (I-FABP. IW was lower in the TA than in the other terms (P<0.05, and the IW/BW ratio was lower in the TA than in the TAV (P<0.005. PTA, PTAV and TA presented high levels of brain damage. In histological intestinal analysis, PTAV and TAV had higher scores than the other groups. Caspase-3 was higher in PTAV (cortex and TA (cortex/hippocampus (P<0.005. I-FABP was higher in PTAV (P<0.005 and TA (ileum (P<0.05. I-FABP expression was increased in PTAV subgroup (P<0.0001. Brain and intestinal responses in neonatal rats caused by neonatal asphyxia, with or without mechanical ventilation, varied with gestational age, with increased expression of caspase-3 and I-FABP biomarkers.

  15. Histological Changes in the Thyroid Gland in Cases of Infant and Early Childhood Asphyxia-A Preliminary Study.

    Science.gov (United States)

    Byard, Roger W; Bellis, Maria

    2016-05-01

    A retrospective blinded study of thyroid gland histology was undertaken in 50 infants and young children aged from 1 to 24 months. Deaths were due to (i) suffocation (N = 7), hanging (4), wedging (3), and chest and/or neck compression (4), and (ii) SIDS (20), noncervical trauma (7), organic disease, (4) and drug toxicity (1). In the asphyxia group (N = 18), thyroid gland congestion ranged from 0 to 3+ with 39% of cases (7/18) having moderate/marked congestion. In three cases, focal aggregates of red blood cells (blood islands) were observed within the intrafollicular colloid. These deaths involved chest compression, chest and/or neck compression, and crush asphyxia in a vehicle accident, and all had facial petechiae. Only 22% of the 32 control cases (7/32) had moderate/marked congestion with no blood islands being identified (p crushing or compression and may provide supportive evidence for this diagnosis. PMID:27122404

  16. Asfixia perinatal e problemas cardíacos Perinatal asphyxia and heart problems

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    Gesmar Volga H. Herdy

    1998-08-01

    Full Text Available OBJETIVO: Avaliar a gravidade das complicações cardíacas na asfixia neonatal, sua evolução e correlacioná-las com o grau e duração do processo hipóxico. MÉTODOS: Foram estudados 90 bebês nos últimos 7 anos com grau de Apgar PURPOSE: To evaluate the severity of cardiac complications of neonatal asphyxia in relation to the length and degree of hipoxia. METHODS: Ninety babies with an Apgar score <6 were examined in the intensive care unit at our institution during seven years. Arterial blood for measuring pH, glucose, LDH and MB fraction of CK, together with serial electrocardiogram (ECG, echocardiogram and chest X rays was obtained. The fatal cases were studied with macro and microscopic examination. RESULTS: From a total of 90 cases, 73 were premature: 30 (41% appropriate for gestation age (AGA and 43 (59% small for gestation age (SGA. Twenty one (23% cases had arterial pH <7.2. The most common clinical conditions were: pneumonia 28 (31%, anemia 24 (26% and jaundice 12 (13%. The main cardiological findings were: systolic murmur in 46 (50%, signs of heart hypertrophy in 18 (20% and heart failure in 8 (9%. On ECG the main findings were ST and T abnormalities. The echocardiogram showed a patent ductus arteriosus (PDA in 20 (22%, tricuspid regurgitation in 6 (7%, pulmonary hypertension in 6 (7%, dyskinesia and ventricular dilatation in 4 (5%. Necropsy was performed in 23 cases and macro and microscopy obtained in 14; the most frequent findings were: myocite necrosis in 8 (54%, congestion, vacuolization and loss of striae in 4 (29%. CONCLUSION: In the majority of cases, patients had a benign course, even those presenting with severe acidemia. Many abnormal EKGs and echocardiograms became normal after a few weeks. Among those who had a fatal outcome, the severity of histological lesions was observed in babies who had suffered asphyxia for more prolonged periods.

  17. Experimental modelling of the consequences of brief late gestation asphyxia on newborn lamb behaviour and brain structure.

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    Margie Castillo-Melendez

    Full Text Available Brief but severe asphyxia in late gestation or at the time of birth may lead to neonatal hypoxic ischemic encephalopathy and is associated with long-term neurodevelopmental impairment. We undertook this study to examine the consequences of transient in utero asphyxia in late gestation fetal sheep, on the newborn lamb after birth. Surgery was undertaken at 125 days gestation for implantation of fetal catheters and placement of a silastic cuff around the umbilical cord. At 132 days gestation (0.89 term, the cuff was inflated to induce umbilical cord occlusion (UCO, or sham (control. Fetal arterial blood samples were collected for assessment of fetal wellbeing and the pregnancy continued until birth. At birth, behavioral milestones for newborn lambs were recorded over 24 h, after which the lambs were euthanased for brain collection and histopathology assessments. After birth, UCO lambs displayed significant latencies to (i use all four legs, (ii attain a standing position, (iii find the udder, and (iv successfully suckle--compared to control lambs. Brains of UCO lambs showed widespread pathologies including cell death, white matter disruption, intra-parenchymal hemorrhage and inflammation, which were not observed in full term control brains. UCO resulted in some preterm births, but comparison with age-matched preterm non-UCO control lambs showed that prematurity per se was not responsible for the behavioral delays and brain structural abnormalities resulting from the in utero asphyxia. These results demonstrate that a single, brief fetal asphyxic episode in late gestation results in significant grey and white matter disruption in the developing brain, and causes significant behavioral delay in newborn lambs. These data are consistent with clinical observations that antenatal asphyxia is causal in the development of neonatal encephalopathy and provide an experimental model to advance our understanding of neuroprotective therapies.

  18. Neuroprotection by the cannabinoid agonist WIN-55212 in an in vivo newborn rat model of acute severe asphyxia.

    Science.gov (United States)

    Martínez-Orgado, José; Fernández-Frutos, Beatriz; González, Rita; Romero, Eva; Urigüen, Leire; Romero, Julián; Viveros, M Paz

    2003-06-10

    This study was designed to evaluate the neuroprotective effect of the cannabinoid agonist WIN-55212 after inducing acute severe asphyxia in newborn rats. The left common carotid artery was ligated in anaesthetised 7-day-old Wistar rats, which were then asphyxiated by inhaling 100% nitrogen for 10 min. Pups recovering from asphyxia were s.c. administered vehicle (n=23), WIN-55212 (0.1 mg/kg, n=18), or WIN-55212 plus the CB1 receptor antagonist SR141716 (3 mg/kg, n=10). Pups undergoing a sham operation served as controls (n=12). Coronal sections of the brain were obtained on the 14th day after surgery and observed under light microscope after Nissl or Fluoro-Jade B (FJB) staining, to respectively quantify surviving or degenerating neurones in the CA1 area of the hippocampus and parietal cortex. Acute asphyxia led to early neurone loss amounting to 19% in the hippocampus and 29% in the cortex (both ANOVA P<0.05 vs. control). Delayed neurone loss occurred in the proportions 13% in the hippocampus and 20% in the cortex (both ANOVA P<0.05 vs. control). Neuronal loss was fully prevented by WIN-55212 administration. Co-administration of SR141716 failed to modify the protective effect of WIN-55212 on early neuronal death, but abolished the WIN-55212-induced prevention of delayed neuronal death. We conclude that when administered after acute severe asphyxia in newborn rats, WIN-55212 shows a neuroprotective effect, reducing both early and delayed neurone loss. This effect is achieved through two parallel CB1-dependent and -independent mechanisms.

  19. Clinical significance of blood gas and electrolyte analysis, CK, CK-MB and HBDH changes in neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    Bao-Hua Xu; Xin Lin; Mi-Jia Huang

    2016-01-01

    Objective:To investigate the clinical significance of blood gas and electrolyte analysis, CK, CK-MB and HBDH changes in neonatal asphyxia.Methods:A total of 100 newborns with asphyxia who visited in our hospital were collected, and divided into severe group (n=20) and mild group (n=80) according to the asphyxia degree, and 50 healthy newborns regarded as control group. The 3 groups received blood gas analysis (pH, BE and PaCO2), electrolyte (K+, Na+ and Ca2+) and 3 kinds of enzymes (CK, CK-MB and HBDH) were tested and compared.Results: Compared with control group, pH and BE of blood gas indexes decreased significantly and PaCO2 increased significantly in severe group (P0.05). Compared with mild group, pH and BE of blood gas indexes decreased significantly and PaCO2 increased significantly in severe group (P0.05). Compared with mild group, the level of Ca2+ decreased significantly in severe group (P<0.05); Compared with control group, the levels of CK, CK-MB and HBDH increased significantly in severe and mild group (P<0.05). Compared with mild group, the levels of CK, CK-MB and HBDH increased significantly in severe group (P<0.05).Conclusions:The detection of blood gas and electrolyte analysis, CK, CK-MB and HBDH can provide an objective evidence for the diagnosis of neonatal asphyxia and estimation of severity degree which was helpful in clinical treatment.

  20. Subcutaneous fat necrosis in neonates with hypoxic ischaemic encephalopathy registered in the Swiss National Asphyxia and Cooling Register

    OpenAIRE

    Grass, Beate; Weibel, Lisa; Hagmann, Cornelia; Brotschi, Barbara

    2015-01-01

    Background Neonates with hypoxic ischaemic encephalopathy (HIE) are routinely treated with therapeutic hypothermia (TH) for 72 h in order to improve neurological outcome. Subcutaneous fat necrosis (SCFN) is an adverse event occurring in neonates with HIE. Methods We analyzed risk factors for SCFN regarding demographic factors, cooling methods and deviation from target temperature range during hypothermia therapy. Data of all neonates registered in the National Asphyxia and Cooling Register in...

  1. Effect of perinatal asphyxia on tuberomammillary nucleus neuronal density and object recognition memory: A possible role for histamine?

    Science.gov (United States)

    Flores-Balter, Gabriela; Cordova-Jadue, Héctor; Chiti-Morales, Alessandra; Lespay, Carolyne; Espina-Marchant, Pablo; Falcon, Romina; Grinspun, Noemi; Sanchez, Jessica; Bustamante, Diego; Morales, Paola; Herrera-Marschitz, Mario; Valdés, José L

    2016-10-15

    Perinatal asphyxia (PA) is associated with long-term neuronal damage and cognitive deficits in adulthood, such as learning and memory disabilities. After PA, specific brain regions are compromised, including neocortex, hippocampus, basal ganglia, and ascending neuromodulatory pathways, such as dopamine system, explaining some of the cognitive disabilities. We hypothesize that other neuromodulatory systems, such as histamine system from the tuberomammillary nucleus (TMN), which widely project to telencephalon, shown to be relevant for learning and memory, may be compromised by PA. We investigated here the effect of PA on (i) Density and neuronal activity of TMN neurons by double immunoreactivity for adenosine deaminase (ADA) and c-Fos, as marker for histaminergic neurons and neuronal activity respectively. (ii) Expression of the histamine-synthesizing enzyme, histidine decarboxylase (HDC) by western blot and (iii) thioperamide an H3 histamine receptor antagonist, on an object recognition memory task. Asphyxia-exposed rats showed a decrease of ADA density and c-Fos activity in TMN, and decrease of HDC expression in hypothalamus. Asphyxia-exposed rats also showed a low performance in object recognition memory compared to caesarean-delivered controls, which was reverted in a dose-dependent manner by the H3 antagonist thioperamide (5-10mg/kg, i.p.). The present results show that the histaminergic neuronal system of the TMN is involved in the long-term effects induced by PA, affecting learning and memory. PMID:27444242

  2. Brain caspase-3 and intestinal FABP responses in preterm and term rats submitted to birth asphyxia

    Science.gov (United States)

    Figueira, R.L.; Gonçalves, F.L.; Simões, A.L.; Bernardino, C.A.; Lopes, L.S.; Castro e Silva, O.; Sbragia, L.

    2016-01-01

    Neonatal asphyxia can cause irreversible injury of multiple organs resulting in hypoxic-ischemic encephalopathy and necrotizing enterocolitis (NEC). This injury is dependent on time, severity, and gestational age, once the preterm babies need ventilator support. Our aim was to assess the different brain and intestinal effects of ischemia and reperfusion in neonate rats after birth anoxia and mechanical ventilation. Preterm and term neonates were divided into 8 subgroups (n=12/group): 1) preterm control (PTC), 2) preterm ventilated (PTV), 3) preterm asphyxiated (PTA), 4) preterm asphyxiated and ventilated (PTAV), 5) term control (TC), 6) term ventilated (TV), 7) term asphyxiated (TA), and 8) term asphyxiated and ventilated (TAV). We measured body, brain, and intestine weights and respective ratios [(BW), (BrW), (IW), (BrW/BW) and (IW/BW)]. Histology analysis and damage grading were performed in the brain (cortex/hippocampus) and intestine (jejunum/ileum) tissues, as well as immunohistochemistry analysis for caspase-3 and intestinal fatty acid-binding protein (I-FABP). IW was lower in the TA than in the other terms (Pmechanical ventilation, varied with gestational age, with increased expression of caspase-3 and I-FABP biomarkers. PMID:27356106

  3. Early pattern recognition in severe perinatal asphyxia: a prospective MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Baenziger, O. (Children' s Hospital, Univ. Zurich (Switzerland)); Martin, E. (Children' s Hospital, Univ. Zurich (Switzerland)); Steinlin, M. (Children' s Hospital, Univ. Zurich (Switzerland)); Good, M. (Children' s Hospital, Univ. Zurich (Switzerland)); Largo, R. (Children' s Hospital, Univ. Zurich (Switzerland)); Burger, R. (Children' s Hospital, Univ. Zurich (Switzerland)); Fanconi, S. (Children' s Hospital, Univ. Zurich (Switzerland)); Duc, G. (Children' s Hospital, Univ. Zurich (Switzerland)); Buchli, R. (Children' s Hospital, Univ. Zurich (Switzerland)); Rumpel, H. (Children' s Hospital, Univ. Zurich (Switzerland)); Boltshauser, E. (Children' s Hospital, Univ. Zurich (Switzerland))

    1993-01-01

    On the basis of MRI examinations in 88 neonates and infants with perinatal asphyxia, we defined 6 different patterns on T2-weighted images: pattern A-scattered hyperintensity of both hemispheres of the telencephalon with blurred border zones between cortex and white matter, indicating diffuse brain injury; pattern B-parasagittal hyperintensity extending into the corona radiata, corresponding to the watershed zones; pattern C-hyper- and hypointense lesions in thalamus and basal ganglia, which relate to haemorrhagic necrosis of iron deposition in these areas; pattern D-periventricular hyperintensity, mainly along the lateral ventricles, i.e. periventricular leukomalacia (PVL), originating from the matrix zone; pattern E-small multifocal lesions varying from hyper- to hypointense, interpreted as necrosis and haemorrhage; pattern F-periventricular centrifugal hypointense stripes in the centrum semiovale and deep white matter of the frontal and occipital lobes. Contrast was effectively inverted on T1-weighted images. Patterns A, B and C were found in 17%, 25% and 37% of patients, and patterns D, E and F in 19%, 17% and 35%, respectively. In 49 patients a combination of patterns was observed, but 30% of the initial images were normal. At follow-up, persistent abnormalities were seen in all children with patterns A and D, but in only 52% of those with pattern C. Myelination was retarded most often in patients with diffuse brain injury and PVL (patterns A and D). (orig.)

  4. Influences on the activities of tissue- type plasminogen activator of mouse brain in asphyxia%窒息对鼠脑分泌组织型纤溶酶原激活物的影响

    Institute of Scientific and Technical Information of China (English)

    徐剑文; 王玮; 康仲涵; 赵小贞; 张更

    2001-01-01

    Objective To observe the changes of the activity of tissue-type plasminogen activator(TPA) after asphyxia. Methods Asphyxia was induced in mouse pups by performing a‘ delayed cesarean section' . The experiment was designed for a control group and 4 asphyctic groups to detect the activity of TPA. Results TPA activity of brain increased after asphyxia (P<0.01). Conclusion TPA increased after asphyxia might be able to attack the basement membrane of microvessels, then opened the blood-brain barrier and induced neuronal damage.

  5. Reducing one million child deaths from birth asphyxia – a survey of health systems gaps and priorities

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    Manandhar Ananta

    2007-05-01

    Full Text Available Abstract Background Millions of child deaths and stillbirths are attributable to birth asphyxia, yet limited information is available to guide policy and practice, particularly at the community level. We surveyed selected policymakers, programme implementers and researchers to compile insights on policies, programmes, and research to reduce asphyxia-related deaths. Method A questionnaire was developed and pretested based on an extensive literature review, then sent by email (or airmail or fax, when necessary to 453 policymakers, programme implementers, and researchers active in child health, particularly at the community level. The survey was available in French and English and employed 5-point scales for respondents to rate effectiveness and feasibility of interventions and indicators. Open-ended questions permitted respondents to furnish additional details based on their experience. Significance testing was carried out using chi-square, F-test and Fisher's exact probability tests as appropriate. Results 173 individuals from 32 countries responded (44%. National newborn survival policies were reported to exist in 20 of 27 (74% developing countries represented, but respondents' answers were occasionally contradictory and revealed uncertainty about policy content, which may hinder policy implementation. Respondents emphasized confusing terminology and a lack of valid measurement indicators at community level as barriers to obtaining accurate data for decision making. Regarding interventions, birth preparedness and essential newborn care were considered both effective and feasible, while resuscitation at community level was considered less feasible. Respondents emphasized health systems strengthening for both supply and demand factors as programme priorities, particularly ensuring wide availability of skilled birth attendants, promotion of birth preparedness, and promotion of essential newborn care. Research priorities included operationalising

  6. Early biochemical indicators of hypoxic-ischemic encephalopathy after birth asphyxia.

    Science.gov (United States)

    Nagdyman, N; Kömen, W; Ko, H K; Müller, C; Obladen, M

    2001-04-01

    Hypoxic-ischemic encephalopathy (HIE) after perinatal asphyxia is a condition in which serum concentrations of brain-specific biochemical markers may be elevated. Neuroprotective interventions in asphyxiated newborns require early indicators of brain damage to initiate therapy. We examined brain-specific creatine kinase (CK-BB), protein S-100, and neuron-specific enolase in cord blood and 2, 6, 12, and 24 h after birth in 29 asphyxiated and 20 control infants. At 2 h after birth, median (quartiles) serum CK-BB concentration was 10.0 U/L (6.0-13.0 U/L) in control infants, 16.0 U/L (13.0-23.5 U/L) in infants with no or mild HIE, and 46.5 U/L (21.4-83.0 U/L) in infants with moderate or severe HIE. Serum protein S-100 was 1.6 microg/L (1.4-2.5 microg/L) in control infants, 2.9 microg/L (1.8-4.7 microg/L) in asphyxiated infants with no or mild HIE, and 17.0 microg/L (3.2-34.1 microg/L) in infants with moderate or severe HIE 2 h after birth. No significant difference was detectable in serum neuron-specific enolase between infants with no or mild and moderate or severe HIE 2 and 6 h after birth. A combination of serum protein S-100 (cutoff value, 8.5 microg/L) and CK-BB (cutoff value, 18.8 U/L) 2 h after birth had the highest predictive value (83%) and specificity (95%) of predicting moderate and severe HIE. Cord blood pH (cutoff value, 17 mM) increase the predictive values of protein S-100 and CK-BB. We conclude that elevated serum concentrations of protein S-100 and CK-BB reliably indicate moderate and severe HIE as early as 2 h after birth.

  7. Histological Changes in the Thyroid Gland in Cases of Infant and Early Childhood Asphyxia-A Preliminary Study.

    Science.gov (United States)

    Byard, Roger W; Bellis, Maria

    2016-05-01

    A retrospective blinded study of thyroid gland histology was undertaken in 50 infants and young children aged from 1 to 24 months. Deaths were due to (i) suffocation (N = 7), hanging (4), wedging (3), and chest and/or neck compression (4), and (ii) SIDS (20), noncervical trauma (7), organic disease, (4) and drug toxicity (1). In the asphyxia group (N = 18), thyroid gland congestion ranged from 0 to 3+ with 39% of cases (7/18) having moderate/marked congestion. In three cases, focal aggregates of red blood cells (blood islands) were observed within the intrafollicular colloid. These deaths involved chest compression, chest and/or neck compression, and crush asphyxia in a vehicle accident, and all had facial petechiae. Only 22% of the 32 control cases (7/32) had moderate/marked congestion with no blood islands being identified (p thyroid gland may be caused by congestion associated with crushing or compression and may provide supportive evidence for this diagnosis.

  8. Atrial fibrillation in rats induced by rapid transesophageal atrial pacing during brief episodes of asphyxia: a new in vivo model.

    Science.gov (United States)

    Haugan, Ketil; Lam, Henrik Rye; Knudsen, Carsten Boye; Petersen, Jørgen Søberg

    2004-07-01

    Non-pharmacological in vivo models of atrial fibrillation (AF) have been developed in large animals only. We aimed to develop and characterize a new small animal non-pharmacological in vivo model of AF. AF was induced by transesophageal atrial burst pacing during 35 seconds periods of asphyxia in anesthetized male Sprague-Dawley rats. AF was reproducibly induced in 81% of the rats. The presence of AF was associated with an increased heart rate, and a decreased blood pressure. Treatment with amiodarone, D,L-sotalol, flecainide, and propranolol all reduced duration of AF, whereas verapamil treatment was associated with a marked profibrillatory effect. Increasing gap junction intracellular communication using the antiarrhythmic peptide analogue AAP10 did not affect AF duration. Basal plasma level of epinephrine and norepinephrine were increased 5- to 20-fold relative to values reported by others, but unchanged following 35 seconds of asphyxia. The results from our study demonstrate that the rat model shares several clinical key characteristics with human AF: (1) hemodynamic response to AF; (2) increased autonomic tone; (3) antiarrhythmic effects of clinically used drugs; (4) profibrillatory effect of verapamil. Relative to existing models of AF in larger animals, this model offers rapid, predictive, and inexpensive testing of antiarrhythmic/profibrillatory effects of new drugs.

  9. 新生儿窒息血清微量元素观察%Analysis of the serum trace elements of newborns with asphyxia

    Institute of Scientific and Technical Information of China (English)

    李帅; 王荣刚

    2013-01-01

    目的 探讨新生儿窒息血清微量元素水平变化情况,分析不同窒息程度新生儿血清微量元素的差异.方法 选取2011年4月至2012年7月本院的53例窒息新生儿为观察组,同期的53例健康新生儿为对照组,将2组新生儿的血清锌、铁、硒、镁、钙及铜水平进行检测及比较,并将观察组中重度窒息者及轻度窒息者的上述指标进行比较.结果 观察组的血清锌、铁、硒、镁及钙水平均明显低于对照组,而血清铜水平则明显高于对照组,而观察组中重度窒息者的血清锌、铁、硒、镁及钙水平低于轻度窒息者,血清铜则高于轻度窒息者,差异有统计学意义(P<0.05).结论 窒息新生儿血清微量元素水平呈现异常状态,且重度窒息新生儿表现更为明显.%Objective To study the change state of serum trace elements of newborns with asphyxia and the differences of serum trace elements between different asphyxia degree.Methods A total of 53 newborns with asphyxia in our hospital from April 2011 to July 2012were selected as observation group,and 53 healthy newborns at the same time were selected as control group.Then the serum zinc,iron,selenium,magnesium,calcium and copper of two groups were compared,and these indexes of observation group with mild asphyxia and severe asphyxia were compared.Results The serum zinc,iron,selenium,magnesium and calcium of observation group were obviously lower than those of control group,serum copper was obvious higher than that of control group,while the serum zinc,iron,selenium,magnesium and calcium of observation group with severe asphyxia were lower than those with mild asphyxia,and serum copper was higher than those with mild asphyxia; there were significant differences (allP <0.05).Conclusion The serum trace elements of newborns with asphyxia show an abnormal state,and those of newborns with serve asphyxia were more obvious.

  10. Iatrogenic scald injuries in Nigerian babies with perinatal asphyxia: A re-awakening call to strengthen primary health care services

    Directory of Open Access Journals (Sweden)

    Kuti Bankole Peter

    2015-01-01

    Full Text Available Birth asphyxia is a major cause of neonatal morbidity and mortality in developing countries. Majority of pregnant women in Nigeria still deliver their babies in places where there are no personnel skilled in essential obstetric care and neonatal resuscitation. Consequently newborns are poorly handled at delivery with resultant poor outcome. We report two cases of iatrogenic burns injuries from hot water formentation in an attempt to resuscitate two neonates at peripheral health care facilities in Ilesa, Nigeria. These babies needlessly sustained burns injuries coupled with hypoxic-ischaemic injuries and poor perinatal outcome. These unfortunate cases of "insults upon injuries" underscore the need to strengthen the primary health care system in Nigeria by training and retraining health workers at these facilities. Proper antenatal care, adequate screening of high risk pregnancy for delivery at adequately equipped centres and making efficient referral system available will go a long way in reducing these needless injuries and morbidities.

  11. Forensic Identification of 50 Cases of Aspiration Asphyxia Death%50例吸入性窒息死亡的法医学鉴定分析

    Institute of Scientific and Technical Information of China (English)

    刘钧; 石磊; 帅群; 雷普平; 于建云

    2013-01-01

    Objective To investigate the forensic identification points of deaths caused by aspiration asphyxia, and provide the help to daily work of forensic identification. Methods We collected 50 cases died of aspiration asphyxia in Judicial Identification of Center Kunming Medical University from 1990 to 2012, and retrospectively analyzed the gender, age, inhalation causes, choking sign, and obstructive site. Results Aspiration asphyxia was the most common in infants and young children, secondly in young adults. Newborn infants always died by amniotic fluid aspiration, babies got aspiration asphyxia based on diseases like pneumonia, encephalitis, and meningitis, and more reasons caused this in young adults. Choking signs were impacted by the factors like inhalation traits, inhaled amount, obstructive site, time of asphyxia process. Conclusion With the reference to the epidemiological characteristics above-mentioned of aspiration asphyxia death, combined with case scene, comprehensive necropsy, and toxicological examination in identification work, can make a scientific and objective appraisal conclusion.%目的 探讨吸入性窒息死亡案例的法医学鉴定要点,为其法医学鉴定工作提供帮助.方法 收集昆明医科大学司法鉴定中心1990年1月至2012年1月间吸入性窒息死亡案例50例,对吸入性窒息死亡案例的性别、年龄、吸入原因、窒息征象、堵塞部位等因素回顾性分析.结果 吸入性窒息常见于婴幼儿,其次是青壮年.新生儿多为羊水吸入,婴幼儿多在肺炎、脑炎、脑膜炎等疾病的基础上引发吸入性窒息,中青年吸入性窒息的发生原因则较多.窒息征象受吸入物性状、数量、堵塞部位、窒息过程的长短等多方面因素影响.结论 参考上述吸入性窒息死亡的流行病学特征,鉴定时结合现场、案情及全面系统的尸体检验、毒化检验,才能作出科学客观的鉴定结论.

  12. Life-long environmental enrichment counteracts spatial learning, reference and working memory deficits in middle-aged rats subjected to perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Pablo eGaleano

    2015-01-01

    Full Text Available Continuous environmental stimulation induced by exposure to enriched environment (EE has yielded cognitive benefits in different models of brain injury. Perinatal asphyxia results from a lack of oxygen supply to the fetus and is associated with long-lasting neurological deficits. However, the effects of EE in middle-aged rats suffering perinatal asphyxia are unknown. Therefore, the aim of the present study was to assess whether life-long exposure to EE could counteract the cognitive and behavioral alterations in middle-aged asphyctic rats. Experimental groups consisted of rats born vaginally (CTL, by cesarean section (C+, or by C+ following 19 min of asphyxia at birth (PA. At weaning, rats were assigned to standard (SE or enriched environment (EE for 18 months. During the last month of housing, animals were submitted to a behavioral test battery including Elevated Plus Maze, Open Field, Novel Object Recognition and Morris water maze (MWM. Results showed that middle-aged asphyctic rats, reared in SE, exhibited an impaired performance in the spatial reference and working memory versions of the MWM. EE was able to counteract these cognitive impairments. Moreover, EE improved the spatial learning performance of middle-aged CTL and C+ rats. On the other hand, all groups reared in SE did not differ in locomotor activity and anxiety levels, while EE reduced locomotion and anxiety, regardless of birth condition. Recognition memory was altered neither by birth condition nor by housing environment. These results support the importance of environmental stimulation across the lifespan to prevent cognitive deficits induced by perinatal asphyxia.

  13. Life-long environmental enrichment counteracts spatial learning, reference and working memory deficits in middle-aged rats subjected to perinatal asphyxia

    Science.gov (United States)

    Galeano, Pablo; Blanco, Eduardo; Logica Tornatore, Tamara M. A.; Romero, Juan I.; Holubiec, Mariana I.; Rodríguez de Fonseca, Fernando; Capani, Francisco

    2015-01-01

    Continuous environmental stimulation induced by exposure to enriched environment (EE) has yielded cognitive benefits in different models of brain injury. Perinatal asphyxia results from a lack of oxygen supply to the fetus and is associated with long-lasting neurological deficits. However, the effects of EE in middle-aged rats suffering perinatal asphyxia are unknown. Therefore, the aim of the present study was to assess whether life-long exposure to EE could counteract the cognitive and behavioral alterations in middle-aged asphyctic rats. Experimental groups consisted of rats born vaginally (CTL), by cesarean section (C+), or by C+ following 19 min of asphyxia at birth (PA). At weaning, rats were assigned to standard (SE) or enriched environment (EE) for 18 months. During the last month of housing, animals were submitted to a behavioral test battery including Elevated Plus Maze, Open Field, Novel Object Recognition and Morris water maze (MWM). Results showed that middle-aged asphyctic rats, reared in SE, exhibited an impaired performance in the spatial reference and working memory versions of the MWM. EE was able to counteract these cognitive impairments. Moreover, EE improved the spatial learning performance of middle-aged CTL and C+ rats. On the other hand, all groups reared in SE did not differ in locomotor activity and anxiety levels, while EE reduced locomotion and anxiety, regardless of birth condition. Recognition memory was altered neither by birth condition nor by housing environment. These results support the importance of environmental stimulation across the lifespan to prevent cognitive deficits induced by perinatal asphyxia. PMID:25601829

  14. Importance of blood gas measurements in perinatal asphyxia and alternatives to restore the acid base balance status to improve the newborn performance

    Directory of Open Access Journals (Sweden)

    H. Orozco-Gregorio

    2007-01-01

    Full Text Available Prolonged or intermittent asphyxia in utero and during farrowing weakens piglets and renders them less capable of adaptation to extrauterine life. Piglets with lesser viability at birth have increased blood pCO2 and blood lactic acid concentrations and decreased blood pH. Moreover, the ability to thermoregulate during an acute cold stress is inversely related to umbilical blood lactate concentrations. Blood gas measurements and noninvasive estimations provide important information about oxygenation. The general goals of oxygen therapy in the neonate are to maintain adequate arterial PaO2 and SaO2, and to minimize cardiac work and the work of breathing. Arterial blood gas determinations of pCO2 provide the most accurate determinations of the adequacy of alveolar ventilation. Blood gases obtained in the immediate perinatal period can help assess perinatal asphyxia, but particular attention must be paid to the sampling site, the time of life, and the possible and proven diagnoses. The decision to obtain blood gases must be weighed by the individual clinician against the potential benefits. Current measures for restoring the acid base balance status in the newborn with perinatal asphyxia are discussed.

  15. Glial Fibrillary Acidic Protein is not an early marker of injury in perinatal asphyxia and hypoxic ischaemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Ann-Marie eLooney

    2015-12-01

    Full Text Available Brain specific glial fibrillary acidic protein (GFAP has been suggested as a potential biomarker for hypoxic ischaemic encephalopathy (HIE in newborns (1, 2. Previous studies have shown increased levels in postnatal blood samples. However its ability to guide therapeutic intervention in HIE is unknown. Therapeutic hypothermia for HIE must be initiated within 6 hours of birth, therefore a clinically useful marker of injury would have to be available immediately following delivery. The goal of our study was to examine the ability of GFAP to predict grade of encephalopathy and neurological outcome when measured in umbilical cord blood. Infants with suspected perinatal asphyxia (PA and HIE were enrolled in a single, tertiary maternity hospital, where umbilical cord blood (UCB was drawn, processed and bio-banked at birth. Expression levels of GFAP were measured by ELISA. In total 169 infants (83 controls, 56 PA, 30 HIE were included in the study. GFAP levels were not increased in UCB of case infants (PA/HIE when compared to healthy controls or when divided into specific grades of HIE. Additionally, no correlation was found between UCB levels of GFAP and outcome at 36 months.

  16. Expression of intestinal trefoil factor, proliferating cell nuclear antigen and histological changes in intestine of rats after intrauterine asphyxia

    Institute of Scientific and Technical Information of China (English)

    Ling-Fen Xu; Jun Li; Mei Sun; Hong-Wei Sun

    2005-01-01

    AIM: To study the expressions of intestinal trefoil factor (ITF) and proliferating cell nuclear antigen (PCNA) and histologic changes in intestine, to investigate the relationship between ITF and intestinal damage and repair after intrauterine hypoxia so as to understand the mechanism of intestinal injury and to find a new way to prevent and treat gastrointestinal diseases.METHODS: Wistar rats, pregnant for 21 d, were used to establish animal models of intrauterine asphyxia by clamping one side of vessels supplying blood to uterus for 20 min, another side was regarded as sham operation group. Intestinal tissues were taken away at 0, 24, 48and 72 h after birth and stored in different styles. ITF mRNA was detected by RT-PCR. PCNA expression was measured by immunohistochemistry. Intestinal tissues were studied histologically by HE staining in order to observe the areas and degree of injury and to value the intestinal mucosa injury index (IMDI).RESULTS: ITF mRNA appeared in full-term rats and increased with age. After ischemia, ITF mRNA was decreased to the minimum (0.59±0.032) 24 h after birth, then began to increase higher after 72 h than it was in the control group (P<0.01). PCNA positive staining located in goblet cell nuclei. The PCNA level had a remarkable decline (53.29±1.97) 48 h after ischemia. Structure changes were obvious in 48-h group, IMDI (3.40±0.16) was significantly increased. Correlation analyses showed that IMDI had a negative correlation with ITF mRNA and PCNA (r = -0.543,P<0.05; r = -0.794, P<0.01, respectively).CONCLUSION: Intrauterine ischemia can result in an early decrease of ITF mRNA expression. ITF and PCNA may play an important role in the damage and repair of intestinal mucosa.

  17. Analysis of relationship between amniotic fluid pollution and neonatal asphyxia%羊水污染与新生儿窒息关系的分析

    Institute of Scientific and Technical Information of China (English)

    李晓明

    2015-01-01

    羊水污染是胎儿窘迫的重要临床表现。羊水污染与新生儿窒息发生率呈正相关。因此,临床上应加强产程观察,及时发现羊水污染并根据羊水污染程度正确分析判断胎儿缺氧状况,尽早积极处理,降低新生儿窒息率、围产儿死亡率,预防胎粪吸入综合症。此外,脐带因素、胎盘因素、胎膜早破、早产、产程及胎位异常均可导致胎儿窘迫和新生儿窒息,这些因素也必须关注。%Amniotic fluid pollution is the important clinical manifestation of fetal distress. The incidence of amniotic fluid pollution was positively correlated with the incidence of neonatal asphyxia. Therefore, clinical should strengthen the observation of birth process, timely detection of amniotic fluid contamination and according to the degree of amniotic fluid pollution correct analysis determine fetal hypoxia condition, early aggressive treatment, reduce the rate of neonatal asphyxia and perinatal mortality, prevention of meconium aspiration syndrome. In addition, umbilical cord factors, placental factors, premature rupture of membranes, premature birth, birth process and fetal abnormalities can lead to fetal distress and neonatal asphyxia, so we should also must pay close attention to these factors.

  18. 集体外伤后儿童心理健康随访研究%Mental Health of Adolescents Suffered from Traumatic Asphyxia

    Institute of Scientific and Technical Information of China (English)

    赵映敏; 陈沛文

    2001-01-01

    目的:探讨集体外伤后患儿的心理健康状况。方法:使用症状自评量表(SCL-90)、艾森克个性测量问卷(EPQ)、于外伤窒息后1周、6周、10周、16周、34周对44例外伤性窒息患儿的心理健康状况进行跟踪调查,精神创伤后应激障碍(PTSD)按CCMD-2-R标准进行诊断。结果:全部患儿外伤后均有不同程度的应激反应,1周内有19例患儿、6周时有10例患儿符合PTSD诊断,其中8例患儿于34周后恢复正常。结论:外伤性窒息治疗中应重视对患儿精神状态的观察,对有心理障碍者应及时进行适当处理。%Objective: To explore the effect of traumatic asphyxia on mental health of adolescents. Method: Forty-four adolescents were assessed with Styles Questionnaire (SCL-90), Eysenck Personality Questionnaire (EPQ) after one week, 6 weeks, 10 weeks, 16 weeks and 34 weeks of asphyxia. Post-traumatic Stress Disorder (PTSD) was diagnosed according to CCMD-2-R. Results: All 44 adolescents suffered from traumatic asphyxia had some psychiatric symptoms. Nineteen of them fulfilled the symptomatic criterta of DTSD in the first week,10 of them were diagnosed as PTSD at the 6th week,8 of the them returned to normal after 34 weeks. Conclusion: Mental health of adolescents suffered from traumatic asphyxia need our attention.

  19. The prognostic value of multivoxel magnetic resonance spectroscopy determined metabolite levels in white and grey matter brain tissue for adverse outcome in term newborns following perinatal asphyxia

    Energy Technology Data Exchange (ETDEWEB)

    Doormaal, Pieter Jan van [University Medical Center Groningen and University of Groningen, Department of Pediatrics, Division of Neonatology, Groningen (Netherlands); Meander Medical Center Amersfoort, Department of Radiology, PO Box 1502, Amersfoort (Netherlands); Meiners, Linda C.; Sijens, Paul E. [University Medical Center Groningen and University of Groningen, Department of Radiology, Groningen (Netherlands); Horst, Hendrik J. ter; Veere, Christa N. van der [University Medical Center Groningen and University of Groningen, Department of Pediatrics, Division of Neonatology, Groningen (Netherlands)

    2012-04-15

    Magnetic resonance spectroscopy can identify brain metabolic changes in perinatal asphyxia by providing ratios of metabolites, such as choline (Cho), creatine (Cr), N-acetyl aspartate (NAA) and lactate (Lact) [Cho/Cr, Lact/NAA, etc.]. The purpose of this study was to quantify the separate white and grey matter metabolites in a slab cranial to the ventricles and relate these to the outcome. A standard 2D-chemical shift imaging protocol was used for measuring a transverse volume of interest located cranial to the ventricles allowing for direct comparison of the metabolites in white and grey matter brain tissue in 24 term asphyxiated newborns aged 3 to 16 days. Cho, NAA and Lact showed significant differences between four subgroups of asphyxiated infants with more and less favourable outcomes. High levels of Cho and Lact in the grey matter differentiated non-survivors from survivors (P = 0.003 and P = 0.017, respectively). In perinatal asphyxia the levels of Cho, NAA and Lact in both white and grey matter brain tissue are affected. The levels of Cho and Lact measured in the grey matter are the most indicative of survival. It is therefore advised to include grey matter brain tissue in the region of interest examined by multivoxel MR spectroscopy. (orig.)

  20. Efficacy of creatine phosphate sodium on myocardial ischemia in neonatal asphyxia%磷酸肌酸钠治疗新生儿窒息心肌缺血

    Institute of Scientific and Technical Information of China (English)

    张佳磊

    2015-01-01

    目的:探讨磷酸肌酸钠治疗新生儿窒息心肌缺血的疗效。方法选择2013年1月至2014年11月新生儿窒息致心肌缺血的早产儿53例,随机分为实验组27例和对照组26例。对照组给予维生素 C 和三磷酸腺苷的常规治疗,实验组在此基础上加用磷酸肌酸钠。比较两组疗效。结果实验组总有效率为81.5%,对照组为53.8%,实验组总有效率高于对照组,差异有统计学意义(P <0.05)。结论磷酸肌酸钠治疗新生儿窒息心肌缺血有效,值得临床应用。%Objective To investigate the efficacy of creatine phosphate sodiym on myocardial ischemia in neonatal asphyxia. Methods From Janyary 2013 to November 2014,53 patients with myocardial ischemia in neonatal asphyxia were selected,and they were randomly divided into control groyp with 26 cases and experimental groyp with 27 caces. The control groyp was given the conventional treatment of vitamin C and adenosine triphosphate,the experimental groyp based on the yse of creatine phos-phate sodiym. The effects of the two groyps were observed. Results The total effective rate of experimental groyp was 81. 5% , while that of control groyp was 53. 8% ,the difference was significant(P < 0. 05). Conclusion Creatine phosphate sodiym has positive effect on neonatal asphyxia with myocardial damage,so it is worthy of application.

  1. Influence on the Rates of Neonatal Asphyxia and Successful Resuscitation of Midwife Resuscitation Training%助产士窒息复苏培训对新生儿窒息率及复苏成功率的影响

    Institute of Scientific and Technical Information of China (English)

    叶小苏

    2013-01-01

    Objective:To analyze effects on the rates of neonatal asphyxia and successful resuscitation of midwife resuscitation train-ing. Methods:The control group consisted of 12548 infants born from April 2006 to 2008 Aprils, the observation group consisted of 12460 infants born from May 2008 to May 2010, incidence of neonatal asphyxia was compared and analyzed before and after the midwife training. Results:The incidence of neonatal asphyxia was 3.65%in the control group, and that was 1.94%in the observa-tion group, the observation group was significantly better than the control group (P<0.01). Conclusion: Resuscitation training for midwives is obviously effective to decrease the rate of neonatal asphyxia, and rate of neonatal asphyxia will remain stable at a cer-tain level, when midwives are proficient in resuscitation technique and adhered to standards.%  目的:分析助产士窒息复苏培训对新生儿窒息复苏率以及复苏成功率的影响。方法:选取2006年4月~2008年4月出生的12548名新生儿作为对照组,2008年5月~2010年5月出生的12460名新生儿作为观察组,对助产士培训前后新生儿窒息发生率的变化进行对比分析。结果:对照组新生儿窒息的发生率为3.65%,观察组新生儿窒息的发生率为1.94%,观察组显著低于对照组(P<0.01)。结论:对助产士进行窒息复苏培训对降低新生儿窒息率具有非常明显的效果,且当助产士的复苏技术熟练而且操作规范时,新生儿的窒息率会在一定水平上保持稳定。

  2. 新生儿窒息后肾损害的阴离子间隙分析%Analysis on Anion Gap of Neonates with Renal Injury after Asphyxia

    Institute of Scientific and Technical Information of China (English)

    任青; 张兴芳

    2014-01-01

    目的:分析窒息后肾功能损害新生儿的阴离子间隙(AG)变化及其与肾损害的关系。方法首先测定151例窒息新生儿的血尿素氮(BUN)、肌酐(Cr)、电解质、动脉血气分析;然后,从中选取肾损害新生儿60例,并同时测定30例正常足月儿的上述指标,计算AG值并分析。结果窒息后肾损害的60例新生儿,代谢性酸中毒发生率为76.7%,且以高AG代酸为主,随窒息程度的加重,BUN、Cr无明显变化。结论窒息后肾功能损害新生儿血AG值可明显异常,需及时处理,BUN、Cr不能早期反映新生儿肾损害。%Objective To analysis the changes of anion gap (AG) and discuss the relationship between AG and renal function of the neonates with renal injury after asphyxia. Methods Firstly, interval index of serum BUN, Cr, electrolytes, artery blood gas analysis was detected in 151 cases of neonatal asphyxia. Then, 60 cases of neonates with renal injury were selected from them and the same interval index of 30 cases of normal term infants was also detected. The AG value was calculated and analyzed. Results In 60 cases of neonates with renal injury after asphyxia, the incidence of metabolic acidosis was 76.7%, especially metabolic acidosis with high AG. With the severity of asphyxia, serum BUN and Cr made no obvious changes. Conclusion AG in neonates with renal injury after asphyxia changed significantly and should be treated promptly, BUN and Cr were not early indicators of neonates with renal injury.

  3. CK-MB在新生儿窒息脑损伤诊断中的价值研究%Study on value of CK - MB% in diagnosing Neonatal Asphyxia with brain damage

    Institute of Scientific and Technical Information of China (English)

    郑佳音; 章利群; 应俊; 周伟丽; 陈筱菲; 杨建荣

    2011-01-01

    目的:研究CK-MB在反映新生儿窒息所致的脑损伤中的临床意义及诊断价值.方法:收集49例实验组及20例对照组,其中将实验组分成合并脑损伤(27例)和不合并脑损伤(22例)两对比组,分别采用自动生化分析仪法与琼脂糖凝胶电泳法检测其总CK活性、同工酶活性和CK-MB%.结果:(1)对照组两方法测定结果比较,自动生化分析仪法测定的CK-MB%高于琼脂糖凝胶电泳法(简称电泳法)检测的结果(P0.05).(2)实验组中合并脑损伤组中CK-MB%和不合并脑损伤组比较,测定结果无差别(P>0.05).结论:自动生化分析仪法测定的CK-MB%明显高于电泳法检测的CK-MB%.上述两种方法检测的CK-MB%在实验组和对照组间以及在新生儿窒息中是否合并脑损伤并无显著性差异,不宜作为诊断新生儿窒息所致的脑损伤的生化指标.%Objective:To study the value of CK - MB in diagnosing neonatal asphyxia with brain damage. Methods: 69 patients(22 neonatal asphyxia,27 neonatal asphyxia with brain damage,20 normal) were evaluated with total CK,CK -MB,calculate CK - MB ratio using automatic biochemical analyser and agarose sugar electrophoresis method. Results: ( 1 ) The results of CK- MB% measured by automatic biochemical analyser were higher than the agarose sugar electrophoresis in the control group and the test group( P < 0.01 ). Compared between two groups, results were indifferent ( P > 0.05 ). ( 2 ) Compared the brain damage group with neonatal asphyxia group, results were indifferent( P > 0.05 ). Conclusion: The results of CK - MB% measured by automatic biochemical analyser were significantly higher than the agarose sugar electrophoresis. The results of CK - MB%may not be regarded as a biochemical indicator in diagnosing neonatal asphyxia with brain damage.

  4. 助产士复苏培训在新生儿窒息防治中的应用价值%The application value of recovery training of midwives in neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    李爱红

    2015-01-01

    目的:探讨助产士复苏培训在新生儿窒息防治中的应用价值.方法:收治产妇1920例,随机分为A组和B组各960例,A组接受未经系统化复苏培训的助产士助产,B组接受经系统化复苏培训的助产士助产者,比较两组的新生儿窒息发生率、窒息复苏成功率及复苏成功患儿生命体征情况.结果:B组24例患者发生新生儿窒息,A组40例发生新生儿窒息,B组明显低于A组(P<0.05).同时,B组新生儿窒息复苏成功率95.83%,A组75.00%,B组明显高于A组(P<0.05).此外,复苏成功的新生儿中,B组呼吸频率(R)、心率(HR)、血氧饱和度(SpO2)及Apgar评分均明显高于A组(P<0.05).结论:助产士复苏培训可有效地改善患者新生儿窒息情况.%Objective:To explore the application value of recovery training of midwives in the prevention and cure of neonatal asphyxia.Methods:1920 cases were selected,they were randomly divided into A group and B group with 960 cases in each,A group received midwives midwifery without systematic recovery training,B group received midwives midwifery with systematic recovery training,we compared the incidence of neonatal asphyxia,the success rate of resuscitation for neonatal asphyxia and vital signs of children after successful recovery of the two groups.Results:In B group,24 patients had neonatal asphyxia,in A group,40 patients had neonatal asphyxia,the B group was significantly lower than that in A group(P<0.05).At the same time,the success rate of neonatal asphyxia was 95.83% in the B group,the A group was 75% ,the B group was significantly higher than that in the A group(P<0.05).In addition,in the newborn with successful recovery,the respiratory rate(R),heart rate(HR),blood oxygen saturation(SpO2) and Apgar score of B group were significantly higher than those in A group(P<0.05).Conclusion:The recovery training of midwives can effectively improve neonatal asphyxia.

  5. 运用心肌酶谱检测对急诊检测的重要意义%Significance of myocardial enzyme inspection in emergency diagnosis of myocardial infarction and neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    羊艺艺

    2015-01-01

    Objective:To study the significance and necessity of using myocardial enzyme inspection in emergency detection of myocardial infarction and neonatal asphyxia. Methods:During January 2013 and January 2014, 60 cases of patients with acute myocardial infarction and 60 cases of children with neonatal asphyxia to the hospital were randomly selected. Myocardial enzyme values of 60 healthy people were colected for comparison with that of the myocardial infarction patients and the neonatal asphyxia patients to find the relationship between the change of myocardial enzyme values and the two diseases. Results:Myocardial enzyme values including CK, LDH, AST, α-HBD, CK-MB and other enzymes of the myocardial infarction patients were significantly higher than that of the normal people and the difference is of statistical significance (P<0.05). The average value of myocardial enzyme [(3487.39±224.56)U/L] of severe asphyxia children is much higher than that of the mild asphyxia children [(943.56±62.17)U/L] and that of the moderate asphyxia children [(1658.34±103.28)U/L]. The difference is of statistical significance (P<0.05). Conclusion: Myocardial enzyme inspection has good clinical significance and utility in emergency diagnosis of myocardial infarction and neonatal asphyxia.%目的:探讨急诊运用心肌酶谱检测对急诊检测的重要意义及必要性.方法:选取2013年1月至2014年1月来院治疗的60例急性心肌梗死患者组、60例新生儿窒息的患儿组及60例正常人组,比较心肌梗死组与正常组的心肌酶值,通过检测其心肌酶的变化探究其与以上两种疾病之间存在关系.结果:心肌梗死组的CK、LDH、AST、α-HBD、CK—MB等各项心肌酶值明显高于正常人,差别有统计学意义(P<0.05);重度窒息患儿的心肌酶的平均值(3487.39±224.56) U/L明显高于轻度窒息患儿的心肌酶的平均值(943.56±62.17)U/L,以及中度心肌酶平均值(1658.34±103.28)U/L,差异均有统计学意义(P<0

  6. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats.

    Science.gov (United States)

    Blanco, Eduardo; Galeano, Pablo; Holubiec, Mariana I; Romero, Juan I; Logica, Tamara; Rivera, Patricia; Pavón, Francisco J; Suarez, Juan; Capani, Francisco; Rodríguez de Fonseca, Fernando

    2015-01-01

    Perinatal asphyxia (PA) is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS) is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory, and mood. Endocannabinoids, and other acylethanolamides (AEs) without endocannabinoid activity, have recently received growing attention due to their potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the present study, we aimed to analyze the changes produced by PA in the major metabolic enzymes and receptors of the ECS/AEs in the hippocampus using a rodent model of PA. To induce PA, we removed uterine horns from ready-to-deliver rats and immersed them into a water bath during 19 min. Animals delivered spontaneously or by cesarean section were employed as controls. At 1 month of age, cognitive functions were assessed and immunohistochemical procedures were carried out to determine the expression of NeuN and glial fibrillary acidic protein, enzymes responsible for synthesis (DAGLα and NAPE-PLD) and degradation (FAAH) of ECS/AEs and their receptors (CB1 and PPARα) in the hippocampus. Postweaned asphyctic rats showed impaired recognition and spatial reference memory that were accompanied by hippocampal astrogliosis and changes in the expression of enzymes and receptors. The most remarkable findings in asphyctic rats were a decrease in the expression of NAPE-PLD and PPARα in both hippocampal areas CA1 and CA3. In addition, postweaned cesarean delivery rats showed an increase in the immunolabeling for FAAH in the hippocampal CA3 area. Since, NAPE-PLD and PPARα are proteins that participate in the biochemical process of AEs, specially the neuroprotective oleoylethanolamide, these results suggest that PA dysregulates this system. These data encourage conducting future studies using AEs as potential neuroprotective compounds in animal models of PA.

  7. Autopsy practice in forensic pathology - evidence-based or experience-based? a review of autopsies performed on victims of traumatic asphyxia in a mass disaster.

    Science.gov (United States)

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte; Lynnerup, Niels

    2014-02-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts.

  8. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats.

    Science.gov (United States)

    Blanco, Eduardo; Galeano, Pablo; Holubiec, Mariana I; Romero, Juan I; Logica, Tamara; Rivera, Patricia; Pavón, Francisco J; Suarez, Juan; Capani, Francisco; Rodríguez de Fonseca, Fernando

    2015-01-01

    Perinatal asphyxia (PA) is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS) is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory, and mood. Endocannabinoids, and other acylethanolamides (AEs) without endocannabinoid activity, have recently received growing attention due to their potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the present study, we aimed to analyze the changes produced by PA in the major metabolic enzymes and receptors of the ECS/AEs in the hippocampus using a rodent model of PA. To induce PA, we removed uterine horns from ready-to-deliver rats and immersed them into a water bath during 19 min. Animals delivered spontaneously or by cesarean section were employed as controls. At 1 month of age, cognitive functions were assessed and immunohistochemical procedures were carried out to determine the expression of NeuN and glial fibrillary acidic protein, enzymes responsible for synthesis (DAGLα and NAPE-PLD) and degradation (FAAH) of ECS/AEs and their receptors (CB1 and PPARα) in the hippocampus. Postweaned asphyctic rats showed impaired recognition and spatial reference memory that were accompanied by hippocampal astrogliosis and changes in the expression of enzymes and receptors. The most remarkable findings in asphyctic rats were a decrease in the expression of NAPE-PLD and PPARα in both hippocampal areas CA1 and CA3. In addition, postweaned cesarean delivery rats showed an increase in the immunolabeling for FAAH in the hippocampal CA3 area. Since, NAPE-PLD and PPARα are proteins that participate in the biochemical process of AEs, specially the neuroprotective oleoylethanolamide, these results suggest that PA dysregulates this system. These data encourage conducting future studies using AEs as potential neuroprotective compounds in animal models of PA. PMID:26578900

  9. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats

    Science.gov (United States)

    Blanco, Eduardo; Galeano, Pablo; Holubiec, Mariana I.; Romero, Juan I.; Logica, Tamara; Rivera, Patricia; Pavón, Francisco J.; Suarez, Juan; Capani, Francisco; Rodríguez de Fonseca, Fernando

    2015-01-01

    Perinatal asphyxia (PA) is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS) is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory, and mood. Endocannabinoids, and other acylethanolamides (AEs) without endocannabinoid activity, have recently received growing attention due to their potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the present study, we aimed to analyze the changes produced by PA in the major metabolic enzymes and receptors of the ECS/AEs in the hippocampus using a rodent model of PA. To induce PA, we removed uterine horns from ready-to-deliver rats and immersed them into a water bath during 19 min. Animals delivered spontaneously or by cesarean section were employed as controls. At 1 month of age, cognitive functions were assessed and immunohistochemical procedures were carried out to determine the expression of NeuN and glial fibrillary acidic protein, enzymes responsible for synthesis (DAGLα and NAPE-PLD) and degradation (FAAH) of ECS/AEs and their receptors (CB1 and PPARα) in the hippocampus. Postweaned asphyctic rats showed impaired recognition and spatial reference memory that were accompanied by hippocampal astrogliosis and changes in the expression of enzymes and receptors. The most remarkable findings in asphyctic rats were a decrease in the expression of NAPE-PLD and PPARα in both hippocampal areas CA1 and CA3. In addition, postweaned cesarean delivery rats showed an increase in the immunolabeling for FAAH in the hippocampal CA3 area. Since, NAPE-PLD and PPARα are proteins that participate in the biochemical process of AEs, specially the neuroprotective oleoylethanolamide, these results suggest that PA dysregulates this system. These data encourage conducting future studies using AEs as potential neuroprotective compounds in animal models of PA. PMID:26578900

  10. 新生儿窒息多器官损害发生率、高危因素和转归的多中心研究%Incidence, risk factors and outcomes of multiple organ damage after neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    新生儿窒息多器官损害临床诊断多中心研究协作组

    2016-01-01

    重度窒息,且合并严重代谢性酸中毒时更严重。%ObjectiveTo investigate the incidence, risk factors and outcomes of multiple organ damage (MOD) after neonatal asphyxia and formulate the diagnostic criteria of MOD, in order to strengthen the management of neonatal asphyxia and provide evidences for reduction of the mortality and disability rate of asphyxia newborns.MethodsTotally, 487 asphyxiated newborns, who were term neonates or preterm neonates with fetal age over 34 weeks and birth weight over 2 500 g and admitted to hospitals included in the collaboration group from November 2012 to February 2015 were selected. Neonatal asphyxia was diagnosed based on Apgar score, and all recruited newborns were divided into mild and severe groups, and those in severe group were devided into two subgroups (GroupⅠ and groupⅡ). GroupⅠ included those babies with severe asphyxia and serious metabolic acidosis (pH≤7 and/or base excess≤-16 mmol/L) and groupⅡ were those without serious metabolism acidosis group (7asphyxia, 371 were mild asphyxia and 116 were severe ones. Altogether, 232 out of the 487 babies (47.6%) developed multiple organ injury of asphyxia. More MOD babies were seen in the severe asphyxia group than in the mild asphyxia group [79.3% (92/116) vs 37.7% (140/371),χ2=59.58,P<0.01]. (2) Babies with MOD after asphyxia were more likely to be born by emergency cesarean delivery [14.7% (34/232) vs 5.9% (15/255)], but less likely to have regular prenatal care [57.8% (134/232) vs 89.8% (229/255)] (χ2=9.04 and 65.73, allP<0.01). (3) Incidence of MOD in group I was significantly higher than that in groupⅡ [90.7% (39/43) vs 73.0% (27/37),χ2=11.36,P<0.01];(4) The median hospital stay of MOD newborns was longer than that of non-MOD ones [11 (8-15) vs 8 (6-9) d, P<0.01], the recovery rate

  11. Effect of neonatal asphyxia on the impairment of the auditory pathway by recording auditory brainstem responses in newborn piglets: a new experimentation model to study the perinatal hypoxic-ischemic damage on the auditory system.

    Directory of Open Access Journals (Sweden)

    Francisco Jose Alvarez

    Full Text Available Hypoxia-ischemia (HI is a major perinatal problem that results in severe damage to the brain impairing the normal development of the auditory system. The purpose of the present study is to study the effect of perinatal asphyxia on the auditory pathway by recording auditory brain responses in a novel animal experimentation model in newborn piglets.Hypoxia-ischemia was induced to 1.3 day-old piglets by clamping 30 minutes both carotid arteries by vascular occluders and lowering the fraction of inspired oxygen. We compared the Auditory Brain Responses (ABRs of newborn piglets exposed to acute hypoxia/ischemia (n = 6 and a control group with no such exposure (n = 10. ABRs were recorded for both ears before the start of the experiment (baseline, after 30 minutes of HI injury, and every 30 minutes during 6 h after the HI injury.Auditory brain responses were altered during the hypoxic-ischemic insult but recovered 30-60 minutes later. Hypoxia/ischemia seemed to induce auditory functional damage by increasing I-V latencies and decreasing wave I, III and V amplitudes, although differences were not significant.The described experimental model of hypoxia-ischemia in newborn piglets may be useful for studying the effect of perinatal asphyxia on the impairment of the auditory pathway.

  12. Pharmacological neuroprotection after perinatal asphyxia

    NARCIS (Netherlands)

    Fan, Xiyong; van Bel, Frank

    2010-01-01

    Recent progress has provided us with several promising neuroprotective compounds to reduce perinatal hypoxic-ischemic (HI) brain injury. In the early post HI phase, therapies can be concentrated on ion channel blockage (Xenon), anti-oxidation (allopurinol, 2-iminobiotin, and indomethacin), anti-infl

  13. significance of umbilical arterial blood gas analysis in diagnosing neonatal asphyxia%脐动脉血气分析诊断新生儿窒息的临床意义

    Institute of Scientific and Technical Information of China (English)

    王璇; 吴晓宇; 杨宏; 张媛

    2012-01-01

    目的 通过分析脐动脉血气及新生儿Apgar评分之间的关系,探索更准确诊断新生儿窒息的标准.方法 随机采集(2008年5月至2009年5月)陕西省妇幼保健院分娩活婴1 980例脐动脉血进行血气分析,同时对新生儿进行1、5、10分钟Apgar评分.登记新生儿一般信息、出生情况、母围产因素,并跟踪新生儿的临床过程及窒息后的治疗结果.对1分钟Apgar≤7分的低Apgar评分与相应的脐动脉血气结果进行分析.结果 1分钟Apgar评分≤3分的重度窒息新生儿与≥8分正常新生儿的脐动脉血气分析结果比较,H+浓度负对数、二氧化碳分压、氧分压、剩余碱值均有非常显著性差异(F值分别为8.375、43.479、6.978、80.557,均P<0.01).1分钟Apgar评分4~7分的轻度窒息新生儿与≥8分正常新生儿的脐动脉血气分析结果比较,H+浓度负对数、二氧化碳分压、剩余碱值均有显著性差异(F值分别为6.622、22.467、6.890,均P<0.05).1分钟Apgar评分≤3分的新生儿重度窒息与Apgar评分4~7分的新生儿轻度窒息血气分析结果中,H+浓度负对数、剩余碱和氧分压值均有显著性差异(F值分别为9.012、15.926、8.244,均P<0.05).结论 脐动脉血气分析比Apgar评分更具客观性,脐动脉血气分析结合低Apgar评分作为诊断新生儿窒息的重要指标,可减少误诊率、漏诊率.%Objective To analyze the relationship between umbilical arterial blood gas and neonatal Apgar score, so as to explore a more accurate index of diagnosing neonatal asphyxia. Methods From May 2008 to May 2009 umbilical arterial blood of 1 980 live newborns delivered in Shaanxi Maternal and Child Health Hospital were collected to analyze blood gas, and Apgar score at 1, 5 and 10 minute of newborns were recorded. The general information and birth status of the newborns and perinatal factors were registered, and neonatal clinical situation and treatment outcomes were followed up. The low Apgar

  14. 脐动脉血血气分析对新生儿窒息的预后评估价值%Gas analysis of umbilical cord artery blood on predicating the prognosis of asphyxia neonate

    Institute of Scientific and Technical Information of China (English)

    曹棨; 潘革; 莫锦丽; 何潇; 农常亮; 黄芬

    2016-01-01

    目的:探讨脐动脉血与桡动脉血血气分析在缺氧新生儿预后评估中的临床应用价值。方法选取2014年9月至2015年9月我院分娩的足月新生儿328例,根据Apgar评分分为重度窒息组11例、轻度窒息组27例、健康对照组290例,出生后取脐动脉血、桡动脉血行血气分析,计算氧合指数,定期随访窒息组新生儿行为神经评估( NBNA)结果,分析其与脐动脉血血气分析pH值之间的关系。结果重度窒息组脐动脉血的pH值、PO2、PCO2、氧合指数分别为7�11±0�25、(73�93±23�35) mmHg、(51�36±16�37) mmHg、206�23±98�12,与轻度窒息组[7�24±0�05、(86�35±12�56) mmHg、(45�89±9�21) mmHg、411�22±57�94]和健康对照组[7�28±0�08、(87�80±12�07) mmHg、(43�68±6�45) mmHg、426�23±73�30]比较,差异均有统计学意义( P均<0�05);桡动脉血 pH 值、PO2、PCO2、氧合指数分别为7�25±0�18、(74�66±24�09) mmHg、(51�42±17�83) mmHg、332�03±65�19,与轻度窒息组[7�31±0�09、(87�24±11�75) mmHg、(45�73±10�21) mmHg、405�67±82�65]和健康对照组[7�32±0�06、(87�99±11�81) mmHg、(42�84±9�32) mmHg、439�89±60�76]比较差异均有统计学意义(P均<0�05);重度窒息组NBNA为(34�09±5�02)分,低于轻度窒息组[(36�62±2�04)分],差异有统计学意义(F=21�65,P<0�05);重度窒息组脐动脉血pH值与NBNA呈正相关( r=0�877,P<0�01)。结论重度窒息组脐动脉血与桡动脉血血气分析的pH值、PO2、氧合指数下降,PCO2升高。重度窒息组NBNA与脐动脉血气分析pH值相关,脐动脉血气分析pH值有助于评估新生儿近期预后。%Objective To study the gas analysis of umbilical cord artery blood and radial artery blood on predicating the prognosis of asphyxia neonate

  15. Compensatory rebound of body movements during sleep, after asphyxia in neonatal rats Resposta compensatória dos movimentos corporais do sono após a asfixia em ratos recém-nascidos

    Directory of Open Access Journals (Sweden)

    Olivia Adayr Xavier Suarez

    2008-06-01

    Full Text Available PURPOSE: The usefulness of body movements that occur during sleep when assessing perinatal asphyxia and predicting its long-term consequences is contradictory. This study investigated whether neonatal rats manifest these movements in compensatory rebound after asphyxia, and if these alterations play an important role in its pathogenesis. METHODS: Eight neonatal rats (aged 6-48h were implanted with small EMG and EKG electrodes and sleep movements were recorded over a 30-minute control period. Recordings were continued during asphyxia caused by the enclosure of the animal in a polyvinyl sheet for 60 minutes, followed by a 30-minute recovery period. RESULTS: Heart rate was lowered to bradycardic level during asphyxia causing behavioral agitation and increased waking time during the initial phase (30 minutes. Sleep-related movements were also significantly reduced from 12.5 ± 0.5 (median ± SE/2min to 9.0 ± 0.44 in the final half of the period (Anova, pOBJETIVO: A utilidade dos movimentos corporais (MC que ocorrem durante o sono para diagnosticar e predizer as conseqüências, em longo prazo, da asfixia perinatal é contraditório. Este estudo investigou se ratos recém-nascidos (RN manifestam MC em resposta compensatória à asfixia, e se estas alterações podem ter alguma importância na sua patogênese. MÉTODOS: Oito ratos RN (6-48h de vida foram submetidos à implantação de pequenos eletrodos para registros da eletromiografia e eletrocardiografia. Os MC e a freqüência cardíaca (FC foram registrados durante períodos de 30 min: fase controle (F1, fases de asfixia (F2; F3 e fase de recuperação pós-asfixia (F4. A asfixia foi promovida pelo envolvimento completo do animal com uma lâmina de polivinil. RESULTADOS: A FC diminuiu progressivamente durante F2 e F3 até a bradicardia. Em F2 houve grande agitação dos animais e aumento dos períodos de vigília. Em F3 houve redução significante dos MC de 12,5 ± 0,5 (Md ± SE/2min para 9,0

  16. 核因子-кB与窒息新生鼠缺氧缺血性脑损伤相关性研究%THE CORRELATIONAL RESEARCH OF NF-KB AND HYPOXIA ISCHEMIA REPERFUSION BRAIN INJURY OF NEWBORN RATS WITH ASPHYXIA

    Institute of Scientific and Technical Information of China (English)

    张海鸿; 王宝宏; 赵国英

    2011-01-01

    [目的]观察新生鼠窒息后不同时间段脑组织NF-кB动态变化,以探讨NF-кB信号途径在新生鼠窒息后缺氧缺血性脑损伤中的作用.[方法]出生7 d新生鼠随机分为对照组(A组)和窒息组(B组);制备新生鼠窒息模型,并于窒息后1、3、5和7 d取脑组织行石蜡切片.采用免疫组织化学方法检测窒息新生鼠脑组织NF-KB p65活性表达水平.[结果]窒息组各组脑组织NF-кB的表达均较A组显著增强(P<0.05),以5 d时升高最明显,并伴有神经细胞坏死及凋亡现象.[结论]NF-кB可能通过炎症反应机制介导窒息后脑损伤过程.%[Objectjve]To observe the activation of NF-κB in hypoxia ischemia reperfusion brain injury of newborn rats with asphyxia. To explore the effect of NF-κB signal pathway on brain injury of newborn with asphyxia .[Methods]The new born rats(7days old)were randomly dividen into control group (A) and asphyxia grup(B). The model of asphyxia was induced in B group ,immunohisto-chemical method was used to detect the activity of NF-κB P65 in the brain of the newborn rats,and hematoxylin- eosin staining was per -formed to observe the histological evidence of asphyxia in the brain, [Results]The activity of NF- κB P65 was higher in group B than that jn group A(p< 0.05) , increased to the highest peak at 5th day, with newe cell death and apaptosia in group B. [Conclusion] The NF-κB may play an important role in brain injury ,with asphyxia.

  17. 血乳酸联合血糖监测在产后新生儿窒息诊断中的应用%Application of the monitoring of blood lactic acid and blood sugar levels in the diagnosis of postpartum neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    罗孝华

    2014-01-01

    Objective:To investigate the role of the monitoring of blood lactic acid and blood sugar levels in the diagnosis of postpartum neonatal asphyxia. Methods:Eighty newborns with asphyxia in our hospital from February, 2013 to March, 2014 were selected as an observation group and meanwhile 30 cases healthy newborns as a control group. Blood lactate and blood sugar levels in two groups were compared. The relationship between postpartum neonatal asphyxia and both blood lactate and blood sugar levels and risk factors of postpartum neonatal asphyxia were analyzed. Results:Blood lactate and blood sugar levels in the observation group were (5.86±2.18) mmol/L and (5.15±2.26) mmol/L, which were signiifcantly higher than the (2.81±0.49) mmol/L and (2.74±0.62) mmol/L in the control group (P<0.05). The results of Pearson correlation analysis showed that both blood lactate and blood sugar levels were negatively correlated with postpartum neonatal asphyxia (P<0.05). The results of Logistic multivariate regression analysis showed that the risk factors resulting in postpartum newborns asphyxia were ascribed to the high levels of blood lactic acid, blood sugar and indirect bilirubin and blood pressure, etc. Conclusion:The levels of both blood lactic acid and blood sugar may be as an important predictors for postpartum neonatal asphyxia, which can be used for the auxiliary diagnosis of postpartum neonatal asphyxia.%目的:探讨血乳酸联合血糖监测在产后新生儿窒息诊断中的应用价值。方法:选取2013年2月-2014年3月在我院出生的80例发生窒息的新生儿为观察组,并选取同期健康新生儿30例作为对照组。统计分析两组血乳酸和血糖水平与新生儿窒息的关系并进行产后新生儿窒息发生的危险因素的多因素分析。结果:观察组血乳酸和血糖水平分别为(5.86±2.18)mmol/L和(5.15±2.26)mmol/L,显著高于对照组的(2.81±0.49)mmol/L和(2.74±0.62)mmol/L,

  18. Umbilical artery blood gas analysis in the diagnosis of multiple organ damage of neonatal asphyxia%新生儿脐动脉血气分析在新生儿窒息多器官损害诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    全国新生儿窒息多器官损害临床诊断多中心研究协作组

    2016-01-01

    Objective To study the relationship between umbilical arterial blood gas analysis and perinatal high risk factors, Apgar score and multiple organ damage of neonatal asphyxia. Methods Clinical data of cases of neonatal asphyxia in from the Neonatal Department and Intensive Care Unit of our research group from November 2012 to December 2014 were studied. Full term infants and premature infants ( gestational age >34 weeks, birth weight >2500 g) with neonatal asphyxia, whose umbilical artery blood gas analysis ( including pH and BE) were tested were enrolled in our study. Neonatal asphyxia was diagnosed according to the Apgar score, umbilical artery blood gas analysis, mild asphyxia group and severe asphyxia group were assigned into three groups respectively: severe metabolic acidosis group: pH≤7 and/or BE≤-16 mmol/L; non-severe metabolic acidosis group:77. 2, BE> -8 mmol/L. The diagnosis of multiple organ damage of neonatal asphyxia was made according to the history of perinatal hypoxia,clinical manifestations,laboratory examination and imaging examination.Results Therewere 111 cases in our study ( mild asphyxia: n =79 , severe asphyxia: n =32 ) . ( 1 ) The pH and BE of umbilical artery blood gas were positively related to 1 minute Apgar score ( pH: r=0. 223, P=0. 016;BE: r=0. 293, P=0. 002). (2) Multi-factor analysis of umbilical artery blood pH and BE showed that abnormal fetal heart rate was an important factor (β =0. 080 , 95℅ CI 0. 010 -0. 160 , P =0. 025 ) . (3) The incidence of multiple organ damage in severe asphyxia group was significantly higher than that in mild asphyxia group (75. 0℅ vs. 29. 1℅, Χ2 =17. 810, P34周、生后检测脐动脉血pH和BE的窒息新生儿,根据Apgar评分诊断新生儿窒息,根据脐血血气分析将轻度窒息组和重度窒息组分别分为严重代谢性酸中毒组(pH≤7和/或BE≤-16mmol/L)、非严重代谢性酸中毒组(77.2且BE>-8).根据围产期缺氧病史、临床表现、实验室检查和影

  19. 围生期窒息新生儿脑损伤早期超声的临床诊断价值%Diagnostic value of cerebral ultrasound in early brain damage of asphyxia children in perinatal period

    Institute of Scientific and Technical Information of China (English)

    李静波; 王建荣; 张海峰

    2015-01-01

    目的:对围生期窒息病史的新生儿,72h内行床旁颅脑超声检查,观察脑组织结构及血流动力学改变,探讨此类患儿早期常见脑损伤类型及超声表现。方法方患儿出生后72h内行首次颅脑超声检查,多普勒技术经颞囟检测大脑前动脉、中动脉血流动力学变化,主要参数:收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)。结果生后72h内超声检查,60例患儿中47例表现不同程度的脑损伤,阳性率78.3%。结论围生期窒息患儿易造成缺氧缺血性脑损伤,颅脑超声可早期发现脑组织结构改变及血流动力学变化,72h内检查阳性率高,对NICU中的重症患儿,超声具有床旁检查的优势。%Objective In this work ,the newborn babies with the history of asphyxia in the perinatal period were subjec‐ted to the bedside cerebral ultrasound examination within 72 h .The brain structure and hemodynamic changes were ob‐served so as to early explore the the common type of brain injury and sonographic findings in these children .Methods Children born within 72 h underwent the bedeside cerebral ultrasound examination for the first time .The main parame‐ters ,which reflected the blood flow dynamic changes in anterior cerebral artery and middle cerebral artery ,in terms of the peak systolic blood flow velocity (Vs) ,end‐diastolic velocity (Vd) ,and resistance index (RI) ,were detected with doppler technique via temporal fontanelle .Results By the Ultrasound test within 72 h after birth ,47 out of 60 cases were shown brain injury at different extent .The positive rate was 78 .3% .Conclusion Children with asphyxia in the perinatal period are prone to hypoxic ischemic brain damage .Cerebral ultrasound can early detect the changes of brain tissue structure and hemodynamics .Checking within 72 h ,the positive rate is high .For the severe patients in NICU ,ultrasound has the ad‐vantages for

  20. 脐动脉血气指标诊断新生儿窒息的临床研究%Clinical research of umbilical arterial blood gas indicators on neonatal asphyxia diagnosis

    Institute of Scientific and Technical Information of China (English)

    张振宗

    2012-01-01

    Objective To study the umbilical arterial blood gas reference values of newborns and to guide diagnosis and treatment of the premature infants. Methods Three hundred and ninety - eight full - term newborns in our hospital were included in the study. Their umbilical arterial blood gas value was measured within 1 min after birth. The correlation among the umbilical arterial blood gas value, Apgar score and organ damage was analyzed. Results With the lower pH value, the incidence of neonatal organ injury gradually increased. pH value of umbilical arterial blood and Apgar were significantly and negatively correlated with hypoxic organ damage. The lower the pH and Apgar values were, the higher the incidence of organ damage was. Conclusion Low Apgar score with umbilical arterial pH less than 7. 0 help the diagnosis of neonatal asphyxia. Blood gas analysis is one of the key indicators for the diagnosis of premature infants.%目的 研究新生儿生后脐动脉血气参考值,以指导早产儿临床对窒息的诊断及处理.方法 对在本院分娩的398例足月新生儿生后1 min内行脐动脉血血气测定,并分析其与Apgar评分、脏器损伤之间的相关性.结果 随着pH值的降低,新生儿脏器损伤发生率逐渐增高.脐动脉血pH、Apgar分别与缺氧性脏器损伤呈显著负相关,pH、Apgar值愈低,脏器损伤的发生率愈高.结论 低Apgar评分结合脐动脉血pH<7.0有助于诊断新生儿窒息.血气分析结果为诊断早产儿窒息的主要指标之一.

  1. Association of heart rate variability with 5-minute Apgar score in neonates with severe asphyxia%重度窒息新生儿5分钟Apgar评分的心率变异性分析

    Institute of Scientific and Technical Information of China (English)

    王瑾; 李丽; 阚亚楠; 梁宏伟; 陈家菲

    2013-01-01

    目的探讨重度窒息新生儿5 min Apgar评分与心率变异性(HRV)的关系。方法入选103例出生后1 min Apgar评分为0~3分的重度窒息新生儿,根据出生后5 min Apgar评分分组,>7分为A组(n=50),≤7分B组(n=53);同时以40例1、5 min Apgar评分均>7分的足月新生儿作为对照组;三组新生儿均于出生后第3天行24 h动态心电图检查,并分析其HRV变化。结果 B组较对照组及A组HRV时域指标PNN50、rMSSD、SDSD降低,SDNN、SDANN升高,差异均有统计学意义(P0.05)。结论新生儿窒息损伤自主神经功能,5 min Apgar评分联合HRV时域参数可作为重度窒息新生儿自主神经功能损伤及预后的无创判断指标。%Objective To explore the relationship between 5-minute Apgar score and heart rate variability (HRV) in severely asphyxiated neonates. Methods A total of 103 severely asphyxiated neonates with 1-minute Apgar score of 0 to 3 points were selected. They were divided into Group A (>7 points, n=50) and Group B (≤7 points, n=53) based on 5-minute Apgar score. Meanwhile, 40 full-term neonates with 1-and 5-minute Apgar score greater than 7 points were selected as control group. 24-hour dynamic electrocardiogram was performed and HRV was analyzed on the third day after birth in three groups. Results PNN50, rMSSD, SDSD were decreased and SDNN, SDANN were increased in group B as compared with group A and control group (P0.05). Conclusions Neonatal asphyxia can cause damage to autonomic nervous system. 5-minute Apgar score and HRV can be joint-ly used as a non-invasive index in autonomic nervous damage and its prognosis in asphyxiated newborns.

  2. Icterus Neonatorum in Near-Term and Term Infants: An overview

    OpenAIRE

    Rehan Ali; Shakeel Ahmed; Maqbool Qadir; Khalil Ahmad

    2012-01-01

    Neonatal jaundice is the yellowish discoloration of the skin and/or sclerae of newborn infants caused by tissue deposition of bilirubin. Physiological jaundice is mild, unconjugated (indirect-reacting) bilirubinaemia, and affects nearly all newborns. Physiological jaundice levels typically peak at 5 to 6 mg/dL (86 to 103 μmol/L) at 72 to 96 hours of age, and do not exceed 17 to 18 mg/dL (291–308 μmol/L). Levels may not peak until seven days of age in Asian infants, or in infants born at 35 to...

  3. Thermopharmacology of anticonvulsive treatment after perinatal asphyxia

    NARCIS (Netherlands)

    van den Broek, M.P.H.

    2013-01-01

    Therapeutic hypothermia in the immediate postnatal period has been shown to be a successful strategy for neuroprotection in encephalopathic newborns in clinical trials. Due to the effect of hypothermia on physiological functions, such as heart rate and liver enzyme metabolic capacity, as well as eff

  4. Acute kidney injury in asphyxiated neonates

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    Roy Amardiyanto

    2013-07-01

    Full Text Available Background Asphyxia neonatorum may result in multiorgan dysfunction including renal involvement. There is no consensus on the determination of acute kidney injury (AKI in neonates making establishment of the diagnosis and its management becomes difficult. The Acute Kidney Injury Network (AKIN recommends AKI criteria based on increased serum creatinine level and reduced urine output. Objectives To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria, to compare the difference of AKI stages, and the glomerular filtration rates (GFR between moderate and severe asphyxia. Methods This was a cross-sectional analytical study conducted between July 2012 and January 2013. Subjects were all asphyxiated neonates (Apgar score 35 weeks delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital, Jakarta, Indonesia. Glomerular filtration rate was calculated using the components of urine creatinine, serum creatinine, and urine output; while AKI stages were determined according to AKIN criteria. Urinary output was measured via urethral catheterization. Results Of 94 subjects, there were 70 neonates with moderate and 24 neonates with severe asphyxia, with the prevalence of AKI was 63%. Twenty one out of 24 neonates with severe asphyxia experienced AKI, while neonates with moderate asphyxia who experienced AKI was 38 out of 70 subjects (54%. Two third of neonates with severe asphyxia who experienced AKI had stage 3 of AKI. More severe AKI stages and lower median GFR were found in neonates with severe compared to moderate asphyxia (P<0.001. Conclusion The prevalence of AKI in neonatal asphyxia is high (63%. The more severe degree of neonatal asphyxia, the more severe AKI stage and the lower median GFR. [Paediatr Indones. 2013;53:232-8.].

  5. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis Asfixia perinatal asociada a la mortalidad neonatal temprana: estudio de población de los óbitos evitables Perinatal asphyxia associated with early neonatal mortality: populational study of avoidable deaths

    Directory of Open Access Journals (Sweden)

    Mandira Daripa

    2013-03-01

    TODOS: Cohorte de población constituida por 2.873 óbitos evitables hasta seis días de vida asociados a la asfixia perinatal ocurridos entre enero de 2001 y diciembre de 2003. Se consideró como asfixia perinatal la presencia de hipoxia intraútero, asfixia al nacer o síndrome de aspiración de meconio en cualquier línea de la Declaración de Óbito original. Variables epidemiológicas también fueron extraídas de las Declaraciones de Nacido Vivo. RESULTADOS: En el trienio, 1,71 muertes por 1.000 nacidos vivos estaban asociadas a la asfixia perinatal, correspondiendo al 22% de los óbitos neonatales tempranos. De los 2.873 óbitos evitables, 761 (27% tuvieron lugar en São Paulo, capital; 640 (22%, en la región metropolitana de la capital; y 1.472 (51% en el interior de la provincia. En las dos primeras regiones predominaron las muertes en hospitales públicos, recién nacidos con edad gestacional inferior a 37 semanas y peso inferior a 2.500g. En el interior, los óbitos fueron más frecuentes en entidades benéficas, recién nacidos a término y con peso superior a 2.500g. La mayoría de los bebés nació durante el día en el municipio de residencia materna y evolucionó a óbito en el hospital de nacimiento hasta 24 horas después del parto. El síndrome de aspiración de meconio estuvo presente en el 18% de los óbitos. CONCLUSIONES: La asfixia perinatal es un contribuyente frecuente a la muerte neonatal temprana evitable en la provincia con el más grande producto interno bruto per capita de Brasil, lo que evidencia la necesidad de intervenciones específicas con enfoque regionalizado en la asistencia al parto y al nacimiento.OBJECTIVE: To compare the epidemiological profile of avoidable early neonatal deaths associated with perinatal asphyxia according to region of death in the State of São Paulo, Brazil. METHODS: Population-based cohort study including 2,873 avoidable deaths up to six days of life associated with perinatal asphyxia from January 2001 to December

  6. An experimental study on the effects of rhythmic abdominal lifting and compression during cardiopulmonary resuscitation in a swine model of asphyxia%腹部提压法对窒息性心搏骤停猪复苏效果的实验研究

    Institute of Scientific and Technical Information of China (English)

    李秀满; 王立祥; 刘亚华; 孙鲲; 马立芝; 郭晓东; 李会清

    2012-01-01

    功能评分(分)低于CC-CPR组(1.11±0.33比3.50±0.70,P<0.01).结论 在窒息性心搏骤停猪的复苏早期,ALC-CPR较CC-CPR更具优势.%Objective To compare the hemodynamic and respiratory influences of chest compressioncardiopulmonary resuscitation (CC-CPR) and rhythmic abdominal lifting and compression-cardiopulmonary resuscitation (ALC-CPR) in a swine model of asphyxia cardiac arrest (CA),and evaluate the effectiveness of rhythmic abdominal lifting and compression.Methods Thirty swines were randomly divided into two groups,with 15 swines in each group.CA model was reproduced by asphyxia as a result of clamping the trachea,and CC-CPR and ALC-CPR was conducted in two groups,respectively.Electrocardiogram (ECG),pulse oxygen saturation (SpO2),end-tidal partial pressure of carbondioxide (PETCO2),aorta systolic blood pressure (SBP),diastolic blood pressure (DBP),central venous pressure (CVP),and tidal volume (VT) were monitored continuously from 10 minutes before asphyxia to the end of experiment.The aorta mean arterial pressure (MAP),coronary perfusion pressure (CPP) and minute ventilation (MV) were calculated. Artery blood samples were collected to determine the blood gas analysis at 10 minutes before asphyxia,10 minutes after asphyxia,and 5,10,20 minutes after resuscitation.The restoration of spontaneous circulation (ROSC) rate,24-hour survival rate and 24-hour neurological function score were observed.Results There were no significant differences in all mentioned indexes between two groups at 10 minutes before and 10 minutes after asphyxia.At 2 minutes after the resuscitation,the MAP (mm Hg,1 mm Hg=0.133 kPa) and CPP (mm Hg) in CC-CPR group were significantly higher than those in ALC-CPR group (MAP:43.60 ± 12.91 vs.33.40 ± 6.59,P<0.05; CPP:21.67 ± 11.28 vs.11.80 ± 4.16,P<0.01 ),the Vr (ml) and MV (L/min) in ALC-CPR group were significantly higher than those in CC-CPR group (VT:111.67 ± 18.12 vs.56.60 ± 7.76; MV:11.17 ± 1.81vs.5.54 ± 0.79,both P<0.01 ).At 5,10,20 minutes

  7. Effect of Simo decoction,Clostridium butyricnm powder in treatment of neonatal asphyxia during perinatal period after feeding intolerance%四磨汤与酪酸梭菌活菌散治疗新生儿围生期窒息后喂养不耐受的观察

    Institute of Scientific and Technical Information of China (English)

    卓文娟

    2012-01-01

    [目的]观察四磨汤、酪酸梭菌活菌散治疗新生儿围生期窒息后喂养不耐受的情况. [方法]选择本院有围生期窒息后喂养不耐受的新生儿68例为实验对象,并随机分为对照组(n=36)和治疗组(n=32),羊水有胎粪污染者,两组均予洗胃,洗胃后禁食6h才开奶,对照组予枯草杆菌二联活菌颗粒治疗,治疗组予四磨汤、酪酸梭菌活菌散治疗.每天记录呕吐的次数、呕吐量、进食的奶量、大便次数、腹胀消失的日龄、恢复出生体重的日龄等. [结果]实验组呕吐次数减少、呕吐及腹胀消失时间提前、达50 kCal/(kg·d)日龄,恢复出生体重的日龄均提前,差异有统计学意义(P<0.05).[结论]四磨汤、酪酸梭菌活菌散治疗新生儿围生期窒息后喂养不耐受,能促进胃肠功能成熟,提高喂养的耐受性,而且安全.%[Objective] To observe the effect of Simo decoction,the condition of intolerant infants under Clostridium butyricum powder in treatment of neonatal asphyxia during perinatal period after feeding. [Methods] 68 infants selected as cases and were randomly divided into the control group (n=36) and treatment group (n = 32) cases with amniotic fluid meconium pollution in two groups were treated with gastric lav-age,after gastric lavage they could not open the milk until fasting for 6 hours. The control group received the treatment of Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines,Live,and the treatment group was treated with the Simo decoction,Clostridium bulyricutn powder treatment,daily record of vomiting,amount of milk,stool frequency,abdominal distention disappeared days of age,the days of birth weight,such as age of recovery. [Results] The experimental group reduced frequency of vomiting ,and vomiting, abdominal distension disappeared ahead of time,up to 50 kCal/Ckg·) days in advance, to restore the birth weight of the days in advance,with statistically significant (P<0. 05

  8. Investigation on protective effect of fructose 1, 6-diphosphate used within 6 hours after birth on brain of neonates with asphyxia%窒息新生儿6h内使用1,6-二磷酸果糖对脑保护的效果研究

    Institute of Scientific and Technical Information of China (English)

    卢峥俏; 李宏; 李晓菲; 尹琦

    2011-01-01

    Objective: To explore the protective effect of fructose 1, 6 - diphosphate used within 6 hours on brain of neonates with asphyxia. Methods: 70 neonates with asphyxia were divided into fructose 1, 6 - diphosphate group (40 neonates) and control group (30 neonates), the incidence of hypoxic - ischemic encephalopathy (HIE) in neonates within 72 hours was observed, the changes of serum enzymes (LDH, AST, CK, CK-MB and HBDH), interleukin -6 (IL-6), interleukin -8 (IL-8), tumor necrosis factor-α (TNF-α)levels within 6 hours after birth, 3 days, 10 days were monitored; the neonates at 13 ~ 14 days and 27 ~28 days after birth received neonatal behavioral neurological assessment ( NBNA), psychomotor development quotient (DQ) was detected by Gesell development table at 42 days,3 months, 6 months, 9 months and 12 months after birth. Results: The incidences of HIE and moderate to severe HIE in fructose 1, 6 -diphosphate group were significantly lower than those in control group ( P < 0. 05 ); there was significant difference in the decrease levels of serum enzymes between fructose 1, 6 -diphosphate group and control group (P <0. 01 ); at three days after birth, the level of serum IL-6 in fructose 1, 6 - diphosphate group was significantly higher than that in control group (P < 0. 05 ), while the levels of serum lL - 8 and TNF - α in fructose 1, 6 - diphosphate group were significantly lower than those in control group ( P < 0. 01 ); at ten days after birth, the levels of serum IL - 8 and TNF - α in fructose 1, 6 - diphosphate group were significantly lower than those in control group ( P < 0. 01 );NBNA score and DQ in fructose 1, 6 - diphosphate group were significantly higher than those in control group ( P < 0. 05 ) . Conclusion:For the neonates with asphyxia, fructose 1, 6 -diphosphate used within 6 hours after birth can prevent and treat HIE significantly, which has a protective effect on brain of neonates.%目的:探讨研究窒息新生儿于生后6

  9. Detection of the therapeutic effect on Yunnan Baiyao combined with Aluminum Phosphate Gel on severe asphyxia in newborn combined gastric bleeding%云南白药联合磷酸铝凝胶治疗新生儿重度窒息合并胃出血的效果

    Institute of Scientific and Technical Information of China (English)

    史军然; 金静维; 张秀华; 刘彦霞

    2015-01-01

    Objective To investigate the curative effect of Yunnan Baiyao combined with Aluminum Phosphate Gel on severe neonatal asphyxia combined gastric bleeding. Methods Eighty three severely asphyxiated combined gastric bleeding full-term normal delivery newborn were selected in Shijiazhuang Maternal and Child Health Hospital from January 2012 to September 2014. They were divided into 43 cases of the therapy group and 40 cases of the control group according to the odevity of admission number. Two sets were all treated the primary disease and to detain the gastric tube, absolute diet, and other some supporting curation according to the clinical syndromes. The therapy group was nasal fed Yunnan Baiyao and Aluminum Phosphate Gel alternately. But the control group was only given Yunnan Baiyao. The curative effect was observed as well as untoward reaction. Results The effective power was 97.67% in the therapy group that super to 82.50%of the control group. There was a statistically significant difference (P<0.05). The time of stopping hematemesis, occult blood darkening in stomach contents and stopping row tarry stools between the therapy group and the control group was (3.77±1.43), (43.91±16.88), (8.77±2.11) h and (7.35±1.78), (55.63±19.04), (9.88±2.50) h respectively. Time of reaching valid was earlier than the control group (P<0.05 or P<0.01). Conclusion Yunnan Baiyao combined with Aluminum Phosphate Gel on severe neonatal asphyxia combined gastric bleeding is convenient and economy on medication. The therapeutic effect is precise. Time of reaching valid is quick. And it has a diminutive toxic and side-effect. So it deserves clinical promotion.%目的:观察云南白药治疗新生儿重度窒息合并胃出血的临床效果。方法将2012年1月~2014年9月河北省石家庄市妇幼保健院收治的83例重度窒息合并胃出血新生儿,按住院号奇偶数分为治疗组43例,对照组40例。两组均积极治疗原发病,留置胃管,禁食,

  10. Predictive value of qualitative assessment of general movements for adverse outcomes at 24 months of age in infants with asphyxia%全身运动质量评估对窒息新生儿24月龄时不良结局的预测价值

    Institute of Scientific and Technical Information of China (English)

    陈楠; 温晓红; 黄金华; 王水云; 祝月娥

    2015-01-01

    ObjectiveTo investigate the predictive value of the qualitative assessment of general movements (GMs) for adverse outcomes at 24 months of age in full-term infants with asphyxia.MethodsA total of 114 full-term asphyxiated infants, who were admitted to the neonatal intensive care unit between 2009 and 2012 and took part in follow-ups after discharge were included in the study. All of them received the qualitative assessment of GMs within 3 months after birth. The development quotient was determined with the Bayley Scales of Infant Development at 24 months of age.ResultsThe results of the qualitative assessment of GMs within 3 months after birth showed that among 114 infants, 20 (17.5%) had poor repertoire movements and 7 (6.1%) had cramped-synchronized movements during the writhing movements period; 8 infants (7.0%) had the absence of fidgety movements during the fidgety movements period. The results of development quotient at 24 months of age showed that 7 infants (6.1%) had adverse developmental outcomes:6 cases of cerebral palsy and mental retardation and 1 case of mental retardation. There was a poor consistency between poor repertoire movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=-0.019;P>0.05). There was a high consistency between cramped-synchronized movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=0.848;P0.05)。痉挛性同步运动与24月龄时患儿发育结局的一致性较高(Kappa=0.848, P<0.05),其对24月龄发育结局的预测效度为98.2%,敏感度为85.7%,特异度为99.1%,阳性预测值为85.7%,阴性预测值为99.1%。不安运动阶段不安运动缺乏与24月龄时患儿发育结局的一致性较高(Kappa=0.786, P<0.05),其对24月龄发育结局的预测效度为97.4%,敏感度为85.7%,特异度为98.1%,阳性预测值为75.0%,阴性预测值为99.1%。结论 GMs评估示痉挛性同步

  11. 心肺复苏后大鼠皮质区凋亡相关性微小RNA的表达变化%Expression changes in apoptosis-related microRNA in cerebral cortex after cardiopulmonary resuscitation in rat models of cardiac arrest induced by asphyxia

    Institute of Scientific and Technical Information of China (English)

    任妙丹; 何爱文; 陈寿权; 李章平; 乔江华; 李东芳; 李惠萍; 黄唯佳; 程俊彦

    2014-01-01

    Objective To observe the expression changes in apoptosis-related microRNA(miRNA) in cerebral cortex after cardiac arrest-cardiopulmonary resuscitation(CA-CPR)in rats and explore the factors that may affect the mechanism of CPR. Methods 24 clean male Sprague-Dawley(SD)rats were randomly divided into three groups,the normal control group,sham operation group and CA-CPR group(each n=8). The animal model of CA induced by asphyxia was established and CPR was performed. In the normal control group,no special management was performed. In the sham operation group,only abdominal cavity anesthesia,tracheotomy,vascular puncture and electrocardiogram(ECG)were performed without clamping the trachea and resuscitating. Normal feeding in normal control group and 24 hours after tracheotomy in sham operation group,at 24 hours after recovery of spontaneous circulation(ROSC)in CA-CPR group,cerebral cortex specimens were obtained for detection of the expression of miRNA by using real time fluorescence quantitative reverse transcription - polymerase chain reaction(RT-PCR). Flow cytometry(FCM)was used to detect the neurocyte apoptotic rate. Results Compared between normal control and sham operation groups,there were no significant differences in the expression of apoptosis-related miRNA and neurocyte apoptosis rate of cerebral cortex(both P>0.05). Compared with sham operation group,in CA-CPR group, 16 miRNA expressions were up-regulated,including Let-7c,miR-15a,miR-21,miR-24,miR-29,miR-29b, miR-34a, miR-103, miR-200a, miR-200b, miR-200c, miR-210, miR-326, miR-338-3p, miR-494 and miR-497,and there were 22 down-regulated,being Let-7a,Let-7b,Let-7d,Let-7e,miR-19a,miR-19b-1, miR-20a,miR-20b,miR-23a,miR-23b,miR-25,miR-98,miR-107,miR-122a,miR-125a,miR-125b, miR-145,miR-181a,miR-181c,miR-335,miR-384-5p and miR-422a. Eight miRNA had significant changes at 24 hours after ROSC,in which miR-15a,miR-21,miR-34a,miR-497 were up-regulated respectively for 6.831±2.625,8.122±3.442,5.349±2.010,6.590±3

  12. Feasibility of Implementing an Early Intervention Program in an Urban Low-Income Setting to Improve Neurodevelopmental Outcome in Survivors Following Birth Asphyxia Faisabilité de mise en œuvre d'un Programme d'Intervention Précoce dans les milieux urbains à faibles revenus afin d'améliorer le résultat neurodéveloppemental chez les enfants survivant à une asphyxie à la naissance Viabilidad de la aplicación de un Programa de Intervención Precoz en un entorno urbano de bajos ingresos para mejorar el neurodesarrollo en los supervivientes luego de un cuadro de asfixia perinatal

    Directory of Open Access Journals (Sweden)

    Elwyn Chomba

    2011-08-01

    Full Text Available Birth asphyxia is a leading cause of neonatal mortality, accounting for 23% of neonatal deaths. An early intervention program (EIP could improve neuro-developmental outcomes in survivors of birth asphyxia, but its feasibility in low-income countries has not been tested.  In this pilot study in Zambia, eighty live-born infants > 1500 g of weight who had birth asphyxia and received resuscitation with bag and mask were enrolled for a study of standard care or EIP. Mothers/babies pairs were randomized into control (standard care and intervention (EIP groups and were followed up at home on a bi-weekly basis from 8 weeks to 8 months of age. Forty two mothers/babies (52.5% completed the study at 8 months. Reasons for not completing the study were: 19 (50.1% were lost to follow up, 16 (42.1% withdrew, and 3 (7.8% died. Follow-up to 8 months of age was not feasible for the majority in a large urban city with a low income population. Thus, interventions for children who have suffered birth asphyxia that require additional health care visits may not be currently feasible in the setting tested. There is a need to conduct further EIP studies to determine ways to improve follow up rates of children surviving birth asphyxia. Integrating early intervention programs with other successful health programs, such as the existing immunization programs, may improve follow up rates.L'asphyxie à la naissance est une cause majeure de la mortalité néonatale et représente 23 % des morts néonatales. Un programme d'intervention précoce (EIP, sigle en anglais pourrait améliorer les résultats neurodéveloppementaux chez les nouveau-nés survivant à une asphyxie à la naissance, mais sa faisabilité dans les pays à faibles revenus n'a pas été testée. Dans cette étude pilote conduite en Zambie, quatre-vingt nourrissons nés vivants d'un poids > 1 500 g, ayant souffert d'une asphyxie à la naissance et réanimés avec un masque et un ballon, ont été retenus pour

  13. PELAYANAN KESEHATAN PERINATAL DI DAERAH PEDESAAN UJUNG BERUNG

    Directory of Open Access Journals (Sweden)

    Anna Alisjahbana

    2012-09-01

    Full Text Available A survey on perinatal care in a rural area at Ujung Berung district, located 15—20 km outside Bandung, West Java was conducted. Three villages with a population of 40,787 were selected. Health services were provided by one health post and several family planning posts. In this study 1303 pregnant women were followed throughout the 28 weeks of pregnancy until the infant is 28 days of age. Among the 1303 pregnant women 5.7% had received tetanus toxoid immunization. Perinatal mortality rate (PMR was 43.6 per thousand and incidence of low birth weight was 14.3 percent. Only 12.8% pregnant women were using some kind of contraception before the last pregnancy. The PMR decreased in spite of the low percentage users. The main causes of death during perinatal period vece asphyxia neonatorum and infections. The incidence of tetanus neonatorum during neonatal period was 17 per thousand live births. An evaluation of health service activities showed 47.5% of these pregnant women had antenatal care. Care during delivery and early postnatal period was carried out by TBAs. No significant difference was found between the PMR of trained and untrained TBAs. Another aspect of health service activities is referral to the health centre or hospital. A total of 3.8 percent infants were referred because of neo­natal problems; among these, refusal was 12.5% due to the totalistic attitude of the parents in the village. The results showed that coverage of pregnant women and their infants by safe health care services is very low. This may be due to lack of facilities and health personnel, and probably also due to the confidence of village people for traditional health care providers. Thus, education and training as well as supervision of traditional health care providers and their integration into the formal health care structure is of extreme importance.  

  14. 胎盘早剥42例临床分析%The Clinical Analysis of 42 Cases of Placental Abruption

    Institute of Scientific and Technical Information of China (English)

    梁白云

    2014-01-01

    Objective To explore the clinical features and treatment of placental abruption. Methods 42 cases of puerperants with placental abruption admitted in our hospital were selected, and the clinical data of them were taken for retrospectively analysis. Results Of the 42 cases of puerperants with placental abruption, there were 16 cases of normal childbirth, 26 cases of cesarean section;27 cases of abruption I degree, and 2 cases of postpartum hemorrhage;11 cases of early stripping II degree, and 4 cases of postpartum hemorrhage;4 cases of early stripping III degree, and all with postpartum bleeding, 1 case had disseminated inravascu-lar coagulation and was treated with hysterectomy. Of the 42 cases of puerperants with placental abruption, all were single births, there were 16 cases of asphyxia neonatorum (38.1%), 2 cases of stillbirth (4.8%); the result of placental abruption caused by as-phyxia neonatorum had statistical difference (P<0.05). Conclusion The clinical characteristics and inducement of placental abrup-tion should be attached importance, and accessory examination should be conducted regularly and placental abruption should be diagnosed and treated early.%目的:探析胎盘早剥的临床特征及处理情况。方法入选该院胎盘早剥产妇42例,对其临床资料进行回顾性分析。结果胎盘早剥42例中顺产16例,剖宫产26例;27例早剥I度,2例产后出血;11例早剥II度,4例产后出血;4例III度早剥,全部产后出血,1例出现弥散性血管内凝血予以子宫切除术。胎盘早剥42例孕妇,均为单胎,导致新生儿窒息16例(38.1%),死胎2例(4.8%),胎盘早剥分度引发的新生儿窒息情况,结果差异有统计学意义(P<0.05)。结论应对胎盘早剥的临床特征及诱因予以重视,定期进行辅助检查,早期诊治胎盘早剥。

  15. Clinical valuation on intrathecal block for pain relief in labor%椎管内阻滞用于分娩镇痛的观察

    Institute of Scientific and Technical Information of China (English)

    陆伟峰

    2013-01-01

    目的观察腰硬联合麻醉与单纯硬膜外麻醉用于分娩镇痛的效果。方法将自愿接受分娩镇痛的产妇40例随机分成硬膜外阻滞(CEA组)与腰硬联合阻滞(CSEA组)各20例,另随机抽取40例未施行分娩镇痛者作为对照组。在镇痛效果、产程进展、分娩方式、新生儿窒息等方面进行比较。结果3组在产程进展、分娩方式、新生儿窒息差异无显著性。在分娩镇痛方面,CSEA组镇痛效果优于CEA组,2组比较有显著差异。结论椎管内麻醉镇痛效果好,安全性高,适用于分娩镇痛,CSEA法比CEA法镇痛效果更佳。%Objective To observe the effect of spinal analgesia combined with epidural anesthesia for pain relief in labor. Methods 80 puerpera divide two groups randomly;40 puerpera on epidural anesthesia and 40 puerpera on spinal-epidural anesthesia.Another 80 puerperans without anesthesia as matched group.Compare the anesthesia effect, progress of labor, asphyxia neonatorum. Results they were not significant differences at progress of labor, asphyxia neonatorum between anesthesia group and matched group.But spinal- epidural anesthesia group was superior to simplicity epidural anesthesia group at anesthesia effect,there were significant differences. Conclusion There were definite anesthesia effect and high safety with intravertebral anesthesia as analgesia of parturition.and spinal- epidural anesthesia was more definite than simplicity epidural anesthesia .

  16. Síndrome de Asfixia Sumersión Asphyxia Drowning Syndrome

    Directory of Open Access Journals (Sweden)

    A. Sibón Olano

    2005-07-01

    Full Text Available El hallazgo de un cadáver en el agua siempre nos plantea dudas diagnósticas: ¿Estamos ante un cadáver arrojado o caído al agua? ¿El sujeto ha fallecido por causas distintas a la sumersión, incluidas las de origen natural? ¿Se trata de una verdadera muerte por sumersión?. La utilización de exámenes complementarios en el diagnóstico de asfixia por sumersión ha sufrido diversos avatares. Las determinaciones bioquímicas han tropezado con los artefactos debidos a la putrefacción, lo que ha llevado a la aparición de determinados métodos de diagnóstico muy controvertidos. Además, los experimentos realizados en animales no siempre son extrapolables al ser humano, dado que hasta la cantidad de agua absorbida por vía aérea, parece ser mucho menor para estos últimos. El diagnóstico de muerte por sumersión se realizará, por lo tanto, estableciendo una correlación entre los hallazgos propios de la sumersión observados en la autopsia y las diferentes pruebas analíticas realizadas en el laboratorio.The finding of a corpse in water always raise doubts for a proper diagnosis: Are we before a corpse thrown or fallen into the water? Was the death due to causes different from drowning, including naturals?. It is a true death by drowning?. The use of complementary examinations in the diagnosis of drowning has undergone diverse ups and downs. The biochemical determinations have been confronted with the artefacts related to the putrefaction which has favoured the appearance of certain very controverted methods of diagnosis. In addition, the experiments made in animals not always must be applied to the human's beings, since the absorbed amount of water by air passages seems to be much smaller for the latest's. The diagnosis of death by drowning will be made, therefore, establishing a correlation between the typical findings of the submersion observed in the autopsy and the different complementary laboratory tests.

  17. Inhaled 45–50% argon augments hypothermic brain protection in a piglet model of perinatal asphyxia

    Science.gov (United States)

    Broad, Kevin D.; Fierens, Igor; Fleiss, Bobbi; Rocha-Ferreira, Eridan; Ezzati, Mojgan; Hassell, Jane; Alonso-Alconada, Daniel; Bainbridge, Alan; Kawano, Go; Ma, Daqing; Tachtsidis, Ilias; Gressens, Pierre; Golay, Xavier; Sanders, Robert D.; Robertson, Nicola J.

    2016-01-01

    Cooling to 33.5 °C in babies with neonatal encephalopathy significantly reduces death and disability, however additional therapies are needed to maximize brain protection. Following hypoxia–ischemia we assessed whether inhaled 45–50% Argon from 2–26 h augmented hypothermia neuroprotection in a neonatal piglet model, using MRS and aEEG, which predict outcome in babies with neonatal encephalopathy, and immunohistochemistry. Following cerebral hypoxia–ischemia, 20 Newborn male Large White piglets < 40 h were randomized to: (i) Cooling (33 °C) from 2–26 h (n = 10); or (ii) Cooling and inhaled 45–50% Argon (Cooling + Argon) from 2–26 h (n = 8). Whole-brain phosphorus-31 and regional proton MRS were acquired at baseline, 24 and 48 h after hypoxia–ischemia. EEG was monitored. At 48 h after hypoxia–ischemia, cell death (TUNEL) was evaluated over 7 brain regions. There were no differences in body weight, duration of hypoxia–ischemia or insult severity; throughout the study there were no differences in heart rate, arterial blood pressure, blood biochemistry and inotrope support. Two piglets in the Cooling + Argon group were excluded. Comparing Cooling + Argon with Cooling there was preservation of whole-brain MRS ATP and PCr/Pi at 48 h after hypoxia–ischemia (p < 0.001 for both) and lower 1H MRS lactate/N acetyl aspartate in white (p = 0.03 and 0.04) but not gray matter at 24 and 48 h. EEG background recovery was faster (p < 0.01) with Cooling + Argon. An overall difference between average cell-death of Cooling versus Cooling + Argon was observed (p < 0.01); estimated cells per mm2 were 23.9 points lower (95% C.I. 7.3–40.5) for the Cooling + Argon versus Cooling. Inhaled 45–50% Argon from 2–26 h augmented hypothermic protection at 48 h after hypoxia–ischemia shown by improved brain energy metabolism on MRS, faster EEG recovery and reduced cell death on TUNEL. Argon may provide a cheap and practical therapy to augment cooling for neonatal encephalopathy. PMID:26687546

  18. Setting research priorities to reduce almost one million deaths from birth asphyxia by 2015.

    OpenAIRE

    Lawn, Joy E.; Rajiv Bahl; Staffan Bergstrom; Bhutta, Zulfiqar A; Darmstadt, Gary L; Matthew Ellis; Mike English; Kurinczuk, Jennifer J.; Anne C C Lee; Mario Merialdi; Mohamed Mohamed; David Osrin; Robert Pattinson; Vinod Paul; Siddarth Ramji

    2011-01-01

    Intrapartum-related neonatal deaths (previously called “birth asphyxia”) are the fifth most common cause of deaths among children under 5 years of age, accounting for an estimated 814,000 deaths each year, and also associated with significant morbidity, resulting in a burden of 42 million disability adjusted life years (DALYs). This paper uses a systematic process developed by the Child Health Nutrition Research Initiative (CHNRI) to define and rank research options to reduce mortality...

  19. Firing probability and mean firing rates of human muscle vasoconstrictor neurones are elevated during chronic asphyxia

    DEFF Research Database (Denmark)

    Ashley, Cynthia; Burton, Danielle; Sverrisdottir, Yrsa B;

    2010-01-01

    in the obstructive sleep apnoea syndrome (OSAS) is associated with an increase in firing probability and mean firing rate, and an increase in multiple within-burst firing. Here we characterize the firing properties of muscle vasoconstrictor neurones in patients with chronic obstructive pulmonary disease (COPD), who...... are chronically asphyxic. We tested the hypothesis that this elevated chemical drive would shift the firing pattern from that seen in healthy subjects to that seen in OSAS. The mean firing probability (52%) and mean firing rate (0.92 Hz) of 17 muscle vasoconstrictor neurones recorded in COPD were comparable...

  20. Long-term sequelae of perinatal asphyxia in the aging rat

    DEFF Research Database (Denmark)

    Weitzdoerfer, R; Gerstl, N; Hoeger, H;

    2002-01-01

    function was tested by an observational test battery and rota rod test. Cognitive functions were examined by multiple-T-maze and the Morris water maze (MWM). Increased serotonin transporter (SERT) immunoreactivity in the CA2 region of the hippocampus and a significant difference in the escape latency, when...

  1. Cerebral blood flow and oxygenation in infants after birth asphyxia. Clinically useful information?

    DEFF Research Database (Denmark)

    Greisen, Gorm

    2014-01-01

    perfusion and lack of normal cerebral blood flow regulation are also typically present, but whether the perfusion abnormalities at this secondary stage are detrimental, beneficial, or a mere epiphenomenon remains elusive. In contrast, incomplete reoxygenation of the brain during and following resuscitation......The term 'luxury perfusion' was coined nearly 50 years ago after observation of bright-red blood in the cerebral veins of adults with various brain pathologies. The bright-red blood represents decreased oxygen extraction and hence the perfusion is 'luxurious' compared to oxygen needs. Gradual loss...

  2. Carbon dioxide euthanasia in rats: Oxygen supplementation minimizes signs of agitation and asphyxia

    NARCIS (Netherlands)

    Coenen, A.M.L.; Drinkenburg, W.H.I.M.; Hoenderken, R.; Luijtelaar, E.L.J.M. van

    1995-01-01

    This paper records the effects of carbon dioxide when used for euthanasia, on behaviour, electrical brain activity and heart rate in rats. Four different methods were used. Animals were placed in a box (a) that was completely filled with carbon dioxide; (b) into which carbon dioxide was streamed at

  3. Conventional versus combined apgar scores in neonatal asphyxia: a prospective study

    Directory of Open Access Journals (Sweden)

    Amir Kamal Hardani

    2015-01-01

    Conclusion: In asphyxiated neonates sensitivity and specificity of combined apgar were more than conventional apgar. With respect to this study, better assessment could be achieved by combined apgar score method instead of conventional Apgar.

  4. 过期妊娠分娩方式及终止妊娠时机与胎儿预后的分析研究%Analysis of Delivery Mode and Time of Ending Pregnancy for Prolonged Pregnancy and Fetus Prognosis

    Institute of Scientific and Technical Information of China (English)

    孙建华

    2013-01-01

      目的:探讨过期妊娠分娩方式及终止妊娠时机与胎儿预后的关系。方法:以病例对照研究方法分析2009年1月-2012年12月共86例过期妊娠及684例延期妊娠病例。结果:过期妊娠剖宫产胎儿窘迫率及新生儿窒息率显著低于阴道产,而产后出血率比较差异无统计学意义;过期妊娠组的胎儿窘迫率及新生儿窒息率均显著高于延期妊娠组,但羊水过少发生率比较差异无统计学意义。结论:加强宣教,定期产验,延期妊娠时加强胎儿监护,积极采取恰当的处理,终止妊娠,以减少过期妊娠的发生;发生过期妊娠时放宽剖宫产指征,及时终止妊娠,均有利于降低胎儿窘迫、新生儿窒息、新生儿死亡率。%Objective:To explore the relationship between delivery mode and time of ending pregnancy of prolonged pregnancy with fetus prognosis.Method:86 cases of prolonged pregnancy and 684 cases of delayed pregnancy from January 2009 to December 2012 were analyzed by case-control method.Result:The fetal distress rate and neonatal asphyxia rate of prolonged pregnancy caesarean section were significantly lower than those of vaginal delivery,but there was no significant difference in postpartum hemorrhage rate;the fetal distress rate and neonatal asphyxia rate of prolonged pregnancy were significantly higher than those of delayed pregnancy,but there was no significant difference in the incidence rate of oligohydramnios.Conclusion:Strengthening education,regular prenatal examination, reinforcing fetus supervision in delayed pregnancy,handling actively and properly and ending the pregnancy should be taken to decrease delayed pregnancy. Relaxing the indication cesarean section,ending pregnancy in time when delayed pregnancy is occurred both can help reduce the occurrence rate of fetal distress, asphyxia neonatorum and newborn mortality.

  5. Gastric Myoelectrical Activity of Neonatal Asphyxia%窒息后新生儿胃电活动的研究

    Institute of Scientific and Technical Information of China (English)

    毛志芹; 王伟; 李军; 孙梅; 张惠

    2001-01-01

    目的利用胃电图探讨窒息对新生儿胃电活动的影响. 方法采用瑞典CTd-synectics公司生产的便携式胃电图(EGG)记录仪对50例窒息后新生儿和20例正常新生儿进行了喂奶前、后各30 min的胃电活动的检测,利用计算机EGG Version 6.40软件分析系统分析数据. 结果 70例新生儿有39例(56%)成功记录到EGG.轻度窒息组与对照组比较,喂奶前胃动过缓(4 cpm)百分比明显增多(P<0.01).主功频率不稳定系数(DFIC)增高(P<0.01). 结论 EGG可以用来研究窒息后新生儿的胃电活动,进而研究新生儿消化道动力;围产期轻度窒息新生儿喂奶前胃动过缓增多,重度窒息新生儿喂奶前、后正常慢波百分比明显降低,胃动过速百分比明显增多,提示围产期窒息的新生儿出现拒乳、腹胀、呕吐等症状,可能与其胃电节律异常有关.

  6. Formal training in general movement assessment is required to effectively evaluate infants with perinatal asphyxia in outpatient settings

    DEFF Research Database (Denmark)

    Brown, Annemette K; Greisen, Gorm; Haugsted, Ulla;

    2016-01-01

    AIM: General movement assessment (GMA) can help to identify children with a high risk of developing neurological dysfunction, such as cerebral palsy, and certified training is provided in this specialism. The aim of this study was to investigate the feasibility and reliability of using video...... were analysed using proportional agreement and nominal kappa statistics were used to calculate 95% confidence intervals (95% CI). RESULTS: We found substantial and almost perfect inter-observer and intra-observer reliability. Intra-observer agreement was 0.85 (95% CI: 0.65-1.00; p<0.0001) and 0.85 (95...... the reliability of the GMA method in a busy multidisciplinary Danish paediatric outpatient setting, when assessors had been formally trained in the method and used it regularly. This article is protected by copyright. All rights reserved....

  7. Development of cerebral gray and white matter injury and cerebral inflammation over time after inflammatory perinatal asphyxia

    NARCIS (Netherlands)

    Bonestroo, Hilde J C; Heijnen, Cobi J.; Groenendaal, Floris; Van Bel, Frank; Nijboer, Cora H.

    2015-01-01

    Antenatal inflammation is associated with increased severity of hypoxic-ischemic (HI) encephalopathy and adverse outcome in human neonates and experimental rodents. We investigated the effect of lipopolysaccharide (LPS) on the timing of HI-induced cerebral tissue loss and gray matter injury, white m

  8. 羊水胎粪污染与新生儿窒息观察%Observation of newborn asphyxia and meconium polution in amniotic fluid

    Institute of Scientific and Technical Information of China (English)

    李改彦; 武秀春; 张红菱

    2004-01-01

    @@ 为了探讨羊水胎粪污染与新生儿窒息的关系,我院产科对2002年12月1日~2003年11月30日的1618例活产分娩者(臀位分娩除外)羊水及新生儿情况进行评估,对羊水胎粪污染的原因、程度、发生率与新生儿窒息的关系进行分析,并针对问题提出预防措施,现报告如下.

  9. 窒息对新生儿胃电活动的影响%The Study of Gastric Myoelectrical Activity Neonatal Asphyxia

    Institute of Scientific and Technical Information of China (English)

    李利; 陈艳敏; 范红; 李献珍; 曾明辉

    2002-01-01

    目的:研究窒息对新生儿胃电活动的影响.方法:研究对象来自我院1998年9月~2000年5月以窒息收住新生儿病房的足月新生儿32例,其中重度窒息20例,轻度窒息12例.对照组:系同期以新生儿生理性黄疸收住院的足月新生儿10例,无消化道症状,吃奶好,二便正常.采用瑞典Synectics公司生产的便携式Digitrapper双电极EGG记录仪进行胃电图检查,用计算机运行频谱分析数据.结果:窒息组与对照组比较,餐前胃动过缓显著增加,正常节律百分比、胃动过速明显降低,差别有显著意义(P<0.01和P<0.05).餐后胃动过缓也有增加,差别有显著意义(P<0.01).餐后正常节律百分比、胃动过速也有降低但差别无显著性意义.重度窒息组与轻度窒息组比较,前者餐前胃动过缓明显增加,正常节律百分比明显降低,差别有显著意义(P<0.01).两者餐前胃动过速及餐后各项指标比较均无显著差异(P>0.05).结论:(1)窒息新生儿存在明显胃电节律紊乱.临床多表现为拒奶、喂养不耐受、呕吐和腹胀等消化道症状;(2)体表胃电图与胃肌电活动的相关性较好,可用来研究窒息新生儿的胃电活动,进而研究新生儿消化道动力;(3)窒息组胃电提示异常者,曾试用普瑞博思0.2 mg/(kg@次)治疗能改善临床症状,但尚缺乏胃电图观察,有待进一步胃电图研究.

  10. Antenatal allopurinol for reduction of birth asphyxia induced brain damage (ALLO-Trial); a randomized double blind placebo controlled multicenter study

    NARCIS (Netherlands)

    Kaandorp, Joepe J.; Benders, Manon J. N. L.; Rademaker, Carin M. A.; Torrance, Helen L.; Oudijk, Martijn A.; de Haan, Timo R.; Bloemenkamp, Kitty W. M.; Rijken, Monique; van Pampus, Maria G.; Bos, Arie F.; Porath, Martina M.; Oetomo, Sidarto Bambang; Willekes, Christine; Gavilanes, A. W. Danilo; Wouters, Maurice G. A. J.; van Elburg, Ruurd M.; Huisjes, Anjoke J. M.; Bakker, Saskia C. M. J. E. R.; van Meir, Claudia A.; von Lindern, Jeannette; Boon, Janine; de Boer, Inge P.; Rijnders, Robbert J. P.; Jacobs, Corrie J. W. F. M.; Uiterwaal, Cuno S. P. M.; Mol, Ben Willem J.; Visser, Gerard H. A.; van Bel, Frank; Derks, Jan B.

    2010-01-01

    Background: Hypoxic-ischaemic encephalopathy is associated with development of cerebral palsy and cognitive disability later in life and is therefore one of the fundamental problems in perinatal medicine. The xanthine-oxidase inhibitor allopurinol reduces the formation of free radicals, thereby limi

  11. Effects of Oligohydramnios in Post Expected Date of Confinement Pregnancies on Both Mothers and Their Babies Clinial Analysis of 96 Cases%延期妊娠并发羊水过少对母婴的影响96例临床观察

    Institute of Scientific and Technical Information of China (English)

    王兆菊

    2001-01-01

    目的探讨延期妊娠并发羊水过少对母婴的影响。方法采用回顾性分析方法,对延期妊娠分娩的产妇羊水正常组244例及羊水过少组96例进行对比分析。结果羊水过少组中羊水Ⅱ度以上粪染、胎盘成熟Ⅲ+级及胎盘钙化、胎儿宫内窘迫、新生儿窒息率、产后出血率及剖宫产率明显高于羊水正常组。结论羊水过少是胎儿宫内慢性缺氧最敏感的特异性指标,无论是延期妊娠还是过期妊娠一经确珍,应积极引产,估计短时间内不能分娩者,宜行剖宫产结束妊娠。%Objective To study the effects of oligohydramnios in post expected date of confinement pregnancies on both mothers and their babies. Methods  340 cases in post expected date of confinement pregnancies were retrospectively analysed. Women were divided into two groups (Oligohydramnios group, n=96, normal amniotic fluid group, n=244). Results The rate of amniotic fluid turbidity Ⅱ—Ⅲ degree, placental maturity Ⅲ+ degree and calcification, fetal distress, asphyxia neonatorum, labor induced, postpartum hemorrhage and cesarean section in the oligohydramnios group were significantly higher than those in the normal amniotic fluid group. Conclusion In post expected date of confinement pregnancies or prolonged pregnancies, oligohydramnios is a most specific and sensitive marker to diagnose fetal anoxia in uterus. Once it is accurately diagnosed, we must actively terminate the pregnancy. Cesarean section should be the first choice if the vaginal delivery can't be expected to initiate in a short time.

  12. Etiological Analysis of172 Cases of Mental Retardation%智力低下172例病因分析

    Institute of Scientific and Technical Information of China (English)

    李维君

    2001-01-01

    Objective: To investigate the cause of mental retardation (MR) and its preventive and therapeutic measures. Methods: One hundred and seventy-two children with mental retardation were divided into 2 groups according to age, the younger group being 4 m~3 yrs and the elder group 4~14 yrs old. And 172 healthy children were selected for matched survey from outpatients of child healthy clinic, and the cause of disease was analyzed also. Results: (1) More patients with severe MR were found in the younger group,but more patients of mild MR were found in the older group; (2) Asphyxia neonatorum, premature birth and intracranial infection were important factors causing MR; (3) The development of children's intelligence was closely related with economic condition and cultural level of urban and rural areas. Conclusion:To decrease the occurrence of MR, good service of antenatal care, during delivery and postnatal breeding should be done.%目的:了解智力低下的病因,探索其防治规律。方法:选择儿保门诊172例智力低下患儿按年龄分为4月~3岁78例和4~14岁94例二组,同时选同龄、同性别门诊正常儿172例,采用1:1配对的方法进行病因分析。结果:(1)小年龄组重度智力低下儿较大年龄组多,而大年龄组轻型智力低下者多;(2)新生儿窒息、早产儿、颅内感染是产生智力低下的重要因素;(3)儿童的智能发育状况与城乡经济状况、文化程度密切相关。结论:做好产前、产时、产后各阶段的优生优育优教工作,才能减少智力低下儿的产生。

  13. Influence of scarred uterus pregnancy on pregnancy outcome in patients with placenta previa%瘢痕子宫妊娠并发前置胎盘对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    邬华; 梁旭霞

    2013-01-01

    目的 探讨瘢痕子宫妊娠并发前置胎盘对妊娠结局的影响.方法 68例前置胎盘患者根据是否存在瘢痕子宫分为瘢痕子宫组32例和非瘢痕子宫组36例,比较2组患者的妊娠结局.结果 瘢痕子宫组患者剖宫产率、产后出血率、子宫切除率、新生儿早产发生率、窒息发生率和围生儿病死率均显著高于非瘢痕子宫组(P<0.05),瘢痕子宫组患者产后24 h出血量显著大于非瘢痕子宫组(P<0.05),瘢痕子宫组新生儿体质量显著低于非瘢痕子宫组(P<0.05).结论 瘢痕子宫妊娠并发前置胎盘可增加产妇剖宫产及新生儿早产、窒息、死亡的危险.%Objective To investigate the influence of scarred uterus pregnancy on pregnancy outcome in patients with placenta previa. Methods Sixty-eight patients with placenta previa were divided into scarred uterus group (n =32) and non-scarred uterus group(n =36) according to whether had scarred uterus, then the pregnancy outcome was compared between the two groups. Results The rates of cesarean section, postpartum hemorrhage, hysterectomia, omotocia, apnoea neonatorum and death in the scarred uterus group were significantly higher than those in the non-scarred uterus group(P <0.05), the bleeding of postpartum 24 hours in the scarred uterus group was significantly more than that in the non-scarred uterus group (P < 0. 05), but the body weight of neonates in the scarred uterus group was significantly lower than that in the non-scarred uterus group(P<0. 05). Conclusion The occurrence of scarred uterus pregnancy in patients with placenta previa can increase the risks of cesarean section, omotocia, asphyxia and death.

  14. OBSERVATION ON NEONATOL ASPHYXIA β2-MICROGLOBULIN CONCETRATION LEVELS IN URINE DURING SEVEN DAGS%新生儿窒息尿β2微球蛋白浓度七天内的变化分析

    Institute of Scientific and Technical Information of China (English)

    张润秋; 郑广钧; 郑军; 孟庆和

    1992-01-01

    本文检测58例新生儿窒息和8例宫内窘迫而出生后Apgar评分正常者第1、3、7天尿中β2微球蛋白(简称β2MG))浓度,结果窒息组、宫内窘迫组与正常新生儿比较尿β2MG浓度明显高于对照组,而且呈持续性增高,提示新生儿窒息引起肾小管功能损伤将持续7天.

  15. 脑电图在窒息新生儿早期诊断脑损伤的应用研究%Early evaluation of brain injury by electroencephalogram in neonates with asphyxia

    Institute of Scientific and Technical Information of China (English)

    宋雄; 廖家宣

    2008-01-01

    目的 探讨脑电图(EEC)在窒息新生儿超早期诊断脑损伤的价值.方法 对2003年9月至2005年6月收治住院的49例窒息新生儿生后6 h内进行EEG检查.结果 49例窒息新生儿中,诊断缺氧缺血性脑病(HIE)33例,EEG异常21例,异常率63.3%;单纯窒息16例,EEG仅1例异常,异常率6.3%,中重度HIE患儿EEG异常100%.EEG异常程度与HIE 临床分度基本一致,EEG表现为电静息、爆发抑制改变且2周后持续不恢复者预后差.结论 新生儿窒息早期(6 h内)即可出现EEG改变,EEG可早期反映窒息后脑损伤及程度,EEG可作为窒息新生儿超早期诊断脑损伤的重要检查方法,值得推广应用.

  16. 窒息新生儿脑白质软化的早期诊断及相关因素探讨%Early diagnosis and correlation study of periventricular leukomalacia in asphyxia newborn

    Institute of Scientific and Technical Information of China (English)

    李茂盛

    2004-01-01

    本文应用B超诊断技术进行窒息新生儿脑室周围白质软化(PVL)的早期诊断,并对相关围生因素进行探讨。以期探寻减少窒息新生儿PVL的发生及早期干预措施,改善预后,提高生存质量。

  17. 新生儿窒息后左室射血分数与心肌损伤的关系研究%Study on relationship between ejection fraction of left ventricle and myocardial damage in neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    刘晗; 董应梅; 张素芬; 蔡西方

    2008-01-01

    目的:研究新生儿窒息后左室射血分数与心肌损伤的关系.方法:应用美国百胜公司产CARIS PLUS型彩色超声诊断仪及日本奥林巴斯AU400生化测定仪等,对30例窒息新生儿出生后1 d、3 d、7 ~10 d不同时期左室射血分数及心肌酶测定,并以30例年龄、体重相近的正常新生儿作为对照组.结果:窒息新生儿左室射血分数明显低于正常,心肌酶明显高于正常.经治疗7 ~10 d后心肌酶及左室射血分数逐渐恢复至正常对照组.结论:窒息缺氧可引起心肌损伤,心肌损害越重,心肌酶越高,左室射血分数越低,两者呈正相关,提示左室射血分数可用作反映窒息新生儿心脏受损的指标.

  18. Maternal and fetal prognosis analyses in 13 cases of single intrauterine death in twin pregnancies%13例双胎之一胎儿宫内死亡病例的母儿预后分析

    Institute of Scientific and Technical Information of China (English)

    黄莺莺; 张燕菲; 张园; 王志坚

    2014-01-01

    Objective To investigate the perinatal outcome, maternal and fetal prognosis of single intrauterine death in twin pregnancy. Method 13 cases of single intrauterine death in twin pregnancies from June 2002 to December 2012 in Nanfang Hospital, Southern Medical University were analyzed retrospectively, then carried a follow-up investigation. Results (1) Time of fetal death was detected from 13 w+1 d to 36 w+5 d gestational weeks, average is 29 w gestational weeks. Birth weight of living fetus is 1130g~2890 g,average is 2220 g.(2) In 13 neonates, 1 case was severe asphyxia in newborn, 1 case was mild asphyxia neonatorum. The reasons of fetal death included torsion of umbilical cord, chromosome disorder, unchal cord, chorioamnionitis and placental abruption. 8 cases couldn't be found definite death cause. 2 cases showed ultrasound abnormal, one was fetal septum pellucidum, the other was FGR. (3) 2 puerperants suffered rheumatoid arthritis and chronic hypertension, the disease still present after delivery;1 puerpera suffered gestational diabetes mellitus her blood glucose was still abnormal after delivery. In 13 puerperants, 1 case happened postpartum hemorrhage, 1 case happened post partum chronicity DIC. Survivors’age are from 2 months to 10 years old. There is a 7 years old boy, his physical development is hysteresis compare with the same age children. 1 surviror was detected mild blood coagulation dysfunction. Conclusions Single intrauterine death in twin pregnancy raises up premature labor rate and uterine-incision delivery rate. It has greater influence on puerperants’s blood clotting function when fetal death happened in late pregnancy. Pregnancy outcome has no significant difference between normal labor and uterine-incision delivery. Survivors’prognosis is more related with gestational age, birth weight and asphyxia.%目的:探讨双胎之一胎儿宫内死亡的妊娠结局及母儿预后。方法回顾性分析2002年6月至2012年12月在南方医科

  19. Clinical analysis of 79 case of placental abruption%79例胎盘早剥临床分析

    Institute of Scientific and Technical Information of China (English)

    许园园; 谢穗

    2015-01-01

    To investigate the risk factors of placental abruption, enhance the accuracy of early diagnosis,and decrease the complication of mother and fetus. Methods:The clinical data of 79 cases with placental abruption were retrospectively reviewed in hospital. According to placental separation area are divided into three groups.Ⅰ° placental abruption 34 cases, Ⅱ° placental abruption 30 cases, Ⅲ° placental abruption 15 cases. Results:Ⅱ° andⅢ° placenta l abruption have more typical clinical symptom. The prenatal diagnosis rate of three groups were 93.3% , 100%and 76.4%, Ⅰ° placental abruption had significant difference compared with the other two groups. At the risk factors of three groups,Hypertensive disorders complicating pregnancy for the first. Three groups of asphyxia neonatorum, perinatal death, uterine apoplexy, the incidence of postpartum hemorrhage rate difference has statistics (P<0.05).The rate of cesarean section in Ⅱ° and Ⅲ° placental abruption was higher than that in Ⅰ° placental abruption (P<0.05).Conclusion:Early diagnosis of placental abruption has important clinical significance to strive for the time for rescue, timely terminate pregnancy and reduce maternal and neonatal complications.%目的::探讨胎盘早剥的致病因素,提高早期确诊率,降低母婴并发症。方法:收集某院住院收治的79例胎盘早剥患者资料,比较Ⅰ度、Ⅱ度、Ⅲ度胎盘剥离患者的临床资料。结果:Ⅱ度、Ⅲ度胎盘早剥临床表现较为典型,产前诊断率分别为93.3%及100%,Ⅰ度胎盘早剥的产前诊断率76.4%,Ⅰ度与Ⅱ度、Ⅲ度两组相比有统计学差异(P<0.05)。在三组胎盘早剥的危险因素中,妊娠期高血压疾病占第1位。三组患者的新生儿窒息、围产儿死亡、子宫卒中、产后出血的发生率均有统计学差异(P<0.05),Ⅱ度及Ⅲ度胎盘早剥的剖宫产率明显高于Ⅰ度(P<0.05)。结论:早期诊断胎盘早

  20. Application of Cook Cervical Expansion Ballon in Full-term Pregnancy Cervical Ripening and Labor Induction%COOK宫颈扩张球囊在足月妊娠促宫颈成熟并引产中的应用

    Institute of Scientific and Technical Information of China (English)

    何吕琼

    2015-01-01

    postpartum hemorrhage,asphyxia neonatorum,puerperal infection,cervical laceration and other harmful maternal and neo-natal effects of these two groups has no statistical significance. Conclusion Using cook cervical expansion ballon together with ar-tificial rupture of membranes and oxytocin can increase the rates of induced labor and lower the rates of caesarean section. So it is a safe and effective way of labor induction.

  1. Application effect study on nursing serving model of midwife group in perinatal care%助产士小组护理服务模式在围产期保健中的应用效果研究

    Institute of Scientific and Technical Information of China (English)

    钟萍

    2013-01-01

    目的探讨助产士小组护理服务模式在围产期保健服务中的应用价值。方法选取100例初产妇,随机分为助产士小组护理模式的观察组和常规产科护理模式的对照组,比较两组分娩方式及新生儿窒息率、不同产程时间及出血量、产妇负面情绪等。结果观察组患者自然分娩显著高于对照组(x2=11.422,P<0.01);阴道助产率(2.0%)、剖宫产率(6.0%)、新生儿窒息率(2.0%)均明显低于对照组(x2=4.891、5.316、4.891,P<0.05);第一产程、第二产程、产后出血量明显低于对照组(t=4.784、6.695、5.292,P<0.05),第三产程略低于对照组,但差异无统计学意义(t=0.688,P>0.05);焦虑评分、抑郁评分均明显低于对照组(t=8.035、9.095,P<0.05)。结论助产士小组护理服务模式可以有效提高自然分娩率,缩短产程时间,缓解负性情绪,具有积极的临床意义。%Objective To discuss the using value of nursing serving model of midwife group in perinatal care. Methods 100 primiparas were randomly divided into observation group given nursing serving model of midwife group and control group given routine obstetrics nursing serving model. The delivery mode, asphyxia rate of neonatorum, different time of labor stage, amount of bleeding and negative emotion of puerperal of two groups were compared. Results Cesarean section rate in observation group was significantly higher than that in control group(x2=11.422, P0.05). The score of anxiety and depression in observation group were significantly lower than those in control group(t=8.035,9.095, P<0.05). Conclusion Nursing serving model of midwife group may effectively improve cesarean section rate,shorten the time of labor stage, relieve negative emotion, and which has a positive clinical meaning.

  2. Integralidade e acessibilidade no cuidado à criança portadora de paralisia cerebral Integralidad y accesibilidad en el cuidado del niño portador de parálisis cerebral Integration and accessibility of care for children with brain paralysis

    Directory of Open Access Journals (Sweden)

    Viviane Marten Milbrath

    2009-12-01

    ón: La inaccesibilidad de la asistencia no se restringe al nivel de la atención básica, él mismo se extiende a todas las esferas de atención, no contemplando la referencia y contra-referencia.Objective: To determine the Brazilian Universal Health Care System (Sistema Único de Saúde [SUS] health services integration and accessibility of care for children with brain paralysis. Methods: This was an exploratory, descriptive, qualitative study. Six families with children who have brain paralysis caused by asphyxia neonatorum and who were residents in Rio Grande, RS, participated in the study. Data were collected in the participants' home through a semi-structured interview. Results: Families had difficulties with the SUS health services' integration and accessibility. There were gaps between the care the SUS proposes to provide and the care the families actually received. Conclusion: The lack of access to adequate care extends beyond primary care and not always observes reference and contra reference.

  3. 汉中市农村与城区5岁以下儿童死亡对比分析%Contrastive analysis of the death of children under 5 years old in urban and rural areas of Hanzhong

    Institute of Scientific and Technical Information of China (English)

    彭海玲; 白倩; 王琼

    2013-01-01

    Objective To analyze the death oi children under 5 years old in urban and rural areas of Hanzhong and to explore possible interventional measures. Methods Death data of 5 years old children from 2000 to 2010 in both of urban and rural areas of Hanzhong was analyzed retrospectively. Results The mortality rate of children under 5 years old in Hantai and Nanzheng was 13.65‰ and 20. 32‰, respectively. The mortality rate of newboms , infants , children of 1-4 years old and children under 5 years old in urban area ( Hantai) was much lower than that in rural area ( Nanzheng ) (χ2 value was 16. 89, 42. 69, 17. 54 and 59. 04, respectively, all P 0. 05 ). The causes of death of children under 5 years old in two areas were different. The first five causes of death in the urban were congenital malformation , asphyxia neonatomm , contretemps, premature and low birth weight, and pneumonia, while they were asphyxia neonatorum , pneumonia, contretemps, congenital malformation , and premature and low birth weight in the rural area. Conclusion In the past 11 years, the mortality rate of children under 5 years old of each age groups decreases year by year', and the death rate in the urban area is lower than that in the rural area . Infants and newboms death takes the majority of the death of children under 5 years old. The top five causes of children 's death in the urban and rural area are different , which indicates different impact of economics , culture and medical care on children in urban and rural area . Therefore, the future work in different areas should have their own focus .%目的 对汉中市农村与城区5岁以下儿童死亡进行对比分析,并探讨其干预措施.方法 将2000至2010年汉中市城市与农村5岁以下儿童死亡资料进行回顾性分析.结果 汉台区、南郑县5岁以下儿童死亡率分别为13.65‰和20.32‰;城区(汉台)的新生儿、婴儿、1~4岁、5岁以下死亡率明显低于农村(南郑)(χ2值分别为16.89、42

  4. 24 h动态血糖监测在妊娠期糖尿病患者中对妊娠结局的影响%Effect of continuous glucose monitoring system to pregnancy outcome in gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    王娟; 陈学敬; 杨香菊; 陈柳华; 郭中秋; 王秀梅; 陈玉华

    2014-01-01

    Objective To investigate the influence of pregnancy outcome in GDM patients by continuous glucose moni-toring system (CGMS). Methods 60 patients with GDM in Longgang District People's Hospital of Shenzhen City from January 2011 to December 2012 were selected and divided into group A and group B with 30 cases in each group. The group A was treated with continuous glucose monitoring for 24 h, group B was treated with normal peripheral blood sugar checking without continuous glucose monitoring. The indexes were observed and compared:①the occurrence rate of perinatal complications of pregnancy induced hypertension, premature birth, intrauterine infection, polyhydramnios, premature rupture of fetal membranes, cesarean delivery in pregnant women of the two groups; ②the occurrence rate of hyperbilirubinemia, hypoglycemia, perinatal death, asphyxia neonatorum, fetal macrosomia, weight and gestational age in newborn of the two groups. Results ①The occurrence rate of pregnancy induce d hypertension, pregnancy induced hypertension, intrauterine infection, polyhydramnios, premature rupture of fetal membranes, caesarean section in group B [13.33% (4/30), 6.67% (2/30), 6.67% (2/30), 6.67% (2/30), 10.00% (3/30), 53.33% (16/30)] were all higher than those in group A [6.67% (2/30), 3.33% (1/30), 0.00%(0/30), 0.00% (0/30), 3.33% (1/30), 40.00%(12/30)], the differences were statistically significant (P< 0.05).②The hyperbilirubinemia, hypoglycemia, newborn weight, neonatal asphyxia, fetal macrosomia in group B [13.33%(4/30), 6.67%(2/30), (3345±512) g, 6.67%(2/30), 6.67%(2/30)] were all higher than those in group A [6.67% (2/30), 0.00% (0/30), (3045±460) g, 0.00% (0/30), 0.00% (0/30)], the differences were statistically significant (P< 0.05). Conclusion It is able for CGMS to provide the early dynamic blood sugar monitoring for GDM patients, it also can provide more accurate blood sugar basis for the subsequent treat-ment, it is one of the methods to reduce the maternal

  5. Statistical survey of skin changes in Japanese neonates.

    Science.gov (United States)

    Hidano, A; Purwoko, R; Jitsukawa, K

    1986-02-01

    We observed 5387 infants over 10 years in weekly visits to a neonatal ward and obtained the following frequency data on these skin changes: erythema toxicum neonatorum, 40.8%; perianal dermatitis, 18.9%; scrotal pigmentation, 15.2%; miliaria, 8.5%; and adnexal polyp of neonatal skin, 4.1%. The frequencies of the types of birthmarks were: mongolian spots, 81.5%; salmon patches, 22.3%; nevocellular nevi, 2.7%; port-wine stains, 2.1%; strawberry marks, 1.7%; café au lait spots, 1.7% (including a case of von Recklinghausen's disease); epidermal and sebaceous nevi, 0.3%; accessory auricles, 0.3%; and smooth muscle hamartomas, 0.2%. A positive relationship was observed between infant maturity and the prevalence of erythema toxicum neonatorum. Apart from candidiasis, neonatal skin infections were extremely rare. PMID:3952030

  6. Two cases of death due to plastic bag suffocation.

    Science.gov (United States)

    Nadesan, K; Beng, O B

    2001-01-01

    Deaths due to plastic bag suffocation or plastic bag asphyxia are not reported in Malaysia. In the West many suicides by plastic bag asphyxia, particularly in the elderly and those who are chronically and terminally ill, have been reported. Accidental deaths too are not uncommon in the West, both among small children who play with shopping bags and adolescents who are solvent abusers. Another well-known but not so common form of accidental death from plastic bag asphyxia is sexual asphyxia, which is mostly seen among adult males. Homicide by plastic bag asphyxia too is reported in the West and the victims are invariably infants or adults who are frail or terminally ill and who cannot struggle. Two deaths due to plastic bag asphyxia are presented. Both the autopsies were performed at the University Hospital Mortuary, Kuala Lumpur. Both victims were 50-year old married Chinese males. One death was diagnosed as suicide and the other as sexual asphyxia. Sexual asphyxia is generally believed to be a problem associated exclusively with the West. Specific autopsy findings are often absent in deaths due to plastic bag asphyxia and therefore such deaths could be missed when some interested parties have altered the scene and most importantly have removed the plastic bag. A visit to the scene of death is invariably useful.

  7. Relationship between the Changes of Activity of Tissue-Type Plasminogen Activator on Brains and Cerebral Edema in Asphyxia Status of Mice%窒息鼠脑组织型纤溶酶原激活物活性变化与脑水肿的关系

    Institute of Scientific and Technical Information of China (English)

    徐剑文; 王玮; 康仲涵; 赵小贞; 张更

    2002-01-01

    目的探讨窒息对鼠脑分泌组织型纤溶酶原激活物(TPA)的影响与脑水肿的关系. 方法通过"延迟剖宫产术"致胎鼠宫内窘迫,实验分空白对照组、窒息15 min组、窒息30 min组;窒息15 min复氧30 min组,窒息30 min复氧30 min五个实验组.每组各取8例测试脑组织TPA的活性及含水量. 结果窒息后鼠脑TPA活性与含水量均升高(P<0.01). 结论窒息可致TPA活性增高,同时发生脑水肿.高活性的TPA可能是脑缺氧缺血致不可逆神经元损伤的一个重要媒介.

  8. Clinical Significances of Using Fetal Heart Rate Monitoring,Apgar Score and Umbilical Arterial Blood Gas Analysis to Assess Perinatal Asphyxia%胎心监护、Apgar评分及脐动脉血气分析评估围生儿窒息的临床意义

    Institute of Scientific and Technical Information of China (English)

    苏晋琼; 朱小瑜; 王晨虹; 杨传忠

    2010-01-01

    目的 探讨胎心率、Apgar评分及脐动脉血气分析在围生儿窒息评估中的意义.方法 收集本院胎心率<90次·min-1、持续时间>1 min、重复出现5次以上、儿科医师提前到场接生、电子胎心监护(EFM)异常的73例足月儿为EFM异常组.对照组为同期分娩胎心监护正常,按EFM异常组胎龄、体质量、分娩方式、Apgar分值及高危因素等配对的73例新生儿.观察2组不同Apgar评分新生儿脐动脉血气变化.结果 EFM异常组血气pH、碳酸氢根(HCO3-)、碱剩余(BE)较对照组显著降低(Pa<0.05,0.01).EFM异常组1 min Apgar8~10分患儿血HCO3-、BE均较对照组降低(Pa<0.05).EFM异常组Apgar 1~7分患儿血pH、HCO3-、BE较对照组降低(Pa<0.05,0.01).EFM异常组Apgar 1~3分、4~7分、9~10分三者间血气pH、Pa(CO2)、HCO3-、BE比较,差异有统计学意义(Pa<0.05,0.01);Apgar4~7分患儿血气pH、pa(CO2)、HCO3-、BE与Apgar 8分患儿一致,差异均无统计学意义(Pa>0.05);Apgar评分8分患儿血pH、HCO3-、BE均较Apgar 9~10分患儿降低(Pa<0.05).对照组不同Apgar评分组间血气比较,差异均无统计学意义(Pa>0.05).结论 胎心率持续减速对胎儿窘迫有预警作用;胎心率、Apgar评分及脐动脉血气3种方法组合应用,对准确评估围生儿窒息具有重要意义.

  9. 脐血血气分析、胎心监护、Apgar评分联合监测新生儿窒息%The Study on Asphyxia of Newborn supervised with Blood Gas Analysis of the Umbilical artery, Fetal Heart Electronic Monitoring and Apgar Rating

    Institute of Scientific and Technical Information of China (English)

    姚敏卿

    2006-01-01

    目的 探讨脐血血气分析、胎心监护及Apgar评分的相关性,为预测和诊断新生儿窒息及减低新生儿窒息发生提供重要依据.方法 对我院205例新生儿出生后立即采集脐动脉血进行血气分析,结合产前胎心监护及Apgar评分进行统计分析.结果 1.Apgar评分≤7分的新生儿与评分≥8分新生儿在血气分析结果中pH值、PaCO2、PaO2、BE值及HCO3-均有显著性差异,(<0.05~0.01).2.随着pH值下降,Apgar低评分增多,产前胎心电子监护异常发生率也随之增加,新生儿窒息发生率增高.结论 联合监测脐血血气分析、胎心监护及Apgar评分可提高新生儿窒息诊断的正确性,降低围产儿患病率和死亡率.

  10. 脐动脉血pH值对评价新生儿窒息的应用价值研究%The research of clinical application value in evaluating the newborn asphyxia with Umbilical arterial blood pH value

    Institute of Scientific and Technical Information of China (English)

    张良江; 赖瑶纯; 薛彦锐

    2013-01-01

    目的 探讨研究脐动脉血pH值对评价新生儿窒息的应用价值.方法 从2011年6月~2012年12月于本院阴道分娩的新生儿中随机抽取480例新生儿,将其依据新生儿Apgar评分分为正常组(Apgar评分>7分)和窒息组(Apgar评分≤7分),对新生儿的脐动脉血pH值进行监测,分析研究其与Apgar评分间的关系.结果 Apgar评分>7分462例、Apgar评分≤7分18例;脐动脉血pH值检测:pH≥7.20共461例,pH﹤7.20共19例;脐动脉血pH值与新生儿1 min内Apgar评分呈正相关,并且正常组和窒息组pH值差异显著具有统计学意义(P < 0.05).脐动脉血pH值的敏感度和特异度分别为90.0%、99.8%,Apgar评分的敏感度和特异度分别为45.0%、98.0%,差异有统计学意义(P < 0.05).pH 值异常与羊水污染度呈正相关,随着污染度加重发生率上升,差异显有统计学意义(P < 0.05).结论 对于评价新生儿窒息,脐动脉血pH值比Apgar评分有更高的敏感度和特异度,能直接揭示窒息的病理生理本质和反映缺氧、酸中毒的严重程度,对及时采取措施防止并发症的发生有重要意义,应在临床中推广应用.

  11. Distribution study of Chlamydia trachomatis genotypes in symptomatic patients in Buenos Aires, Argentina: association between genotype E and neonatal conjunctivitis

    Directory of Open Access Journals (Sweden)

    Corominas Ana I

    2010-02-01

    Full Text Available Abstract Background Chlamydia trachomatis infections are the most prevalent sexually transmitted bacterial infections in the world. There is scarce data available referring to the distribution of C. trachomatis genotypes in Argentina. The aim of this study was to identify the genotypes of C. trachomatis circulating in the metropolitan area of Buenos Aires (Argentina associated with ophthalmia neonatorum and genital infections. Findings From 2001 to 2006, 199 positive samples for C. trachomatis infection from symptomatic adult patients and neonates with ophthalmia neonatorum from two public hospitals were studied. C. trachomatis genotypes were determined by PCR-RFLP of an ompA fragment. Genotype E was the most prevalent regardless of the sample origin (46.3% 57/123 in adults and 72.4% 55/76 in neonates, followed by genotype D (19.5% 24/123 and F (14.6% 18/123 in adults, and G (9.2% 7/76 and D (7.9% 6/76 in neonates. We detected a significantly higher frequency of genotype E (p ophthalmia neonatorum than in genital specimens. Genotype D was associated with genital localization (p Conclusion We found a particularly increased frequency of C. trachomatis genotype E in neonatal conjunctivitis, which may indicate an epidemiological association between this genotype and the newborn population. The present study also contributed to increase the knowledge on genotype distribution of Chlamydia trachomatis in symptomatic adult patients in Buenos Aires, Argentina, in which genotypes E, D and F were the predominant ones.

  12. Syndromes Associated with Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Max Chernesky

    2005-01-01

    Full Text Available Excellent technologies have been developed to identify the specific microbial agents of chlamydia, gonorrhea, syphilis, herpes, chancroid, trichomoniasis, human papillomavirus and HIV infection. However, it is also crucial to recognize syndromes that may be caused by one or more sexually transmitted pathogens. When laboratory services are lacking or are inadequate to provide timely results to enable appropriate treatment, some patients must be managed and treated syndromically. Most Canadian laboratories should be able to provide diagnostic services to determine the etiology of syndromes such as cervicitis, urethritis, pelvic inflammatory disease, prostatitis, genital ulcers, sexually transmitted infection (STI-related enteric infections, epididymitis, hepatitis, ophthalmia neonatorum, vulvovaginitis and vaginosis.

  13. Stem cell therapy for neonatal brain injury : Perspectives and Challenges

    NARCIS (Netherlands)

    Titomanlio, Luigi; Kavelaars, Annemieke; Dalous, Jeremie; Mani, Shyamala; El Ghouzzi, Vincent; Heijnen, Cobi; Baud, Olivier; Gressens, Pierre

    2011-01-01

    Cerebral palsy is a major health problem caused by brain damage during pregnancy, delivery, or the immediate postnatal period. Perinatal stroke, intraventricular hemorrhage, and asphyxia are the most common causes of neonatal brain damage. Periventricular white matter damage (periventricular leukoma

  14. Woe patient is purple

    Directory of Open Access Journals (Sweden)

    Hatice Dogan

    2014-08-01

    Conclusion: Traumatic asphyxia is a clinical condition caused by blunt thoracoabdominal trauma, and with good trauma management patients can be discharged with less mortality and morbidity. [Cukurova Med J 2014; 39(4.000: 914-917

  15. Hubungan Kompetensi Bidan Dengan Penatalaksanaan Manajemen Asfiksia Bayi Baru Lahir Di Wilayah Kerja Dinas Kesehatan Kota Langsa

    OpenAIRE

    Fauziah

    2016-01-01

    Competence is a capability which is based on skill and knowledge, supported by work attitude and its implementation in carrying out a task. Asphyxia management of a new-born baby is a midwifery care which has to be done by a competent midwife who needs knowledge, attitude, and skill in any critical condition. The research was an observational survey which was aimed to analyze the correlation between a midwife’s competence (knowledge and attitude) and the implementation of asphyxia manag...

  16. Hypothermia and room air resuscitation in NT2-N neurons, immature rats and newborn pigs

    OpenAIRE

    2011-01-01

    Perinatal asphyxia remains one of the major causes of perinatal mortality and morbidity worldwide. Mild therapeutic hypothermia reduces brain injury after perinatal asphyxia. There is an ongoing search for strategies to further improve outcome, including best practice resuscitation and interventions that can be used in combination with hypothermia. The use of supplemental oxygen during resuscitation causes a number of harmful effects including increased cerebral injury. It is not known whethe...

  17. Přednemocniční neodkladná péče u dětí s akutním dušením

    OpenAIRE

    VETÝŠKOVÁ, Petra

    2014-01-01

    Bachelor thesis is prehospital emergency care for children with acute asphyxia. It discusses the treatment of children in prehospital care, whereby it becomes specific because care of children and adults is not always identical. Acute asphyxia is a very unpleasant condition, which requires expert intervention as fast as possible. Without help the patient's life can be threatened by loss of consciousness with shortness of breath. The theoretical section of the thesis deals initially with a con...

  18. A premature infant with a bilateral thalamostriatal hemorrhage

    International Nuclear Information System (INIS)

    Hemorrhagic areas were seen on ultrasonography and computed tomography in both thalamostriatal regions in a preterm female infant with perinatal asphyxia due to abruptio placentae. At autopsy, marked perivascular bleeding in the thalamus and putamen and eosinophilic neuronal changes in the thalamus and pontine tegmentum were seen. These thalamostriatal and brain stem lesions are thought to have been caused by an acute process causing total asphyxia. (author)

  19. Crystallographic investigationsof urine at newborns with ischemic nephropathy

    Directory of Open Access Journals (Sweden)

    Loboda A.

    2012-01-01

    Full Text Available The study is devoted to the identification of structural markers of ischemic nephropathy by studying facies (dry drops of urine in newborn infants. The study involved two groups of full-term newborns with gestational age 38-41 weeks and signs of ischemic nephropathy: 1st - 75 children who suffered severe asphyxia, 2nd - 75 children with moderate asphyxia. Comparison group consisted of 20 infants without asphyxia at birth. Morphological changes were detected in dry drops by microscopy at 40-fold increase in 1-2 and 7-8 days of life. Asphyxia cause disturbance of renal filtration, tubular reabsorption and secretion that lead to increase levels of organic components and mineral salts in urine, crystallization of which forms a specific picture of facies. By urine’s facies morphology at 1-2 days of life is possible to evaluate renal function in newborns suffered from asphyxia. The number of inclusions in facies, their total area and distribution are depending on the severity of asphyxia. Structural changes in the urine of children with ischemic nephropathy remain till the end of the early neonatal period.

  20. 纤支镜下微波治疗气管内肿瘤患者6个月的生存质量随访%The quality of life follow up of 6 months for the patients with intratracheal tumor accepted microwave treatment under fibrobronchoscope

    Institute of Scientific and Technical Information of China (English)

    傅恩清; 金发光; 王琰; 刘同刚; 党永进; 谢永宏

    2002-01-01

    Objective To research treatment effect of microwave heat coagulation assisted laser and local chemotherapy under fibrobronchoscope for the acute respiratory distress from intratracheal tumor or metastasis neoplasia, and assess quality of life after treatment. Method In the emergency, applied microwave histological coagulation treatment under fibrobronchoscope to 2 patients of acute respiratory distress, even asphyxia from intratracheal tumor or metastasis tumor. Removed the mass, and assisted laser and local chemotherapy necessarily to relieve respiratory distress. Observed quality of life. Results The intratracheal mass of 2 patients were eliminated completely, distress and asphyxia were relieved and there were no severe side effects. The patients lived over 6 months, completed self care, and joined the light physical strength labor. The muscle power also reach Ⅳ level fromⅠ level. Conclusion The treatment of microwave histological coagulation assisted laser and local chemotherapy is one good method to relieve the respiratory distress or asphyxia from late intratracheal tumor or transmission tumor, and promote quality of life obviously.

  1. Canadian Laboratory Standards for Sexually Transmitted Infections: Best Practice Guidelines

    Directory of Open Access Journals (Sweden)

    Max A Chernesky

    2005-01-01

    Full Text Available Sexually transmitted infections (STI continue to spread, and show no international boundaries. Diseases such as gonorrhea and syphilis, which we thought were under control in Canadian populations, have increased in incidence. Sexually transmitted or associated syndromes such as cervicitis, enteric infections, epididymitis, genital ulcers, sexually related hepatitis, ophthalmia neonatorum, pelvic inflammatory disease, prostatitis and vulvovaginitis present a challenge for the physician to identify the microbial cause, treat the patient and manage contacts. During the past 10 years, new technologies developed for the diagnosis of STIs have provided a clearer understanding of the real accuracy of traditional tests for the diagnosis of infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex viruses, hepatitis B virus, human papillomaviruses, HIV, Haemophilus ducreyi, Trichomonas vaginalis and mycoplasmas. This has presented a major challenge to the diagnostic laboratory, namely, selecting the most sensitive and specific test matched with the most appropriate specimens to provide meaningful and timely results to facilitate optimal patient care.

  2. Birthmarks and congenital skin lesions in Chinese newborns.

    Science.gov (United States)

    Tsai, F J; Tsai, C H

    1993-09-01

    The presence of various types of birthmarks was determined in 3,345 Chinese infants under 48 hours of age. Mongolian spots were present in 86.3% of the studied infants. Vascular lesions included salmon patch (22.6%), port-wine stain (0.4%), and strawberry marks (0.7%). Nevocellular nevi (1%), sebaceous nevi (0.1%), and café au lait spots (0.4%) were also found. The following non-birthmark skin changes were observed: erythema toxicum neonatorum (33.7%), preauricular tags (1.3%), preauricular pits (2.5%) and a hyperpigmented scrotum (31.3%; in 1,727 male infants), which was related to the presence of mongolian spots. PMID:7904869

  3. Chlamydia trachomatis causing neonatal conjunctivitis in a tertiary care center

    Directory of Open Access Journals (Sweden)

    Kakar S

    2010-01-01

    Full Text Available Chlamydia trachomatis is considered a major aetiological agent of conjunctivitis in newborns. The objective of the present study was to determine the aetiology of neonatal conjunctivitis and clinico-epidemiological correlates of chlamydial ophthalmia neonatorum. Fifty-eight newborns with signs and symptoms of conjunctivitis were studied. Conjunctival specimens were subjected to Gram staining, routine bacteriological culture, culture for Neisseria gonorrhoeae and direct fluorescent antibody (DFA staining for diagnosis of C. trachomatis infection. C. trachomatis was detected in 18 (31% neonates. Findings suggest that since C. trachomatis is the most common cause of neonatal conjunctivitis, routine screening and treatment of genital C. trachomatis infection in pregnant women and early diagnosis and treatment of neonatal Chlamydial conjunctivitis may be considered for its prevention and control.

  4. The cranial MRI in severe cerebral palsy

    International Nuclear Information System (INIS)

    The magnetic resonance examination was performed in 38 patients with severe cerebral palsy (CP; 15 males and 23 females) who had both motor delay (unable to move anywhere) and mental retardation (I.Q. or D.Q. below 30). Neuroimaging findings were compared with the CP type, etiology, and grade of understanding of language. Cranial magnetic resonance imagings (MRI) in CP were divided into five types. In type 1, nine predominantly showed cyst-liked ventricles and periventricular hyperintensity on T2-weighted imaging (PVH) and only scarred basal ganglia and thalamus were visible. All suffered from neonatal asphyxia and the clinical type was rigospastic tetraplegia (RST). In type 2, eleven predominantly showed PVH and hyperintensity on T2-weighted (HT2) in basal ganglia and thalamus. All suffered from neonatal asphyxia and the clinical type was RST or rigospastic diplegia. In type 3, five showed PVH and three had cortical atrophy. All suffered from neonatal asphyxia and the clinical type was spastic diplegia. In type 4, four predominantly showed HT2 in putamen and thalamus. Three had cortical atrophy. All suffered from neonatal asphyxia. The clinical type was athetotic CP (ATH). In type 5, nine predominantly showed HT2 in globus pallidus. Four had cortical atrophy and two had hippocampal atrophy. All suffered from neonatal jaundice and the clinical type was ATH. All patients who suffered from neonatal asphyxia and spastic CP had MRI in PVH. All patients who suffered from neonatal asphyxia and ATH showed HT2 in putamen and thalamus. Almost patients who suffered from neonatal jaundice and ATH showed HT2 in globus pallidus. With athetotic CP, cases with atrophy of the cerebral cortex and/or hippocampus were lower grade of understanding of language than no atrophy of both. The results of studies of MRI are in agreement with neuropathological findings. (author)

  5. The cranial MRI in severe cerebral palsy; A comparative study with clinical data

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Kazutaka; Itoh, Masahiro; Fueki, Noboru; Hirasawa, Kyoko; Suzuki, Noriko; Kurata, Kiyoko (Metropolitan Medical Center of the Severely Handicapped, Tokyo (Japan)); Sato, Junichi; Morimatsu, Yoshio; Yagishita, Akira

    1993-09-01

    The magnetic resonance examination was performed in 38 patients with severe cerebral palsy (CP; 15 males and 23 females) who had both motor delay (unable to move anywhere) and mental retardation (I.Q. or D.Q. below 30). Neuroimaging findings were compared with the CP type, etiology, and grade of understanding of language. Cranial magnetic resonance imagings (MRI) in CP were divided into five types. In type 1, nine predominantly showed cyst-liked ventricles and periventricular hyperintensity on T[sub 2]-weighted imaging (PVH) and only scarred basal ganglia and thalamus were visible. All suffered from neonatal asphyxia and the clinical type was rigospastic tetraplegia (RST). In type 2, eleven predominantly showed PVH and hyperintensity on T[sub 2]-weighted (HT2) in basal ganglia and thalamus. All suffered from neonatal asphyxia and the clinical type was RST or rigospastic diplegia. In type 3, five showed PVH and three had cortical atrophy. All suffered from neonatal asphyxia and the clinical type was spastic diplegia. In type 4, four predominantly showed HT2 in putamen and thalamus. Three had cortical atrophy. All suffered from neonatal asphyxia. The clinical type was athetotic CP (ATH). In type 5, nine predominantly showed HT2 in globus pallidus. Four had cortical atrophy and two had hippocampal atrophy. All suffered from neonatal jaundice and the clinical type was ATH. All patients who suffered from neonatal asphyxia and spastic CP had MRI in PVH. All patients who suffered from neonatal asphyxia and ATH showed HT2 in putamen and thalamus. Almost patients who suffered from neonatal jaundice and ATH showed HT2 in globus pallidus. With athetotic CP, cases with atrophy of the cerebral cortex and/or hippocampus were lower grade of understanding of language than no atrophy of both. The results of studies of MRI are in agreement with neuropathological findings. (author).

  6. Cutaneous lesions in new born

    Directory of Open Access Journals (Sweden)

    Sachdeva Meenakshi

    2002-11-01

    Full Text Available Five hundred unselected newborn babies delivered in the Department of Obstetrics and Gynaecology, Unit II of SGBT Hospital attached to Government Medical College, Amritsar during April 2000 to October 2000 were examined for cutaneous lesions daily for the first five days after birth. Different cutaneous lesions were seen in 474(94. 8% newborns. The physiological skin changes observed in order of frequency were Epstein pearls in 305(61%, Mongolian spot in 301(60. 2%, superficial cutaneous desquamation in 200(40%, icterus in 128(25. 6%, milia in 119(23. 8%, sebaceous gland hyperplasia in 107 (21. 4%, occipital alopecia in 94(18. 8%, lanugo in 72(14. 4%, peripheral cyanosis in 47(9. 4%, breast hypertrophy in 29(5. 8% and miniature puberty in 28(5. 6% newborns. Of the transient non-infective skin diseases, erythema toxicum neonatorum was observed most commonly in 105(21 %, followed by miliaria rubra in 103(20. 6% and acne neonatorum in 27(5. 4% newborns. The naevi and other developmental defects in the descending order were salmon patch in 69(13. 8%, congenital melanocytic noevi in 10(2%, accessory tragi in 3(0.6%, spina bifida in 2(0.4%, hydrocephalus in 1(0.2% and poliosis in 1(0.2% newborns. Cradle cap was the only dermatitis observed in 50(10% newborns. One (0.2% case each of Harlequin ichthyosis and labial cyst was seen.

  7. Diagnósticos diferenciales de la histiocitosis a células de Langerhans The differential diagnostics of Langerhans cell histiocytosis

    Directory of Open Access Journals (Sweden)

    C. N. Chirino

    2007-06-01

    Full Text Available La histiocitosis a células de Langerhans (HCL debe diferenciarse de las siguientes entidades: eritema tóxico neonatorum (ETN, dermatitis seborreica (DS, foliculitis pustulosa eosinofílica (FPE, incontinencia pigmenti (IP, mastocitosis/urticaria pigmentosa (M/UP, acrodermatitis enteropática (ADE, síndrome de Wiskott-Aldrich (WAS, acropustulosis infantil (API. Además se deben considerar la enfermedad de Rosai- Dorfman (ERD, xantomas diseminados, melanosis pustulosa neonatal (MPN, candidiasis congénita, listeriosis neonatal, herpes simple perinatal y la varicela neonatal. Debido a que los métodos auxiliares de laboratorio no siempre están disponibles o los resultados laboratoriales algunas veces son extemporáneos, y puesto que el médico práctico a menudo necesita tomar decisiones precozmente, es que la epidemiología resulta útil, pues brinda el marco adecuado para ordenar y jerarquizar las sospechas diagnósticas frente a un caso concreto, con un paciente determinado, en un momento específico.The differential diagnostics of Langerhans cell histiocytosis should include the following disorders: erythema toxicum neonatorum, seborrheic dermatitis, eosinophilic pustular folliculitis, incontinentia pigmenti, mastocytosis / urticaria pigmentosa, acrodermatitis enteropathica, Wiskott-Aldrich syndrome, infantile acropustulosis, Rosai- Dorfman disease, xanthoma disseminatum, neonatal pustular melanosis, congenital candidiasis, perinatal listeriosis, perinatal herpes simplex, neonatal varicella. Since the auxiliary methods of lab are not always available, or lab results are sometimes extemporaneous, the physicians often needs to make quick decisions. The epidemiology is useful because it offers the appropriate mark to prioritize the diagnostic in specific cases

  8. A pediatric case of life-threatening airway obstruction caused by a cervicomediastinal thymic cyst

    Energy Technology Data Exchange (ETDEWEB)

    Komura, Makoto; Kanamori, Yutaka; Sugiyama, Masahiko; Iwanaka, Tadashi [University of Tokyo Hospital, Department of Pediatric Surgery, Tokyo (Japan); Fukushima, Noriyoshi [University of Tokyo Hospital, Department of Pathology, Tokyo (Japan)

    2010-09-15

    Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. Only 6-10% suffer dysphagia, dyspnoea, stridor, cervical pain or vocal paralysis. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants. We report a unique case of a 20-month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children. (orig.)

  9. Does internal podalic version of the non-vertex second twin still have a place in obstetrics?

    DEFF Research Database (Denmark)

    Jonsdottir, Fjola; Henriksen, Lonny; Secher, Niels Jørgen;

    2015-01-01

    of delivery mode, 5-min Apgar score, asphyxia, umbilical cord pH, admission to neonatal intensive care unit, treatment by mechanical ventilation, and experience level of obstetricians performing internal podalic version. RESULTS: 457 births were available for analysis: 39 cases of internal podalic version...... and breech extraction and 418 cesarean section cases for second twin. Compared with the cesarean section group, the internal podalic version group had lower rates of asphyxia. Apgar scores and umbilical cord pH levels were not significantly different, although with a tendency to be higher in the internal...

  10. When Self-Pleasuring Becomes Self-Destruction: Autoerotic Asphyxiation.

    Science.gov (United States)

    Jenkins, Andrew P.

    This paper describes autoerotic asphyxia (AEA), using strangulation to enhance the pleasure of masturbation. AEA claims the lives of between 250-1,000 U.S. young men each year (though it is likely that it is underreported). Though AEA is found primarily among males, females participate, but in far smaller numbers. The most common motivation for…

  11. Origin and timing of brain lesions in term infants with neonatal encephalopathy

    NARCIS (Netherlands)

    Cowan, F; Rutherford, M; Groenendaal, F; Eken, P; Mercuri, E; Bydder, GM; Meiners, LC; Dubowitz, LMS; de Vries, LS

    2003-01-01

    Background The role of intrapartum asphyxia in neonatal encephalopathy and seizures in term infants is not clear, and antenatal factors are being implicated in the causal pathway for these disorders. However, there is no evidence that brain damage occurs before birth. We aimed to test the hypothesis

  12. Security problems at Vivitron

    International Nuclear Information System (INIS)

    The risks of accidents and the safety actions concerning the components and the staff protection at Vivitron are analyzed. The risks induced by the utilization of SF6 is mainly asphyxia. The sealing defects on the gas storage devices and gas leaking inside Vivitron are considered. The safety actions and devices are summarized. Radiation protection problems are also discussed

  13. Risk factors for meconium stained amniotic fluid and its implications

    Directory of Open Access Journals (Sweden)

    Ramya Sundaram

    2016-08-01

    Conclusions: Meconium stained amniotic fluid is associated with a higher incidence of operative deliveries resulting in an increased maternal morbidity. It is also associated with an increased neonatal morbidity due to birth asphyxia and respiratory depression at birth and a significant risk of neonatal mortality due to meconium aspiration syndrome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2503-2506

  14. Myocardial infarction and arterial thrombosis in identical newborn twins with homozygosity for the PAI-1 4 G/5 G polymorphism

    OpenAIRE

    De Lucia, Vittoria; Andreassi, Maria Grazia; Sabatini, Laura; Ait-Ali, Lamia; Spadoni, Isabella; Giusti, Sandra

    2009-01-01

    Myocardial infarction in the perinatal period, in the absence of congenital heart disease or coronary artery lesions, is rare. The most common etiology described are the thromboembolism and perinatal asphyxia. We report a case of monozygotic twins who developed, after birth, acute vascular events and both had PAI-1 4G/4G homozygosity.

  15. Incidence and risk factors of neonatal thrombocytopenia: a pr

    Directory of Open Access Journals (Sweden)

    Nila Kusumasari

    2010-03-01

    Conclusions The incidence of neonatal thrombocytopenia was 12.2%. Significant risk factor of mother that caused thrombocytopenia was pre-eclampsia, while risk factors of neonates were asphyxia, sepsis and necrotizing enterocolitis.[Paediatr Indones. 2010;50:31-7].

  16. MATERNAL AND FETAL OUTCOME IN PREGNANCIES WITH SLE - A PROSPECTIVE STUDY OF 40 CASES

    OpenAIRE

    Menon Nalini; Lakshmi

    2015-01-01

    Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES : T o find out 1) T he most common complicatio...

  17. Comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position

    Directory of Open Access Journals (Sweden)

    Hong-Yu Zhang

    2016-06-01

    Conclusions: This study proves that women who delivered in the hands-and-knees position achieved low rates of episiotomy and intact perineum. Moreover, the rates of neonatal asphyxia and postpartum bleeding did not increase. Pregnant patients who prefer to adopt the hands-and-knees position should be assisted in assuming such position during delivery.

  18. Socioeconomic Inequality in Malnutrition in Developing Countries

    NARCIS (Netherlands)

    E. Van de Poel (Ellen); A.R. Hosseinpoor (Ahmad); N. Speybroeck (Niko); T.G.M. van Ourti (Tom); J. Vega (Jeanette)

    2008-01-01

    textabstractEpidemiological evidence points to a small set of primary causes of child mortality that are the main killers of children aged less than 5 years: pneumonia, diarrhoea, low birth weight, asphyxia and, in some parts of the world, HIV and malaria. Malnutrition is the underlying cause of one

  19. 高压氧治疗新生儿缺氧缺血性脑病39例%Therapy of hyperbaric oxygenation for 39 children with hypoxic and ischemic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    周宝华; 裴颖; 刘俊礼

    2003-01-01

    @@ BACKGROUND: Hypoxic and ischemic encephalopathy(HIE) of new-born is thought as a severe disease with organ suf-fering anoxic and iscbemic injury caused by perinatal asphyxi-a. Now it is generally recognized that HIE serves as a main factorleading to the sequela of death and disableement of new-born.

  20. The silver bullet.

    Science.gov (United States)

    Sinn, L E

    1993-06-01

    A case of autoerotic asphyxiation is presented. The incident demonstrates 12 of the 13 characteristics particular to autoerotic asphyxias. The elements of attire and bondage used are unique in comparison with previously reported cases. The addictive nature of this behavior is well demonstrated in the victim's sexual history. Interestingly, his spouse was aware of his autoerotic activity. PMID:8328435

  1. Umbilical cord blood lactate: a valuable tool in the assessment of fetal metabolic acidosis

    DEFF Research Database (Denmark)

    Gjerris, Anne Cathrine Roslev; Staer-Jensen, Jette; Jørgensen, Jan Stener;

    2008-01-01

    The aim of the present study was (1) to evaluate the relationship between umbilical cord arterial blood lactate and pH, standard base excess (SBE), and actual base excess (ABE) at delivery and (2) to suggest a cut-off level of umbilical cord arterial blood lactate in predicting fetal asphyxia usi...

  2. Letalt forløb efter overset fremmedlegeme i luftvejen

    DEFF Research Database (Denmark)

    Jensen, Karen Schow; Sommer, Jesper; Toft, Jan Green;

    2012-01-01

    A 52-year-old previously healthy woman suffered death from choking. Asphyxia after aspiration of a foreign body is a well-known, but frequently overlooked cause of sudden death. We describe a case in which a foreign body in the airway was initially overlooked. Early recognition and treatment might...

  3. Laryngotracheal stenosis and reconstruction

    NARCIS (Netherlands)

    L.M. Janssen (Luuk)

    2010-01-01

    textabstractThe patency of the larynx and the trachea is sometimes compromised acutely with a direct threat of suffocation or asphyxia. Of old this occurred quite often as a consequence of diphteria and other infectious diseases or as a result of various kinds of exogenous traumata. Infectious disea

  4. Laktat i navlearterie- og navleveneblod hos nyfødte

    DEFF Research Database (Denmark)

    Rubak, Sune Leisgaard Mørck; Henriksen, Tine Brink

    2010-01-01

    . The inclusion criteria were gestational age above 35 weeks and no signs of foetal hypoxia or perinatal asphyxia. RESULTS: Out of 208 newborn children, 105 children were excluded in accordance with the above criteria, thus the remaining 103 newborn children were included. We demonstrated that lactate and CO2...

  5. Neonates and Infants At Risk for Hearing and Speech-Language Disorders.

    Science.gov (United States)

    Clark, David A.

    1989-01-01

    High-risk infants may exhibit hearing impairments which can subsequently impede speech/language development. Discussed are prenatal risk factors, including environmental toxins and infections; and perinatal factors such as prematurity, asphyxia, intracranial hemorrhage, bilirubin, ototoxic drugs, and environmental noise. A table summarizes factors…

  6. IMPAIRED LEARNING AND ABNORMAL OPEN-FIELD BEHAVIORS OF RATS AFTER EARLY POSTNATAL ANOXIA AND THE BENEFICIAL EFFECT OF THE CALCIUM-ANTAGONIST NIMODIPINE

    NARCIS (Netherlands)

    NYAKAS, C; MARKEL, E; SCHUURMAN, T; LUITEN, PGM

    1991-01-01

    Perinatal anoxia/hypoxia is considered a serious risk factor for normal brain development. Anoxia induced by repeated asphyxia at 2 and 4 days after birth resulted in a transient hyperactivity in the small open-field, and a behavioural depression in adult open-field activity of male Wistar rats. The

  7. PROFILE OF ASPHYXIATED BABIES AT NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL IN NORTH EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Ananta Kumar

    2016-05-01

    Full Text Available BACKGROUND Birth asphyxia is one of the major causes of neonatal mortality as well as morbidity in India, but it studied that the causes which lead to asphyxia are usually preventable. Many metabolic as well as other sequential changes occurs in the body as a result of birth asphyxia which further lead to major long-term sequelae like cerebral palsy, mental retardation and seizure disorder. AIM To identify antepartum, intrapartum and postnatal risk factors for neonatal mortality due to birth asphyxia and to assess the clinico-biochemical status and outcome in the early neonatal period of babies who were asphyxiated at birth. DESIGN Cohort study. SETTING Neonatal Intensive Care Unit, Gauhati Medical College and Hospital. METHODS After clearance from the Hospital Ethical Committee, all severely asphyxiated babies at birth, admitted to neonatal unit from August 2009 to July 2010 were included in the study. A specially designed questionnaire was used to assess the role of maternal factors and neonatal presentation of birth asphyxia. Antenatal and intrapartum factors like maternal anaemia, Pregnancy Induced Hypertension (PIH, eclampsia, antenatal visits, Meconium Stained Amniotic Fluid (MSAF were recorded. Asphyxiated babies were observed for stages of Hypoxic Ischaemic Encephalopathy (HIE, reflexes and any end organ involvement. Investigations were done for blood counts, electrolytes, USG, etc. RESULTS Among 150 babies, we found significant association between birth asphyxia and factors like poor antenatal check-up (48%, MSAF (38.7%, maternal anaemia (78%, PIH (20.7%, eclampsia (15.3%, prolonged labour (28%, ante partum foetal distress (14.7%; 24% cases were in HIE stage I, 32% in stage II and 44% in stage III. Multiorgan involvement seen with renal (9.3%, haematological (3.3% abnormalities. During management 54.6% needed inotropes (54.6% for circulatory support, 60% cases needed anticonvulsant and mortality rate was (48%. CONCLUSION There were lots

  8. Brain Research to Ameliorate Impaired Neurodevelopment - Home-based Intervention Trial (BRAIN-HIT

    Directory of Open Access Journals (Sweden)

    Mahantshetti Niranjana S

    2010-04-01

    Full Text Available Abstract Background This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia. Methods/Design This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors. Discussion The trial is supervised by a trial steering committee, and an independent data monitoring

  9. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  10. Unassisted smothering in a pillow.

    Science.gov (United States)

    Schmeling, Andreas; Fracasso, Tony; Pragst, Fritz; Tsokos, Michael; Wirth, Ingo

    2009-11-01

    We report the case of a 33-year-old man admitted to a psychiatric hospital because of paranoid schizophrenia. The man was found dead lying in his bed with the face pressed against a pillow and with elevated buttocks. The autopsy did not reveal a cause of death. The histological findings displayed the signs of the haemorrhagic-dysoric syndrome with acute emphysema; these findings are pathognomonic of obstructive asphyxia. The adverse effects of the neuroleptics demonstrated by the toxicological findings may have accelerated the loss of consciousness and facilitated the unusual position of the body. On the basis of the clinical history, the autopsy findings, the histological features and the toxicological results, asphyxia due to smothering was diagnosed as the cause of death.

  11. Litigation related to intrapartum fetal surveillance.

    Science.gov (United States)

    Schifrin, Barry S; Soliman, Mohamed; Koos, Brian

    2016-01-01

    The role of intrapartum care including cardiotocography (CTG) monitoring in cases of perinatal neurological injury receives considerable debate in both clinical and medicolegal settings. The debate, however, has distracted attention from fundamental questions about the timing, mechanism, and preventability of perinatal injury. CTG tracings are used as a surrogate for asphyxia with the timing of intervention ("rescue") predicated on the presumed severity of asphyxia. Using CTG in this way has prevented intrapartum stillbirth, but it has not reduced the long-term injury in part, because, contrary to popular belief, the majority of intrapartum fetal injuries are unassociated with severe hypoxia or severe neonatal depression. This article describes the timing and mechanisms, including mechanical factors, of intrapartum perinatal injury and the benefit of using the CTG, not for the purpose of "rescue", but for identifying risk factors for fetal injury and keeping the fetus out of harm's way. PMID:26227999

  12. The man in the scarlet cloak. The mysterious death of Peter Anthony Motteux.

    Science.gov (United States)

    Ober, W B

    1991-09-01

    Peter Anthony Motteux (1663-1718), a Huguenot refugee in London, established a literary reputation by completing Sir Thomas Urquhart's translation of Rabelais' Gargantua and Pantagruel, then Cervantes' Don Quixote. He later became an import-export merchant. On his 55th birthday he donned his scarlet cloak and went out on the town. He picked up a prostitute and after some dalliance returned to her bordello. Shortly thereafter he was found dead, although the evidence is that he was in good health when he arrived. Literary evidence is that he died from assisted erotic asphyxia, a variant of autoerotic asphyxia, cf. the case of Frantisek Koczwara (Am J Forensic Med Pathol 5:145-149, 1984.)

  13. Aqua-eroticum: an unusual autoerotic fatality in a lake involving a home-made diving apparatus.

    Science.gov (United States)

    Sauvageau, Anny; Racette, Stéphanie

    2006-01-01

    The term Aqua-eroticum was first introduced in 1984 by Sivaloganathan to describe the unusual autoerotic death of a man using submersion as an asphyxia method. This was the first case of that kind, and since then, no other case of autoerotic submersion has been reported, nor other autoerotic fatality in open water. Here we report the case of a 25-year-old man, nude under a home-made plastic body suit, overdressed for the season with winter clothes and restrained by complex bondage. He was submersed, tied underwater to a boat and was using a home-made diving apparatus for air supply. Death was ruled as accidental autoerotic asphyxia from rebreathing, caused by the faulty air-supply device. PMID:16423240

  14. Autoerotic death due to electrocution

    Directory of Open Access Journals (Sweden)

    Piotr Arkuszewski

    2014-08-01

    Full Text Available Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

  15. Evaluation of the effect of allopurinol treatment of hypoxic-ischemic encephalopathy in newborns%别嘌醇治疗新生儿缺氧缺血性脑病疗效评价

    Institute of Scientific and Technical Information of China (English)

    沙彬; 陈燕琳; 周文浩

    2008-01-01

    1文献来源[1] Van Bel F, Shadid M, Moison RM, et al. Effect of allopurinol on postasphyxial free radical formation, cerebral hemodynamics, and electrical brain activity. Pediatrics, 1998, 101(2) :185-193 [2 ] Benders MJ, Bos AF, Rademaker CM, et al. Early postnatal allopurinol does not improve short term outcome after severe birth asphyxia. Arch Dis Chi Fetal Neonatal Ed, 2006, 91(3) :163-165

  16. Recent Trends in Erythropoietin-mediated Neuroprotection

    OpenAIRE

    McPherson, Ronald J.; Juul, Sandra E.

    2007-01-01

    Fifteen years of evidence have established that the cytokine erythropoietin offers promise as a treatment for brain injury. In particular, neonatal brain injury may be reduced or prevented by early treatment with recombinant erythropoietin. Extreme prematurity and perinatal asphyxia are common conditions associated with poor neurodevelopmental outcomes including cerebral palsy, mental retardation, hearing or visual impairment, and attention deficit hyperactivity disorder. When high doses of e...

  17. Xenon and sevoflurane provide analgesia during labor and fetal brain protection in a perinatal rat model of hypoxia-ischemia.

    Directory of Open Access Journals (Sweden)

    Ting Yang

    Full Text Available It is not possible to identify all pregnancies at risk of neonatal hypoxic-ischemic encephalopathy (HIE. Many women use some form of analgesia during childbirth and some anesthetic agents have been shown to be neuroprotective when used as analgesics at subanesthetic concentrations. In this study we sought to understand the effects of two anesthetic agents with presumptive analgesic activity and known preconditioning-neuroprotective properties (sevoflurane or xenon, in reducing hypoxia-induced brain damage in a model of intrauterine perinatal asphyxia. The analgesic and neuroprotective effects at subanesthetic levels of sevoflurane (0.35% or xenon (35% were tested in a rat model of intrauterine perinatal asphyxia. Analgesic effects were measured by assessing maternal behavior and spinal cord dorsal horn neuronal activation using c-Fos. In separate experiments, intrauterine fetal asphyxia was induced four hours after gas exposure; on post-insult day 3 apoptotic cell death was measured by caspase-3 immunostaining in hippocampal neurons and correlated with the number of viable neurons on postnatal day (PND 7. A separate cohort of pups was nurtured by a surrogate mother for 50 days when cognitive testing with Morris water maze was performed. Both anesthetic agents provided analgesia as reflected by a reduction in the number of stretching movements and decreased c-Fos expression in the dorsal horn of the spinal cord. Both agents also reduced the number of caspase-3 positive (apoptotic neurons and increased cell viability in the hippocampus at PND7. These acute histological changes were mirrored by improved cognitive function measured remotely after birth on PND 50 compared to control group. Subanesthetic doses of sevoflurane or xenon provided both analgesia and neuroprotection in this model of intrauterine perinatal asphyxia. These data suggest that anesthetic agents with neuroprotective properties may be effective in preventing HIE and should be

  18. Genomic insights into the etiology and classification of the cerebral palsies

    OpenAIRE

    Moreno-De-Luca, Andres; Ledbetter, David H.; Martin, Christa L.

    2012-01-01

    Cerebral palsy (CP), the most common physical disability of childhood, is a clinical diagnosis that encompasses a highly heterogeneous group of neurodevelopmental disorders resulting in movement and posture impairments that persist throughout life. Despite being commonly attributed to a variety of environmental factors, particularly to birth asphyxia, the specific cause remains unknown in the majority of individuals. Conversely, a growing body of evidence suggests that CP is likely caused by ...

  19. Korioamnionitis sebagai Faktor Risiko Terjadinya Palsi Serebral

    OpenAIRE

    Lubis, Siska Mayasari

    2010-01-01

    Cerebral palsy affects motion, muscle strength, balance, and coordination. Despite improvements in perinatal medicine, the prevalence of cerebral palsy has increased over the last 2 decades, and the etiology of cerebral palsy remains poorly understood. Evidence suggests that 70-80% of cases are due to prenatal factors, and that birth asphyxia plays a relatively minor role. A number of studies have assessed the relationship between chorioamnionitis and cerebral palsy in infants. Multicenter co...

  20. Capnography during cardiac resuscitation: a clue on mechanisms and a guide to interventions

    OpenAIRE

    Gazmuri, Raúl J.; Kube, Erika

    2003-01-01

    Measurement of the end-tidal partial pressure of carbon dioxide (PETCO2) during cardiac arrest has been shown to reflect the blood flow being generated by external means and to prognosticate outcome. In the present issue of Critical Care, Grmec and colleagues compared the initial and subsequent PETCO2 in patients who had cardiac arrest precipitated by either asphyxia or ventricular arrhythmia. A much higher PETCO2 was found immediately after intubation in instances of asphyxial arrest. Yet, a...

  1. Non-invasive optical monitoring of the newborn piglet brain using continuous-wave and frequency-domain spectroscopy

    International Nuclear Information System (INIS)

    We have used continuous-wave (CW) and frequency-domain spectroscopy to investigate the optical properties of the newborn piglet brain in vivo and non-invasively. Three anaesthetized, intubated, ventilated and instrumented newborn piglets were placed into a stereotaxic instrument for optimal experimental stability, reproducible probe-to-scalp optical contact and 3D adjustment of the optical probe. By measuring the absolute values of the brain absorption and reduced scattering coefficients at two wavelengths (758 and 830 nm), frequency-domain spectroscopy provided absolute readings (in contrast to the relative readings of CW spectroscopy) of cerebral haemoglobin concentration and saturation during experimentally induced perturbations in cerebral haemodynamics and oxygenation. Such perturbations included a modulation of the inspired oxygen concentration, transient brain asphyxia, carotid artery occlusion and terminal brain asphyxia. The baseline cerebral haemoglobin saturation and concentration, measured with frequency-domain spectroscopy, were about 60% and 42 μM respectively. The cerebral saturation values ranged from a minimum of 17% (during transient brain asphyxia) to a maximum of 80% (during recovery from transient brain asphyxia). To analyse the CW optical data, we have (a) derived a mathematical relationship between the cerebral optical properties and the differential pathlength factor and (b) introduced a method based on the spatial dependence of the detected intensity (dc slope method). The analysis of the cerebral optical signals associated with the arterial pulse and with respiration demonstrates that motion artefacts can significantly affect the intensity recorded from a single optode pair. Motion artefacts can be strongly reduced by combining data from multiple optodes to provide relative readings in the dc slope method. We also report significant biphasic changes (initial decrease and successive increase) in the reduced scattering coefficient measured

  2. Non-invasive optical monitoring of the newborn piglet brain using continuous-wave and frequency-domain spectroscopy

    Science.gov (United States)

    Fantini, Sergio; Hueber, Dennis; Franceschini, Maria Angela; Gratton, Enrico; Rosenfeld, Warren; Stubblefield, Phillip G.; Maulik, Dev; Stankovic, Miljan R.

    1999-06-01

    We have used continuous-wave (CW) and frequency-domain spectroscopy to investigate the optical properties of the newborn piglet brain in vivo and non-invasively. Three anaesthetized, intubated, ventilated and instrumented newborn piglets were placed into a stereotaxic instrument for optimal experimental stability, reproducible probe-to-scalp optical contact and 3D adjustment of the optical probe. By measuring the absolute values of the brain absorption and reduced scattering coefficients at two wavelengths (758 and 830 nm), frequency-domain spectroscopy provided absolute readings (in contrast to the relative readings of CW spectroscopy) of cerebral haemoglobin concentration and saturation during experimentally induced perturbations in cerebral haemodynamics and oxygenation. Such perturbations included a modulation of the inspired oxygen concentration, transient brain asphyxia, carotid artery occlusion and terminal brain asphyxia. The baseline cerebral haemoglobin saturation and concentration, measured with frequency-domain spectroscopy, were about 60% and 42 µM respectively. The cerebral saturation values ranged from a minimum of 17% (during transient brain asphyxia) to a maximum of 80% (during recovery from transient brain asphyxia). To analyse the CW optical data, we have (a) derived a mathematical relationship between the cerebral optical properties and the differential pathlength factor and (b) introduced a method based on the spatial dependence of the detected intensity (dc slope method). The analysis of the cerebral optical signals associated with the arterial pulse and with respiration demonstrates that motion artefacts can significantly affect the intensity recorded from a single optode pair. Motion artefacts can be strongly reduced by combining data from multiple optodes to provide relative readings in the dc slope method. We also report significant biphasic changes (initial decrease and successive increase) in the reduced scattering coefficient measured

  3. The Success of Cardiotocography in predicting Perinatal Outcome

    OpenAIRE

    Kaban, Alpaslan; Cengiz, Hüseyin; Kaban, Işık; Özcan, Alim; Karakaş, Sema

    2012-01-01

    Objectives: The determination of the fetal condition during labor is important to minimize fetal death due to asphyxia and the neurological sequelae of fetal hypoxia. This study evaluated the success of fetal cardiotocography in predicting perinatal consequences. Materials and methods: This study enrolled 101 full-term pregnant women admitted for delivery to Vakif Gureba Training and Research Hospital between October 2009 and February 2010. Women were included if they were aged 18-45 year...

  4. Cardiotocography in the Prognosis of Perinatal Outcome

    OpenAIRE

    Bogdanovic, Gordana; Babovic, Adnan; Rizvanovic, Mirzeta; LJUCA Dzenita; Grgic, Gordana; Djuranovic–Milicic, Jadranaka

    2014-01-01

    ABSTRACT Aim: The objective of the study was to examine whether cardiotocography can (CTG) predict asphyxia of the embryo, manifested as hypoxic-ischemic encephalopathy (HIE), and to what extent one can rely on CTG record. Material and methods: Retrospective research was carried out at the Clinic for Gynecology and Obstetrics UKC Tuzla and medical documentation from the history of mothers and newborns was used. The study group consisted of 68 pregnancies and newborns who developed HIE. The co...

  5. Modern methods in the prevention and management of complications in labor

    OpenAIRE

    Ojala, K.

    2010-01-01

    Abstract Although in Finland the incidence of maternal and neonatal mortality in labor is very low, labor carries some risks. This study focused on two major complications in labor: fetal asphyxia and maternal hemorrhage. The roles of fetal electrocardiographic ST-analysis (STAN) and pelvic artery embolization in the prevention and management of these complications were investigated. Intrapartum fetal monitoring aims at a timely detection of fetal hypoxemia. When non-selected parturie...

  6. Intrapartum fetal monitoring by ST-analysis of the fetal ECG

    OpenAIRE

    Westerhuis, M.E.M.H.

    2010-01-01

    Objective Intrapartum fetal monitoring aims to identify fetuses at risk for neonatal and long-term injury due to asphyxia. To serve this purpose, cardiotocography (CTG) combined with ST-analysis of the fetal electrocardiogram (ECG), which is a relatively new method, may be used. The main aim of this thesis was to quantify the (cost) effectiveness of intrapartum fetal monitoring by ST-analysis of the fetal ECG in women with a singleton term pregnancy in cephalic position. Methods Several studi...

  7. Subdural haemorrhage and severe coagulopathy resulting in transtentorial uncal herniation in a neonate undergoing therapeutic hypothermia

    OpenAIRE

    Wang, Dianna; McMillan, Hugh; Bariciak, Erika

    2014-01-01

    Therapeutic hypothermia has been shown to be efficacious for improving long-term neurodevelopmental outcomes following perinatal asphyxia. Thus, cooling protocols have been adopted at most tertiary neonatal centres. We present a case of a term neonate who underwent therapeutic whole-body cooling for hypoxic ischaemic encephalopathy following a difficult forceps delivery. She abruptly deteriorated, exhibiting signs of transtentorial uncal herniation and severe disseminated intravascular coagul...

  8. IMPACT OF MECONIUM STAINED AMNIOTIC FLUID ON EARLY NEONATAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Uday

    2013-11-01

    Full Text Available ABSTRACT: OBJECTIVE: To find out the incidence, neonatal outcome and associated maternal antepartum & intrapartum risk factors of meconium stained amniotic fluid (MSAF. DESIGN: Prospective St udy. SETTINGS: Neonatal Unit of Hospital and PNC Ward. SUBJECTS & METHODS: Prospective Study was conducted including 100 babies born with meconium stained amniotic fluid who are admitted in NICU and with mother in PNC ward in a period of six months (April 2012 - October 2012 excluding those who born with congenital abnormalities. Detail history of babies and mother with MSAF noted with emphasis on antepartum and intrapartum risk factors and outcome in terms of morbidity and mortality. RESULTS: Incidence of M SAF in the study was 8. 98%. Out of 100, 24 babies were admitted to NICU with most common indications being birth asphyxia (16% and Meconium Aspiration Syndrome (MAS (6%. Majority babies were delivered through thin Meconium Stained Liquor (MSL (44% fo llowed by thick (35% and moderate (21%. Total number of deaths were 9 and all these babies had thick meconium with severe birth asphyxia. Ninety one babies were born at >37 weeks of gestation and 57 had birth weight over 2. 5 Kg. Nineteen percent were no n vigorous requiring tracheal suctioning and positive pressure ventilation at birth. Common mode of delivery was emergency Cesarean in 83% patients. Common maternal and fetal risk factors were fetal distress (30% followed by Oligohydramnios (30%, Pregnan cy induced hypertension (PIH (24%, anemia (14%, severe anemia (5%, Antepartum hemorrhage (4% and Antepartum eclampsia (4%. CONCLUSIONS: Oligohydramnios, PIH, anemia and fetal distress were common antenatal and intranatal factors associated with MSAF. Major morbidity and indication for NICU admission was Birth asphyxia and non vigorous babies. Mortality rate was 9% which is commonly associated with thick meconium and severe birth asphyxia.

  9. Characterization of newborns with nonimmune hydrops fetalis admitted to a neonatal intensive care unit Caracterização dos recém-nascidos com hidropisia fetal não imune admitidos em uma unidade neonatal de terapia intensiva

    OpenAIRE

    Renata Suman Mascaretti; Mário Cícero Falcão; de Silva, Andrea M; Flávio Adolfo Costa Vaz; Cléa Rodrigues Leone

    2003-01-01

    PURPOSE: To determine the incidence and characteristics of nonimmune hydrops fetalis in the newborn population. METHOD: A retrospective study of the period between 1996 and 2000, including all newborns with a prenatal or early neonatal diagnosis of nonimmune hydrops fetalis, based on clinical history, physical examination, and laboratory evaluation. The following were analyzed: prenatal follow-up, delivery type, gender, birth weight, gestational age, presence of perinatal asphyxia, nutritiona...

  10. Cerebrocostomandibular syndrome in four sibs, two pairs of twins.

    OpenAIRE

    Drossou-Agakidou, V; Andreou, A.; Soubassi-Griva, V; Pandouraki, M

    1991-01-01

    We report four sibs, two pairs of twins, with cerebrocostomandibular syndrome (CCMS). The family history was negative. All four babies had the characteristic features of CCMS, including Pierre-Robin anomalad and rib dysplasia. Cerebral involvement was evident in two of the patients who had suffered perinatal asphyxia. The presence of the syndrome in all four sibs together with the negative family history in previous generations is consistent with Mendelian autosomal recessive inheritance with...

  11. DENGUE DURING PREGNANCY: ASSOCIATION WITH LOW BIRTH WEIGHT AND PREMATURITY

    Science.gov (United States)

    RIBEIRO, Christiane Fernandes; LOPES, Vânia Glória Silami; Brasil, Patricia; da Silva, Licinio Esmeraldo; RIBEIRO, Pedro Henrique Fernandes Josephson; UGENTI, Luca Cipriani; NOGUEIRA, Rita Maria Ribeiro

    2016-01-01

    The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively). PMID:26910454

  12. Virtual simulator for the generation of patho-physiological foetal ECGs during the prenatal period

    OpenAIRE

    Martinek, Radek; Kelnar, Michal; Vojčinák, Petr; Koudelka, Petr; Vaňuš, Jan; Bilík, Petr; Janků, Petr; Nazeran, Homer; Žídek, Jan

    2015-01-01

    The design, implementation, and verification of a signal simulator for the generation of patho-physiological records of foetal electrocardiograms (fECGs) during the prenatal period are briefly reported. The simulator enables users to model the patho-physiological changes that occur within the foetus’ myocardium under hypoxic conditions (hypoxemia, hypoxia, asphyxia, etc.) during the 20th to 42nd week of pregnancy. The simulator deploys a dynamic fECG model including an ac...

  13. The efficacy of antihypertensive drugs in chronic intermittent hypoxia conditions

    OpenAIRE

    Lucilia Neves Diogo; Emília Carreira Monteiro

    2014-01-01

    Sleep apnea/hypopnea disorders include centrally originated diseases and obstructive sleep apnea (OSA). This last condition is renowned as a frequent secondary cause of hypertension (HT). The mechanisms involved in the pathogenesis of HT can be summarized in relation to two main pathways: sympathetic nervous system stimulation mediated mainly by activation of carotid body (CB) chemoreflexes and/or asphyxia, and, by no means the least important, the systemic effects of chronic intermittent hyp...

  14. Laryngotracheal stenosis and reconstruction

    OpenAIRE

    Janssen, Luuk

    2010-01-01

    textabstractThe patency of the larynx and the trachea is sometimes compromised acutely with a direct threat of suffocation or asphyxia. Of old this occurred quite often as a consequence of diphteria and other infectious diseases or as a result of various kinds of exogenous traumata. Infectious diseases for instance, epiglottitis are still among us but are usually handled efficiently by medication and occasionally by intubation.

  15. Does Maturity Affect Cephalic Perfusion and T/QRS Ratio during Prolonged Umbilical Cord Occlusion in Fetal Sheep?

    Directory of Open Access Journals (Sweden)

    Guido Wassink

    2014-01-01

    Full Text Available T/QRS ratio monitoring is used to help identify fetal asphyxia. However, immature animals have greater capacity to maintain blood pressure during severe asphyxia, raising the possibility that they may show an attenuated T/QRS increase during asphyxia. Chronically instrumented fetal sheep at 0.6 of gestation (0.6 GA; n = 12, 0.7 GA (n = 12, and 0.8 GA (n = 8 underwent complete umbilical cord occlusion for 30 min, 25 min, or 15 min, respectively. Cord occlusion was associated with progressive metabolic acidosis and initial hypertension followed by severe hypotension, with a more rapid fall in mean arterial blood pressure (MAP and carotid blood flow (CaBF with advancing gestation. T/QRS ratio rose after occlusion more rapidly at 0.8 GA than in immature fetuses, to a similar final peak at all ages, followed by a progressive fall that was slower at 0.8 GA than in the immature fetuses. The increase in T/QRS ratio correlated with initial hypertension at 0.8 GA (P<0.05, R2 = 0.38, and conversely, its fall correlated closely with falling MAP in all gestational groups (P<0.01, R2 = 0.67. In conclusion, elevation of the T/QRS ratio is an index of onset of severe asphyxia in the last third of gestation, but not of fetal compromise.

  16. Intramuscular Injection of “Site Enhancement Oil”

    DEFF Research Database (Denmark)

    Petersen, Maria Louise; Colville-Ebeling, Bonnie; Jensen, Thomas Hartvig Lindkær;

    2015-01-01

    The use of intramuscular injection of foreign substances for aesthetic purposes is well known. Complications are usually local to the site of injection but can be potentially lethal. Here, we present a case of "site enhancement oil" use in a 42-year-old man who died from asphyxia due to hanging. ....... Macroscopic and microscopic changes as well as computed tomographic changes in injected musculature are described and the potentially lethal adverse effects after site enhancement oil use are warranted....

  17. Reclassification of SIDS cases--a need for adjustment of the San Diego classification?

    DEFF Research Database (Denmark)

    Jensen, Lisbeth Lund; Rohde, Marianne Cathrine; Banner, Jytte;

    2012-01-01

    A study was undertaken reclassifying cases of sudden infant death syndrome (SIDS) taken from two geographically separate locations utilizing the San Diego definition with subclassifications. One hundred twenty-eight infant cases were examined from files at Forensic Science South Australia....... None of the cases met the criteria for IA SIDS. Problems arose in assessing cases with failure to thrive, fever, and possible asphyxia. Modifications to the San Diego subclassifications might improve the consistency of categorizing these cases....

  18. Translational Approaches for Studying Neurodevelopmental Disorders Utilizing in Vivo Proton (+H) Magnetic Resonance Spectroscopic Imaging in Rats

    Science.gov (United States)

    Ronca, April E.

    2014-01-01

    Intrauterine complications have been implicated in the etiology of neuripsychiatric disorders including schizophrenia, autism and ADHD. This presentation will describe new translational studies derived from in vivo magnetic resonance imaging of developing and adult brain following perinatal asphyxia (PA). Our findings reveal significant effects of PA on neurometabolic profiles at one week of age, and significant relationships between early metabolites and later life phenotypes including behavior and brain morphometry

  19. Acute Respiratory Distress Due to Methane Inhalation

    OpenAIRE

    Jo, Jun Yeon; Kwon, Yong Sik; Lee, Jin Wook; Park, Jae Seok; Rho, Byung Hak; Choi, Won-Il

    2013-01-01

    Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest rad...

  20. Ellagic acid improves electrocardiogram waves and blood pressure against global cerebral ischemia rat experimental models

    OpenAIRE

    Nejad, Khojasteh Hoseiny; Dianat, Mahin; Sarkaki, Alireza; Naseri, Mohammad Kazem Gharib; Badavi, Mohammad; Farbood, Yaghoub

    2015-01-01

    Background: Global cerebral ischemia (GCIR) arises in patients that are shown a variety of clinical difficulty including cardiac arrest, asphyxia, and shock. In spite of advances in understanding of the brain, ischemia and protective effects to improve ischemic injury still remain unknown. The aim of our study was to investigate the effect of ellagic acid (EA) pretreatment in the rat models of global cerebral ischemia reperfusion. Methods: This experimental study was conducted in 2014 at the ...

  1. Symmetrical thalamic lesions in infants.

    OpenAIRE

    Eicke, M.; Briner, J; Willi, U; Uehlinger, J; Boltshauser, E

    1992-01-01

    Clinical observations and findings on imaging are reported in six newborns with symmetrical thalamic lesions (STL). In three cases the diagnosis was confirmed by postmortem examination. Characteristic observations in this series and 17 previously reported cases include no evidence of perinatal asphyxia, high incidence of polyhydramnios, absent suck and swallow, absent primitive reflexes, appreciable spasticity at or within days of birth, lack of psychomotor development, and death within days ...

  2. Resuscitation and auto resuscitation by airway reflexes in animals

    OpenAIRE

    Tomori, Zoltan; Donic, Viliam; Benacka, Roman; Jakus, Jan; Gresova, Sona

    2013-01-01

    Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath – sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant – autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasp...

  3. Reversal of functional disorders by aspiration, expiration, and cough reflexes and their voluntary counterparts

    OpenAIRE

    ZoltanTomori

    2012-01-01

    Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation (VF), but it fails to revive infants with sudden infant death syndrome (SIDS). Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are two distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations (SIs) can be elicited by nasopharyngeal stimulation, strongly activating the brains...

  4. Sexual Masochism Disorder with Asphyxiophilia: A Deadly yet Underrecognized Disease

    Science.gov (United States)

    Gabbrielli, Mario; Gualtieri, Giacomo; Ferretti, Fabio; Pozza, Andrea; Fagiolini, Andrea

    2016-01-01

    DSM-5 distinguishes between paraphilias and paraphilic disorders. Paraphilias are defined as atypical, yet not necessarily disordered, sexual practices. Paraphilic disorders are instead diseases, which include distress, impairment in functioning, or entail risk of harm one's self or others. Hence, DSM-5 new approach to paraphilias demedicalizes and destigmatizes unusual sexual behaviors, provided they are not distressing or detrimental to self or others. Asphyxiophilia, a dangerous and potentially deadly form of sexual masochism involving sexual arousal by oxygen deprivation, are clearly described as disorders. Although autoerotic asphyxia has been associated with estimated mortality rates ranging from 250 to 1000 deaths per year in the United States, in Italy, knowledge on this condition is very poor. Episodes of death caused by autoerotic asphyxia seem to be underestimated because it often can be confounded with suicide cases, particularly in the Italian context where family members of the victim often try to disguise autoerotic behaviors of the victims. The current paper provides a review on sexual masochism disorder with asphyxiophilia and discusses one specific case as an example to examine those conditions that may or may not influence the likelihood that death from autoerotic asphyxia be erroneously reported as suicide or accidental injury. PMID:27747123

  5. The myths and physiology surrounding intrapartum decelerations: the critical role of the peripheral chemoreflex.

    Science.gov (United States)

    Lear, Christopher A; Galinsky, Robert; Wassink, Guido; Yamaguchi, Kyohei; Davidson, Joanne O; Westgate, Jenny A; Bennet, Laura; Gunn, Alistair J

    2016-09-01

    A distinctive pattern of recurrent rapid falls in fetal heart rate, called decelerations, are commonly associated with uterine contractions during labour. These brief decelerations are mediated by vagal activation. The reflex triggering this vagal response has been variably attributed to a mechanoreceptor response to fetal head compression, to baroreflex activation following increased blood pressure during umbilical cord compression, and/or a Bezold-Jarisch reflex response to reduced venous return from the placenta. Although these complex explanations are still widespread today, there is no consistent evidence that they are common during labour. Instead, the only mechanism that has been systematically investigated, proven to be reliably active during labour and, crucially, capable of producing rapid decelerations is the peripheral chemoreflex. The peripheral chemoreflex is triggered by transient periods of asphyxia that are a normal phenomenon associated with all uterine contractions. This should not cause concern as the healthy fetus has a remarkable ability to adapt to these repeated but short periods of asphyxia. This means that the healthy fetus is typically not at risk of hypotension and injury during uncomplicated labour even during repeated brief decelerations. The physiologically incorrect theories surrounding decelerations that ignore the natural occurrence of repeated asphyxia probably gained widespread support to help explain why many babies are born healthy despite repeated decelerations during labour. We propose that a unified and physiological understanding of intrapartum decelerations that accepts the true nature of labour is critical to improve interpretation of intrapartum fetal heart rate patterns. PMID:27328617

  6. Violent Asphyxial Death: A Study in Dinajpur Medical College, Dinajpur

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    Md. Mizanur Rahman

    2013-07-01

    Full Text Available Background: The word asphyxia is now commonly used to describe a range of conditions for which the lack of oxygen whether it is partial (hypoxia or complete (anoxia is considered to be the cause. The cardinal signs of asphyxia are cyanosis, congestion and petechial haemorrhage.Objective: To investigate the causes and manner of asphyxial death.Materials and Methods: It was a retrospective study conducted in the department of Forensic Medicine, Dinajpur Medical College, Dinajpur during July 2004 to June 2006. A total of 96 cases were examined and recorded. These cases were brought to the morgue of Dinajpur Medical College from 13 different police stations and 1 railway GRP station of Dinajpur district. The data were collected from the autopsy reports (preserved third copy with permission of the concerned autopsy surgeons.Results: 88.55% of asphyxia deaths were due to hanging, 6.25% due to strangulation and 5.20% were due to suffocation.Conclusion: Most of the asphyxial deaths are due to hanging.

  7. FACTORS CONTRIBUTING TO PERINATAL MORTALITY : OPTIMIZING OUTCOME

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    Lakshmi

    2015-03-01

    Full Text Available OBJECTIVE: To evaluate the various causes of perinatal deaths and adopt strategies to improve perinatal outcome at a referral teaching hospital in North Kerala. METHODS: A prospective observational study conducted at Institute of Maternal and Child Health, Government Medical College, Kozhikode. All perinatal deaths during the period January 2013 to December 2014 were analysed and from this factors responsible for perinatal deaths were identified. RESULTS: Out of total 30,042 deliveries , there were 966 perinatal deaths during the study period. 566 were still births and 400 early neonatal deaths. The perinatal mortality rate was 31.1 per 1000 live births. Perinatal asphyxia was the major cause of perinatal mortality. The important factors contributing to perinatal asphyxia were prematurity (39%, abruptio placenta (19% and MSAF ( 12%. Among the antenatal factors, hypertensive disorders of pregnancy leading to iatrogenic elective preterm delivery were the most important. CONCLUSION: Perinatal asphyxia due to prematurity and low birth weight emerged as the most important cause of perinatal mortality in this study and hypertensive disorders of pregnancy were the most important antenatal complication leading to prematurity

  8. Postdatism -- a perinatal problem?

    Science.gov (United States)

    Chhabra, S; Sood, S

    1990-01-01

    It has been traditionally accepted that maternal and fetal complications are at their lowest levels 37-42 weeks into gestation. 20% of pregnancies completed after 42 weeks gestation are thought to be affected by the postmaturity syndrome of uteroplacental insufficiency resulting in oligohydramnios, meconium passage, loss of fetal subcutaneous tissue, fetal asphyxia, and fetal death. Some workers, however, have also found that pregnancies completed between 40 and 42 weeks carry significant risk. The authors explored this question in a case-control study of 464 women seen at the Mahatma Gandhi Institute of Medical Sciences in Maharashtra, India. The cases of postdatism occurred in the absence of any other medical or obstetric problem. The operative delivery rate increased significantly among these patients compared to deliveries between 39 and 40 weeks. There was neither significant asphyxia nor perinatal loss in term completed normal patients. Asphyxia and perinatal mortality did, however, occur with postdatism. The authors note the likely role of oligohydramnios combined with placental dysfunction.

  9. COMPARATIVE STUDY OF NEONATAL OUTCOME IN CEASAREAN SECTION DONE IN REFERRED CASES VS ELECTIVE CEASAREAN DELIVERY IN A RURAL MEDICAL COLLEGE HOSPITAL

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    Sowmya

    2014-11-01

    Full Text Available : OBJECTIVES: To study the fetal outcome of rural referrals undergoing emergency caesarean delivery versus elective caesarean delivery in a tertiary care hospital METHODOLOGY: This comparative study was done at a rural medical college hospital, Karnataka, from October 2010 to October 2011. 50 patients referred to the hospital and who underwent caesarean delivery are emergency group and 50 patients admitted in our hospital who were posted for elective cesarean delivery were the other group in the study with emphasis on indications and perinatal outcome. RESULTS: obstructed labour (34 % was the commonest indication in emergency and previous caesarean delivery (36% being the commonest in elective group. The live birth was 88% in Emergency group as against 100% live births in Elective group. Perinatal mortality from emergency Caesarean sections accounted for 12%, with severe birth asphyxia responsible for most perinatal deaths. There was statistically significant difference in stillbirths, neonatal deaths, and severe neonatal morbidity between emergency and elective caesarean sections-probably related to prolonged labor, asphyxia, and sepsis than in elective caesarean delivery. CONCLUSION: The perinatal mortality was 12%, and the main cause of death was severe birth asphyxia. Emergency caesarean section was more likely than elective to result in a perinatal loss. The indication with the poorest fetal outcome was prolonged obstructed labor. Early diagnosis and timely intervention may result in decrease in incidence of morbidity and mortality. Emergency caesareans, when performed, are often too late to reduce perinatal deaths.

  10. Patterns and causes of neonatal and postneonatal mortality in rural Bangladesh.

    Science.gov (United States)

    Bhatia, S

    1989-01-01

    Community-level research data from a Maternal-Child Health and Family Planning (MCH/FP) program and comparison areas in rural Bangladesh indicate that 60 percent of infant deaths occurred in the neonatal period in both areas. Since the inception of the MCH/FP program, mortality rates declined relative to those in the comparison area. This decline, however, was confined to the neonatal period death rates only, with mortality rates in the postneonatal period remaining similar in the two areas. Prematurity accounted for approximately 40 percent of deaths in the neonatal period. Cause-of-death data indicated that the differences in the neonatal mortality rates between the two areas was mainly due to a marked decline in tetanus neonatorum deaths in the MCH/FP program area, because of the tetanus toxoid immunization of pregnant women there. The interventions in the MCH/FP area, however, did not significantly influence mortality due to any other cause. This study provides an explanation for the limited impact on infant mortality of health interventions that focus on diarrheal diseases and immunizations of children. PMID:2734810

  11. 过期妊娠胎儿的分娩方式及妊娠终止时机差异性预后影响分析%Analysis of the Effect of Different Mode of Delivery and Pregnancy Termination Timing for Prolonged Pregnancy on the Fetal Outcome

    Institute of Scientific and Technical Information of China (English)

    鄂眉

    2015-01-01

    目的:分析过期妊娠胎儿的分娩方式及妊娠终止时机差异性对预后的影响。方法回顾性分析某院2012年5月—2014年11月收治的100例过期妊娠产妇(研究组)及同期80例延期产妇(对照组)临床资料,探究不同分娩方式及妊娠终止时机对胎儿预后的影响。结果研究组顺产胎儿中新生儿窒息8例(25%)、胎儿窘迫15例(46.9%),与剖宫产新生儿窒息3例(4.4%)、胎儿窘迫12例(17.6%)相比较,差异有统计学意义(P<0.05);研究组胎儿窘迫27例(27%)、新生儿窒息11例(11%)、产后出血11例(11%)、产程延长25例(25%),对照组分别为12例(15%)、2例(2.5%)、4例(5%)、3例(3.8%),组间差异有统计学意义(P<0.05)。结论过期妊娠产妇采取剖宫产能够有效降低胎儿窘迫、新生儿窒息发生率,提高胎儿预后,而延期妊娠产妇应加强临床产检、适时终止妊娠,以避免形成过期妊娠,影响胎儿预后。%ObjectiveTo analyze the effect of different mode of delivery and pregnancy termination timing for prolonged pregnancy on the fetal outcome.Methods A retrospective analysis was conducted on the clinical data of 100 puerperants with prolonged pregnancy(study group) and 80 puerperants with delayed pregnancy(control group) admitted in our hospital from May 2012 to November 2014. And the effect of different mode of delivery and pregnancy termination timing on the prognosis of fetal outcome was investigated.Results In the study group, of the fetuses delivered naturally, there were 8 cases with neonatal asphyxia(25%), 15 cases with fetal distress(46.9%); of the fetuses delivered by cesarean section, there were 3 cases with neonatal asphyxia(4.4%), 12 cases with fetal distress(17.6%), the differences in neonatal asphyxia and fetal distress between the fetuses delivered naturally and those delivered by cesarean section in the study group were statistically significant(P<0.05). In the study group, there were 27 cases

  12. Effect of Improved Bird-nest-shaped Package on Nursing of Premature Infants%早产儿应用改良鸟巢体位包的护理效果观察

    Institute of Scientific and Technical Information of China (English)

    陈秋玉; 张莉; 苏敏谊

    2011-01-01

    Objective To observe the effect of improved bird-nest-shaped package on the nursing of premature infants. Methods 100 premature were randomly divided into control group with bird-nest-shaped package and experiment group with improved bird-nest-shaped package. Homoeothermic water-pillows were applied in both groups. Apnea, sclerema neonatorum, SpO2 heart rate and rectal temperature changes 7 days after hospitalization between two groups were compared. Results No sclerema neonatorum occurred in two groups and no statistic significance exist in the comparison of' apnea but there were statistical differences between the comparisons of SpO2, heart rate and rectal temperature of infants in two groups. Conclusion Improved bird-nest-shaped package is beneficial to keeping a stable temperature and the SpO2, controlling the heart rate and maintaining a stable vital sign and the development of the normal physiology functions.%目的 观察改良鸟巢体位包在早产儿护理中的应用效果.方法 2009年7月-2010年10月100例早产儿根据入院的单双日分为对照组和研究组,分别采用传统棉布环形包绕四周的鸟巢和改良鸟巢体位包,即除了四周有棉布环绕外,还配有帽子,背部也有柔软温暖的海绵作为底垫,两组均予恒温水枕垫高头颈部,观察比较两组早产儿入院7 d内发生新生儿硬肿、呼吸暂停、经皮测SpO2<85%、心率>160次/min的例数,及每2 h内肛温<36℃的例数.结果 早产儿入院7 d内研究组与对照组发生呼吸暂停的例数差异无统计学意义,对照组经皮测SpO2<85%、心率>160次/min、入院2h内肛温<36℃的例数较多,差异均有统计学意义,但两组新生儿均未发生新生儿硬肿.结论 改良鸟巢体位包有利于维持患儿体温,维持较高血氧饱和度,能较好控制心率,从而促进早产儿适应宫外环境.

  13. The Relationship Between Pregnancy Outcomes and the Residue Amniotic Fluid Volume After Premature Rupture of Membranes in the Normal Period of Gestation%足月胎膜早破孕妇剩余羊水量与妊娠结局

    Institute of Scientific and Technical Information of China (English)

    余立波

    2014-01-01

    目的:探讨足月胎膜早破孕妇剩余羊水量对妊娠结局的影响。方法孕足月胎膜早破孕妇分为羊水量正常组、羊水量偏少组、羊水量过少组。统计分析三组宫内感染、剖宫产率、胎儿宫内窘迫及新生儿窒息的差别。结果羊水量过少组剖宫产率、胎儿宫内窘迫发生率、新生儿窒息的发生率高于另外两组(P<0.05);三组间羊膜腔感染率差异无统计学意义(P>0.05)。结论胎膜早破的剩余羊水量过少可导致剖宫产率、胎儿宫内窘迫及新生儿窒息发生率升高。%Objective: To determine the relationship between the residue amniotic fluid volume after premature rupture of membranes (PROM) in the normal period of gestation. Methods:According to amniotic fluid index (AFI) by ultrasound, pregnant women were divided intogroup of normal amniotic fluid, group of borderline oligohydramnios, and group of oligohydramnios. Analyzed and compared the rate of intrauterine infection, cesarean section, fetal distress and neonatal asphyxia. Result: Group of oligohydramnios had a high rates of cesarean section, fetal distress and neonatal asphyxia compared with other two groups (P0.05). Conclusion:Oligohydramnios after PROM is associated with the increasing risks of cesarean section, fetal distress and neonatal asphyxia.

  14. An audit of paediatric mortality patterns in a Nigerian teaching hospital

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    Gerald Dafe Forae

    2014-01-01

    Full Text Available Background: The 4 th millennium development goals (2002 reported that sub-Saharan Africa countries including Nigeria have a persistently high childhood mortality rates in-spite of all the preventive and interventional measures to reduce this ugly trend. Patients and Methods: Childhood mortality data was obtained from the medical records department and post-mortem records of the pathology departments over a 5-year period from January 2007 to December 2011. The selection criteria include all case notes with mortality records involving children admitted into the paediatrics department through the labour ward and the obstetrics theater, children emergency unit (CHER, paediatric out-patient clinic. Results : A total of 12,442 children were admitted during this period. Of this, 711 paediatric deaths were documented accounting for 17.5%. The male to female mortality ratio was 1.4:1. The age range was from birth to 17 years. Neonatal deaths accounted for the most common cause of death constituting 344 (48.4% of all deaths. Among the neonatal mortality patterns, severe birth asphyxia/perinatal asphyxia was the most common cause of early neonatal deaths accounting for 97 (28.2%. Septicaemia accounted for the most frequent cause of infant mortality accounting for 28 (21.8%. Among the under-5 age group, severe malaria constituted the most common cause of death accounting for 52 (36.6% cases while malignancy topped the list of 5-17 years mortality rate constituting 15 (15.4% cases. Conclusion: Perinatal and neonatal deaths constitute the vast majority of death in our environment with most of the deaths resulting from severe birth asphyxias, prematurity. Again in the post-neonatal period, infections and other preventable diseases constitute the most common cause of death in children of under age group of five years. Above 5 years childhood malignancies constitutes the highest mortality pattern.

  15. Paediatricians’ perspectives on global health priorities for newborn care in a developing country: a national survey from Nigeria

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    Olusanya Bolajoko O

    2012-07-01

    Full Text Available Abstract Background An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Methods Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test. Results Valid responses were received from 152 (65.8% of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality. Conclusions Current global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the

  16. Predictive Value of Nucleated Red Blood Cell Counts in Cord and Peripheral Blood of Asphyxiated Term Neonates in the First Week of Life

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    B Bahman Bijari

    2010-03-01

    Full Text Available Introduction: Increased numbers of nucleated red blood cells (NRBC circulating in the blood of neonates can be associated with relative hypoxia and adverse outcomes. Thus, the aim of this study was to assess the NRBC count during the first week of life in neonates diagnosed with asphyxia as compared to healthy neonates and to determine the short-term morbidity and mortality for the affected babies. Methods: The cross-sectional study compared 15 healthy neonates with 15 neonates diagnosed with asphyxia confirmed by pH of cord blood or Apgar scores. The nucleated red blood cell (NRBC counts were calculated right after birth, and on days 3 and 7, and the hematological parameters of umbilical cord blood were also evaluated. The infants were followed for mortality and associated morbidity. Statistical analysis was conducted using the Mann-Whitney U test, analysis of variance, chi-square tests, and Pearson’s correlation coefficient. A p-value < 0.05 was considered as statistically significant. Results: The initial NRBC counts were significantly higher in the asphyxiated group than in the control group and the difference remained significant through the end of first week. All of the umbilical cord blood parameters were significantly lower in the study group and were negatively correlated with the NRBC count. At birth, higher NRBC count correlated with higher mortality. conclution: Results show that NRBC count is a useful predictive factor for neonatal asphyxia through the end of the first week of life, although a larger study population and a longer follow up period seems to be necessary.

  17. Antioxidant protects against increases in low molecular weight hyaluronan and inflammation in asphyxiated newborn pigs resuscitated with 100% oxygen.

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    Helene C D Østerholt

    Full Text Available BACKGROUND: Newborn resuscitation with 100% oxygen is associated with oxidative-nitrative stresses and inflammation. The mechanisms are unclear. Hyaluronan (HA is fragmented to low molecular weight (LMW by oxidative-nitrative stresses and can promote inflammation. We examined the effects of 100% oxygen resuscitation and treatment with the antioxidant, N-acetylcysteine (NAC, on lung 3-nitrotyrosine (3-NT, LMW HA, inflammation, TNFα and IL1ß in a newborn pig model of resuscitation. METHODS & PRINCIPAL FINDINGS: Newborn pigs (n = 40 were subjected to severe asphyxia, followed by 30 min ventilation with either 21% or 100% oxygen, and were observed for the subsequent 150 minutes in 21% oxygen. One 100% oxygen group was treated with NAC. Serum, bronchoalveolar lavage (BAL, lung sections, and lung tissue were obtained. Asphyxia resulted in profound hypoxia, hypercarbia and metabolic acidosis. In controls, HA staining was in airway subepithelial matrix and no 3-NT staining was seen. At the end of asphyxia, lavage HA decreased, whereas serum HA increased. At 150 minutes after resuscitation, exposure to 100% oxygen was associated with significantly higher BAL HA, increased 3NT staining, and increased fragmentation of lung HA. Lung neutrophil and macrophage contents, and serum TNFα and IL1ß were higher in animals with LMW than those with HMW HA in the lung. Treatment of 100% oxygen animals with NAC blocked nitrative stress, preserved HMW HA, and decreased inflammation. In vitro, peroxynitrite was able to fragment HA, and macrophages stimulated with LMW HA increased TNFα and IL1ß expression. CONCLUSIONS & SIGNIFICANCE: Compared to 21%, resuscitation with 100% oxygen resulted in increased peroxynitrite, fragmentation of HA, inflammation, as well as TNFα and IL1ß expression. Antioxidant treatment prevented the expression of peroxynitrite, the degradation of HA, and also blocked increases in inflammation and inflammatory cytokines. These findings

  18. Disease profile and Outcome of Newborn admitted to Neonatology unit of BPKIHS

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    Piush Kanodia

    2015-12-01

    Full Text Available Background & Objectives: Neonatal period is a vulnerable time in which the newborn has to adapt to a totally new environment and is susceptible to many problems, which may even be life threatening. Every year, millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU for various indications. It is found that neonatal mortality rate is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, it is crucial to identify the areas where health care can be improved. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to neonatology unit.Materials & Methods: A retrospective study was conducted at neonatology unit of BPKIHS, from January 2014 to December 2014. A total of 1009 neonates (both inborn and out-born were admitted to neonatology division during the study period. Data was collected from the hospital record section. Ethical clearance was taken from the institutional ethical committee before the initiation of the study. Data was entered and descriptive analysis was done by using SPSS 20.0.Results: Total of 1009 neonates were admitted in neonatology unit. Among them, 349(34.5% cases were admitted due neonatal sepsis, 236 (23.3% due to prematurity and 233 (23.1% with birth asphyxia. Among birth asphyxia, 102(43.7% were in HIE III, 34.3% and 21.8% in HIE II and HIE I, respectively. The overall mortality was 47 (4.7% during hospital stay.Conclusion: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortalityJCMS Nepal. 2015;11(3:20-24.

  19. Angiogenesis dysregulation in term asphyxiated newborns treated with hypothermia.

    Directory of Open Access Journals (Sweden)

    Henna Shaikh

    Full Text Available Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesis-related markers following birth asphyxia in human newborns.This study aimed to evaluate the expression of angiogenesis-related protein markers in asphyxiated newborns developing and not developing brain injury compared to healthy control newborns.Twelve asphyxiated newborns treated with hypothermia were prospectively enrolled; six developed eventual brain injury and six did not. Four healthy control newborns were also included. We used Rules-Based Medicine multi-analyte profiling and protein array technologies to study the plasma concentration of 49 angiogenesis-related proteins. Mean protein concentrations were compared between each group of newborns.Compared to healthy newborns, asphyxiated newborns not developing brain injury showed up-regulation of pro-angiogenic proteins, including fatty acid binding protein-4, glucose-6-phosphate isomerase, neuropilin-1, and receptor tyrosine-protein kinase erbB-3; this up-regulation was not evident in asphyxiated newborns eventually developing brain injury. Also, asphyxiated newborns developing brain injury showed a decreased expression of anti-angiogenic proteins, including insulin-growth factor binding proteins -1, -4, and -6, compared to healthy newborns.These findings suggest that angiogenesis pathways are dysregulated following birth asphyxia and are putatively involved in brain injury pathology and recovery.

  20. THE INVESTIGATION OF FACTORS INVOLVED IN "HOW JOINT VACCINATION IS CARRIED OUT IN QUALIFIED WOMEN WHO TURNED TO ZAHEDAN HEALTH CARE CENTRES IN 1380

    Directory of Open Access Journals (Sweden)

    Z MOUDI

    2003-12-01

    Full Text Available Introduction: Tetanus Neonatorum is due to The infection of umbilical cord That Causes mortality rate of neonatal tetanus is 5-60 in 1000 live births that can be prevented by joint vaccination of mother. Objective: The determination of factors involved in "how joint vaccination is carried out in qualified women. Method: According to a case control study In side, each Health center random sampling That data were collected from 300 women of which 150 with a perfect vaccination programme, and 150 without vaccination programme or with an imperfect vaccination programme who turned to 12 Health & Care Centres in Zahedan to vaccinate their babies, and the impact of (vaccination recording system, women"s information - care unit - the number of births -care frequency during pregnancy–mother"s age and education on the way in which joint vaccination is carried out (perfect-imperfect and without vaccination were investigated in two groups. Result: the results indicated a significant correlation with vaccination recording system ,care unit during pregnancy ,the frequency of care by health centre during pregnancy and the number of pregnancies. and on the basis of logestic. Regression The main reasons associated with vaccination Condition first was recording system, second was care unit during pregnancy. Discussion: In order to improve the vaccination condition of qualified women it is necessary 1-to run refreshment courses on "how to carry out vaccination programme using the most recent directions and instructions" for Health personnel. and to have an efficient recording system. 2- to have a monitoring and controlling system on the part of officials with regard to efficient implementation of affairs.

  1. Myiasis in Republic of Yemen (cutaneous myiasis three cases reported and genito-urinary myiasis three cases reported

    Directory of Open Access Journals (Sweden)

    Mohammed Abdul Qader Al-Malmi

    2014-01-01

    Full Text Available Myiasis is a condition resulting from the invasion of living human and animal′s tissues by larval stages of flies. study the cutaneous and genito-urinary myiasis in the Republic of Yemen. Two females and one male, Yemeni patient 12-30 years old presented with urethra-genital discharge, burning, and difficulty during micturition (dysuria. They saw whitish brownish blackish like worms passed in their urine. Three males, Yemeni patients 2 months to 30 years old had solitary and multiple furuncle like skin lesions in upper left thigh (myiasis pubis, right buttock (myiasis neonatorum and in the upper trunk. It was associated with stabbing pain (caused by creeping a foreign body subcutaneously. The duration varied from 2 days to 1 week. The larvae were detected in the urine and the skin lesions. Swab from the urethral discharge was not specific. I used the forceps accidentally and gently caught the larvae and removed them from the fruncular skin lesions. The clinical data and detection of the larvae showed the two females and one male case were genito-urinary myiasis, which caused by latrine Fannia fly larvae during defecation or sleeping and ended spontaneously. The three male patients had cutaneous myiasis, and the causative agent was the larvae of the tumbu fly, Cordylobia anthropophaga species. It penetrates the patients′ normal skin and removed by forceps or squeezing the skin lesion by the patient himself thinking that is abscess to remove the pus. Cutaneous and genito-urinary myiasis was not rare in the Republic of Yemen. Health education, hygiene, and control the flies restrict the incidence of this disease.

  2. A clinical and statistical survey of cutaneous changes in the first 120 hours of life

    Directory of Open Access Journals (Sweden)

    Dinkar J Sadana

    2014-01-01

    Full Text Available Background: The spectrum of dermatological manifestations during neonatal period varies from transient self-limiting conditions to serious dermatoses; the latter, fortunately few, are disproportionately stressful to the parents, who due to lack of specialized pediatric dermatology clinics frequently get tossed between a dermatologist and a pediatrician. Objectives: This study was formulated to record cutaneous changes over the first five postnatal days of life and to statistically correlate those changes occurring in ≥ 11 neonates with three (parity, associated illnesses, and mode of delivery maternal and three (sex, birth weight, and gestational age neonatal factors. Methods: This descriptive, cross-sectional study at a tertiary care hospital entailed recording detailed dermatological examination of 300 neonates having some (physiological and/or pathological cutaneous changes and their statistical evaluation using the Chi-square test and significance (P < 0.05 as above. Results: Superficial cutaneous desquamation (SCD, Mongolian spots (MS, and erythema toxicum neonatorum (ETN were the first three common changes among a total of 15 conditions observed overall; these three, as also milia and icterus, revealed statistical significance with both maternal as well as neonatal factors. Lanugo and napkin dermatitis (ND were statistically significant with respect to two neonatal factors and cradle cap (CC, a single maternal factor. Gestational age was of statistical significance regarding five cutaneous changes, associated maternal illness during pregnancy regarding four, birth weight as well as parity regarding three each, and sex of the neonate as well as mode of delivery regarding two each. Conclusion: Despite observing a statistically significant correlation of eight cutaneous changes with three maternal and/or three neonatal factors, more extensive studies in neonatal dermatology are required for validation of these unique statistical

  3. Severe visual Impairment and blindness in infants: Causes and opportunities for control

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2011-01-01

    Full Text Available Childhood blindness has an adverse effect on growth, development, social, and economic opportunities. Severe visual impairment (SVI and blindness in infants must be detected as early as possible to initiate immediate treatment to prevent deep amblyopia. Although difficult, measurement of visual acuity of an infant is possible. The causes of SVI and blindness may be prenatal, perinatal, and postnatal. Congenital anomalies such as anophthalmos, microphthalmos, coloboma, congenital cataract, infantile glaucoma, and neuro-ophthalmic lesions are causes of impairment present at birth. Ophthalmia neonatorum, retinopathy of prematurity, and cortical visual impairment are acquired during the perinatal period. Leukocoria or white pupillary reflex can be cause by congenital cataract, persistent hyperplastic primary vitreous, or retinoblastoma. While few medical or surgical options are available for congenital anomalies or neuro-ophthalmic disorders, many affected infants can still benefit from low vision aids and rehabilitation. Ideally, surgery for congenital cataracts should occur within the first 4 months of life. Anterior vitrectomy and primary posterior capsulotomy are required, followed by aphakic glasses with secondary intraocular lens implantation at a later date. The treatment of infantile glaucoma is surgery followed by anti-glaucoma medication. Retinopathy of prematurity is a proliferation of the retinal vasculature in response to relative hypoxia in a premature infant. Screening in the first few weeks of life can prevent blindness. Retinoblastoma can be debulked with chemotherapy; however, enucleation may still be required. Neonatologists, pediatricians, traditional birth attendants, nurses, and ophthalmologists should be sensitive to a parent′s complaints of poor vision in an infant and ensure adequate follow-up to determine the cause. If required, evaluation under anesthesia should be performed, which includes funduscopy, refraction

  4. [Gamete donation in an in vitro fertilization program].

    Science.gov (United States)

    Zhang, L Z

    1993-12-01

    Two cases of gamete donation in an IVF program were reported in this paper. In the first case the wife with recurrent abortions was found to have chromosomal abnormality, her karyotype was 45,XX,-14,-14 + rob (14 Q 14 Q). She became pregnant after IVF-ET with donated ova, and was delivered of a normal male baby on June 12, 1992. The baby's karyotype was normal. The blood group of both the husband and wife was O, while that of the baby was B. The baby suffered from icterus neonatorum as a result of ABO incompatibility but recovered quickly after treatment. Further DNA finger print analysis of the husband, wife and baby, combined with the history of egg donation IVF, proved the relationship of the parents with the baby. In the second case the husband's karyotype was 46,XY, t(4; 9) (4Q+; 9Q-). The wife had also history of recurrent abortions. Since 1989, the wife received sperm donation IUI 5 times in another hospital without success. IVF-ET with donated sperms was performed in November 1991 resulting in clinical pregnancy. She was delivered of a pair of twins, one male and one female on July 20, 1992. The possibilities of different types of gamete formation during meiosis in carriers of chromosomal balanced translocation were briefly discussed. Donation of oocytes could be realized only in an IVF program, which is also the only way to propagate for the family. However, IVF with donated sperms is indicated in women with blocked tubes besides the male factor or after repeated failures of other assisted reproductive technologies. PMID:8137642

  5. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Nicole [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Ampanozi, Garyfalia; Schweitzer, Wolf; Ross, Steffen G.; Gascho, Dominic [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Ruder, Thomas D. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, Freiburgstrasse, 3010 Bern (Switzerland); Thali, Michael J. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.uzh.ch [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2015-04-15

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  6. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

    International Nuclear Information System (INIS)

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  7. Cardiovascular dysfunction in infants with neonatal encephalopathy.

    LENUS (Irish Health Repository)

    Armstrong, Katey

    2012-04-01

    Severe perinatal asphyxia with hypoxic ischaemic encephalopathy occurs in approximately 1-2\\/1000 live births and is an important cause of cerebral palsy and associated neurological disabilities in children. Multiorgan dysfunction commonly occurs as part of the asphyxial episode, with cardiovascular dysfunction occurring in up to a third of infants. This narrative paper attempts to review the literature on the importance of early recognition of cardiac dysfunction using echocardiography and biomarkers such as troponin and brain type natriuretic peptide. These tools may allow accurate assessment of cardiac dysfunction and guide therapy to improve outcome.

  8. [Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case].

    Science.gov (United States)

    Ovalle, Alfredo; Martínez, M Angélica; Kakarieka, Elena; García, Mirna; Salinas, Abril

    2009-09-01

    We report a term neonate who developed early-onset sepsis due to Morganella morganii. The child was vaginally delivered after a short labor, and presented signs of perinatal asphyxia. Blood cultures taken soon after birth and from mother's lochia were positive for this microorganism. The infection was unresponsive to treatment with cefotaxime, to which the microorganism was susceptible, and the infant died at 17 days of age. M morganii is an opportunistic and uncommon pathogen, causing disease mainly in patients with underlying illness or after surgery. It is a rare perinatal pathogen, causing severe disease in premature infants, in association with maternal chorioamnionitis and premature rupture of the membranes.

  9. Radiological diagnosis of periventricular and subcortical leukomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Taboada, D.; Alonso, A.; Olague, R.; Mulas, F.; Andres, V.

    1980-08-01

    Nine newborn infants with histories of perinatal asphyxia are presented. The pneumoencephalographic findings which led to the diagnosis are typical and constant. They include marked subcortical atrophy with rounded, dilated, and undisplaced lateral ventricles. Cystography with 3 cc of air demonstrated multiple subcortical and paraventricular cavities, without communication with the ventricular system, but with the typical honeycomb appearance of paraventricular and subcortical leukomalacia described in postmortem findings. The CT findings are typical, and provide the location of the cavities as well as their density.

  10. The outcomes of screening retinopathy in risky preterms Review

    OpenAIRE

    Kavuncuoğlu, Sultan; Karaçorlu, Murat; Arıdaşır, Özlem; Arası, Cengiz; Yılmaz, Çiğdem; Arslan, Gülseren; Palabıyık, Murat; Öztürk, Haydar

    2002-01-01

    As ROP causes serious complications and significiant morbidity in preterms it is mandatory to be screened In this study our aim is determining the incidence of ROP in preterms who were followed in our prematurity unit and search the relationship between risk factors and the disease All patients who were smaller than 1500 gr and 32 gestational weeks GW and prematures small for gestational age SGA who had perinatal asphyxia and received oxygen for more than 48 hours and who had a ventilation wi...

  11. Retinopathy of prematurity in a Danish neonatal intensive care unit, 1985-1991

    DEFF Research Database (Denmark)

    Arrøe, M; Peitersen, Birgit

    1993-01-01

    During the 7 year period 1985 to 1991, 170 infants born in Hvidovre Hospital, Denmark, with birthweight gestational age ... of prematurity (ROP). Eighteen developed blindness or severely reduced vision and 6 developed unilateral blindness. In 21 the ROP changes regressed. Eight infants eventually developed severe myopia. The 45 infants with ROP were compared with the 125 without ROP. There was no difference in birth weight, gender......, or mode of delivery. Significant difference was found in gestational age, asphyxia, intensive treatment and complications. Particularly infants with ROP born with gestational age 27 to 29 weeks needed prolonged and more intensive treatment than infants without ROP. Infants with ROP had more frequently...

  12. Caesarean Section and Hospitalization for Respiratory Syncytial Virus Infection

    DEFF Research Database (Denmark)

    Kristensen, Kim; Fisker, Niels; Haerskjold, Ann;

    2015-01-01

    BACKGROUND AND OBJECTIVE:: Hospitalization for respiratory syncytial virus (RSV) infection and asthma share common determinants, and meta-analyses indicate that children delivered by caesarean section (CS) are at increased risk of asthma. We aimed to investigate whether birth by CS is associated...... regression with adjustment for prematurity, asphyxia, birth weight, multiple births, single parenthood, maternal smoking during pregnancy, older siblings, and asthma diagnoses up to 2 weeks before hospitalization for RSV infection, to compare the effects of acute or elective CS versus vaginal delivery...

  13. Brain hypothermia therapy for neonatal hypoxic-ischemic encephalopathy with a severely elevated serum creatine kinase level

    OpenAIRE

    Kinoshita, Hidetoshi; Imamura, Takashi; Maeda, Hajime; Shibukawa, Yasuko; FUKUDA, Yutaka; Kin, Shogo; Ariga, Hiromichi; Nagasawa, Katsutoshi

    2015-01-01

    Several studies have shown that brain hypothermia therapy (BHT) after neonatal hypoxic-ischemic encephalopathy (HIE) can improve neurodevelopmental outcomes. However, there have been no reports of the neurodevelopmental outcomes for the infant with a serum creatine kinase (CK) level above 20,000 IU/L in association with neonatal HIE. We report a female infant with a very high serum CK level (26,428 IU/L) associated with neonatal asphyxia. We diagnosed this infant with moderate HIE, and BHT wa...

  14. Glucose-6-Phosphate Dehydrogenase Deficiency and Adrenal Hemorrhage in a Filipino Neonate with Hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Akira Ohishi

    2013-05-01

    Full Text Available We report on a Filipino neonate with early onset and prolonged hyperbilirubinemia who was delivered by a vacuum extraction due to a prolonged labor. Subsequent studies revealed adrenal hemorrhage and glucose-6-phosphate dehydrogenase (G6PD deficiency. It is likely that asphyxia and resultant hypoxia underlie the occurrence of adrenal hemorrhage and the clinical manifestation of G6PD deficiency and that the presence of the two events explains the early onset and prolonged hyperbilirubinemia of this neonate. Our results represent the importance of examining possible underlying factors for the development of severe, early onset, or prolonged hyperbilirubinemia.

  15. [Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods].

    Science.gov (United States)

    Bogomolov, D V; Zbrueva, Yu V; Putintsev, V A; Denisova, O P

    2016-01-01

    The objective of the present study WaS to overview the current domestic and foreign literature concerning the up-to-date methods employed for the expert evaluation of intra-vitality of the strangulation mark. The secondary objective was to propose the new approaches for addressing this problem. The methods of expert diagnostics with a view to determining the time of infliction of injuries as exemplified by mechanical asphyxia are discussed. It is concluded that immunohistochemical and morphometric studies provide the most promising tools for the evaluation of intra-vitality of the strangulation mark for the purpose of forensic medical expertise.

  16. TRANSIENT ABNORMAL MYELOPOIESIS IN A NEONATE

    Directory of Open Access Journals (Sweden)

    Ketan P

    2013-01-01

    Full Text Available ABSTRACT: Transient abnormal myelopoiesis (TAM is a unique di sorder of newborns associated intimately with Down’s syndrome, present ing with clinical and morphological features indistinguishable from acute myeloid leuka emia (AML. We report a case in a neonate, presenting with severe perinatal asphyxia and cyanosis ; complicated by metabolic acidosis. The hemogram revealed leucocytosis and thrombocytopenia. The peripheral smear showed marked left shift and 55% circulating myeloblasts. Additio nal findings included a hepatomegaly and mild dysmorphic features. The child eventually succu mbed to pulmonary hemorrhage on day one itself. TAM has to be differentiated from conge nital leukemia which portends a poor prognosis

  17. Neonatal Resuscitation in Low-Resource Settings.

    Science.gov (United States)

    Berkelhamer, Sara K; Kamath-Rayne, Beena D; Niermeyer, Susan

    2016-09-01

    Almost one quarter of newborn deaths are attributed to birth asphyxia. Systematic implementation of newborn resuscitation programs has the potential to avert many of these deaths as basic resuscitative measures alone can reduce neonatal mortality. Simplified resuscitation training provided through Helping Babies Breathe decreases early neonatal mortality and stillbirth. However, challenges remain in providing every newborn the needed care at birth. Barriers include ineffective educational systems and programming; inadequate equipment, personnel and data monitoring; and limited political and social support to improve care. Further progress calls for renewed commitments to closing gaps in the quality of newborn resuscitative care. PMID:27524455

  18. The Apgar Score.

    Science.gov (United States)

    2015-10-01

    The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed. The Apgar score alone cannot be considered as evidence of, or a consequence of, asphyxia; does not predict individual neonatal mortality or neurologic outcome; and should not be used for that purpose. An Apgar score assigned during resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions.

  19. Committee Opinion No. 644: The Apgar Score.

    Science.gov (United States)

    2015-10-01

    The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed. The Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia, does not predict individual neonatal mortality or neurologic outcome, and should not be used for that purpose. An Apgar score assigned during a resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions.

  20. Amniotic fluid index, non-stress test and color of liquor: as a predictor of perinatal outcome

    OpenAIRE

    Ruma Sarkar Anand; Preeti Singh; Renu Sangal; Reena Srivastava; Neela Rai Sharma; Harish Chandra Tiwari

    2016-01-01

    Background: The universal aim of maternity care provision is birth of a healthy baby to a healthy mother. All birth attendants strive to achieve a good standard of care during labor to prevent an outcome such as and lsquo;birth asphyxia'. The aim was to study the role of AFI, NST and color of liquor in predicting perinatal outcome in term pregnancy in active labor. Methods: Prospective observational study of in women 18-35 years of age in active Labor admitted in department of Obstetrics ...

  1. Mortality due to injuries in Maputo City, Mozambique

    DEFF Research Database (Denmark)

    Nizamo, Hanifa; Meyrowitsch, Dan Wolf; Zacarias, Eugénio;

    2006-01-01

    Records of all registered deaths due to injuries maintained by the Legal Medicine Department in Maputo City for the period 1 January to 31 December 2000 were reviewed. Among the 1135 registered deaths, road traffic injuries accounted for the most common underlying cause of death (43.7%), followed...... by firearm discharge (8.7%) and burns (7.8%). For all deaths, skull fracture (21.9%), organ system injury (17.2%) and brain tissue injury (9.3%) were the most important intermediate causes of death and among the immediate causes of death acute anaemia (21.9%) was the most common followed by asphyxia (14...

  2. Spectrum and immediate outcome of seizures in neonates

    International Nuclear Information System (INIS)

    To determine the frequency, etiology, the clinical types, and outcome of seizures in neonates during the course of stay in the neonatal unit. All neonates (1-28 days) presented with seizures during that period were included in the study. Their detailed history, physical examination, and appropriate investigations were recorded on a study proforma. Out of a total 680 patients, 100 patients presented with the seizures; this comprises the frequency of 14.7%. Male to female ratio was 2.1:1. Regarding gestational age, 65% were full-term, 31% were pre-term, and 4% were post-term. Regarding etiology, 40% patients had birth asphyxia; 14% had hypoglycemia; 12% were due to hypocalcaemia, 5% were due to intracranial hemorrhage (ICH), 4% had malformation, 10 % had infection /neonatal sepsis, and in 12%, the etiology was kernicterus. Among the patients with seizures, 45% were completely recovered and discharged and 15% patients had neurological deficit at the time of discharge. From the hospitalized 100 patients, 22% expired. The critical factors for the outcome were etiology, gestational age, birth weight, APGAR score, and clinical characteristics. Generally, birth asphyxia had poor, while metabolic causes had good prognosis. (author)

  3. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

    Science.gov (United States)

    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  4. Tracheobronchial foreign bodies in children - a retrospective study of 2,000 cases in Northwestern China.

    Science.gov (United States)

    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  5. Micro computed tomography features of laryngeal fractures in a case of fatal manual strangulation.

    Science.gov (United States)

    Fais, Paolo; Giraudo, Chiara; Viero, Alessia; Miotto, Diego; Bortolotti, Federica; Tagliaro, Franco; Montisci, Massimo; Cecchetto, Giovanni

    2016-01-01

    Cases of subtle fatal neck compression are often complicated by the lack of specificity of the post-mortem signs of asphyxia and by the lack of clear signs of neck compression. Herein we present a forensic case of a 45-year-old schizophrenic patient found on the floor of the bedroom of a psychiatric ward in cardiopulmonary arrest and who died after two days in a vegetative state. The deposition of the roommate of the deceased, who claimed responsibility for the killing of the victim by neck compression, was considered unreliable by the prosecutor. Autopsy, toxicological analyses, and multi-slice computed tomography (MSCT), micro computed tomography (micro-CT) and histology of the larynx complex were performed. Particularly, micro-CT analysis of the thyroid cartilage revealed the bilateral presence of ossified triticeous cartilages and the complete fragmentation of the right superior horn of the thyroid, but it additionally demonstrated a fracture on the contralateral superior horns, which was not clearly diagnosable at MSCT. On the basis of the evidence of intracartilaginous laryngeal hemorrhages and bilateral microfracture at the base of the superior horns of the larynx, the death was classified as a case of asphyxia due to manual strangulation. Micro-CT was confirmed as a useful tool in cases of subtle fatal neck compression, for the detection of minute laryngeal cartilage fractures, especially in complex cases with equivocal findings on MSCT. PMID:26832384

  6. Are there biomedical criteria to assess an acute carbon dioxide intoxication by a volcanic emission?

    Science.gov (United States)

    Stupfel, Maurice; Le Guern, François

    1989-11-01

    On August 21, 1987, more than 1800 people, thousands of head of cattle and countless wild animals, including birds, were killed by a gas release which occurred during about 4 hours at the lake in the crater Iwi at Nyos in Cameroon; plant life was mostly unaffected. An international inquiry was performed by British, French, Italian, Japanese and U.S. volcanologists and physicians to determine what had been the cause of this disaster. An international conference organised by United Nations Educational Scientific, and Cultural Organisation (U.N.E.S.C.O.), the Cameroon Government and the U.N. Economic Commission for Africa held in Yaoundé March, 1987 concluded: 'that the cause of sudden death was suffocation (asphyxia) in a carbon dioxide atmosphere' The medical findings have been explained by asphyxia caused by carbon dioxide. The presence of other volcanic gases, e.g. hydrogen sulfide, cannot be ruled out' (Sigvaldason, 1989, this issue). This paper reviews what is mainly known about an acute carbon dioxide intoxication in order to disprove or confirm the diagnosis and helps to interpret the field observations and testimonies to provide a basis to discuss the prevention of such an intoxication.

  7. Perinatal and background risk factors for childhood autism in central China.

    Science.gov (United States)

    Duan, Guiqin; Yao, Meiling; Ma, Yating; Zhang, Wenjing

    2014-12-15

    Perinatal and background risk factors for autism were identified in a cohort of autistic children in Zhengzhou, China, to formulate preventative and treatment strategies for high-risk families. In this case-control study, children were screened for suspected autism using the Autism Behavior Checklist (ABC) and diagnosed according to DSM-IV and the Childhood Autism Rating Scale (CARS). We collected perinatal histories and clinical data of 286 confirmed autistic children treated at the Third Affiliated Hospital Children׳s Psychological Clinic of Zhengzhou University from 2011 to 2013. The control group consisted of 286 healthy children from area kindergartens. Maternal age>30 years, parental introversion as measured by the Eysenck Personality Questionnaire, low level of parental education, smoking, abortion threat, pregnancy complications, maternal illness during pregnancy, maternal mental health, family history of mental illness, neonatal jaundice, birth asphyxia, premature rupture of the fetal membrane, and gestational ageautism group. These factors were significantly correlated with behavioral symptoms as measured by ABC scores (Kendall rank correlation). Birth asphyxia, neonatal jaundice, maternal age, parental introversion, family history of mental illness, abortion threat, premature delivery, and smoking were identified as independent risk factors by multivariate logistic regression.

  8. EFFECTS OF BACTERIAL VAGINOSIS ON PERINATAL OUTCOME

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    Rajshree

    2014-02-01

    Full Text Available NTRODUCTION: Bacterial vaginosis is a condition in which the normal lactobacillus ( predominant vaginal flora is replaced with anaerobic bacteria , gardnerella vaginalis and mycoplasma hominis . Our study was designed to find out the effects of bacterial vaginosis on fetomaternal outcome in pregnant women . MATERIAL & METHODS: A prospective study was conducted in MGMCH , Jaipur from S eptember’12 to February ’13 . 100 women attending the antenatal clinic were recruited during their antenatal visit after 20 weeks of gestation and obs erved for presence of bacterial vaginosis and followed till pregnancy outcome . Prevalence of bacterial vaginosis was determined by Nugent and Amsel criteria . Maternal and neonatal morbidity were studied accordingly . RESULT: Prevalence of bacterial vagino sis by Nugent criteria was 19% . There was a significant association between the period of gestation at which the patient delivers and Nugent scoring of her gram stain picture (p=0 . 01 . Relationship between nursery admissions of baby and bacterial vaginosi s was found to be highly significant (p=0 . 01 . Out of the 100 babies delivered , 20% had low birth weight , 2% had birth asphyxia & Apgar score < 5 , 7% delivered prematurely & 14% babies had to be transferred to neonatal care units for various causes . CONCL USION: Bacterial vaginosis was found to be significantly associated with adverse pregnancy outcome in the form of increased risk of preterm delivery , low birth weight , birth asphyxia in neonate . It was also concluded that there was a definite role of trea tment because it can prevent a considerable number of preterm deliveries .

  9. [An experimental study of the effects of ketamine on the central sympathetic system, respiration and circulation (author's transl)].

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    Pfeifer, G; Tauberger, G; Schulte am Esch, J

    1981-06-01

    Cats were given basal anaesthesia (nitrous oxide-oxygen) with artificial ventilation. They were then injected intravenously with 5 mg/kilogram bodyweight of ketamine. The injection was followed by a marked ketamine. The injection was followed by a marked reduction in both the tone of the central sympathetic system and the activity of the phrenic nerve which lasted for 10 minutes and 30 minutes respectively. Doses of 10 mg/kilogram bodyweight caused a longer lasting and more pronounced lowering of sympathetic activity while phrenic activity was approximately the same as with the smaller dosage. Injection of 2.5 mg/kilogram bodyweight reduced the sympathetic tone only if it was accompanied by asphyxia (central stimulation). Administration of 5 mg and of 10 mg/kilogram bodyweight was followed by a fall in blood pressure by 15-45 per cent up to 2 minutes after the injection. The heart rate at rest was unaffected but in the presence of asphyxia there was a dose-dependent reduction in the expected bradycardia. Ketamine also induced definite central inhibition thereby preventing the circulatory activation which occurs when the drug is used for anaesthetic purposes. The observation that the bradycardic effect arising from central stimulation was weakened suggests a reduction of central vagal activity. PMID:7258572

  10. A PROSPECTIVE OBSERVATIONAL STUDY OF SHORT TERM MORBIDITY PATTERN IN PRETERM NEWBORNS DELIVERED IN A TERTIARY CARE HOSPITAL

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    Harsha

    2015-08-01

    Full Text Available OBJECTIVE: To study the short term morbidity pattern in preterm new born babies delivered in a tertiary care hospital with level III neonatal intensive care unit (NICU. MATERIAL AND METHODS: A prospective observational study was conducted in a level III NICU betwee n November 2009 to July 2010 at Grant medical college and JJ Group of hospitals, Mumbai. All the in born preterm babies were assessed for morbidity pattern from the time of admission till discharge or death. RESULT: 156 preterm babies were included in the study. 83(54.21% were male and 73(46.79% were female. The major morbidities observed in the preterm neonates were hyperbilirubinemia in 50.54%, Respiratory distress syndrome (RDS in25.64% and severe birth asphyxia in13.46%. Other common morbidities seen were retinopathy of prematurity in 12.17%, apnoea in 11.54% and anaemia in 10.9%. Preterm neonates also had in 9.62% culture proven sepsis, in 8.33% hypoglycaemia, in 7.05% Intraventricular haemorrhage (IVH and in 6.41% various congenital anomalies. CONCL USION: Hyperbilirubinemia, respiratory distress syndrome and severe birth asphyxia are major preterm morbidity

  11. NEONATAL SEIZURES: ETIOLOGY AND FREQUENCY

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    F. Eghbalian

    2008-11-01

    Full Text Available ObjectiveThe aim of the present study was to evaluate the etiology and frequency of neonatal seizure in hospitalized neonates.Materials and MethodsIn this descriptive, cross-sectional study, we evaluated 1295 neonates with seizures admitted to neonatal and NICU wards in our center. Data was collected on age, sex, birth weight, serum levels of calcium, glucose, and sodium, CT scan findings, history of maternal opium abuse, blood and cerebrospinal fluid culture, and analyzed using SPSS 13.ResultsOf a total of 1295 patients, 34 (2.62% had seizure. Mean age was 14.03 ± 10.05 days (range, 1 to 29 days; twenty-five (73.5% neonates were boys and 9 (26.5% were girls. Of 34 neonates with neonatal seizures, 12 (35.3%, 11 (32.4%, 9 (26.5%, 7 (20.6%, and 3 (8.8% had hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia, respectively.Maternal addiction, meningitis, and sepsis were found in 3 (8.8%, 1 (2.9% and 1 (2.9% of neonates, respectively.ConclusionThe incidence rate of neonatal seizure in the neonates in our NICU and neonatal ward was 2.62%. Common causes of seizure in this study included hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia. Maternal ddiction, meningitis and sepsis had the lowest prevalence.Keywords:Neonate, Seizure, Etiologies.

  12. Association between maternal HBsAg carrier status and neonatal adverse outcomes: meta-analysis.

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    Luo, Lili; Wu, Jinlin; Qu, Yi; Li, Jiao; Pan, Lingli; Li, Deyuan; Wang, Huiqing; Mu, Dezhi

    2014-09-18

    Abstract Objective: We conducted a meta-analysis to evaluate whether maternal hepatitis B virus (HBV) carrier status increases the risk of neonatal complications. Methods: Publications addressing the association between maternal HBV carrier status and neonatal outcomes were selected from the PubMed, EMBASE, Web of Science, Cochrane Library and China National Knowledge Infrastructure. Publication bias and heterogeneity across studies were evaluated and summary odds ratios, weighted mean difference or standardized mean difference and 95% confidence intervals were calculated and compared between groups. Results: Eighteen studies and 7600 pregnant HBV carriers were selected for analyses. A statistically association with maternal HBV carrier status was demonstrated for premature birth and asphyxia, with no difference found among perinatal mortality, gestational age, small for gestational age, large for gestational age, birth weight, low birth weight, macrosomia, Apgar sore at 1 min, jaundice and congenital anomaly. Heterogeneity across studies was found, and no publication bias was detected. Conclusion: Our analysis suggests that maternal hepatitis B carrier status is significantly associated with premature birth and asphyxia. Large-scale prospective studies are still warranted. PMID:25231370

  13. Early Recognition of Foreign Body Aspiration as the Cause of Cardiac Arrest

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    Muhammad Kashif

    2016-01-01

    Full Text Available Foreign body aspiration (FBA is uncommon in the adult population but can be a life-threatening condition. Clinical manifestations vary according to the degree of airway obstruction, and, in some cases, making the correct diagnosis requires a high level of clinical suspicion combined with a detailed history and exam. Sudden cardiac arrest after FBA may occur secondary to asphyxiation. We present a 48-year-old male with no history of cardiac disease brought to the emergency department after an out-of-hospital cardiac arrest (OHCA. The patient was resuscitated after 15 minutes of cardiac arrest. He was initially managed with therapeutic hypothermia (TH. Subsequent history suggested FBA as a possible etiology of the cardiac arrest, and fiberoptic bronchoscopy demonstrated a piece of meat and bone lodged in the left main stem bronchus. The foreign body was removed with the bronchoscope and the patient clinically improved with full neurological recovery. Therapeutic hypothermia following cardiac arrest due to asphyxia has been reported to have high mortality and poor neurological outcomes. This case highlights the importance of early identification of FBA causing cardiac arrest, and we report a positive neurological outcome for postresuscitation therapeutic hypothermia following cardiac arrest due to asphyxia.

  14. Semi-automated analysis of EEG spikes in the preterm fetal sheep using wavelet analysis

    International Nuclear Information System (INIS)

    Full text: Presentation Preference Oral Presentation Perinatal hypoxia plays a key role in the cause of brain injury in premature infants. Cerebral hypothermia commenced in the latent phase of evolving injury (first 6-8 h post hypoxic-ischemic insult) is the lead candidate for treatment however currently there is no means to identify which infants can benefit from treatment. Recent studies suggest that epileptiform transients in latent phase are predictive of neural outcome. To quantify this, an automated means of EEG analysis is required as EEG monitoring produces vast amounts of data which is timely to analyse manually. We have developed a semi-automated EEG spike detection method which employs a discretized version of the continuous wavelet transform (CWT). EEG data was obtained from a fetal sheep at approximately 0.7 of gestation. Fetal asphyxia was maintained for 25 min and the EEG recorded for 8 h before and after asphyxia. The CWT was calculated followed by the power of the wavelet transform coefficients. Areas of high power corresponded to spike waves so thresholding was employed to identify the spikes. The performance of the method was found have a good sensitivity and selectivity, thus demonstrating that this method is a simple, robust and potentially effective spike detection algorithm.

  15. Cardiotocography (CTG as the screening method of fetal condition assessment

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    V. Zulčić-Nakić

    2007-02-01

    Full Text Available A basic function of fetal monitoring is an analysis of fetal cardiac action. Cardiotocography (CTG cannot provide all necessary information for assessment of the fetal condition as it is not sufficiently reliable and gives a large number of false positive results that increase the number of cesarean sections. An objective of this work was to establish CTG reliability as a method for assessment of intrapartal fetal condition. Based on CTG parameters (baseline fetal heart rate, fetal heart rate variability, oscillations and decelerations 100 pathological CTG records, collected at Obstetrics and Gynecology Department of the Tuzla University Clinic Hospital from 01.12.2004 to 05.08.2005 were identified. Using binomial distribution they were classified as non-pathological (indicating absence of asphyxia and pathological (indicating possible presence of asphyxia. After the delivery the condition of newborns was assessed according to the Apgar score. Based on comparison between certain pathological parametres of CTG records and newborns’ conditions at birth the results indicated high positive predictive values whereas sensitivity and accuracy were low. Apgar score 1. from 7 upwards was given to 96 (96% newborns whereas Apgar score 2 from 7 upwards was given to all the newborns with previous pathological CTG records. Results have confirmed that CTG can be used only as a screening method for assessment of intrapartal fetal condition.

  16. Clinical profile of patients with infantile spasms

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    Wael hayel khreisat

    2011-04-01

    Full Text Available Objective: The present study was done in order to obtain a baseline profile of infantile spasms and associated neurological disorders Patient and methods:. The study included 50 patients with infantile spasm in Queen Rania Hospital for children in Jordan. The following data were obtained: sex, age of onset and presentation, details of seizure , family history of epilepsy, significant pre-/peri/post-natal insults, neuro imaging evaluation , detailed neurological and neuro developmental ,assessment were done by. Broad categories of possible etiologies were used the results were recorded for further study. Results: Age of onset of infantile spasm ranged from 1month to 1 year and 6 months , (mean 4.8 months. The mean time of presentation was 9.4 months . A male preponderance was noted (74 %. flexor spasms (52% were the commonest. Other types of seizures also accompanied infantile spasm in 44% children. (84% were born of normal delivery, History of birth asphyxia was obtained in 48%, 3 (6% had positive family history Developmental delay was recognized prior to onset of spasms in 52% . microcephaly was the commonest associated problem , Imaging studies of the brain revealed abnormality in 18 patients. 78% patients symptomatic and 22 % as cryptogenic.. Conclusion: The pattern of infantile spasm in our country do not differ from that of developed countries, further researches is required to prevent both chronic epilepsy and psychomotor retardation and .preventive measurement to prevent birth asphyxia is recommended

  17. Evaluation of 80 Term Neonates with Hypoxic Ischemic Encephalopathy

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    Selahattin Katar

    2007-01-01

    Full Text Available This study aimed to review the etiology, clinical - laboratory features and mortality rate of term 80 neonates with perinatal asphyxia admitted to our neonatal unit between January 2005-April 2006. The sex distribution was 24 (%30 female and 56 (% 70 male. The mean gestational age was 38.6±1.3 weeks and weight 3156±561 gram. Of the patients % 46.25 were delivered with a cesarean section and % 53.75 with spontaneous vaginal delivery. The etiologic factors for hypoxic ischemic encephalopathy were % 31.25 force delivery, meconium aspiration, and % 66.25 preeclampsia, eclampsia and diabetic mother’s infant. The distribution of patients according to HIE statging system (Sarnat&Sarnat were as follows: 33 patients (% 41.25 in stage 1, 20 (% 25 in stage 2 and 27 (% 33.75 in stage 3. Seizures were observed in % 33.75 of patients. The mean duration of hospital stay was 10.6±7.7 days for the surviving patients and 4.2±3.4 days for patients who died. Except from central nervous system, liver and kidney were the most involved organs.Perinatal asphyxia remains to be leading cause of neonatal mortality. Hypoxic ischemic encephalopathy is a common newborn problem and cause important mortality and morbidity where low-social –cultural –education conditions with in regions.

  18. Adverse perinatal outcomes for advanced maternal age: a cross-sectional study of Brazilian births

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    Núbia Karla O. Almeida

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVES: To investigate the risk of adverse perinatal outcomes in women aged ≥41 years relatively to those aged 21-34. METHODS: Approximately 8.5 million records of singleton births in Brazilian hospitals in the period 2004-2009 were investigated. Odds ratios were estimated for preterm and post-term births, for low Apgar scores at 1 min and at 5 min, for asphyxia, for low birth weight, and for macrosomia. RESULTS: For pregnant women ≥41, increased risks were identified for preterm births, for post-term births (except for primiparous women with schooling ≥12 years, and for low birth weight. When comparing older vs. younger women, higher educational levels ensure similar risks of low Apgar score at 1 min (for primiparous mothers and term births, of low Apgar score at 5 min (for term births, of macrosomia (for non-primiparous women, and of asphyxia. CONCLUSION: As a rule, older mothers are at higher risk of adverse perinatal outcomes, which, however, may be mitigated or eliminated, depending on gestational age, parity, and, especially, on the education level of the pregnant woman.

  19. A retrospective study of the outcome of cesarean section for women with severe pre-eclampsia in a third world setting

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    Obinna V Ajuzieogu

    2011-01-01

    Full Text Available Objective: To compare the outcome of subarachnoid block (spinal anesthesia and general anesthesia in Cesarean delivery for women with severe pre-eclampsia. Methods: A retrospective study of women with severe pre-eclampsia requiring Cesarean section from January 2005 to June 2009 was carried out. Maternal age, parity, gestational age at delivery, booking status, Apgar scores, maternal and perinatal mortality of the sub-arachnoid block group were compared with those of general anesthesia group using c2 , Student t-test and Fischer exact test. Results: There were no significant difference between the two groups in overall maternal mortality (5.4% vs. 11.9%, P=0.5 and perinatal mortality (2.7% vs. 11.9%, P=0.15. The general anesthesia group had significantly more birth asphyxia than the spinal group (55.9% vs. 27.0%, P=0.0006. Conclusion: There was no significant difference in the maternal and perinatal mortality outcome of cesarean delivery between women with severe pre-eclampsia who had regional anesthesia and those that had general anesthesia. There was significantly higher proportion of birth asphyxia in babies of women who received general anesthesia.

  20. Different extent in decline of infant mortality by region and cause in Shenyang, China.

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    Huang, Yan-Hong; Wu, Qi-Jun; Li, Li-Li; Li, Da; Li, Jing; Zhou, Chen; Wu, Lang; Zhu, Jingjing; Gong, Ting-Ting

    2016-01-01

    To compare the pattern of cause of death of infant mortality rates by urban/rural areas as well as to generate knowledge for potential strategies to decrease this mortality, we carried out a study by analyzing the infant mortality data from the Shenyang Women and Children Health Care Centre. From 1997 to 2014, 970,583 live births and 6510 infant deaths were registered. Infant mortality rates, percent change, and annual percent change (APC) were calculated. The infant mortality significantly decreased by 5.92%, 7.41%, and 3.92% per year in overall, urban, and rural areas, respectively. Among the categories of causes of infant death, congenital anomalies (APC = -7.87%), asphyxia-related conditions (APC = -9.43), immaturity-related conditions (APC = -3.44%), diseases of the nervous system and sense organs (APC = -6.01%), and diseases of the respiratory system (APC = -6.29%) decreased significantly in the observational periods. Additionally, among selective causes of infant death, pneumonia, congenital heart disease, neural tube defects, preterm birth and low birth weight, birth asphyxia, and intracranial hemorrhage of the newborn significantly decreased by 5.45%, 5.45%, 16.47%, 2.18%, 10.95%, and 10.33% per year, respectively. In conclusion, infant mortality has been continuously decreased in Shenyang from 1997 to 2014, although further efforts are still needed to decrease the infant mortality in rural areas. PMID:27075740

  1. 护理干预对产妇自然分娩及产后出血的影响

    Institute of Scientific and Technical Information of China (English)

    周菊芳; 阳娟娟

    2013-01-01

    Purpose Explore the nursing intervention on natural childbirth and postpartum hemorrhage maternal effects .Method Select a hospital in May 2009---2010 in August obstetric primipara 200 cases were randomly divided into observation group and control group 100 cases.Implementation of routine obstetric care control group,the observation group was given on the basis of relatively systematic nursing intervention.Two groups of maternal mode of delivery,the total labor time,2h postpar-tum hemorrhage and neonatal asphyxia comparing.Result Natural childbirth maternal observation group rate,the total labor time,neonatal asphyxia and postpartum hem-orrhage compared with the control group were significantly different,P<0.05.Conclusion System at the beginning of maternity nursing intervention plays a positive role in promoting the process,you can improve natural childbirth rate,reduce postpartum hemorrhage and neonatal asphyxia,improve delivery quality.%目的:探讨护理干预对产妇自然分娩及产后出血的影响。方法选取我院2009年5月---2010年8月产科的初产妇200例,随机分为观察组和对照组各100例。对照组施行产科常规护理,观察组在对照组的基础上给予相对较系统的护理干预。比较2组产妇的分娩方式、总产程时间、产后2h出血量和新生儿窒息率。结果观察组产妇的自然分娩率、总产程时间、新生儿窒息率以及产后出血量与对照组比较有统计学差异,P<0.05。结论系统的护理干预在初产妇分娩过程起积极的促进作用,可以提高自然分娩率,减少产后出血和新生儿窒息,提高分娩质量。

  2. Meconium stained amniotic fluid neonatal umbilical arterial blood gas value of Apgar score and clinical observation%羊水胎粪污染新生儿脐动脉血气pH值与Apgar评分临床观察

    Institute of Scientific and Technical Information of China (English)

    高建国; 孙庆霞; 于普丽; 宋燕玲; 胡美莲

    2014-01-01

    Objective To explore the relationship between meconium stained amniotic fluid and the degree of asphyxia of newborn hypoxia. Methods Umbilical arterial blood gas analysis and Apgar score were pH value detection method of meconium stained amniotic fluid 1 degrees in 160 cases, 135 cases of meconium stained amniotic fluidⅡ°Ⅲ°, meconium stained amniotic fluid of 189 cases of newborn. Results the difference of umbilical artery blood gas index pH value and Apgar score significantly, and the amniotic fluid meconium pollution degree and umbilical artery blood gas index pH value and Apgar score proportional relationship, namely, the more serious pollution of neonatal asphyxia hypoxic severity. Conclusion Meconium stained amniotic fluid and the degree of asphyxia of newborn anoxic degree, and the problem of Neonatology, obstetrics, puts forward positive prevention interventions.%目的:探讨羊水胎粪污染程度与新生儿窒息缺氧的相关性。方法对羊水胎粪污染Ⅰ度160例、羊水胎粪污染Ⅱ度135例、羊水胎粪污染Ⅲ度189例新生儿的脐动脉血气pH值及Apgar评分结果进行分析。结果3组脐动脉血血气指标pH值及Apgar评分差异显著,且羊水胎粪污染程度与脐动脉血血气指标pH值及Apgar评分成正比关系,即污染程度越严重新生儿窒息缺氧程度越重。结论羊水胎粪污染程度与新生儿窒息缺氧的程度有密切联系,产科、新生儿科应积极给予预防干预措施。

  3. 探讨在自然分娩过程中采取无保护会阴接生技术对分娩结局的影响%To Explore the Effects on Birth Outcomes Take Unprotected Perineum Midwives Technical of Natural Birth

    Institute of Scientific and Technical Information of China (English)

    张建芹

    2015-01-01

    目的:探讨在自然分娩过程中采取无保护会阴接生技术对分娩结局的影响,并进行分析,以供参考。方法选取2013年9月~2014年10月我院妇产科收治的足月产妇,共102例作为研究对象。比较2组产妇的会阴侧切率及其新生儿窒息率,并进行分析。结果实验组产妇的会阴侧切率及其新生儿窒息率均要低于对照组,P<0.05,差异具有统计学意义。结论在自然分娩过程中,对其产妇采取无保护会阴接生技术,可以有效降低产妇的会阴侧切率及其新生儿窒息率,在最大程度上保证了母婴安全。%Objective To explore the effects on birth outcomes take unprotected perineum midwives technical of natural birth and analyze. Methods Selected 102 cases of full-term birth of obstetrics and gynecology from 2013 September to 2014 October in our hospital. Compared the two groups of maternal episiotomy rates and neonatal asphyxiaResults Experimental group maternal and neonatal asphyxia rate of episiotomy rate was signiifcantly lower than the control group, and the difference was statistically signiifcant (P<0.05).Conclusion In natural childbirth, mothers take their unprotected perineum delivery techniques reduce the rate of maternal and neonatal asphyxia episiotomy rate effectively, it possible to the maximum ensure the safety of the mother and child.

  4. Analysis of effect of different delivery modes and termination of pregnancy for fetal prognosis of prolonged pregnancy%不同分娩方式与终止妊娠时机对过期妊娠胎儿预后的影响分析

    Institute of Scientific and Technical Information of China (English)

    王静娴

    2014-01-01

    目的:探讨不同分娩方式与终止妊娠时机对过期妊娠胎儿预后的影响。方法选取2011年6月~2013年6月本院收治的过期妊娠产妇121例,延期妊娠产妇100例,对临床资料进行回顾性研究。结果顺产组胎儿窘迫、新生儿窒息发生率显著高于剖宫产组;观察组胎儿窘迫、新生儿窒息、妊娠产妇产后出血、产程延长发生率显著高于对照组。结论给予过期妊娠产妇进行剖宫产可以显著降低胎儿窘迫、新生儿窒息的发生,延期妊娠产妇应重视产检,加强胎儿监护,适时终止妊娠,避免过期妊娠发生。%Objective To investigate the effects of different delivery modes and termination of pregnancy for fetal prognosis of prolonged pregnancy. Methods Selected from 2011-6 to 2013-6 in our hospital 121 cases of maternal pregnancy, maternal 100 cases of delayed pregnancy, retrospective study.Results Natural delivery group of fetal distress, neonatal asphyxia rate was significantly higher than that of cesarean section group;the observation group of fetal distress, neonatal asphyxia, postpartum hemorrhage, pregnancy, prolonged labor were significantly higher than those in the control group. Conclusion Given the maternal pregnancy cesarean section can reduce the fetal distress, neonatal asphyxia, delayed pregnancy women should pay attention to check, strengthen the fetal monitoring, timely termination of pregnancy, to avoid the occurrence of prolonged pregnancy.

  5. Impact of doula service on obstetric quality%导乐陪伴分娩对产科质量的影响

    Institute of Scientific and Technical Information of China (English)

    张艳勤; 钟萍; 陈青珊

    2010-01-01

    Objective To explore the impact of doula service on labor stages, labor outcomes, postpartum hemorrhage, newborn asphyxia, and breast feeding. Methods 150 puerperae received doula service (study group), and 150 puerperae received no doula (control). Labor duration, delivery patterns, initial time of lactation, satisfaction with midwi ves, and incidences of postpartum hemorrhage and neonatal asphyxia were compared between the two groups. Results Doula service shortened labor stages, increased rate of vaginal delivery, reduced rate of cesarean section, decreased postpartum hemorrhage, had initial time of lactation start early. There were no significant differences in satisfaction with midwives and the incidence of neonatal asphyxia between the two groups. Conclusions Doula service is a puerpera-centered care pattern, which improves the obstetric quality. It is very effective in ensuring maternal and children safety thus worth popularizing.%目的 探讨导乐陪伴分娩对产妇产程、分娩结局、产后出血及新生儿窒息、母乳喂养的影响.方法 选导乐陪伴分娩产妇150例为试验组,同期非导乐陪伴分娩的产妇150例为对照组,比较两组产妇产程时间、分娩方式、产后出血、产妇泌乳始动时间、对助产士的满意度、新生儿窒息等情况.结果 导乐陪伴分娩能够缩短产程,提高阴道分娩率,降低剖宫产率,减少产后出血,产妇泌乳始动时间提前;对助产士满意度提高,新生儿窒息情况两组无明显差异.结论 导乐陪伴分娩是坚持以人为本的护理模式,提高了产科的质量,在确保母婴安全方面效果明显,值得进一步伞面推广.

  6. To Explore the Effects on Birth Outcomes Take Unprotected Perineum Midwives Technical of Natural Birth%探讨在自然分娩过程中采取无保护会阴接生技术对分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    张建芹

    2015-01-01

    Objective To explore the effects on birth outcomes take unprotected perineum midwives technical of natural birth and analyze. Methods Selected 102 cases of full-term birth of obstetrics and gynecology from 2013 September to 2014 October in our hospital. Compared the two groups of maternal episiotomy rates and neonatal asphyxiaResults Experimental group maternal and neonatal asphyxia rate of episiotomy rate was signiifcantly lower than the control group, and the difference was statistically signiifcant (P<0.05).Conclusion In natural childbirth, mothers take their unprotected perineum delivery techniques reduce the rate of maternal and neonatal asphyxia episiotomy rate effectively, it possible to the maximum ensure the safety of the mother and child.%目的:探讨在自然分娩过程中采取无保护会阴接生技术对分娩结局的影响,并进行分析,以供参考。方法选取2013年9月~2014年10月我院妇产科收治的足月产妇,共102例作为研究对象。比较2组产妇的会阴侧切率及其新生儿窒息率,并进行分析。结果实验组产妇的会阴侧切率及其新生儿窒息率均要低于对照组,P<0.05,差异具有统计学意义。结论在自然分娩过程中,对其产妇采取无保护会阴接生技术,可以有效降低产妇的会阴侧切率及其新生儿窒息率,在最大程度上保证了母婴安全。

  7. Observation on the Effect of Humanized Nursing Applied to the Delivery in Primiparas%人性化护理在初产妇分娩中的效果观察

    Institute of Scientific and Technical Information of China (English)

    张淑兰

    2015-01-01

    Objective To observe the effect of humanistic nursing on primiparas undergoing delivery. Methods 260 primiparas un-derwent delivery in our hospital from March 2014 to October 2014 were selected and randomly divided into the observation group (124 cases) and the control group(136 cases). The observation group was given humanistic nursing, and the control group was given general obstetrical nursing. And the natural birth rate, neonatal asphyxia rate and incidence of postpartum hemorrhage were com-pared between the two groups. Results Compared with the control group, the observation group had much higher natural birth rate (87.9%vs 51.5%), obviously lower neonatal asphyxia rate(2.4%vs 12.5%) and incidence of postpartum hemorrhage(1.8%vs 4.4%) with statistically significant difference. Conclusion For primiparas undergoing delivery, humanistic nursing is of great significance in improving the natural birth rate and reducing the neonatal asphyxia rate and incidence of postpartum hemorrhage.%目的:探讨和分析人性化护理在初产妇分娩中的作用。方法整群选取该院2014年3-10月收治分娩的260例初产妇中,随机分为观察组124人,对照组136人,观察组实施人性化护理,对照组给予分娩期的一般护理常规。比较两组的自然分娩率、新生儿窒息率和产后出血率的情况。结果观察组自然分娩率为87.9%,远高于对照组的51.5%;且观察组的新生儿窒息率和产后出血率为2.4%和1.8%,也低于对照组的12.5%和4.4%,差异有统计学意义。结论在初产妇分娩期实施人性化护理对提高自然分娩率、降低新生儿窒息率和产后出血率有重要意义。

  8. 拉玛泽呼吸法在产程中的观察分析%A observation and analysis on Lamaze breathing during the process of labor

    Institute of Scientific and Technical Information of China (English)

    罗冰贤; 何华聪; 黎紫玲

    2013-01-01

    目的 观察拉玛泽呼吸法在产程中的应用效果.方法 选择2010年2月至2013年2月我院阴道试产产妇240例为研究对象,对照组采用常规护理,实验组给予拉玛泽呼吸法,观察比较两组疼痛程度、剖宫产率、产后出血和新生儿窒息.结果 实验组疼痛程度(3.63±1.02)降低,产妇剖宫产率(15.00%)降低,其产后出血率(3.33%)降低,新生儿窒息率(7.50%)降低,与对照组患者比较,P< 0.05,差异有统计学意义.结论 使用拉玛泽呼吸法可以减轻产妇的疼痛,减少产后出血和新生儿窒息,降低剖宫产率,具有较高的优势.%Objective To observe the effect of Lamaze breathing during the process of labor.Methods 240 puerperas who gave vaginal delivery in our hospital during the period of February 2010 to February 2013 were enrolled as study subjects.The control group received routine care,while the study group received Lamaze breathing.The pain level,rate of Cesarean section,postpartum hemorrhage,and neonatal asphyxia.Results The pain level (3.63 + 1.02),and rates of Cesarean section (15.00%),postpartum hemorrhage (3.33%),and neonatal asphyxia (7.50%)were reduced in the study group,with significant differences as compared with the control group (P<0.05).Conclusions Lamaze breathing can relieve pain level in puerperas and reduce rates of postpartum hemorrhage,neonatal asphyxia,and Cesarean section.

  9. 新生儿低血糖症50例临床分析%Clinical treatment and anatysis of 50 neonates with hypoglycemia

    Institute of Scientific and Technical Information of China (English)

    陆蓓; 杨蕾; 朱慧; 陈娟

    2011-01-01

    目的 对50例新生儿低血糖症发病相关因素分析,探讨引起新生儿低血糖症的病因、临床特点,为临床诊治提供一定的参考依据.方法 对我院住院新生儿780例进行常规血糖监测.结果 ①低血糖症的发生与胎龄有关(x2=7.78,P<0.01);②低血糖症的发生与出生体重有关(x2=20.36,P<0.005).③常见病因为窒息14例(28%),硬肿症9例(18%),喂养困难6例(12%),感染5例(10%),母亲患糖尿病5例(10%),开奶延迟4例(12%),出血症4例(8%),先天性心脏病3例(6%).结论 对于有低血糖高危因素的新生儿要监测血糖,及时发现并及时纠正低血糖,以免引起新生儿中枢神经系统损伤,遗留神经系统后遗症.%Objective To study the elements of pathogeny and clinical features of neonates with hypoglycemia, and to offer evidences for clinical treatment. Methods Blood sugar of 780 neonates who were admittied to hospital. Results ①The incidence of hypoglycemia was also associated with birth weight ( x2 = 7. 78 . P < 0. 01 ) ; ②The incidence of hypoglycemia was associated with gestational age ( x2 = 20. 36 , P < 0. 005 ) ; The common clinical findings were suffocation in 14 cases ( 28% ) , sclerema neonatorum in 9 ( 18% ) , feeding dificulty in 6 cases ( 12% ) , infection in 5 cases ( 10% ) , mother sufering from diabetes mellitus in Scases ( 10% ) . hemorrhagic disease in 4 cases ( 8% ) , feeding dalay in 4 cases( 8% ) , congenital heart disease in3 ( 6% ) . Conclusion For the neonates who are likely to suffer from hypoglycemia, blood sugar level needs to monitor frequently. Early detection and corrective measures could avoid damages to the central nervous system of neonates caused hy hypoglycemia.

  10. Aquaporin 3 and skin%水通道蛋白-3与皮肤研究进展

    Institute of Scientific and Technical Information of China (English)

    朱定仙; 方红

    2010-01-01

    水通道蛋白是细胞膜上参与跨膜水转运的一组通道蛋白.水通道蛋白3是人类皮肤中表达量最丰富的水通道蛋白亚型,除对水分子通透外还对甘油等溶质具有通透性.动物研究显示,水通道蛋白3基因敲除后皮肤保湿功能和弹性降低,创伤愈合延缓;水通道蛋白3还与细胞增殖及迁移有关,可能参与皮肤肿瘤的发生、发展和转移.水通道蛋白3与炎症性皮肤病如新生儿中毒性红斑、特应性皮炎等的病理机制相关.维A酸、肿瘤坏死因子-α等多种物质可调节水通道蛋白3的表达,对其表达进行调控将为治疗相关皮肤病带来新的手段.%Aquaporins (AQPs) are a group of membrane transport proteins involved in the transport ofwater across cell membranes. AQP3, the most abundant aquaporin subset in human skin, is permeable notonly to water but also to small solutes such as glycerol. It has been reported that AQP3-knockout mice havereduced stratum corneum water content, elasticity and impaired wound healing. AQP3 has been revealed to berelated to cell proliferation and migration, and involved in the initiation, progression and metastasis of tumors.In addition, AQP3 expression is associated with the pathogenesis of inflammatory cutaneous diseases such asatopic dermatitis and erythema toxicum neonatorum. AQP3 expression can be modulated by multiple factorssuch as retinoic acid and tumor necrosis factor α, and this modulation may provide a new clue for the therapyof related skin diseases.

  11. 孕41周引产结局分析%Analysis of induced labor at 41 weeks of gestation

    Institute of Scientific and Technical Information of China (English)

    俞艇蔚; 邓善文; 杨敬一; 刘增佑

    2010-01-01

    目的 探讨孕41周引产对母儿的影响.方法 对孕41~42周、无妊娠合并症及胎儿体质量异常的孕妇,按临产与否分为自然临产组158例,引产组112例,对两组孕妇的剖宫产率、产后出血率、羊水Ⅲ度污染率、新生儿窒息率、围生儿死亡率进行回顾性分析.结果 引产组剖宫产率(37.5%)明显高于自然临产组(25.3%).两组产后出血率、羊水Ⅲ度污染和新生儿窒息率、围生儿死亡率差异均无统计学意义(均P>0.05).结论 对孕41周孕妇进行引产可增加剖宫产率,不宜常规进行.%Objective To explore the influence to maternal and fetal which induced labor at 41 weeks of gestation.Methods Select all the patients without pregnancy complicatious and dysponderal fetus in the year of 2008 who delivered in our hospital over a period from 41 to 42 weeks of gestation.Distinguish all the patients for two groups,according to whether be in labor naturally or not.Take a retrospective analysis of uterine-incision delivery rate、postpartum hemorrhage rate、apnoea-neonatorum rate、severe contamination rate of amniotic fluid and perinatal mortality rate about this two groupe.Results The uterine-incision delivery rate of the group accepted induced labor (37.5%) is obviously higher than the other one (25.3%)(P<0.05).And the rest indicatrixes have no significant discrepancy between the two groups (all P>0.05).Conclusion Routine induction of labor is not appropriate hecause of higher uterine-incision delivery rate.

  12. Diagnosis and therapy of lacrimal system diseases by micro lacrimal endoscope

    Institute of Scientific and Technical Information of China (English)

    Nan XIANG; Weikun HU; Jing YUAN; Guigang LI; Haixia LIU

    2009-01-01

    The lacrimal endoscope is applied to the diagnosis and therapy of the disorders of the lacrimal system in combination with laser or micro drills under orthophoria. The changes of mucous membranes, the characteristics of pathological changes and the predilection sites of lacrimal system diseases were initially approached. One hundred and forty six pairs of eyes of 128 patients with lacrimal system disease were observed by the lacrimal endoscope in the Ophthalmology Department of Tongji Hospital from June 2006 to March 2007. The dynamic changes in mucous membranes, lesion sites, secreted substances and formation of membrane could be observed under orthophoria. Combined with laser or micro drill, the endoscope was applied to the therapy of lacrimal system disorders and the difference before and after the treatment was observed. Results are as follows: (1) The examination and therapy using the lacrimal endoscope were completed under topical anesthesia in 122 patients, and 6 patients of neonatorum dacryocystitis were examined and treated under general anaesthesia. All patients reported painless. (2) Sharp images of the lacrimal system were obtained by the endoscope. Normal lacrimal mucosal membrane was smooth and light pink, expanded and unobstructed during irrigation. In chronic dacryocystitis patients, the inhomo-geneous colour ofmucosal membranes was red and white, with different degrees of fibrotic membranes at the superior, middle and inferior parts of the nasolacrimal canals and secreted substances at sac could be observed. The lacrimal ducts could not be expanded and obstructed during irrigation. The patients with lacrimal system obstruction had different extents of membrane formation, and stenosis or complete obstruction of the lacrimal duct could be observed, and the corresponding mucosal membrane was not smooth which could not be expanded and obstructed during irrigation. (3) After the treatment by the endoscope combined with laser or micro drill, the major

  13. Curative effect observation of small dose of dopamine combine with dobutamine in the treatment of neonatal scleredema%小剂量多巴胺联合多巴酚丁胺治疗新生儿硬肿症的效果观察

    Institute of Scientific and Technical Information of China (English)

    徐青

    2016-01-01

    目的:探讨小剂量多巴胺联合多巴酚丁胺治疗新生儿硬肿症的效果。方法:将90例新生儿硬肿症患者随机分为观察组和对照组,两组均给予常规综合治疗,对照组静滴多巴酚丁胺,观察组联合应用小剂量多巴胺+多巴酚丁胺以静脉泵持续给药。结果:观察组患儿硬肿消退时间、体温恢复时间及住院时间均短于对照组,有效率明显高于对照组,差异均具有统计学意义(P<0.05)。结论:小剂量多巴胺联合多巴酚丁胺治疗新生儿硬肿症,可明显缩短硬肿消退时间及住院时间,显著提高有效率。%Objective:To evaluate the clinical efficacy of small dose of dopamine combined with dobutamine in the treatment of neonatal scleredema.Methods:90 cases of neonatal scleredema patients were selected.They were randomly divided into the observation group and the control group.All of them were given the routine treatment.The control group were treated with intravenous dobutamine,while the observation group was given small dose dopamine+dobutamine continuous intravenous pump medicine.Results:The scleroderma extinction time,body temperature recovery time and hospitalization time of the observation group were shorter than those of the control group;the efficiency rate was significantly higher than that of the control group;the differences were statistically significant(P<0.05).Conclusion:Small dose of dopamine and dobutamine in the treatment of sclerema neonatorum can shorten the scleroderma extinction time and hospitalization time significantly,and improve the efficiency rate significantly.

  14. Histopathological changes in lungs of the mountain snow avalanche victims and its potential usefulness in determination of cause and mechanism of death

    Directory of Open Access Journals (Sweden)

    Mariusz Kobek

    2016-09-01

    Full Text Available On 28 January 2003 snow avalanche in the Polish Tatras happened, in which 8 people died and 5 were injured. We tried to determine cause and manner of death in 6 fatal victims instead of advanced late post mortem changes in internal organs. Taking into consideration the circumstances of death, we paid special attention to histopathological examination of lungs, extended by Gomori’s and AZAN staining. Pattern of the changes was similar to those observed in forensic medicine in cases of asphyxia due to airway obstruction and/or immobilization of chest and abdomen (Perthes’ syndrome. Histopathological study with the use of more specific staining methods has a significant diagnostic value during establishing the cause and mechanism of death of the deceased snow avalanche victims with advanced post mortem changes.

  15. A CLINICAL STUDY OF MORBIDITY AND MORTALITY PATTERN OF LATE PRETERM INFANTS AT SNCU, WARANGAL

    Directory of Open Access Journals (Sweden)

    Sudhakar

    2016-03-01

    Full Text Available OBJECTIVE A clinical study of morbidity and mortality pattern of late preterm infants in comparison with term infants. STUDY DESIGN Prospective observational study. SETTING SNCU, Mahatma Gandhi Memorial Hospital, Warangal. SUBJECTS Consecutive sample of late preterm infants and term infants referred to our hospital on or before fourth day of life. RESULTS 76 late preterm infants and 76 term infants with any of the pre-defined neonatal condition were included in the study. Late preterm infants were significantly at a higher risk for overall morbidity including hypothermia, sepsis, respiratory morbidity, jaundice, hypoglycemia, birth asphyxia. A trend towards higher mortality was also seen. CONCLUSION In an out born referral center, late preterm infants are more prone to suffer from morbidities than term infants. Hypothermia is the leading cause of morbidity in both term (61% and late pre-term (85% infants.

  16. [Renal ultrasound in fat necrosis].

    Science.gov (United States)

    Tizki, S; Lasry, F; Elftoiki, F Z; Hadj Khalifa, H; Itri, M; Khadir, K; Benchikhi, H

    2013-07-01

    Subcutaneous fat necrosis is an uncommon disease that may be complicated with potentially fatal hypercalcemia or with nephrocalcinosis. We report on the case of a patient with a history of significant perinatal asphyxia, hospitalized for a urinary tract infection. Lesions of subcutaneous fat necrosis were noted, with asymptomatic hypercalcemia at 3.9mmol/L. A renal ultrasound was performed and showed echogenic medullary pyramids bilaterally, consistent with nephrocalcinosis and left nephrolithiasis. The treatment of hypercalcemia included hyperhydration, a diuretic and corticosteroids. Progression was characterized by the total regression of skin lesions and normalization of serum calcium. Hypercalcemia is a rare complication of subcutaneous fat necrosis. It develops within days to weeks after the appearance of skin lesions. Nephrocalcinosis appears after several weeks or months. Hypercalcemia must be treated in due time to avoid the impact on the kidney. PMID:23726682

  17. RESPONSES OF SHEEP TO ZYGADENUS GRAMINEUS, "DEATH CAMAS".

    Science.gov (United States)

    McLaughlin, A R

    1931-01-30

    An extract of Zygadenus gramineus, "death camas," from which most of the resins had been removed was given intravenously to sheep prepared for recording blood-pressure and respiratory movements. Following the intravenous injection of this extract there occurred a respiratory inhibition which in the case of the injection of larger amounts of the extract was followed by asphyxia-like rises of blood-pressure. The graphic record of this asphyxial condition was practically duplicated by closing the tracheal cannula for a short time following the recovery of the animal from the effects of the plant extract. Although, from a field standpoint, no satisfactory antidote has been found, it has been demonstrated that caffein sodio-benzoate possesses marked powers of stimulation for the respiratory center affected by the depressive substances found in Zygadenus gramineus. PMID:17802372

  18. Irish neonatal mortality statistics for 2004 and over the past 17 years: how do we compare internationally?

    LENUS (Irish Health Repository)

    Fleming, P

    2012-02-01

    In the past 17 years neonatal mortality survey has provided important data on the trends in deaths of all live born infants born in Southern Ireland who are greater than 500 g birth weight and who die within the first 28 days of life. The aims of this study were to report neonatal mortality data for Southern Ireland for 2004, to examine trends in neonatal mortality over the past 17 years and compare Irish Neonatal Mortality rates to other countries around the world. The neonatal mortality rate for 2004 was 2.9\\/1000 with a corrected NMR of 1.9\\/1000. The response rate to the survey was 100%. Prematurity is now the leading cause of neonatal mortality representing a change from previous years. Deaths related to asphyxia have remained largely unchanged. When compared to international figures Ireland compares favourably to other countries around the world.

  19. MR imaging of the neonatal brain: Pathologic features

    International Nuclear Information System (INIS)

    Seventy-three neonates, aged 29-43 weeks since conception, were studied. US and/or CT correlations were obtained in most infants with pathology. In the first 4-5 days after hemorrhage, US and CT were superior to MR imaging, but after that time MR imaging was the single best modality for imaging blood. In early premature infants with very watery white matter, US detected infarction and brain edema that were poorly seen on both MR imaging and CT. However, in late premature and full-term infants, MR imaging was better than CT in distinguishing between normal white matter and infarction. Only MR imaging disclosed delayed myelination in 13 term infants with hydrocephalus and severe asphyxia. MR imaging with play an important role in imaging neonates once MR imaging-compatible monitors and neonatal head coils become widely available

  20. Primary health care of the newborn baby.

    Science.gov (United States)

    Bhakoo, O N; Kumar, R

    1990-01-01

    More than 50% of infant deaths in India occur during the neonatal period. High priority therefore needs to be given to improving the survival of newborns. A large number of neonatal deaths have their origin in the perinatal period and are mainly determined by the health and nutritional status of the mother, the quality of care during pregnancy and delivery, and the immediate care of the newborn at birth. Main causes of neonatal mortality are birth asphyxia, respiratory problems, and infections, especially tetanus. Most such deaths occur among low birthweight babies. Hypothermia, undernutrition, and mismanaged breast feeding may also indirectly contribute to neonatal mortality. Community-based studies have, however, demonstrated that most neonatal mortality can be affordably prevented through primary health care. Efforts are underway to expand the health care infrastructure, but the outreach of maternal and child health care remains unsatisfactory especially in rural areas. PMID:12319228

  1. Reducing stillbirths in low-income countries.

    Science.gov (United States)

    Goldenberg, Robert L; Saleem, Sarah; Pasha, Omrana; Harrison, Margo S; Mcclure, Elizabeth M

    2016-02-01

    Worldwide, 98% of stillbirths occur in low-income countries (LIC), where stillbirth rates are ten-fold higher than in high-income countries (HIC). Although most HIC stillbirths occur prenatally, in LIC most stillbirths occur at term and during labor/delivery. Conditions causing stillbirths include those of maternal origin (obstructed labor, trauma, antepartum hemorrhage, preeclampsia/eclampsia, infection, diabetes, other maternal diseases), and fetal origin (fetal growth restriction, fetal distress, cord prolapse, multiples, malpresentations, congenital anomalies). In LIC, aside from infectious origins, most stillbirths are caused by fetal asphyxia. Stillbirth prevention requires recognition of maternal conditions, and care in a facility where fetal monitoring and expeditious delivery are possible, usually by cesarean section (CS). Of major causes, only syphilis and malaria can be managed prenatally. Targeting single conditions or interventions is unlikely to substantially reduce stillbirth. To reduce stillbirth rates, LIC must implement effective modern antepartum and intrapartum care, including fetal monitoring and CS. PMID:26577070

  2. 羊水污染对胎儿危害分析与处理方法的探讨%Exploration of amniotic fluid pollution on fetal harm analysis and han-dling method

    Institute of Scientific and Technical Information of China (English)

    蔡春燕

    2015-01-01

    目的:探讨羊水污染对胎儿的危害及临床处理方法。方法2012年3月~2013年3月在本院产科足月分娩的产妇共2952例,其中剖宫产968例(32.79%),经阴道分娩1984例(67.21%),选取其中发生羊水污染的263例(8.91%)产妇作为研究对象,分析羊水污染对胎儿的影响及其相应的临床处理措施。结果Ⅰ度羊水污染的新生儿窒息率为9.78%,Ⅱ度羊水污染的新生儿窒息率为14.29%,Ⅲ度羊水污染的新生儿窒息率为21.74%,Ⅰ度羊水污染的新生儿窒息率显著低于Ⅱ度和Ⅲ度(P期发生Ⅱ度、Ⅲ度羊水污染,其胎儿窘迫率为21.74%(5/23),新生儿窒息率为4.35%(1/23),潜伏期与活>期比较,差异有统计学意义(P<0.05)。结论羊水污染与胎儿窘迫及新生儿窒息密切相关,对胎儿具有较大危害,针对羊水污染采取相应的临床处理措施,有助于保障围生儿生命安全。%Objective To explore the amniotic fluid pollution on fetal harm and clinical handling method. Methods From March 2012 to March 2013,there were 2952 puerperae of maternal labor in department of obstetrical in our hos-pital,among these participants,968 puerperae (32.79%) was given cesarean section,1984 puerperae (67.21%) was given through vaginal delivery.There were 263 out of 2952 puerperae which took 8.91% occurredwith amniotic fluid pollution were selected as research objects.Influence of amniotic fluid pollution on fetus and the corresponding treatment in clinic was analyzed. Results Incidence of neonatal asphyxia in degree Ⅰ amniotic fluid pollution was 9.78%,14.29% in de-greeII,and 21.74%in degreeⅢ.Incidence of amniotic fluid pollution in degreeⅠ was greatly less than that of degreeII and degree Ⅲ (P<0.05).During latent period, incidence of fetal distress in uterus due to degree II and Ⅲ was 32.14%(18/56),and occurrence rate of neonatal asphyxia was 21.43%(12/56).However,incidences of fetal distress in uterus due to

  3. THE EFFECT OF PHOTOTHERAPY ON SERUM IONIZED CALCIUM LEVELS IN NEONATES WITH UNCONJUGATED HYPER BILIRUBINEMIA

    Directory of Open Access Journals (Sweden)

    Durga

    2015-04-01

    Full Text Available AIM : T o study the occurance of hypocalcemia in neonates with hyperbilirubinemia after 48 hours of continuous phototherapy and to compare the results between term and preterm neonates. METHODS : T his study was performed on 100 neonates with unconjugated hyper bilirubinemia , 55 term and 45 preterm , who were given photo phototherapy in neonatal intensive care unit . serum ionized calcium levels were checked and after 48 hours of phototherapy . The prevalence of hypo calcemia after 48 hrs. of phototherapy was observed and compared between full term and preterm neonates. Neonates who had hyperbilirubinemia , asphyxia , respiratory distress , haemolytic anaemia sepsis were excluded from the study . RESULTS: 46/100 NEONATES, THAT IS 46 % developed hypocalcemia. 22/55 full term neonates , that is 40% and 24/45 preterm neonates that is 53% developed hypocalcemia after 48 hrs. of phototherapy. CONCLUSION: significant decline in serum calcium level is observed in neonates receiving phototherapy for hyperbilirubinemia

  4. Luxatio erecta humeri: Report of a swimming injury with analysis of the mechanism of the injury and associated injuries in literature

    Directory of Open Access Journals (Sweden)

    Kemal Gökkus

    2015-01-01

    Full Text Available Inferior shoulder dislocation also referred to as luxatio erecta is an unusual and rare type of shoulder dislocation. Its incidence is about 0.5% among all shoulder dislocations. After an exhaustive search of all the available literature we were unable to find a swimming accident case that did not have other associated injuries and an uneventful reduction. The mechanism of the injury was mostly related to direct axial loading and indirect hyperabduction lever arm. We would like to emphasize the importance of this being a swimming accident, a type of accident that requires awareness of the possibility of dangerous asphyxia injuries caused by panic in the water (swimming pool, river, lake, sea, etc.. We described the nature of the injury and review the literature concerning the mechanism of the injury and associated neurovascular impairment at admission time. We also presented a supplemental video to contribute to the education of young residents and orthopedic surgeons.

  5. In vitro activation of complement and contact system by lactic acidosis.

    Science.gov (United States)

    Sonntag, J; Emeis, M; Strauss, E; Obladen, M

    1998-01-01

    The activation of complement and contact systems occurs in reperfusion injuries with initial tissue hypoxia, and lactic acidosis such as mycardial infarction and birth asphyxia. The aim of our experiment was the formal proof of activation by sole lactic acidosis. Lactic acid was added to blood and plasma samples from 10 healthy volunteers. C5a and factor XIIa were measured by EIA after incubation at 37 degrees C for 1 h. Both concentrations increased (P < 0.0001 by Friedman analysis) in blood and plasma samples with increasing amount of added lactic acid. Lactic acidosis can activate C5 from the complement system and factor XII from the contact system directly, even in the absence of cellular components. PMID:9839699

  6. Lame from birth: early concepts of cerebral palsy.

    Science.gov (United States)

    Obladen, Michael

    2011-02-01

    Deformations have been attributed to supernatural causes since antiquity. Cerebral palsy was associated with God's wrath, witchcraft, the evil eye, or maternal imagination. Greek scholars recommended prevention by tight swaddling, a custom that persisted into modern times. In the Middle Ages, the midwife's negligence was held responsible as was difficult teething. Morgagni described in 1769 that the neonatal brain can liquefy, and Bednar described leukomalacia in 1850 as a distinct disorder of the newborn. In 1861, Little associated cerebral palsies with difficult or protracted labor and neonatal asphyxia, but he was challenged by Freud, who in 1897 declared that most cases are prenatal in origin. In 1868, Virchow demonstrated inflammatory changes, a view recently confirmed by Leviton and Nelson. Although a causal relationship of cerebral palsy to the birth never has been established, the habit to put the blame for cerebral palsy on someone remained a frequent attitude.

  7. in vitro activation of complement and contact system by lactic acidosis

    Directory of Open Access Journals (Sweden)

    J. Sonntag

    1998-01-01

    Full Text Available The activation of complement and contact systems occurs in reperfusion injuries with initial tissue hypoxia, and lactic acidosis such as mycardial infarction and birth asphyxia. The aim of our experiment was the formal proof of activation by sole lactic acidosis. Lactic acid was added to blood and plasma samples from 10 healthy volunteers. C5a and factor XIIa were measured by EIA after incubation at 37°C for 1 h. Both concentrations increased (P<0.0001 by Friedman analysis in blood and plasma samples with increasing amount of added lactic acid. Lactic acidosis can activate C5 from the complement system and factor XII from the contact system directly, even in the absence of cellular components.

  8. Oxidative stress in relation to surgery: is there a role for the antioxidant melatonin?

    DEFF Research Database (Denmark)

    Kücükakin, Bülent; Gögenur, Ismail; Reiter, Russel J;

    2009-01-01

    During and after surgical procedures, there is a well defined physiological stress response that involves activation of inflammatory, endocrine, metabolic, and immunological mediators. Oxidative stress, which is defined to be a situation where the production of reactive oxygen/nitrogen species...... antioxidant and in many studies melatonin has been shown to be more effective than some "classical" antioxidants (e.g., vitamins E and C) in protecting against oxidative/nitrosative stress. There are numerous experimental studies in which the antioxidant properties of melatonin have been proven....... In preliminary studies in newborns with asphyxia, sepsis, or respiratory distress syndrome, melatonin has proven to be a highly potent antioxidant. This review summarizes the results of animal and human studies wherein melatonin was shown to modulate oxidative stress; this discussion emphasizes the stress...

  9. Setting health research priorities using the CHNRI method: I. Involving funders

    Directory of Open Access Journals (Sweden)

    Igor Rudan

    2016-06-01

    Full Text Available In 2007 and 2008, the World Health Organization's Department for Child and Adolescent Health and Development commissioned five large research priority setting exercises using the CHNRI (Child Health and Nutrition Research Initiative method. The aim was to define research priorities related to the five major causes of child deaths for the period up to the year 2015. The selected causes were childhood pneumonia, diarrhoea, birth asphyxia, neonatal infections and preterm birth/low birth weight. The criteria used for prioritization in all five exercises were the “standard” CHNRI criteria: answerability, effectiveness, deliverability, potential for mortality burden reduction and the effect on equity. Having completed the exercises, the WHO officers were left with another question: how “fundable” were the identified priorities, i.e. how attractive were they to research funders?

  10. Epileptic Encephalopathy in Children with Risk Factors for Brain Damage

    Directory of Open Access Journals (Sweden)

    Josefina Ricardo-Garcell

    2012-01-01

    Full Text Available In the study of 887 new born infants with prenatal and perinatal risk factors for brain damage, 11 children with West syndrome that progressed into Lennox-Gastaut syndrome and another 4 children with Lennox-Gastaut syndrome that had not been preceded by West syndrome were found. In this study we present the main findings of these 15 subjects. In all infants multifactor antecedents were detected. The most frequent risk factors were prematurity and severe asphyxia; however placenta disorders, sepsis, and hyperbilirubinemia were also frequent. In all infants MRI direct or secondary features of periventricular leukomalacia were observed. Followup of all infants showed moderate to severe neurodevelopmental delay as well as cerebral palsy. It is concluded that prenatal and perinatal risk factors for brain damage are very important antecedents that should be taken into account to follow up those infants from an early age in order to detect and treat as early as possible an epileptic encephalopathy.

  11. Computed tomographic (CT) scans in cerebral palsy (CP)

    Energy Technology Data Exchange (ETDEWEB)

    Kolawole, T.M.; Patel, P.J. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Radiology); Mahdi, A.H. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Paediatrics)

    1989-11-01

    The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.).

  12. 头先露胎儿脐带绕颈220例临床分析%Clinical analysis on 220 cases of foetus of cephalic presentation umbilical cord around neck

    Institute of Scientific and Technical Information of China (English)

    梁小玲; 张莹

    2012-01-01

    目的 探讨头位胎儿脐带绕颈在分娩过程中对胎儿、新生儿的影响及分娩方式的选择.方法 回顾性分析头先露胎儿脐带绕颈220例足月妊娠产妇的临床资料,随机抽取220例头位分娩无胎儿脐带绕颈足月妊娠产妇为对照组,对两组产程及其分娩情况作对比观察.结果 观察组胎儿窘迫、新生儿窒息及剖宫产率分别为18.5%,8.6%,49.6%,明显高于对照组的5.4%,1.8%,26.4%(均P<0.05).脐带绕颈1周胎儿窘迫、新生儿窒息发生率为12.6%,1.4%;绕颈2周为27.1%,17.0%;绕颈3周及以上为69.2%,53.8%;脐带绕颈周数与胎儿窘迫、新生儿窒息发生率成正比.结论 加强产前B超检查和监护,重视脐带绕颈这一因素,选择适当分娩方式,可降低胎儿窘迫和新生儿窒息发生率,对产前B超诊断胎儿脐带绕颈3周及以上者应及早选择剖宫产分娩.%Objective To study the influences of fetal umbilical cord around neck on foetus、newborn infants and the choices of delivery mode during delivery.Methods 220 cases of cephalic delivery pregnant women with fetus who had fetal umbilical cord around neck symptom and 220 cases of cephalic delivery pregnant women with fetus who didn't have fetal umbilical cord around neck symptom,were selected to make a contrast observation.Results The foetus who had fetal umbilical cord around neck symptom had higher rate of fetal distress and neonatal asphyxia.The maternal cesarean section would be much higher,too.The rate is 18.5%,8.6%,49.6% which were higher than the foetus who didn't have such kind of symptom,the rate is 5.4%,1.8 %,26.4% ( all P < 0.05 ).The rate of fetal distress and neonatal asphyxia was proportional to the number of circles around neck.One circle around neck is 12.6%,1.4% ;two circles around neck is 27.1%,17.0% ;three and more than 3 circles around neck is 69.2%,53.8%.Conclusion We should enhance perinatal B-mode ultrasonic

  13. What are the factors that interplay from normal pregnancy to near miss maternal morbidity in a Nigerian tertiary health care facility?

    Science.gov (United States)

    Adeoye, Ikeola A; Ijarotimi, Omotade O; Fatusi, Adesegun O

    2015-01-01

    Researchers in Nigeria examined the epidemiological characteristics and factors associated with maternal outcomes using a mixed method approach: a prospective case control study design involving 375 pregnant women who received maternal care from a tertiary facility and in-depth interviews reporting the experience of near-miss survivors. A generalized ordered logit model was used to generate the estimates of partial proportional odds ratios (and 95% confidence intervals) across categories of the outcome variable. Factors strongly associated with maternal morbidity were late referral of women, presence of complications at booking antenatal visits, low birth weight, and severe birth asphyxia. The nearmiss women were further characterized, and a low proportion (25%) had organ dysfunction or failure. The challenge of such diagnoses in resource-constrained settings raises questions about the appropriateness of using organ dysfunction criteria in developing countries.

  14. Supraglottic airway devices in children

    Science.gov (United States)

    Ramesh, S; Jayanthi, R

    2011-01-01

    Modern anaesthesia practice in children was made possible by the invention of the endotracheal tube (ET), which made lengthy and complex surgical procedures feasible without the disastrous complications of airway obstruction, aspiration of gastric contents or asphyxia. For decades, endotracheal intubation or bag-and-mask ventilation were the mainstays of airway management. In 1983, this changed with the invention of the laryngeal mask airway (LMA), the first supraglottic airway device that blended features of the facemask with those of the ET, providing ease of placement and hands-free maintenance along with a relatively secure airway. The invention and development of the LMA by Dr. Archie Brain has had a significant impact on the practice of anaesthesia, management of the difficult airway and cardiopulmonary resuscitation in children and neonates. This review article will be a brief about the clinical applications of supraglottic airways in children. PMID:22174464

  15. Outcome at school-age after neonatal mechanical ventilation.

    Science.gov (United States)

    Gunn, T R; Lepore, E; Outerbridge, E W

    1983-06-01

    103 school-age children (5 to 12 years) who survived mechanical ventilation for neonatal respiratory failure were evaluated for growth, neurological, intellectual, psychological and school function in order to determine those children most at risk for handicap. A major handicap occurred in seven children, preventing attendance at normal school or normal classes. Neurological sequelae were significantly associated with perinatal asphyxia and with birthweights of 1500g or less, and neurological sequelae and socio-economic factors were the major determinants of ability. The effects of the Neonatal Intensive Care Unit (NICU) experience on parents and subsequent parent-child relationships were also investigated: 67 per cent of the mothers were very upset by the experience and many continue to worry excessively about the health of their child. Parents who visited their child in the NICU frequently were significantly more anxious and overprotective, restricting many activities even when the child was of school age. PMID:6873492

  16. Sudden unexpected death in infancy (SUDI) in the early neonatal period: the role of bed-sharing.

    Science.gov (United States)

    Hoffend, Charlotte; Sperhake, Jan-Peter

    2014-06-01

    The incidence of sudden infant death syndrome (SIDS) has declined substantially, but the proportion of sudden unexpected death in infancy (SUDI) in neonates, newborn on the part of an exhausted mother. Fifty-two percent of the incidents occurred while the mother and her newborn were still hospitalized in a birth clinic. Forty-eight percent of the infants had been sleeping in the parents' bed with mother and/or father. In 11 % of the cases, there was a sofa-sharing situation. Bed-sharing seems to increase the risk for SIDS in the newborn period as well as the risk for accidental suffocation/asphyxia of the baby. Therefore, mothers should not be instructed to bed-share. Particularly during the first 24 h after birth, it may be advisable to check mothers and infants regularly. PMID:24399341

  17. Congenital heart block with hydrops fetalis treated with high-dose dexamethasone; a case report.

    Science.gov (United States)

    Chua, S; Ostman-Smith, I; Sellers, S; Redman, C W

    1991-11-26

    A 32-year-old woman with systemic lupus erythematosus was found to have a fetus with heart block and fetal ascites at 23 weeks gestation. Treatment with high-dose corticosteroids ameliorated the early signs of heart failure, although the fetal heart rate gradually fell from 48 beats/min to 42 beats/min by 34 weeks. Sudden deterioration of the fetal state occurred at 35 weeks, and this only partially responded to digitalisation. Neonatal death occurred on Day 18 from the consequences of severe birth asphyxia. The relationship and pathogenesis of anti-Ro antibodies, congenital heart block and hydrops fetals are discussed, together with the in utero management of this condition. PMID:1765211

  18. Epileptic Encephalopathy in Children with Risk Factors for Brain Damage

    Science.gov (United States)

    Ricardo-Garcell, Josefina; Harmony, Thalía; Porras-Kattz, Eneida; Colmenero-Batallán, Miguel J.; Barrera-Reséndiz, Jesús E.; Fernández-Bouzas, Antonio; Cruz-Rivero, Erika

    2012-01-01

    In the study of 887 new born infants with prenatal and perinatal risk factors for brain damage, 11 children with West syndrome that progressed into Lennox-Gastaut syndrome and another 4 children with Lennox-Gastaut syndrome that had not been preceded by West syndrome were found. In this study we present the main findings of these 15 subjects. In all infants multifactor antecedents were detected. The most frequent risk factors were prematurity and severe asphyxia; however placenta disorders, sepsis, and hyperbilirubinemia were also frequent. In all infants MRI direct or secondary features of periventricular leukomalacia were observed. Followup of all infants showed moderate to severe neurodevelopmental delay as well as cerebral palsy. It is concluded that prenatal and perinatal risk factors for brain damage are very important antecedents that should be taken into account to follow up those infants from an early age in order to detect and treat as early as possible an epileptic encephalopathy. PMID:22957240

  19. Computed tomographic (CT) scans in cerebral palsy (CP)

    International Nuclear Information System (INIS)

    The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.)

  20. Focal perinatal acquired brain injury - a sonographic study of the course

    International Nuclear Information System (INIS)

    A case of a perinatal acquired focal brain lesion is reported, and the process of resorption and healing demonstrated by ultrasound. Within four weeks a cortical area of increased echogenicity was resorbed. After two months, the resulting porencephalic cyst had been transformed into glial tissue of very high echogenicity. The neurologic development of two children with such glial focus was good. These cases demonstrate that porencephalic cysts are not always the final state after resorption of a focal brain lesion. They are no reliable prognostic indicator of poor neurological outcome. Traumatic and complicated delivery, asphyxia and coagulopathy are conditions which have been found several times in connection with a focal brain lesion. In contrast to periventricular injury, prematurity does not seem to be a factor of higher risk. (orig.)

  1. Curved reformat of the paediatric brain MRI into a 'flat-earth map' - standardised method for demonstrating cortical surface atrophy resulting from hypoxic-ischaemic encephalopathy.

    Science.gov (United States)

    Simpson, Ewan; Andronikou, Savvas; Vedajallam, Schadie; Chacko, Anith; Thai, Ngoc Jade

    2016-09-01

    Hypoxic-ischaemic encephalopathy is optimally imaged with brain MRI in the neonatal period. However neuroimaging is often also performed later in childhood (e.g., when parents seek compensation in cases of alleged birth asphyxia). We describe a standardised technique for creating two curved reconstructions of the cortical surface to show the characteristic surface changes of hypoxic-ischaemic encephalopathy in children imaged after the neonatal period. The technique was applied for 10 cases of hypoxic-ischaemic encephalopathy and also for age-matched healthy children to assess the visibility of characteristic features of hypoxic-ischaemic encephalopathy. In the abnormal brains, fissural or sulcal widening was seen in all cases and ulegyria was identifiable in 7/10. These images could be used as a visual aid for communicating MRI findings to clinicians and other interested parties. PMID:27337989

  2. Fentanyl-droperidol supplementation of rapid sequence induction in the presence of severe pregnancy-induced and pregnancy-aggravated hypertension.

    Science.gov (United States)

    Lawes, E G; Downing, J W; Duncan, P W; Bland, B; Lavies, N; Gane, G A

    1987-11-01

    Twenty-six patients manifesting severe pregnancy-induced (PIH) or pregnancy-aggravated (PAH) hypertension who presented for emergency Caesarean section under general anaesthesia were studied. All patients came from a previously identified high risk group--namely greater than 25 yr, multiparous and with diastolic arterial pressures sustained at greater than 120 mm Hg. Our standard accelerated induction technique for the management of severely hypertensive mothers was modified to include the use of fentanyl and droperidol before induction. This modification of the induction sequence produced a clinically significant amelioration of the reflex sympathetic hypertensive response to laryngoscopy and intubation in most mothers receiving antihypertensive therapy, without apparent deleterious effect in the immediate postoperative period to those neonates unaffected by intrauterine asphyxia. PMID:3689612

  3. BRAIN HYPOTHERMIA THERAPY FOR NEONATAL HYPOXIC-ISCHEMIC ENCEPHALOPATHY WITH A SEVERELY ELEVATED SERUM CREATINE KINASE LEVEL.

    Science.gov (United States)

    Kinoshita, Hidetoshi; Imamura, Takashi; Maeda, Hajime; Shibukawa, Yasuko; Fukuda, Yutaka; Kin, Shogo; Ariga, Hiromichi; Nagasawa, Katsutoshi

    2015-01-01

    Several studies have shown that brain hypothermia therapy (BHT) after neonatal hypoxic-ischemic encephalopathy (HIE) can improve neurodevelopmental outcomes. However, there have been no reports of the neurodevelopmental outcomes for the infant with a serum creatine kinase (CK) level above 20,000 IU/L in association with neonatal HIE. We report a female infant with a very high serum CK level (26,428 IU/L) associated with neonatal asphyxia. We diagnosed this infant with moderate HIE, and BHT was achieved by head cooling within 6 hours after birth to an esophageal temperature of 34.5°C. There were no significant adverse events during BHT, and the CK level spontaneously decreased. Although we report only the short-term outcomes for this case, she presents neurodevelopmental delays at the age of 18 months. It may be correlated between high serum CK level and long-term neurodevelopmental delays. PMID:25946908

  4. [Acute airway obstruction during chemotherapy-induced agranulocytosis with fever].

    Science.gov (United States)

    Vandenbos, F; Deswardt, Ph; Hyvernat, H; Burel-Vandenbos, F; Bernardin, G

    2006-02-01

    Acute airway obstruction caused by mucoid impaction can cause sometimes life-threatening respiratory distress. Bronchial plugging is usually observed in subjects with chronic diseases such as asthma, allergic bronchopulmonary aspergillosis, or cystic fibrosis. In children, it can be related to heart failure. Acute airway obstruction in a patient without a chronic respiratory disease is exceptional. We report the case of a patient who developed bronchial plugs obstructing the bronchi during a period of agranulocytosis induced by chemotherapy. The patient experienced acute respiratory distress with asphyxia. The plugs were composed of fibrin and required several fibroscopic procedures for clearance. To our knowledge, this is the first case report of acute airway obstruction by plugging during a period of agranulocytosis. PMID:16604039

  5. 极低出生体质量新生儿DIC高危因素分析%HIGH RISK FACTORS OF DISSEMINATED INTRAVASCULAR COAGULATION IN VERY LOW BIRTH-WEIGHT INFANTS

    Institute of Scientific and Technical Information of China (English)

    邵长荣; 姜红; 王启红

    2012-01-01

    Objective To investigate and analyse high risk factors of disseminated intravascular coagulation (DIC) in very low birth-weight infants (VLBWIs), so as to offer an early intervention. Methods Clinical data of 78 VLBWIs treated in the neonatal intensive care unit CNICU) between November 2010 and October 2011 were reviewed retrospectively for the incidence of DIC the information of those in DIC and non-DIC groups was analyzed for their perinatal periodi complicationsi and outcome, Logistic regression analysis was employed for the correlated risk factors. Results Twenty-six of the 78 VLBWIs were diagnosed with DIC, 74(94. 9%) survived. The differences between DIC and non-DIC group were significant in terms of gestational agef birth weight, intrauterine growth retardation (IUGR). asphyxia, septicemia, hypothermia, pulmonary hemorrhage, anemia, respiratory failure, and alimentary tract hemorrhage (t=2, 095,3. 100;X2 = 4. 524 - 18. 567,P<0, 05). Logistic regression analysis showed that IUGR, asphyxia., septicemia, hypothermia, pulmonary hemorrhage, anemia, and respiratory failure were the high-risk factors for DIC (X2 =4. 325-17. 175,P<0. 05). Conclusion VLBWI is the high-risk group of DIC, which is associated with gestational age, birth weight, IUGR, asphyxia, septicemia, anemia, pulmonary hemorrhage, anemia, respiratory failure, and alimentary tract hemorrhage in which, IUGR, asphyxia, septicemia, hypothermia, anemia and respiratory failure are risk factors for DIC. For those with younger gestational age and lighter birth weight, more DIC will be involved.%目的 调查分析极低出生体质量新生儿(VLBWI)弥散性血管内凝血(DIC)高危因素,以便早期干预.方法 回顾性分析2010年11月-2011年10月我院NICU住院治疗VLBWI 78例DIC发生情况,分析DIC组与非DIC组基本资料、围生期情况、并发症及治疗方面的差异,并对相关危险因素行Logistic回归分析.结果 78例VLBWI发生DIC 26例,存活74例(94.9%).DIC组与

  6. Autoerotic asphyxial deaths: analysis of nineteen fatalities in Alberta, 1978 to 1989.

    Science.gov (United States)

    Tough, S C; Butt, J C; Sanders, G L

    1994-04-01

    This paper presents an unusual form of sexual (masturbatory) activity and brings this unusual cause of death to wider medical attention and understanding. All 19 cases of autoerotic asphyxial death that occurred between 1978 and 1989 in the province of Alberta, Canada were reviewed. The fatal victim of autoerotic asphyxia is typically a single male aged 15 to 29 years. Autoerotic sexual activity is typically performed in isolation; often there is evidence of repetitive practice. The accidental death usually results when the "safety" mechanism designed to alleviate neck compression fails. Often the first sign of the activity (usually a surprise to family and friends) is death itself. Physicians who are alert to the practice may suggest counselling when patients present with sexual concerns, unusual marks around the neck or evidence of abrasions to limbs suggesting bondage or other masochistic practices. PMID:8033021

  7. Drill biopsy in the diagnosis of lung lesions.

    Science.gov (United States)

    Shatapathy, P; Sahoo, R C; Rao, K M; Krishnan, K V; Rau, P V; Padhee, A

    1987-11-01

    A high speed pneumatic drill was used to perform 190 percutaneous transthoracic biopsies in 161 patients. The resultant cores of tissue provided a definite diagnosis in 146 patients, giving a success rate of 90.7%. Complications occurred in 58 patients, subcutaneous emphysema being the most common, though only seven patients required active treatment, giving a rate of 3.7% for important complications. One patient died within 24 hours of the biopsy procedure owing to asphyxia resulting from aspiration of the contents of an acutely dilated stomach. Our experience clearly establishes that the drill biopsy as used by us is simple and safe and can be carried out in an outpatient department, yielding better overall results than any other procedure for closed biopsy of the lung currently practised.

  8. Study progress on pathogenesis of pulmonary edema induced by seawater drowning%海水淹溺性肺损伤中肺水肿发生机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    李佳欢; 许敏; 金发光

    2010-01-01

    海水淹溺后,除少数因喉头、气管反射性痉挛引起急性窒息外,导致死亡的主要原因是海水淹溺性肺水肿.海水淹溺性肺水肿的发生机制有海水高渗性的损伤作用、肺泡中液体吸收障碍、炎症介质以及活性氧物质的影响、神经体液因素影响等.%After seawater drowning, except for larynx and trachea reflex spasm causing acute asphyxia, the main cause of death is pulmonary edema of seawater drowning. The mechanisms of pulmonary edema after seawater drowning include the hyperosmolality of seawater, the liquid malabsorption in alveolus,the effects of inflammatory mediators,reactive oxygen species and neurohumoral factors.

  9. Anaesthetic management of a patient with hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Nergis Ataol

    2015-12-01

    Full Text Available Hereditary angioedema is a rare autosomal dominant disorder caused by reduced activity of the C1 esterase inhibitor. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal organs. Attacks may occur either spontaneously or following trauma, stress, surgery, infections and hormonal fluctuations. The most common cause of death is asphyxia related to laryngeal edema. Giving C1 esterase inhibitor is the most effective method of treatment. Also fresh frozen plasma, androgen steroids, quinine pathway inhibitors, antifibrinolytics and bradykinin receptor antagonists can be used as treatment. In this paper, the anesthetic management of a patient with hereditary angioedema undergoing inguinal hernia repair surgery is reported.

  10. [Neonatal renal vein thrombosis in a heterozygous carrier of both factor V Leiden and the MTHFR gene mutation].

    Science.gov (United States)

    Wannes, S; Soua, H; Ghanmi, S; Braham, H; Hassine, M; Hamza, H A; Ben Hamouda, H; Sfar, M-T

    2012-04-01

    Renal vein thrombosis (RVT) is a rare but potentially serious neonatal disease. Its epidemiology and its clinical and biological expression are currently well known, but its etiological exploration, like that of venous thromboembolism, is increasingly complex. Perinatal risk factors such as prematurity, dehydration, and birth asphyxia have lost their direct accountability at the expense of their interaction with constitutional disorders of hemostasis. We report a case of RVT in a newborn who was a heterozygous carrier of both factor V Leiden and the methylene tetrahydrofolate reductase (MTHFR) gene mutation. We recall the clinical and epidemiological characteristics. A search for inborn blood coagulation disorders should be systematic in the newborn infant with venous thrombosis because of the risk of recurrence, taking into account perinatal factors and maternal thrombophilia (especially if RVT is established during the prenatal period).

  11. SUCCESSFUL TREATMENT OF ONE CASE OF SEVERE CEREBRAL PALSY DURING EARLY STAGE WITH FILIFORM SHALLOW NEEDLING COMBINED WITH ACUPOINT-INJECTION OF PIRACETUM

    Institute of Scientific and Technical Information of China (English)

    Wang Junying

    2001-01-01

    @@ He, a baby of aged 94 days, was administered to our hospital on January 11, 2000 due to inability to hold up the head. His mother told me that she gave birth to her baby by cesarean section (term birth). During delivery, owing to twining of the neck by umbilical cord, her baby experienced asphyxia for 30 min. After emergency treatment, the baby recovered autonomous respiration and had a weak cry voice, with the Apgar score being 2 points. Thereafter, this baby frequently had convulsion. CT examination showed encephalatrophy and outer hydrocephalus. It was diagnosed as cerebral palsy, and he was hospitalized for 45 days and treated with Cerebrolysin, hyperbaric oxygen, home training, etc.

  12. Curved reformat of the paediatric brain MRI into a 'flat-earth map' - standardised method for demonstrating cortical surface atrophy resulting from hypoxic-ischaemic encephalopathy.

    Science.gov (United States)

    Simpson, Ewan; Andronikou, Savvas; Vedajallam, Schadie; Chacko, Anith; Thai, Ngoc Jade

    2016-09-01

    Hypoxic-ischaemic encephalopathy is optimally imaged with brain MRI in the neonatal period. However neuroimaging is often also performed later in childhood (e.g., when parents seek compensation in cases of alleged birth asphyxia). We describe a standardised technique for creating two curved reconstructions of the cortical surface to show the characteristic surface changes of hypoxic-ischaemic encephalopathy in children imaged after the neonatal period. The technique was applied for 10 cases of hypoxic-ischaemic encephalopathy and also for age-matched healthy children to assess the visibility of characteristic features of hypoxic-ischaemic encephalopathy. In the abnormal brains, fissural or sulcal widening was seen in all cases and ulegyria was identifiable in 7/10. These images could be used as a visual aid for communicating MRI findings to clinicians and other interested parties.

  13. Child homicide or natural death? A case report of unexpected death of unusual asymptomatic acute laryngotracheobronchitis.

    Science.gov (United States)

    Zhuo, Luo; Liu, Liang; Ren, Liang; Liu, Qian

    2016-07-01

    Cases involving the unexpected deaths of children are always a concern for the police and medical examiners alike. In particular, unexpected deaths due to asphyxia without obvious injuries sometimes make decisions regarding the manner of death more difficult. In the present case, a 2-year-old boy was found dead at home, and his mother was initially believed to have killed him. A complete autopsy and forensic investigation were performed, and no injuries were found on the body; however, marked laryngeal edema was observed. Histology showed extensive inflammatory infiltration of the mucosa and submucosa of the larynx, trachea, and bronchi. The cause of death was given as respiratory failure due to acute laryngotracheobronchitis; thus, the manner of death was natural. This case helps to remind the forensic community to keep an open mind and consider a broad differential diagnosis when approaching a case rather than jumping to a conclusion based solely on a preliminary investigation. PMID:26101441

  14. Neonatal management of pregnancy complicated by diabetes.

    Science.gov (United States)

    Mohsin, Fauzia; Khan, Shareen; Baki, Md Abdul; Zabeen, Bedowra; Azad, Kiswhar

    2016-09-01

    Women with diabetes in pregnancy, either pre-gestational Diabetes Mellitus (Type 1 & Type 2) or Gestational Diabetes, are at increased risk for adverse pregnancy outcomes, including preterm labour and increased foetal mortality rate. Adequate glycaemic control before and during pregnancy is crucial for improving foetal and perinatal outcomes in these babies. Perinatal and neonatal morbidities and mortality rates have declined since the development of specialized maternal, foetal, and neonatal care for women with diabetes and their offspring. However, infants of diabetic mothers are at risk for developing complications as macrosomia, hypoglycaemia, perinatal asphyxia, cardiac and respiratory problems, birth injuries and congenital malformations. In this review article we describe the neonatal management of the offspring of diabetic mothers. PMID:27582162

  15. New operational technology of intrauterine ventilation the fetus lungs by breathing gas

    Science.gov (United States)

    Urakov, A. L.; Nikityuk, D. B.; Urakova, N. A.; Kasankin, A. A.; Chernova, L. V.; Dementiev, V. B.

    2015-11-01

    New operational technology for elimination intrauterine hypoxia and asphyxia of the fetus using endoscopic artificial ventilation lungs by respiratory gas was developed. For intrauterine ventilation of fetal lung it is proposed to enter into the uterus a special breathing mask and wear it on the head of the fetus using the original endoscopic technology. The breathing mask, developed by us is connected with external breathing apparatus with a hose. The device is called "intrauterine aqualung". Intrauterine aqualung includes a ventilator and breathing circuit with a special fold-out breathing mask that is put on inside the uterus on the head of fetus like a mesh hat. Controlled by ultrasound the technology of the introduction of the mask inside of the uterus through the natural opening in the cervix and technology of putting on the respiratory mask on the head of the fetus with its head previa were developed. The technology intrauterine ventilation of the fetus lungs by respiratory gas was developed.

  16. A breath of fresh air for cryogenics training

    CERN Multimedia

    HSE Unit

    2014-01-01

    Whether you work full-time in a cryogenic installation or are required to handle cryogenic substances temporarily, you need to have followed the appropriate safety training.   Photo: Christoph Balle. Two new training courses are now available in English and French at CERN: “Cryogenic Safety – Fundamentals” (at the Prévessin Training Centre) and “Cryogenic Safety – Helium Transfer” (at the Cryolab). The first covers the content of levels 1 and 2 of the old “Cryogenic Safety” course. The second is a completely new course for CERN: it covers specific aspects of the transfer of liquid helium, such as the evaporation process of helium and the associated risks to human health (asphyxia due to displacement of oxygen), the colour code for gas bottles, etc. These training modules have been rewritten in response to the increase in the number of projects involving cryogenics and following various related incident...

  17. OUTCOME OF NEONATES WITH THROMBOCYTOPENIA

    Directory of Open Access Journals (Sweden)

    Sharangouda

    2014-04-01

    Full Text Available OBJECTIVE: To determine etiology, onset, clinical features and outcome of neonates with thrombocytopenia. METHODS: 140 neonates having bleeding or having platelet count (<1.5lakhs/µl were selected from those admitted to NICU’S attached to MR Medical College, Gulbarga. Initial platelet count was done on admission and counts were repeated 12 hours after any therapeutic intervention. OBSERVATION AND RESULTS: Severe thrombocytopenia (<50000/µl was present in 8.5%, moderate (50, 000-1, 00, 000/µl in 17%. Majority (45.33% were preterm and the major cause was sepsis in 51.3%.Mucosal bleed was the most common presentation. Mortality was 37% in severe and 3.9% in moderate thrombocytopenia group. CONCLUSION: Significant association is observed with maternal PIH, Late onset sepsis, NEC and sepsis with DIC .Prematurity, IUGR, Birth asphyxia were common associated morbidities. Severe thrombocytopenia in sick neonates, in NICU, is a poor prognostic indicator.

  18. Brain magnetic resonance imaging of infants exposed prenatally to buprenorphine

    International Nuclear Information System (INIS)

    Purpose: To evaluate the brains of newborns exposed to buprenorphine prenatally. Material and Methods: Seven neonates followed up antenatally in connection with their mothers' buprenorphine replacement therapy underwent 1.5T magnetic resonance imaging (MRI) of the brain before the age of 2 months. The infants were born to heavy drug abusers. Four mothers were hepatitis C positive, and all were HIV negative. All mothers smoked tobacco and used benzodiazepines. All pregnancies were full term, and no perinatal asphyxia occurred. All but one neonate had abstinence syndrome and needed morphine replacement therapy. Results: Neither structural abnormalities nor abnormalities in signal intensity were recorded. Conclusion: Buprenorphine replacement therapy does not seem to cause any major structural abnormalities of the brain, and it may prevent known hypoxic-ischemic brain changes resulting from uncontrolled drug abuse. Longitudinal studies are needed to assess possible abnormalities in the brain maturation process

  19. Premature closure of the upper esophageal sphincter as a cause of severe deglutition disorder in infancy

    DEFF Research Database (Denmark)

    Nielsen, Rasmus; Husby, Steffen; Kruse-Andersen, Søren

    2005-01-01

    Deglutition disorders in infancy are often associated with birth asphyxia or structural abnormalities in the hypopharynx, the trachea, or the esophagus. Manometry can be crucial for clarifying the dynamics of the swallowing disorder in the infant with deglutition problems and without signs...... of these causes. An 8-week-old infant was referred because of suspicion of cricopharyngeal achalasia causing persistent swallowing problems and failure to thrive. Manometry results showed normal resting tone and relaxation but premature closure of the upper esophageal sphincter. The infant was treated...... with balloon dilatation of the upper esophageal sphincter and expectance. A maturation process of the swallowing sequence was noted over time and documented by repeated manometric procedures....

  20. [Interpair differences in the characteristics of the ontogeny, premorbid personality and severity of schizophrenia in twins].

    Science.gov (United States)

    Moskalenko, V D

    1980-01-01

    In each of the studied 124 pairs, a twin A was distinguished (the patient with manifest symptoms in the discordant pairs, or more seriously affected twin in concordant pairs) and twin B--its partner. It was demonstrated that the order of birth, differences in the weight at birth, periodization of development do not correlate with the differences in the clinical expression of schizophrenia. Such unfavourable factors as asphyxia, complications during delivery, severe somatic illnesses had a certain tendency to accumulate in twin A. The most distinct correlation was found between the traits of a premorbid personality and the eventual intrapair differences in the severeity of schizophrenia. Twin A in the majority of the cases was more excitable in childhood, had more fears, slept worse, and had a poor appetite. The twin A by its premorbid traits was generally characterized by prevalent asthenic features, withdrawal signs and a more dysharmonic type of personality. PMID:7188820

  1. Relationship between serum heat—stable alkaline phosphatase level and p[regnancy

    Institute of Scientific and Technical Information of China (English)

    CaoGuo-Xian; DingMei-Juan; 等

    1998-01-01

    Serum heat-stable alkaline phosphatase(HSAP) level in 649 cases of normal pregnancy and 164 cases of high-risk pregnancy is measured by raioimmunoassay (RIA).The results indicate that the HSAP level in normal prenancy increased proportionally with gestation weeks(r=0.9843).In 33 cases of pregnancy induced hypertension and 21 cases of intrauterine fetal growth retardation,the HSAP level is significantly low.In 7 cases of neonatal asphyxia and 26 cases of ftal distress,the HSAP level in the mother's serum is also low.In 53 cases of intrahepatic cholestasis of pregnancy,the HSAP level in similar to those of normal pregnancy,This study illustrates that HSAP RIA can play an important role in the evaluation of placental function and fetal prognosis for cases of high-risk pregancy.

  2. Recent achievements in the management of Raynaud's phenomenon.

    Science.gov (United States)

    Baumhäkel, Magnus; Böhm, Michael

    2010-04-15

    Raynaud's phenomenon is a clinical disorder with episodic digital ischemic vasospasm triggered by cold- or emotional-stress. It was first mentioned by Maurice Raynaud in 1862 describing "a local asphyxia of the extremities" and was further divided into primary Raynaud's disease and secondary Raynaud's phenomenon, which is often related to connective tissue diseases, but also physical or chemical strain. Though pathophysiology of Raynaud's phenomenon is still poorly understood, systemic and local vascular effects are most likely to be involved in primary Raynaud's disease. In secondary Raynaud's phenomenon additional abnormalities in vascular structure and function may play the major role. Thus, medical treatment of Raynaud's phenomenon remains unsatisfactory, due to limited understanding of pathophysiological mechanisms. This review addresses current evidence for medical treatment of primary and secondary Raynaud's phenomenon with regard to pathophysiological mechanisms as well as future perspectives.

  3. Heart size in new born infants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Won; Yu, Yun Jeong; Chung, Hye Kyung [Eul-ji General Hospital, Seoul (Korea, Republic of)

    1985-10-15

    Cardiac size of 291 new-bone infants was measured using the method illustrated on Fig 1. Among the 291 infants, 53 were asphyxiated, and asphyxia was only regarded from Apgar score below 6 on 1 min. and 5 min. Remaining 238 infants were normal, and classified to group with lung abnormalities and without lung abnormalities on chest A-P film. The results are as follows; 1. The average CTR. of normal group was 52.37. (C/T1; 54.89, C/T2; 49.43, C/T3; 49.15, C/T4;55.97) 2. The average CTR. of asphyxiated group was 54.91 (C/T1; 57.13, C/T2; 51.69, C/T3; 51.94, C/T4;58.25) 3. Consequently, asphyxiated infants revealed larger cardiac size than normal infant group.

  4. Obstetrical and neonatal outcomes in women following gastric bypass

    DEFF Research Database (Denmark)

    Berlac, Janne Foss; Skovlund, Charlotte Wessel; Lidegaard, Ojvind

    2014-01-01

    OBJECTIVE: To assess obstetrical and neonatal outcomes in women following gastric bypass, compared with adipose women without surgery and with a normal weight control population. DESIGN: Historical controlled cohort study. SETTING: Denmark. POPULATION: All women undergoing gastric bypass during...... the period 1996-2011, and subsequently giving birth. METHODS AND MAIN OUTCOME MEASURES: Obstetrical and neonatal outcomes in women without gastric bypass matched on age, parity, plurality, year, and body mass index, and normal weight women. RESULTS: In 415 women giving birth after gastric bypass we found...... more admissions to neonatal intensive care unit compared with newborn of normal weight mothers; RR = 1.5 (1.1-2.0). CONCLUSIONS: Gastric bypass may reduce the risk of preeclampsia, emergency cesarean section, and perinatal asphyxia, compared with adipose women without surgery. Compared with normal...

  5. Joubert syndrome presenting as unilateral dysplastic kidney, hypotonia, and respiratory problem

    Directory of Open Access Journals (Sweden)

    Majid Malaki

    2012-01-01

    Full Text Available An 8-month-old girl with a history of asphyxia and respiratory distress immediately after birth was hospitalized at her fourth month of age with the diagnosis of kidney infection and it was revealed that she had a unilateral multicystic dysplastic kidney. In recent admission, she presented to emergency room with fever, hyperpnea, and apnea. In appearance, she was a hypotonic girl with broad forehead, hypertelorism, depressed nasal bridge and bitemporal regions, rapid vertical and horizontal nystagmus, and open mouth with salivation. In spite of normal physical growth, she had delayed developmental milestones. Blood gas O 2 saturation dropped after she received phenobarbital. Her urinary and blood tests were normal; however, her cranial magnetic resonance imaging (MRI revealed vermis agenesis and molar tooth sign. These physical and para-clinical findings suggested Joubert syndrome.

  6. POLA PENYAKIT PENYEBAB KEMATIAN BAYI DI PEDESAAN DAN PERKOTAAN, KONDISI SOSIO EKONOMI PADA KEJADIAN KEMATIAN BAYI DI INDONESIA HASIL RISKE5DAS 2007

    Directory of Open Access Journals (Sweden)

    Tety Rachmawati

    2012-11-01

    Full Text Available Background: Infant health was an important health indicator because of its relationship with various factors, maternal health, the quality of access to health services, socioeconomic conditions and public health services. Many factors influenced the Infant Mortality Rate but it is difficult to determine dominant factors and less dominant factors. The availability of various facilities or access and health services from skilled health workers, and also changing of public mind set from traditional to modern norms in health services are factors that influence the Infant Mortality Rate. This study aimed to asses the pattern infant death cause at urban and rural, socioeconomic conditions and its relations to infant death. Methods: The study design is descriptive. Data were taken from Riskesdas 2007, conducted in all provinces 33 Provinces in Indonesia. The Unit of analysis was infant death (0-11 month in household, during 1 July 2006-February 2008. Results: Results showed that infant mortality the majority patterns of infant death cause in Urban were is Low Birth Weight; followed by digestive infection,Asphyxia/aspiration and meningitis. Meanwhile pattern of Infant death cause in rural the majority were digestive infection, Pneumonia, Asphyxia/aspiration and Low Birth Weight. There was differences in access to health services between urban and rural areas. In rural areas access to health services was more difficult compared to urban. Infant deaths were more common in rural. Suggests to enhance access to health services especially in rural areas such as by enhance Desa SiagaStrategy to shorthen the health services to community like Poskesdes, enhance pre hospital care of obstetric and neonatal emergency at Polindes and puskesmas, socialization of ASI exclusive program, socialization of "PHBS" program. Key words: Infant Death - Pattern of death Cause - access - socioeconomic- Riskesdas 2007

  7. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

    Directory of Open Access Journals (Sweden)

    Liang JM

    2015-08-01

    Full Text Available Jianmin Liang,1 Juan Hu,1 Huimin Chang,2 Ying Gao,1 Huanan Luo,1 Zhenghui Wang,1 Guoxi Zheng,1 Fang Chen,1 Ting Wang,1 Yeye Yang,1 Xiaohui Kou,1 Min Xu1 1Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi’an Jiaotong University, 2Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Xi’an Medical University, Xi’an, People’s Republic of China Abstract: The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs. We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs, anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01. Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. Keywords: respiratory tract foreign body, children, diagnosis, treatment

  8. Clinical analysis of placental abruption%胎盘早剥的临床分析及护理体会

    Institute of Scientific and Technical Information of China (English)

    何琼珍

    2011-01-01

    目的 探讨胎盘早剥的病因、临床表现及护理方法.方法 通过对67例胎盘早剥患者的临床资料回顾性分析,总结临床病情观察、护理的经验.结果 妊娠期高血压综合征和胎盘早破是引起胎盘早剥的最常见原因;临床表现以阴道出血、腹痛为主;诊断需临床表现结合超声检查.67例胎盘早剥患者均痊愈,新生儿轻度窒息34例,重度窒息11例,死胎7例.结论 加强孕产期保健,积极防治胎盘早剥的诱发因素是关键,正确的护理方法是达到理想治疗效果的保证.%Objective To explore the cause of placental abruption, clinical manifestations and nursing. Methods The clinical data of 67 cases with placental abruption were retrospectively analyzed and summarized the clinical condition observation and nursing experience. Results The pregnancy induced hypertension and premature rupture was the most common cause of placental abruption. The main clinical manifestations of this disease was vaginal bleeding, abdominal pain. The diagnosis was clinical manifestations and ultrasonography. 67 cases of placental abruption patients were cured, 34 cases of newborns with mild asphyxia and severe asphyxia in 11 cases and7 cases of fetal death. Conclusion Pregnant and prenatal care, active control is the key triggers of placental abruption, the proper methods of care is guaranteed to a-chieve the desired therapeutic effect.

  9. Low Neonatal Mortality and High Incidence of Infectious Diseases in a Vietnamese Province Hospital.

    Science.gov (United States)

    Ho, Binh T T; Kruse, Alexandra Y; Le, Hue T H; Cam, Phuong N; Pedersen, Freddy K

    2016-01-01

    Background. Neonatal deaths constitute the majority of child mortality in Vietnam, but studies are scarce and focus on community settings. Methods. During a 12-month period, all sick neonates admitted to a pediatric department in a province hospital were studied. Potential risk factors of death covering sociodemographic factors, pregnancy history, previous neonatal period, and status on admission were registered. The neonates were followed up until discharge or death or until 28 completed days of age if still hospitalized or until withdrawal of life support. The main outcome was neonatal death. Results. The neonatal mortality was 4.6% (50/1094). In a multivariate analysis, four associated risk factors of death were extremely low birth weight (OR = 22.9 (2.3-233.4)), no cry at birth (OR = 3.5 (1.3-9.4)), and cyanosis (OR = 3.3 (1.2-8.7)) and shock (OR = 12.3 (2.5-61.5)) on admission. The major discharge diagnoses were infection, prematurity, congenital malformations, and asphyxia in 88.5% (936/1058), 21.3% (225/1058), 5.0% (53/1058), and 4.6% (49/1058), respectively. In 36, a discharge diagnosis was not registered. Conclusion. Infection was the main cause of neonatal morbidity. Asphyxia and congenital malformations were diagnosed less frequently. The neonatal mortality was 4.6%. No sociodemographic factors were associated with death. Extreme low birth weight, no cry at birth, and cyanosis or shock at admission were associated with death. PMID:27597956

  10. A 12-month prospective survey of perinatal outcome of liveborn neonates in Julu County, China

    Institute of Scientific and Technical Information of China (English)

    MA Li; SUN Bo; LIU Cui-qing; ZHENG Xiu-ling; XIN Shen-fang; JI Zeng-liang; LI Ya-mei; YAN Guo-ping; TIAN Chao-fang; TANG Long-mei

    2010-01-01

    Background Population based epidemiologic study on the main diseases and birth status of liveborn neonates remains scarce in China, especially in rural areas where a large number of neonates are born. The aim of this study was to establish an epidemiological basis of live births in Julu County, a representative of the northern and mid-western parts of China in terms of demography, disease pattern and women and children's health care infrastructure.Methods The perinatal data of all live births were prospectively collected in three participating county-level hospitals from September 1, 2007 to August 30, 2008.Results There were 5822 live births in these hospitals. Among all live births, 53.7% were male and 4.5% were bornprematurely. Mean (SD) birth weight (BW) was (3348±503) g. The low (<2500 g) and very low BW (<1500 g) infants accounted for 3.8% and 0.5% of the total births, with 6.5% as small for gestational age and 2.8% as multi-births.Cesarean section rate was 30.2%, of which 68.6% were elective. There were 745 infants (12.8% of the live births)admitted to local neonatal wards within 7 days of postnatal life, in which 48.3% and 19.3% were due to perinatal asphyxia and prematurity, respectively. The incidences of perinatal aspiration syndrome, transient tachypnea and respiratory distress syndrome were 4.9%, 0.6% and 0.5%, respectively. Neonatal mortality was 7.6%. (44/5822), with 16 in delivery room and 28 in neonatal ward before discharge.Conclusions This study provided a population-based perinatal data of live births and neonatal mortality in a northern China county with limited resources. Neonatal disorders related to perinatal asphyxia remain a serious clinical problem,which calls for sustained education of advanced neonatal resuscitation and improvement in the quality of perinatal-neonatal care.

  11. MATERNAL AND FETAL OUTCOME IN PREGNANCIES WITH SLE - A PROSPECTIVE STUDY OF 40 CASES

    Directory of Open Access Journals (Sweden)

    Menon Nalini

    2015-03-01

    Full Text Available Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES : T o find out 1 T he most common complications and their incidence . 2 M aternal and fetal outcome in SLE patients during pregnancies. Study design; Prospective observational study. MATERIALS AND METHODS : Patients are enrolled for the study from pregnant mothers with known as well as newly diagnosed SLE who are attending outpatient department of obstetrics and gynecology department of Institute of maternal and child health, Calicut Government Medical college from 2011 February to 2012 June (18 months . Data collected from available past medical records, interview, physical examination, progress records and laboratory investigations of patients using predesigned profo r ma. RESULTS : Of the total 40 patients enrolled in the study, 45% were in the age group 26 - 30. 25% had one abortion in the past and 2 patients had 3 abortions. 65% had the disease for more than 6 years. Prior to the present pregnancy, 95% patients were in remission. During the present pregnancy 25 % patients had active lupus nephritis and 20% had flare. 25% and 75% patients had gestational diabetes mellitus and hypertensive disorders respectively. The incidence of intra uterine growth retardation was 45%. Placental abruption occurred in 10% pregnancies. The incidence of intrau terine death (25% was higher than that of neonatal deaths (10%. 20% babies had birth asphyxia and the incidence of low birth weight was very high (60%. 10% mothers had flare and 10% babies neonatal lupus. Maternal mortality was 5%. CONCLUSION : The study highlights the increased incidence of complications associated with pregnancies in SLE and thus the need for high quality care for better maternal and

  12. Prophylaxis of neonatal respiratory distress syndrome by intra-amniotic administration of pulmonary surfactant

    Institute of Scientific and Technical Information of China (English)

    张建平; 王英兰; 王蕴慧; 张睿; 陈环; 苏浩彬

    2004-01-01

    Background Neonatal respiratory distress syndrome (NRDS) is caused by a deficiency in pulmonary surfactant (PS) and is one of the main reasons of neonatal mortality. This study was conducted to evaluate the efficacy and safety of intra-amniotic administration of pulmonary surfactant for prophylaxis of NRDS.Methods Forty-five pregnant women who were due for preterm delivery and whose fetuses' lungs proved immature were divided into two groups. Fifteen women (study group) were administered one dose of pulmonary surfactant injected into the amniotic cavity and delivered within several hours. Nothing was injected into the amniotic cavity of 30 women of the control group. The proportion of neonatal asphyxia, NRDS, mortality and the time in hospital were analyzed to determine if there was any difference between the two groups. Results There was no significant difference between the two groups for neonatal asphyxia. Foam tests showed that higher proportion of neonates in the study group than in the control group (56.3% vs 13.3%, P<0.05) had lung maturity. A greater number of control neonates (11/30, 32.3%) had NRDS, compared with the neonates given PS via the amniotic cavity before delivery (1/16, 6.3%, P<0.05). The neonates in the study group spent nearly 10 days less in hospital than the control group [(32.4±7.6) days vs (42.0±15.7) days, P<0.05], but the difference in mortality between the two groups was not statistically significant. Conclusions Intra-amniotic administration of pulmonary surfactant can significantly reduce the proportion of NRDS and the time in hospital of preterm neonates. Whether this method can reduce the mortality of preterm neonates needs to be evaluated further. Intra-amniotic administration of pulmonary surfactant provides an additional effectual means for NRDS prophylaxis.

  13. B超监测羊水性状在孕晚期可疑羊水过少中的应用%B-mode ultrasound monitoring of amniotic fluid character in suspected oligohydramnios during late pregnancy

    Institute of Scientific and Technical Information of China (English)

    李晓峥; 朱科俊

    2016-01-01

    目的::B超监测羊水性状在孕晚期可疑羊水过少中的应用,方法:2012年1月至2014年12月就诊我院系统产检300例患者,比较单纯可疑羊水过少组(150例)与合并羊水浑浊组(150例)的剖宫产率和新生儿窒息率。结果:可疑羊水过少且合并羊水浑浊组发生剖宫产分娩率、新生儿窒息率升高( P<0.01)。结论:B超监测羊水性状为孕晚期可疑羊水过少提供敏感指标,为临床分娩方式选择提供依据。%Objective:To investigate the value of B-mode ultrasound monitoring of amniotic fluid character in suspected oligohydramnios during late pregnancy. Methods:Included in this study were 300 patients subjected to systemic prenatal examination in our hospital between January 2012 and December 2014. These patients were with suspected oligohydramnios alone (n=150) or concomitant amniotic fluid turbidity (n=150). The rates of cesarean section and neonatal asphyxia in these patients were compared. Results: Patients with suspected oligohydramnios and concomitant amniotic fluid turbidity were more likely to have cesarean delivery (P<0.01) and neonatal asphyxia ( P<0.01) . Conclusion:B-mode ultrasound monitoring of amniotic fluid can offer sensitive indicators for suspected oligohydramnios during late pregnancy and evidence for selection of delivery mode.

  14. Influence of prenatal fever on delivery and nursing care%产前发热对产妇分娩的影响及护理

    Institute of Scientific and Technical Information of China (English)

    张慧珠; 郭芳; 何超; 钟俊敏

    2011-01-01

    目的:探讨产前发热对产妇分娩的影响及相应护理方法.方法:将204例分娩前发热产妇作为观察组,进行回顾性病例分析;同时随机抽取同期产前无发热产妇200例作为对照组.分析、比较两组分娩、新生儿窒息及产后出血等情况,并制定出系统护理措施.结果:观察组羊水污染、剖宫产、新生儿窒息发生率明显高于对照组(P<0.01).结论:产妇产前发热对分娩有不良影响,采取针对性的护理方法具有重要临床意义.%Objective:To discuss the influence of prenatal fever on delivery and proper nursing methods. Methods: 204 pregnant women with prenatal fever before delivery were taken as observation group and the clinical history of them was retrospectively analyzed; another 200 randomly selected pregnant women without prenatal fever at the same time were taken as control group. The delivery, neonatal asphyxia and postpartum hemorrhage of those puerperant were compared between the two groups and the systematic nursing measures were implemented. Results: The incidence of amniotic fluid pollution , cesarean section and neonatal asphyxia was significantly higher in the observation group than those in the control group ( P <0. 01 ). Conclusion: The influences of prenatal fever on delivery are obvious and taking appropriate nursing methods has the important clinical significance.

  15. The efficacy of pancreatic kallikrein treatment of early-onset preeclampsia and which impact of patient D-dimmer

    Institute of Scientific and Technical Information of China (English)

    Ying Yu; Min Liu

    2015-01-01

    Objective: To analyze the pancreatic kallikrein treatment of early-onset preeclampsia therapeutic effect and impact on patients D-dimer. Methods: 94 cases of early-onset pre-eclampsia patients were divided into the control group and the observation group. In the control group patients were treated with magnesium sulfate treatment. In the observation group patients were treated with pancreatic kallikrein based on the control group use of common treatment. Results: After treatment, D-dimer levels in serum in the observation group patients were lower than that of the control group, significant differences (P<0.01). After treatment, 24 h urine protein, random urine protein/creatinine ratio in urine in the observation group patients were lower than that of the control group, significant differences (P<0.01). The incidence of severe neonatal asphyxia was 4.26% in the observation group patients were lower than that of the control group was 29.79%, significant differences (P<0.01). After treatment, Pregnancy was prolonged (12.43±4.31) days, gestational age newborns (35.84±2.71) weeks, birth weight (2 564.21±507.19) g in the observation group patients were higher than that of the control group, significant differences (P<0.01). Conclusions: Pancreatic kallikrein treatment of early-onset preeclampsia can effectively improve the treatment, ameliorate the hypercoagulable state and renal function of the patients’ blood, extend the number of days of pregnancy, and reduce the incidence of severe neonatal asphyxia.

  16. A case of impairment of mitochondrial fatty acid beta-oxidation.

    Science.gov (United States)

    Hasegawa, Tomonobu; Hori, Naoaki; Du, Wenlin

    2002-06-01

    We describe a patient with impairment of mitochondrial fatty acid P-oxidation. A Japanese baby boy was delivered in the 38th week of gestation by emergency cesarean section due to fetal asphyxia. His birth weight was 1,985 g (head circumference 31.0 cm (10th percentile). His Apgar scores were 3 and 5 at 1 min and 5 min, respectively. Blood glucose was 12 mg/dl at 1 hour after birth, requiring glucose administration. On day 1 his serum CK was 20,780 IU/l, which was thought to be due to asphyxia. His serum CK levels gradually began to decrease. At 3 months of age, he sucked poorly, had poor body weight gain, and muscle hypotonia was observed. On day 117 his general condition was impaired, and marked hepatomegaly was observed. The blood glucose level was 43 mg/dl. The patient's urine was negative for ketone bodies. His serum triglyceride level was 3,670 mg/dl. Abdominal CT scan revealed a fatty liver. Serum levels of acyl carnitine from very-long chain fatty acid increased. On day 118 he died due to ventricular fibrillation. On necropsy, massive lipid deposition was observed in the liver, cardiac muscle, kidney, skeletal muscle, and intestinal mucosa. The ratio of very-long chain acyl-CoA dehydrogenase (VLCAD) activity for C16/C8 fatty acid was 0.50 (normal control 1.29), suggesting abnormal VLCAD. He was diagnosed as having impairment of mitochondrial fatty acid beta-oxidation, presumably due to the VLCAD deficiency. PMID:12125906

  17. RETROSPECTIVE CLINICAL ANALYSIS OF STILL BIRTH AND NEONATAL DEATHS

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    Uttam

    2014-03-01

    Full Text Available : OBJECTIVE: Aim was to evaluate clinical and associated risk factors for still births and neonatal deaths at tertiary health care centre. METHODS: A retrospective analytical study of new born at birth conducted at tertiary health care centre for three consecutive years. Demographic variables, status of new born at birth, NICU care and neonatal causes of death were analyzed. RESULTS: There were 1072,990,995 births for 2011, 2012, and 2013 year respectively Still births were 30, 36 and 41 and newborn deaths were 15,8,15 for three consecutive years. Mean age of mother was 25.35 yrs standard deviation 4.4. 82 % of still births were preterm. Maximum 67% of still births birth weight was less than 1.5 kg. NICU admission included 51% full term neonate, 44% preterm and 5% post term neonate. Maximum (51% NICU admissions neonatal birth weight was less < 1.5 kg.79% of dead neonates were preterm. Life threatening congenital defects was seen in 26%. Cause of death birth asphyxia 37% hyaline membrane disease 15%. CONCLUSION: Statistically significant mean gestational age of baby with mother was 38.26 weeks (SD 2.260, NICU neonates 36.70 weeks (SD 3.3 and still births 31.34 weeks (SD 4.6. Maternal urinary tract infection, Hypertensive diseases, diabetes mellitus were major reasons for stillbirths. Neonatal mortality from 26% reduced to 8% with increasing birth weight. Major neonatal deaths are because of birth asphyxia, congenital defects. Low Birth Weight and prematurity were overlapping factor for neonatal death. Still birth rate was 35; perinatal mortality rate was 44/1000 live births. Early neonatal mortality rate & Total neonatal mortality rate was 12 /1000 live births each

  18. Early cerebral hemodynamic, metabolic and histological changes in hypoxic-ischemic fetal lambs during postnatal life

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    Carmen eRey-Santano

    2011-09-01

    Full Text Available The hemodynamic, metabolic and biochemical changes produce during transition from fetal to neonatal life could be aggravated if asphyctic event occur during fetal life. The aim of the study was to examine the regional cerebral blood flow (RCBF, histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress for the first hours of postnatal life following severe fetal asphyxia. 18 chronically instrumented fetal lambs were assigned to: hypoxic-ischemic group, following fetal asphyxia animals were delivered and maintained on intermittent-positive-pressure-ventilation for 3 hours, and non-injured animals that were managed similarly to the previous group and used as control group. During hypoxic-ischemic insult, injured group developed acidosis, hypoxia, hypercapnia, latacidaemia and tachycardia in comparison to control group, without hypotension. Intermittent-positive-pressure-ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilation-support, the increased RCBF in inner zones was maintained for hypoxic-ischemic group, but cortical flow did not exhibit differences compared to the control group. Also, the increase of TUNEL positive cells (apoptosis and antioxidant enzymes, and decrease of ATP reserves was significantly higher in the brain regions where the RCBF were not increased.In conclusion, early metabolic, histological and hemodynamic changes involved in brain damage have been intensively investigated and reported in premature asphyctic lambs for the first 3 hours of postnatal life. Those changes have been described in human neonates, so our model could be useful to test the security and the effectiveness of different neuroprotective or ventilatory strategies when are applied in the first hours after fetal hypoxic-ischemic injury.

  19. The role of Omi/HtrA2 protease in neonatal postasphyxial serum-induced apoptosis in human kidney proximal tubule cells

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    Zhang Yong

    2012-01-01

    Full Text Available Omi/HtrA2, a proapoptotic mitochondrial serine protease, is involved in both caspase-dependent and caspaseindependent apoptosis. A growing body of evidence indicates that Omi/HtrA2 plays an important role in the pathogenesis of a variety of ischemia-reperfusion (I/R injuries. However, the role of Omi/HtrA2 in renal injuries that occur in neonates with asphyxia remains unknown. The present study was designed to investigate whether Omi/HtrA2 plays an important role in the types of renal injuries that are induced by neonatal postasphyxial serum. Human renal proximal tubular cell line (HK-2 cells were used as targets. A 20% serum taken from neonates one day after asphyxia was applied to target cells as an attacking factor. We initially included control and postasphyxial serum-attacked groups and later included a ucf-101 group in the study. In the postasphyxial serum-treated group, cytosolic Omi/HtrA2 and caspase-3 expression in HK-2 cells was significantly higher than in the control group. Moreover, the concentration of cytosolic caspase-3 was found to be markedly decreased in HK-2 cells in the ucf-101 group. Our results suggest both that postasphyxial serum has a potent apoptosis-inducing effect on HK-2 cells and that this effect can be partially blocked by ucf-101. Taken together, our results demonstrate for the first time that postasphyxial serum from neonates results in Omi/HtrA2 translocation from the mitochondria to the cytosol, where it promotes HK-2 cell apoptosis via a protease activity-dependent, caspase-mediated pathway.

  20. A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy.

    Science.gov (United States)

    Kyng, Kasper J; Skajaa, Torjus; Kerrn-Jespersen, Sigrid; Andreassen, Christer S; Bennedsgaard, Kristine; Henriksen, Tine B

    2015-05-16

    Birth asphyxia, which causes hypoxic-ischemic encephalopathy (HIE), accounts for 0.66 million deaths worldwide each year, about a quarter of the world's 2.9 million neonatal deaths. Animal models of HIE have contributed to the understanding of the pathophysiology in HIE, and have highlighted the dynamic process that occur in brain injury due to perinatal asphyxia. Thus, animal studies have suggested a time-window for post-insult treatment strategies. Hypothermia has been tested as a treatment for HIE in pdiglet models and subsequently proven effective in clinical trials. Variations of the model have been applied in the study of adjunctive neuroprotective methods and piglet studies of xenon and melatonin have led to clinical phase I and II trials(1,2). The piglet HIE model is further used for neonatal resuscitation- and hemodynamic studies as well as in investigations of cerebral hypoxia on a cellular level. However, it is a technically challenging model and variations in the protocol may result in either too mild or too severe brain injury. In this article, we demonstrate the technical procedures necessary for establishing a stable piglet model of neonatal HIE. First, the newborn piglet (< 24 hr old, median weight 1500 g) is anesthetized, intubated, and monitored in a setup comparable to that found in a neonatal intensive care unit. Global hypoxia-ischemia is induced by lowering the inspiratory oxygen fraction to achieve global hypoxia, ischemia through hypotension and a flat trace amplitude integrated EEG (aEEG) indicative of cerebral hypoxia. Survival is promoted by adjusting oxygenation according to the aEEG response and blood pressure. Brain injury is quantified by histopathology and magnetic resonance imaging after 72 hr.

  1. The success of cardiotocography in predicting perinatal outcome

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    Alpaslan Kaban

    2012-06-01

    Full Text Available Objectives: The determination of the fetal condition duringlabor is important to minimize fetal death due to asphyxiaand the neurological sequelae of fetal hypoxia.This study evaluated the success of fetal cardiotocographyin predicting perinatal consequences.Materials and methods: This study enrolled 101 full-termpregnant women admitted for delivery to Vakif GurebaTraining and Research Hospital between October 2009and February 2010. Women were included if they wereaged 18-45 years and within 36-41 weeks of gestation.During a 20-min period of fetal monitoring, a change inFHR (fetal heart rate lasting for 15 s or two elevated runsof 15 beats was evaluated as a reactive NST (non-stresstest. The umbilical artery pH was used as the “gold standard”for assessing fetal asphyxia.Results: The mean age of the women included in thestudy was 27.82 ± 5.29 years, the average parity was1.09± 0.96. The pH was normal in 85 neonates, while 13 hadfetal asphyxia. No significant difference in umbilical cordblood pH, pO2, or pCO2 was observed between these twogroups (p = 0.497, p = 0.722, and p = 0.053, respectively.No significant difference in maternal age, parity, or birthweight was found between the group with fetal distressbased on CTG (cardiotocography and the normal group.Conclusion: Cardiotocography is an important test duringlabor for labor management, it is insufficient for predictingthe perinatal outcome. Therefore, labor should beevaluated on an individualized basis. J Clin Exp Invest2012; 3(2: 168-171

  2. Nursing experience of the application of fundal pressing midwifery%应用宫底按压助产法的护理体会

    Institute of Scientific and Technical Information of China (English)

    刘玲妹

    2016-01-01

    Objective:To investigate the efficacy of fundal pressing midwifery for vaginal delivery.Methods:62 cases of pregnant women were selected.They were randomly divided into the observation group and the control group with 31 cases in each.The control group received conventional mode of delivery,and the observation group received the uterine bottom pressing midwifery and accept the high quality nursing intervention in childbirth.Results:The second stage of labor time,maternal satisfaction rate, perineal laceration, neonatal asphyxia rate of the observation group were better than those of the control group(P<0.05). Conclusion:The implementation of high quality nursing combined with fundus pressing midwifery can shorten the delivery time, reduce postpartum complications and the rate of neonatal asphyxia,and improve the nursing satisfaction rate.%目的:探讨宮底按压助产法用于阴道分娩的效果。方法:收治产妇62例,随机分为观察组和对照组各31例,对照组实施常规分娩方式,观察组在实施宫底按压助产法的同时接受优质护理干预分娩。结果:观察组第二产程分娩时间、产妇满意率、会阴撕裂率、新生儿窒息情况优于对照组(P<0.05)。结论:实施优质护理措施联合宫底按压助产法,可缩短分娩时间,减少产后并发症及新生儿窒息率,提高护理满意率。

  3. Negative Modulation of NO for Diaphragmatic Contractile Reduction Induced by Sepsis and Restraint Position

    Institute of Scientific and Technical Information of China (English)

    XIANG Jian; GUAN Su-dong; SONG Xiang-he; WANG Hui-yun; GU Zhen-yong

    2014-01-01

    In practice of forensic medicine, potential disease can be associated with fatal asphyxia in re-straint position. Research has demonstrated that nitric oxide (NO) and nitric oxide synthase (NOS) are plentifully distributed in skeletal muscle, contributing to the regulation of contractile and relaxation. In the current study, respiratory functions, indices of diaphragmatic biomechanical functions ex vivo, as well as NO levels in serum, the expressions of diaphragmatic inducible NOS (iNOS) mRNA, and the effects of L-NNA on contractility of the diaphragm were observed in sepsis induced by cecal ligation and punc-ture (CLP) under the condition of restraint position. The results showed that in the CLP12-18 h rats, respiratory dysfunctions; indices of diaphragmatic biomechanical functions (Pt, +dT/dtmax, -dT/dtmax, CT, Po, force over the full range of the force-frequency relationship and fatigue resistance ) declined progressive-ly; the NO level in serum, and iNOS mRNA expression in the diaphragm increased progressively; force increased significantly at all stimulation frequencies after L-NNA pre-incubation. Restraint position 1 h in CLP12 h rats resulted in severe respiratory dysfunctions after relative stable respiratory functions, almost all the indices of diaphragmatic biomechanical functions declined further, whereas little change took place in NO level in serum and diaphragmatic iNOS mRNA expression; and the effects of L-NNA were lack of statistical significance compared with those of CLP12 h, but differed from CLP18 h group. These results suggest that restraint position and sepsis act together in a synergistic manner to aggravate the great reduction of diaphragmatic contractility via, at least in part, the negative modulation of NO, which may contribute to the pathogenesis of positional asphyxia.

  4. Clinical profile, predisposing factors, and associated co-morbidities of children with cerebral palsy in South India

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    Vykuntaraju K Gowda

    2015-01-01

    Full Text Available Introduction: Cerebral palsy (CP is the most common physical disorder of children. Causes like jaundice and birth injury though are decreasing; complications resulting from the survival of low birth weight babies are replacing some of the older etiologies. Hence, this study was planned. Objectives: The objective was to study the clinical patterns, predisposing factors, and co-morbidities in children with CP. Materials and Methods: The present study is a hospital based prospective study conducted from January 2012 to January 2013 in children presenting to neurodevelopmental clinic at a tertiary care teaching hospital in India. Hundred cases with clinical features suggestive of CP were included in the study. Cases were evaluated by history, clinical examination, and necessary investigations. Results: Results of the study showed 81% of spastic, 12% of hypotonic, 5% of dystonic, and 2% of mixed CP cases. The mean age of presentation was 2 year, 2 month, and male to female ratio of 1:2. Pregnancy-induced hypertension (PIH was the most common antenatal complication observed in 6%. Four percent had neonatal sepsis and 19% were born premature. Associated co-morbidities were mental retardation (55%, seizure disorder (46%, visual problems (26%, hearing problems (19%, and failure to thrive (47%. Discussion: Sex distribution observed in our study was male to female ratio of 1.2, which was comparable with a multicenter study in Europe. PIH was observed in 6% of cases, which was comparable with prior studies. Birth asphyxia was observed in 43% of cases. Eighty-one percent of the cases constituted a spastic variety of CP which was comparable to other studies. Conclusion: Perinatal asphyxia was the important etiological factor. We found preventable intranatal causes (60% and antenatal causes (20% forming a significant proportion. Co-morbidities were significantly observed in our study.

  5. Localised proton magnetic resonance spectroscopy of the brain after perinatal hypoxia: a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Chateil, J.F. [Service de Radiologie A, Hopital Pellegrin, Bordeaux (France)]|[Unite de Radiopediatrie, Hopital Pellegrin, Bordeaux (France); Quesson, B.; Thiaudiere, E.; Delalande, C.; Canioni, P. [Resonance Magnetique des Systemes Biologiques, CNRS, Bordeaux (France); Brun, M.; Diard, F. [Service de Radiologie A, Hopital Pellegrin, Bordeaux (France); Sarlangue, J.; Billeaud, C. [Service de Neonatalogie, Hopital Pellegrin, Bordeaux (France)

    1999-03-01

    Objectives. Perinatal hypoxic ischaemic injury is a significant cause of neurodevelopmental impairment. The aim of this study was to evaluate localised proton magnetic resonance spectroscopy ({sup 1}H-MRS) after birth asphyxia. Materials and methods. Thirty newborn infants suspected of having perinatal asphyxia (Apgar score < 3) were studied. The mean gestational age was 37 weeks, mean age at the MR examination was 18 days and mean weight was 2.9 kg. A 1.5-T unit was used for imaging and spectroscopy. None of the babies had mechanically assisted ventilation. No sedation was used. Axial T1-weighted and T2-weighted images were obtained. {sup 1}H-MRS was recorded in a single voxel, localised in white matter, using a STEAM sequence. Results. Image quality was good in 25 of 30 babies. {sup 1}H-MRS was performed in 19 of 30 subjects, with adequate quality in 16. Choline, creatine/phosphocreatine and N-acetylaspartate peaks and peak-area ratios were analysed. Lactate was detected in four infants. The N-acetylaspartate/choline ratio was lower in infants with an impaired neurological outcome, but the difference was not statistically significant. Conclusions. This study suggests that {sup 1}H-MRS may be useful for assessing cerebral metabolism in the neonate. A raised lactate level and decreased N-acetylaspartate/choline ratio may be predictive of a poor outcome. However, in our experience this method is limited by the difficulty in performing the examination during the first hours after birth in critically ill babies, the problems related to use of a monovoxel sequence, the dispersion of the ratios and the lack of determination of the absolute concentration of the metabolites. (orig.) With 3 figs., 2 tabs., 20 refs.

  6. Evaluation of a cluster-randomized controlled trial of a package of community-based maternal and newborn interventions in Mirzapur, Bangladesh.

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    Gary L Darmstadt

    Full Text Available BACKGROUND: To evaluate a delivery strategy for newborn interventions in rural Bangladesh. METHODS: A cluster-randomized controlled trial was conducted in Mirzapur, Bangladesh. Twelve unions were randomized to intervention or comparison arm. All women of reproductive age were eligible to participate. In the intervention arm, community health workers identified pregnant women; made two antenatal home visits to promote birth and newborn care preparedness; made four postnatal home visits to negotiate preventive care practices and to assess newborns for illness; and referred sick neonates to a hospital and facilitated compliance. Primary outcome measures were antenatal and immediate newborn care behaviours, knowledge of danger signs, care seeking for neonatal complications, and neonatal mortality. FINDINGS: A total of 4616 and 5241 live births were recorded from 9987 and 11153 participants in the intervention and comparison arm, respectively. High coverage of antenatal (91% visited twice and postnatal (69% visited on days 0 or 1 home visitations was achieved. Indicators of care practices and knowledge of maternal and neonatal danger signs improved. Adjusted mortality hazard ratio in the intervention arm, compared to the comparison arm, was 1.02 (95% CI: 0.80-1.30 at baseline and 0.87 (95% CI: 0.68-1.12 at endline. Primary causes of death were birth asphyxia (49% and prematurity (26%. No adverse events associated with interventions were reported. CONCLUSION: Lack of evidence for mortality impact despite high program coverage and quality assurance of implementation, and improvements in targeted newborn care practices suggests the intervention did not adequately address risk factors for mortality. The level and cause-structure of neonatal mortality in the local population must be considered in developing interventions. Programs must ensure skilled care during childbirth, including management of birth asphyxia and prematurity, and curative postnatal

  7. The effect of non-infectious diseases on serum procalcitonin concentrations in premature neonates%非感染因素对早产新生儿血清降钙素原浓度的影响

    Institute of Scientific and Technical Information of China (English)

    吴志新; 郭婕; 许靖; 武荣; 花少栋; 封志纯

    2015-01-01

    Objective To study the effect of non-infectious factors on serum procalcitonin(PCT) in preterm neonates.MethodThe premature infants of neonatal intensive care unit(NICU) in our hospital were chosen from gestational age ranged from 33 to 36 weeks, birth time less than 12 hours without premature rupture and hospitalization period from January 2012 to December 2012. All of the premature infants were drawn blood immediately admitted to hospital and C-reactive protein (CRP), blood cultures and procalcitonin were tested. The types of premature infants non-infectious diseases included intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and the control group (preterm infants) without disease. The blood routine , C-reactive protein, blood culture, procalcitonin and other infections indicators in each group were monitored dynamicly in order to study the impact of these non-infectious diseases on serum procalcitonin concentrations by statistical analysis.Results ① Compared with the current literature recommended serum procalcitonin concentrations (<0.5ng / ml), procalcitonin concentrations in preterm neonates singniifcantly increase (1.07± 0.76) ng / ml.②Compared with control group (1.07±0.76) ng/ml,the procalcitonin levels in intracranial hemorrhage group (2.12± 0.99) ng/ml, neonatal respiratory distress syndrome group (2.28±1.09) ng/ml and asphyxia group (3.64± 3.17) ng / ml signiifcantly increased (F= 10.462,P <0.05).There were no signiifcant differences (F= 0.173,P= 0.950) among the different levels of intracranial hemorrhage group; Compared with the ifrst grade NRDS , the procalcitonin leves in second grade and third grade NRDS groups were significantly increased (F=5.475,P= 0.010); The procalciton level in severe asphyxia group was signiifcantly higher than in mild asphyxia group (t= 5.245,P= 0.003). Conclusions The procalcitonin concentration physiologically increased after preterm neonates were born. Many factors

  8. 人文关怀在产科宫底按压助产法实施中的价值分析%Analysis of the value of humanistic care of the fundal pressing delivery method in the obstetric midwifery

    Institute of Scientific and Technical Information of China (English)

    杜丽

    2014-01-01

    Objective:To investigate the value of humanistic care of the fundal pressing delivery method in the obstetric midwifery. Methods:498 cases of maternal childbirth were pressed by fundus midwifery method for the treatment were selected from 2012 to 2013.They were randomly divided into the first group and the second group.The first groups of maternal were given the routine care in general,and the second group were given humanistic care.We recorded the birth outcomes and the adverse reactions after delivery and its causes,and also recorded a variety of production conditions on newborn.Finally,we compared and analyzed the records of two groups of maternal and neonatal.Results:The second groups take humanistic care nursing mothers had 2 cases of perineal wound dehiscence side continued,and the first group to conventional nursing and midwifery were occurred in 10 cases of perineal wound dehiscence side extension,and 2 cases of perineal wound dehiscence phenomenon serious.The difference between the two groups was significant maternal condition.In contrast to that of the neonates in the two groups, two groups were smooth production.The second group took the humanistic care delivery of the newborn in 2 cases had mild asphyxia,1 cases with severe asphyxia.While the first group received routine nursing and midwifery neonates there were 12 cases of mild asphyxia,3 cases appeared the phenomenon with severe asphyxia.Contrasting the differences between the two groups of neonatal visible was also more obvious.Conclusion:Taking fundal pressing midwifery in women in childbirth,the humanistic nursing care can reduce maternal pain itself and neonatal asphyxia rate than the routine nursing care,with the promotion and popularization in clinical significance.%目的:探讨人文关怀在产科宫底按压助产法实施中的价值。方法:2012-2013年收治通过宫底按压助产法进行分娩治疗的产妇498例,将产妇按照随机的方式分为第一组

  9. Frequency of Hypoxic-Ischemic Encephalopathy Among Hospitalized Neonates in West Iran

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    Fatemeh Eghbalian

    2010-06-01

    Full Text Available Hypoxic-ischemic encephalopathy (HIE is brain damage from a shortage of oxygen or blood flow to the tissues[1,2] and is characterized by clinical and laboratory evidence of acute or subacute brain injury due to asphyxia[1-6]. It is a major contributor to neonatal death and morbidity[4-6]. 15%-20% of HIE cases die during the neonatal period and 30% of those who survive suffer from neurodevelopmental disorders[1,3,6].An estimated 23% of the 4 million neonatal deaths and 8% of all deaths at <5 years of age throughout the world each year are associated with signs of asphyxia at birth[1,4]. Even at referral centers in developed countries, death or moderate to severe disability occurs for 53% to 61% of infants diagnosed as having moderate to severe HIE[1,4,6]. Children with moderate/severe neonatal encephalopathy are at risk for reduced school performance, whereas those with mild encephalopathy have school performance scores similar to those of their peers[1,6]. HIE is one of the most common causes of cerebral palsy and other severe neurologic deficits in children occurring in two to nine of every 1000 live births [1-6]. The incidence of HIE reported in different studies varies widely[2-6], which may be explained by the selection criteria for studies of HIE during the neonatal period[3,4].The aim of the present study was to evaluate the frequency of hypoxic-ischemic encephalo-pathy in hospitalized neonates with seizure in Hamedan (west Iran in a two year period.This is a retrospective cross sectional study on 34 neonates from 2004 to 2006.Inclusion criteria were: all neonates with seizures due to HIE asphyxia having pH below 7, 5th minute Apgar score between 0 and 3, decreased muscle tone and consciousness, cortical atrophy in brain CT scan and multiple organ involvement (eg, kidney, lungs, liver, heart, intestines. Neonates with jitteriness were excluded from the study.The study was based on the recorded files of the patients. CT scan findings, blood

  10. 凶险型前置胎盘65例临床分析%CLINICAL ANALYSIS OF 65 CASES OF PERNICIOUS PLACENTA PREVIA

    Institute of Scientific and Technical Information of China (English)

    季淑英; 姬明杰; 李桂荣; 冯小明; 杨小杰

    2014-01-01

    Objective To analyze the clinical characters of pernicious placenta previa ,and to prepare well pre-operation ,choose appropriate operation manner ,reduce intraoperative blood loss ,decrease the proba-bility of metrectomy .Methods A retrospective analysis in 65 cases with pernicious placenta previa was performed ,the data of placenta accrete ,the rate of neonatal asphyxia ,probability of metrectomy and intra-operative blood loss were collected .The operation manner was chosen according to the characters of the placenta previa ,comparison of the probability of metrectomy and intraoperative blood loss between cases with different operation manner were performed .Results Forty -five from a total of 65 cases occurred placenta accrete ,7 cases of neonatal asphyxia and 6 cases of metrectomy .A total of 65 cases with perni-cious placenta previa were divided into 4 groups according to the treatment ,45 cases occurred placenta ac-crete ,7 cases of neonatal asphyxia and 6 cases of metrectomy .The intraoperative blood loss ,rate of me-trectomy and complication of maternal (DIC ,death) in group C ,which were treated by lower segment ce-sarean section after bilateral uterine artery chemoembolization induced by radiation ,were significantly lower than those from other 3 groups .Conclusion Pernicious placenta previa heavily threatens maternal ,a con-firmed preoperative diagnosis is necessary ,well preparation before operation and rescue measure for intrao-perative bleeding ,and interventional embolization w hen needed ,can reduce the complication and maternal mortality .%目的:分析凶险型前置胎盘的临床特点,如何充分术前准备,据病情选择适当的手术方式,减少术中出血,降低子宫切除几率。方法对65例凶险型前置胎盘病例胎盘植入情况、新生儿窒息率、子宫切除几率、术中出血情况等多项指标进行回顾性分析,根据术中胎盘前置及植入情况选择不同处理方式,并比较各种处

  11. 自然分娩中限制会阴切开的应用%Restrictive use of episiotomy during spontaneous vaginal delivery

    Institute of Scientific and Technical Information of China (English)

    李玉玲; 郭培奋; 孔欣; 彭翠霞

    2012-01-01

    Objective To compare the maternal and neonatal outcomes of restrictive use of episiotomy (only if tearing becomes apparent) versus routine episiotomy (in all cases) . Methods 314 nulliparous women at ≥37 weeks of gestation with live singleton cephalic pregnancies and no contraindication to vaginal birth, who were recruited from November 2010 to March 2011 in this department, received restrictive use of episiotomy while 739 nulliparous women from January to November in 2010 underwent episiotomy as control group. In both groups, we strengthened cardiotocograph mornitoring and intrapartum care and improved the management of the perineum ( hand on or hand off) . Total duration of labor including the first and the second stages of labour, and blood loss in 2 hours postpartum were recorded as a continuous variable. Apgar scores and anal sphincter (third or fourth degree) tears were also recorded. Results No significant difference was observed in each stage of labour between the two groups (P > 0. 05) . Restrictive use of episiotomy resulted in more blood loss than in the control group (P <0. 01) . Since the cases with severe perineum tear and neonatal asphyxia in both groups were rare, they were excused from Fisher' s exact test. However, the rate of neonatal asphyxia was a little higher in restrictive use group. Conclusions According to this clinical observation, the rate of episiotomy should and could be properly reduced, as the routine and restritive use of episiotomy results in no significant difference in labor duration, anal sphincter tear or neonatal asphyxia.%目的 探索头位初胎自然分娩中实施"限制会阴切开"对产程、严重会阴裂伤、新生儿出生评分的影响.方法 自然分娩头位足月初产妇314例作为限制会阴切开组,加强产程观察、产时对胎儿胎心率监测及改进接产手法,对具有明确会阴侧切适应证者实施会阴切开助产,对于无必要者则严格限制会阴切开;以常规会阴切开

  12. 对助产士进行新生儿窒息复苏规范化培训后的效果观察%Efficacy observation of standardized neonatal resuscitation training on midwives

    Institute of Scientific and Technical Information of China (English)

    李彩霞

    2014-01-01

    Objective:To investigate the influence the Standardized neonatal resuscitation training on midwives on newborn resuscita -tion success.Methods:2120 neonates from May.2011 to Dec.2011 of our hospital were chosen as the control group , 2016 neonates from May 2012 to Dec.2012 in our hospital were chosen as the observation group .The control group were not given neonatal resuscitation train-ing on midwives , while the observation group were given .The asphyxia and resuscitation success rate of two groups were observed .Re-sults:The neonatal asphyxia rate of observation was 1.14%(30 cases), which was obviously lower than the control group (3.67%,74 ca-ses).The resuscitation success rate of observation group was 93.3%(28 cases), which was significantly higher than the control group (81.08%, 60 cases).Conclusion:Standardized neonatal resuscitation training on midwives , which could reduce the neonatal asphyxia rate, improve the resuscitation success rate , and had important significance on improving neonatal motility and improving neonatal survival quality, which could be worth of promoting .%目的:探讨对助产士进行新生儿窒息复苏规范化培训后对新生复苏成功的影响。方法:收集2011年5~12月我院出生的新生儿2120例作为对照组,2012年5~12月我院出生的新生儿2016例作为观察组。对照组新生儿的助产士未进行窒息复苏培训,观察组新生儿的助产士规范化新生儿窒息复苏培训。观察2组新生儿窒息率及复苏成功率。结果:观察组新生儿窒息发生率为30例,占1.41%,显著低于对照组的74例占3.67%。观察组复苏成功率28例占93.3%,显著高于对照组60例占81.08%。结论:对助产士进行新生儿窒息复苏培训有利于降低新生儿窒息率,提高复苏成功率,对提高新生儿存活率,降低其死亡率有重要意义,值得临床推广应用。

  13. 分娩期的心理分析及护理干预对分娩结局的影响%Analysis on psychological state of woman during delivery and significance of nursing intervention

    Institute of Scientific and Technical Information of China (English)

    赵晴雅

    2015-01-01

    目的:分析产妇分娩期各产程的心理状态,探讨对其实施护理干预的作用和意义。方法选择2012年1月至2013年1月足月单胎初产妇无妊娠合并症和合并内外科疾病的,分为实验组和对照组各100例,实验组在常规宣教的基础上针对性分析产妇分娩各期的心理需求并进行护理干预。对照组采取常规宣教护理。观察比较两组产妇分娩方式,产后出血率及新生儿窒息率。结果两组相比较,实验组剖宫产率,产后出血率及新生儿窒息率较对照组降低,P<0.05,具有统计学意义。结论针对分娩期对初产妇实施产前产时产后的心理分析并给予护理干预,促进产妇能积极主动配合医务人员的各种治疗护理,使产妇安全度过分娩期,降低手术产率,产后出血率,新生儿窒息率等有非常重要的作用。%Objective To analyze the psychological state of labor, discuss the function and significance of the implementation of nursing intervention.Methods January, 2012 to January 2013, singletons first-time mothers without full term pregnancy complications and merging of local disease, divided into experimental group and the control group (n=60), the experimental group on the basis of conventional education evaluation of lying-in woman's psychological needs and nursing intervention.Control group take routine mission of nursing.Compare two groups of puerpera childbirth way, the total labor time, the rate of postpartum hemorrhage and neonatal asphyxia rate.Results Compared two groups, experimental group cesarean section rate and the total labor time, the rate of postpartum hemorrhage and neonatal asphyxia rate than the control group decreased, P<0.05, with statistical significance.Conclusions In view of the intrapartum for primipara antenatal psychological analysis of postpartum nursing, and give the promotion can actively cooperate with the medical staff of maternal care, maternal safety

  14. Analysis of related factors influencing the prognosis of women with severe pre-eclampsia and their perinatal fetuses%影响重度子痫前期孕妇及围产儿预后的相关因素

    Institute of Scientific and Technical Information of China (English)

    张红卫; 王琪; 吴静

    2010-01-01

    Objective To investigate related factors influencing the prognosis of women with severe preeclampsia and their perinatal fetuses. Methods Data of 157 women with severe pre-eclampsia from Beijing Obstetrics and Gynecology Hospital were retrospectively collected. Risk factors affecting the outcomes of the subjects and their perinatal fetuses were analyzed by logistic stepwise regression model. Results Hypertension while admission was found related to complications at pregnancy termination. The risk of occurrence of complications in pregnant women with severe hypertension was 3. 147 ( 95% CI: 1.483~6. 679) times higher than those with mild hypertension. Pregnancy termination at 32 - 36 weeks of gestation was a protective factor of neonatal asphyxia. Incidence of neonatal asphyxia in subjects of 32~36 weeks of gestation was significantly lower than in those of less than 27 weeks ( OR =0. 026, 95% CI:0. 004~0. 169). Conclusions For women with severe pre-eclampsia, hypertension while admission was a risk factor for their prognosis, and pregnancy termination at 32~36 weeks of gestation was a protective factor of neonatal asphyxia.%目的 了解影响重度子痫前期孕妇及围产儿预后的相关因素.方法 采用以医院为基础的方法 收集回顾性资料,共纳入157例研究样本.采用SAS8.2对孕产儿结局的危险因素进行单因素分析和多因素Logistic回归分析.结果经单因素和多因素分析,入院时血压与妊娠终止时孕妇的并发症有关,重度高血压孕妇发生并发症的危险是轻度高血压孕妇的3.147倍(95%CI:1.483~6.679).32~36孕周终止妊娠是新生儿窒息发生的保护因素,期间所产新生儿窒息发生的危险是≤27孕周的0.026倍(95%CI:0.004~0.169).结论 重度子痫前期孕妇的入院时血压情况(重度高血压)是孕妇预后的危险因素,32~36孕周终止妊娠是围产儿并发症发生的保护因素.

  15. Effect for Parturient Fetal Distress in Term Pregnancy by Delivery Mode on Pregnancy Outcome%足月妊娠临产胎儿窘迫中分娩方式对母婴结局影响的探讨

    Institute of Scientific and Technical Information of China (English)

    马艳分

    2015-01-01

    Objective: To investigate the inlfuence of pregnancy parturient fetal distress in ful-term fetal delivery mode on maternal and neonatal outcomes.Methods: 131 cases of fetal distress in labor of full-term pregnancy, according to fetal production methods are divided into 2 groups, 62 cases in the control group, the average age of (26.94±3.17) years old, mean gestational age (39.37±3.94) weeks, using vaginal delivery; 69 cases in observation group, the average age of (27.53±2.88) years old, average pregnancy (39.61±4.02) weeks, by cesarean section. Observation on Parturients and newborns may cause factors of fetal distress, neonatal Apger score evaluation, asphyxia, pneumonia and death incidence.Results:In the observation group, the umbilical cord reasons inlfuencing the incidence of fetal distress, neonatal asphyxia and cranial hematoma or injury incidence was signiifcantly lower than the control group,P0.05).Conclusion:Using fetal the appropriate mode of delivery can reduce the parturient term pregnancy with fetal distress, neonatal asphyxia of perinatal mortality.%目的:探讨足月妊娠临产胎儿窘迫中胎儿分娩方式对母婴结局的影响。方法:足月妊娠临产胎儿窘迫病例131例,按胎儿生产方式分为2组,对照组62例,平均年龄(26.94±3.17)岁,平均孕期(39.37±3.94)周,采用阴道助产术;观察组69例,平均年龄(27.53±2.88)岁,平均孕期(39.61±4.02)周,采用剖宫产。观察产妇及新生儿可能导致胎儿窘迫的因素,评估新生儿的Apger 评分、窒息、肺炎及死亡等发生率。结果:观察组脐带原因影响胎儿窘迫的发生率、新生儿窒息和头颅血肿或损伤发生率明显低于对照组,P<0.05;两组胎膜早破、羊水过少和产程延长、肺炎、其他并发症和死亡、新生儿症状改善等结果比较差异无统计学意义(P>0.05)。结论:采用合适的胎儿生产方式可减少足月妊娠临产胎儿窘

  16. 加强助产护理对高龄产妇分娩的影响分析%Analysis of Effect of Strengthening Midwifery Care for Older Maternal Childbirth

    Institute of Scientific and Technical Information of China (English)

    黄雪霞

    2015-01-01

    Objective:To study and observe the effect of midwifery care in older maternal childbirth. Method:105 cases of advanced maternal age were collected, according to the odd and even numbers of maternal admission date number 52 cases for control group and 53 patients for the observation group, the control group received routine nursing care, the observation group added midwifery on the basis of the routine nursing care, the natural yield of two groups of puerperas, natural birth average amount of bleeding, neonatal asphyxia occurred rate and forceps delivery rate, time of the first labor, the second stage of labor time, the producing process, total labor time, splits the palace production causes were observed and compared.Result:Maternal natural yield of the observation group was significantly higher than that of the control group;maternal natural average amount of bleeding,maternal neonatal asphyxia incidence and aternal forceps delivery rate of the observation group were significantly lower than those of the control group;maternal labor time, time of the second stage of labor, the labor, the total labor time of the observation group were significantly shorter than those of the control group, maternal cesarean section rate of the observation group was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:In the delivery process of advanced maternal age,strengthen nursing and midwifery can effectively reduce production when the amount of bleeding and improve the efficiency of natural childbirth, reduce the rate of cesarean section,reduce the rate of neonatal asphyxia, is conducive to maternal and child health,and is worthy of popularization and application.%目的:研究和观察在高龄产妇的分娩过程中使用助产护理的效果.方法:收集高龄产妇共105例,根据产妇入院日期的单双号数分为对照组52例和观察组53例,对照组产妇接受常规护理,观察组在此基础

  17. Analysis on death of children under five years and interventional measures in Guyuan city from 2006 to 2009%固原市2006~2009年度5岁以下儿童死亡分析及干预措施

    Institute of Scientific and Technical Information of China (English)

    惠芳; 海霞

    2012-01-01

    Objective: To explore the causes, current situation, change trend and regularity of related factors of death of children under five years in Guyuan city, provide a theoretical basis for making health policies to reduce the mortality of children under five years and infantile mortality. Methods; The monitoring data of the children under five years in Guyuan city from 2006 to 2009 were summarized and analyzed. Results; Among the dead children, the proportion of infantile death, especially neonatal death was higher. Among 1 967 dead children, the proportion of neonatal death was 66. 4% ( 1 307 neonates) . The main causes of death included premature delivery, low birth weight, and birth asphyxia. Conclusion; To reduce the mortality of children under five years and infantile mortality, perinatal health care should be enhanced, the quality of systematical and standard management of maternal and child health care works should be improved. Congenital heart disease and other congenital abnormalities become the risk factors affecting the survival and development of the children under five years. Pregestational and gestational health education should be strengthened, various factors inducing congenital abnormalities should be intervened and prevented timely to reduce birth defects. Premature delivery and asphyxia should be prevented, the construction of obstetrical department should be enhanred, the quality of obstetrical department should be improved, the intrapartum monitoring should be normalized, and the occurrence of neonatal asphyxia should be prevented. Perfecting systematical management of children and preventing, controlling the occurrence of corresponding diseases and death may achieve the goal of reducing the mortality of children.%目的:探究固原市5岁以下儿童的死亡原因、现状、相关因素变化的趋势与规律,为制定降低5岁以下儿童死亡率和婴儿死亡率的卫生政策提供理论依据.方法:对2006~2009年固原市连续4

  18. Impact of Doula accompany delivery combined with administration of drugs on birth process and neonates%Doula陪伴分娩联合药物对产妇产程及新生儿的影响

    Institute of Scientific and Technical Information of China (English)

    高爱荣

    2012-01-01

    目的:探讨药物联合Doula陪伴分娩对经阴分娩产妇产程及新生儿的影响.方法:选取在我院定期做产前检查并且入院后经全身检查没有剖宫产指征拟阴道分娩者的240例,随机抽取120例作为观察组,进行Doula陪伴分娩联合药物干预,其余120例作为传统模式分娩组,给予药物治疗及常规护理.观察两组产妇的产程、产后出血量及新生儿窒息率.结果:观察组第一产程、第二产程时间均短于对照组;观察组产后出血量(105.92±11.74)ml,对照组(125.67±12.13) ml;观察组产后出血量低于对照组;观察组新生儿窒息率0.83%,对照组为6.67%.以上结果两组比较差异有统计学意义(P<0.05).结论:Doula陪伴分娩联合药物大大缩短了产程,减少了产后出血情况,降低了新生儿窒息率,有利于母婴健康,是一种值得提倡的新的分娩方式.%Objective: To investigate the impact of Doula accompany delivery combined with administration of drugs on birth process and neonates. Methods: 240 parturient who had regular prenatal examination in our hospital and would have vaginal delivery, without an)' indications for cesarean section after systemic examination, were randomly divided in to the observation group and the conventional delivery group ( 120 parturient in each group ). Doula accompany delivery combined with pharmacological interventions was adopted in the observation group and the parturient in the conventional delivery group received medication and routine nursing care. The birth process, postpartum hemorrhage and the incidence of neonatal asphyxia were observed in the two groups. Results:The first and second stage of labor was shorter in the observation group than the control group; postpartum hemorrhage was ( 105. 92 ± 11. 74 ) ml in the observation group and ( 125. 67 ± 12. 13 ) ml in the control group;the incidence of neonatal asphyxia was 0. 83% in the observation group and 6. 67% in the control group, the

  19. Death analysis and mortality prediction in children under 5 from 2006 to 2012 in Zhabei District, Shanghai%上海市闸北区2006-2012年5岁以下儿童死亡分析及死亡率预测

    Institute of Scientific and Technical Information of China (English)

    张国慧; 万秋萍; 权力

    2014-01-01

    [目的]在分析上海市闸北区2006-2012年5岁以下儿童死因的基础上,运用灰色模型GM(1,1)预测闸北区5岁以下儿童死亡率的变化趋势。[方法]对近5年的监测资料进行死因分析,并使用灰色模型( GM )进行拟合、预测死亡率。[结果]闸北区2006-2012年5岁以下儿童死亡以婴儿死亡为主,婴儿死亡以新生儿死亡为主。5年间5岁以下儿童死亡率为3.30‰~4.98‰,2010年略有上升。2006-2012年,新生儿期主要死亡原因为出生窒息,占31.82%。婴儿期主要死亡原因为其他先天异常,占30.43%,出生窒息为第2位,占20.29%。 GM拟合效果好,2013年预测死亡率为3.88‰。[结论]先天异常、出生窒息和意外死亡严重威胁闸北区5岁以下儿童的生命,必须加大新生儿筛查力度,普及新生儿意外死亡的宣教,从而有效降低5岁以下儿童死亡率。灰色模型GM(1,1)对5岁以下儿童死亡率的拟合效果好,可以应用于预测。%Objective] By the use of GM(1,1) model to predict mortality trends of children un-der 5 years, on the basis of the analysis of cause of death in children under 5 from 2006 to 2012 in Zhabei District of Shanghai City . [ Methods] Nearly 5 years of monitoring data were used for analysis of the cause of death , and the grey model ( GM) was used to fit and predict mortality . [ Results] The death of children under 5 was mainly infant death and the infant death was mainly newborns death from 2006 to 2012 in Zhabei District.During this five-year period, children mortality under 5 fluctuated from 3.30‰ to 4 .98‰and was slightly increased in 2010 .The main cause of death in the neonatal period was birth as-phyxia ,accounting for 31 .82%.For infant period , The first cause was congenital anomaly , accounting for 30.43% and the second cause was birth asphyxia ,accounting for 20.29%.The fitting effect of GM was fine and the predicted

  20. 2000~2010年哈尔滨市婴儿死亡趋势分析%Trend analysis on infantile death in Harbin city from 2000 to 2010

    Institute of Scientific and Technical Information of China (English)

    刘丽; 王春华; 吴晶; 李佳; 武丽杰

    2013-01-01

    Objective: To grasp the characteristics, rank order, and change trend of infantile death in Harbin city, and reduce infantile mortality. Methods: The data were collected and arranged according to Death Monitoring Proposal of Children below Five Year Old in China; the diagnosis and classification of infantile death were conducted according to ICD - 10. Results: The infantile mortality from 2001 to 2010 showed a decreasing trend in the whole (P <0. 05) ; from 2000 to 2010, early neonatal death accounted for 82. 95% of neonatal death, neonatal death accounted for 77. 73% of infantile death, infantile death accounted for 85. 10% of children death under five years old, the proportions didnt change obviously from 2000 to 2010; preterm low birth weight was the top cause of infantile death. The top five causes of infantile death included preterm low birth weight, congenital heart disease, neonatal asphyxia, congenital abnormalities, and pneumonia. From 2000 to 2010, the proportion of neonatal asphyxia decreased from 14. 88% to 9. 24%. Conclusion: The infantile mortality showed a decreasing trend in the whole, preterm low birth weight was still the first cause of infantile death, congenital heart disease was the second cause from 2006 to 2010. Neonatal asphyxia was the third cause of infantile death from 2000 to 2010, but the proportion showed a significant decreasing trend. Reducing neonatal mortality especially early neonatal mortality is the key point to reduce infantile mortality.%目的:掌握哈尔滨市婴儿死亡特点、死因顺位及变化趋势,降低婴儿死亡率.方法:按照《中国5岁以下儿童死亡监测方案》的要求进行资料的收集和整理.死亡诊断和分类依据国际疾病分类标准(ICD-10)进行分类和评价.结果:①2001~2010年婴儿死亡率变化趋势:婴儿死亡率总体呈下降趋势(P<0.05);②2000~2010年11年间早期新生儿占新生儿死亡82.95%,新生儿占婴儿死亡77.73%,婴儿死亡占5

  1. 胎心率监护在高危妊娠中的应用%Applicationofthefetalheartratemonitorinthehigh-riskpregnancy

    Institute of Scientific and Technical Information of China (English)

    于清玲; 刘红秀; 彭玉兰; 彭妮莎

    2013-01-01

    Objective To explore the clinical effects of the fetal heart rate monitor in a high-risk pregnancy to monitor fetal. Methods The pregnant women were used the fetal heart rate monitor to tutelage when they were in the ante partum and intrapartum,68 cases were being the Non stress test,48 cases were being the contyaction stress test and oxytocin challenge test. Results In NST68 cases,the reaction type with 63 cases accounting for 92.65%,the unresponsive type with 5 cases accounting for 7.35%.In CST + in OCT48 cases,43 cases were negative accounting for 89.58%,5 cases were positive accounting for 10.42%.NST reaction type of high-risk pregnancy maternal fetal distress,neonatal asphyxia,operative delivery were significantly lower than the NST reactive high-risk pregnant women (P < 0.05),the CST + OCT negative high-risk pregnancy maternal fetal Palace inner distress,neonatal asphyxia,and operative delivery rate was significantly lower than the CST + OCT positive risk pregnancy women (P < 0.05). Conclusion Fetal heart rate the electronic detection of abnormal fetal heart rate monitor high-risk pregnant women can increase early detection of fetal hypoxia,reduce the incidence of neonatal asphyxia and premature birth,and improve the success rate of Threatened fetus,reducing preinstall children mortality.%  目的探讨胎心率监护仪在高危妊娠中监测胎儿宫内情况的临床效果。方法采用胎儿心率电子监护仪对高危妊娠孕妇进行产前、产时监护,其中行无负荷试验(NST)68例,宫缩应激试验(CST)和催产素激惹试验(OCT)48例。结果NST 68例中反应型63例占92.65%,无反应型5例占7.35%,CST+OCT 48例中阴性43例占89.58%,阳性5例占10.42%。NST反应型的高危妊娠孕妇胎儿宫内窘迫、新生儿窒息发生率、手术产率均明显低于NST无反应型的高危妊娠孕妇(P<0.05),CST+OCT阴性的高危妊娠产妇其胎儿宫内窘迫、新生儿窒息发生率及手术产

  2. 一对一责任制助产对产妇分娩的影响%Influence of one-to-one responsibility midwifery for maternity

    Institute of Scientific and Technical Information of China (English)

    韩燕敏

    2014-01-01

    Objective In order to better maternal childbirth, analysis the one-to-one responsibility system and traditional midwifery model of assisted birth's influence on the Puerperal childbirth. Methods in the Past two years in our hospital 200 cases of Puerperal childbirth, its randomly divided into control group and observation group, an average of 100 People in each group, the observation groups was given one-to-one responsibility midwifery, the control group given traditional midwifery model childbirth, comparison and analysis the effect of two groups of Puerperal childbirth. Results The maternal, SAS, SDS score (34.88±3.44) Points score of observation groups significantly lower than the control group(27.45+1.87) Points of maternal SDS score(53.45 ±4.22), SAS score(58.22 ±2.18), the experimental groups of maternal Postpartum haemorrhage amount mL(248.30±80.70) and neonatal asphyxia was significantly lower than the control groups 26.00% of maternal Postpartum haemorrhage amount mL (402.30 ±145.60) and neonatal asphyxia rate 50.00%, and two groups have significant difference, statistically significant (P<0.05). Conclusion The implementation of one-on-one responsibility midwifery, maternal Psychological state, blood loss, incidence of neonatal asphyxia significantly lower than the traditional midwifery model.%目的:分析一对一责任制助产与传统助产模式对产妇分娩的影响。方法选取近2年在我院分娩的200例产妇,随机将其分为对照组和观察组,平均每组100例。观察组给予一对一责任制助产,对照组给予传统助产模式,对比分析2组产妇分娩效果。结果观察组产妇SDS评分(34.88±3.44)分、SAS评分(27.45±1.87)分,明显低于对照组产妇的SDS评分(53.45±4.22),SAS评分(58.22±2.18);观察组产妇的产后出血量(248.30±80.70)mL,明显低于对照组产妇的产后出血量(402.30±145.60)mL;观察组新生儿窒息发生率26.00%,明显低

  3. 早产儿脑室周围-脑室内出血继发脑积水的高危因素%Risk factors for hydrocephalus after periventricular-intraventricular hemorrhages in premature infants

    Institute of Scientific and Technical Information of China (English)

    马兴娜; 李秋平; 刘敬; 韩同英; 陈颖; 黄婕婷; 封志纯

    2013-01-01

    Objective To study the risk factors for secondary hydrocephalus after periventricular-intraventricular hemorrhage(PVH-IVH) in premature infants.Methods From Jun.2007 to Jun.2012,214 premature infants who were admitted to the Neonatal Intensive Care Unit after birth were enrolled and head ultrasonography showed PVH-IVH from 3 to 7 days after birth.They were classified into PVH-IVH alone group (n =161) and secondary hydrocephalus after PVH-IVH group (n =53) based on the different prognosis.Single factor and multivariate Logistic regression analysis were used to identify risk factors for secondary hydrocephalus after PVH-IVH.Results Single analysis indicated 8 factors associated with hydrocephalus after PVH-IVH,including male,gestational age < 28 weeks,birth weight < 1000 g,severe asphyxia,PVH-IVH Ⅲ or Ⅳ,metabolic acidosis,hyponatremia,and hypoglycemia or hyperglycemia (all P <0.05) ;multivariate Logistic regression analysis showed that male (OR =3.317),severe asphyxia (OR =13.838),PVH-IVH Ⅲ or Ⅳ (OR =43.281),and hyponatremia (OR =2.731) were independent risk factors for hydrocephalus after PVH-IVH (all P < 0.05).Conclusions Male,severe asphyxia,PVH-IVH Ⅲ or Ⅳ,and hyponatremia are closely related to hydrocephalus after PVH-IVH in preterm infants.After PVH-IVH,these clinical risk factors should be followed closely in the prevention of hydrocephalus.%目的 探讨早产儿脑室周围-脑室内出血(PVH-IVH)继发脑积水的高危因素,为早产儿PVH-IVH继发脑积水的防治提供依据.方法 2007年6月至2012年6月入住NICU、出生3~7d床旁头颅B超检查结果提示存在PVH-IVH的早产儿214例,根据预后不同分为单纯PVH-IVH组(n=161)和PVH-IVH继发脑积水组(n=53),采用单因素分析和多因素Logistic回归分析调查PVH-IVH后继发性脑积水的高危因素.结果 单因素分析显示,男童、胎龄<28周、出生体质量<1000 g、重度窒息、PVH-IVH Ⅲ级或Ⅳ级、代谢性酸中毒、低钠血症

  4. Analysis on the effect of glycemic control of pregnant women with gestational diabetes mellitus on pregnancy outcome%妊娠期糖尿病孕妇血糖控制对妊娠结局的影响分析

    Institute of Scientific and Technical Information of China (English)

    王丽丽

    2012-01-01

    目的:探讨控制妊娠期糖尿病(GDM)孕妇血糖对妊娠结局的影响.方法:将104例GDM孕妇根据治疗后血糖情况分为血糖控制满意组84例,血糖控制不满意组20例,并设健康孕妇87例为对照组,对各组妊娠期高血压、胎膜早破、羊水过多、产后出血、巨大儿以及新生儿窒息等指标进行比较.结果:血糖控制满意组的妊娠期高血压、胎膜早破、羊水过多、产后出血、巨大儿以及新生儿窒息等发生率与对照组比较差异均无统计学意义(P>0.05).血糖控制不满意组的妊娠期高血压、胎膜早破、羊水过多、产后出血、巨大儿以及新生儿窒息等发生率均高于对照组,差异有统计学意义(P<0.05).结论:有效控制GDM孕妇的血糖对妊娠有较大影响,应及时进行筛查与治疗.%Objective; To explore the effect of blood glucose in pregnant women with gestational diabetes mellitus (GDM) on pregnancy outcome. Methods; A total of 104 pregnant women with GDM were divided into well - controlled blood glucose group (84 pregnant women ) and bad - controlled blood glucose group ( 20 pregnant women) according the levels of blood glucose after treatment, and 87 healthy pregnant women were selected as control group; the incidences of GDM, premature rupture of membrane, polyhydramnios, postpartum hemorrhage , macrosomia, and neonatal asphyxia were compared among the three groups. Results; There was no statistically significant difference in the incidences of GDM, premature rupture of membrane, polyhydramnios, postpartum hemorrhage, macrosomia, and neonatal asphyxia between well - controlled blood glucose group and control group (P > 0. 05 ) , the incidences of GDM, premature rupture of membrane, polyhydramnios , postpartum hemorrhage, macrosomia, and neonatal asphyxia in bad - controlled blood glucose group were statistically significantly higher than those in control group (P < 0. 05) . Conclusion: Controlling blood glucose

  5. CLINICAL STUDY OF GESTATIONAL IMPAIRED GLUCOSE TOLERANCE IN 140 CASES%妊娠糖耐量受损140例临床研究

    Institute of Scientific and Technical Information of China (English)

    张英玲

    2012-01-01

    [Objective] To investigate the effect on the outcome of pregnancy women and fatus in gestational impaired glucose tolerance (GIGT). [Methods] Pregnancy women 2515 cases oral 50g glucose senitiv lest (GST) , glucose challenge test is abnomai, fasting again 75g oraglucose toerance test (OGTT) dignoses gestational Diabetes mellitus (GDM) and gesta-tional impaired glucose.and be compaired on the outcome pregnancy and fetus in GIGT group. in GDM group and normal group. [Results] Complication during the pregnancy and delivery, the dysklocia rate and the incidence in perint newbom.in the normal group, GIGT group, GDM group of hypertensive disorder complicating pregnancy, premature delivery, polyhydramnios, neonatal asphyxia, neonatal hypoglycemia, cesarean section, fetal macrosomia difference was statistically significant (P 0.05) ; hypertensive disorder complicating pregnancy、neonatal asphyxia, neonatal glucopenia, cesarean section, fatal raacrosomia of GDM and GIGT group were higher significantly than normal group (P 0.05 > 0.017) ; GIGT group with GDM between neonatal asphyxia complications significantly higher than GIGT group (P 0.05 > 0.017). [Conclusion] To trent-ment of GIGT in time. Prognosis of pregnant women and fetus Inprove in gestational glucose metabolic disorder%[目的]探讨妊娠糖耐量受损(GIGT)对母儿结局的影响.[方法]对2 515例孕妇进行口服50g葡萄糖筛查试验,对异常者,再空腹口服75 9葡萄糖进行糖耐量试验(OGTT)以确诊妊娠期糖尿病(GDM)及妊娠糖耐量受损.并分正常组、GIGT组及GDM组进行比较母儿结局.[结果]孕期及分娩过程中的合并症,难产率及围产儿患病率中,在正常组、GIGT组、GDM组的妊娠期高血压疾病、早产、胎膜早破、羊水过多、新生儿窒息、新生儿低血糖、剖宫产、巨大儿差异有统计学意义(P< 0.01).而胎膜早破的并发症差异无统计学意义(P>0.05);在GDM组与GIGT组中,妊娠期高血压疾病、新

  6. The clinical effect of nursing interventions on abnormal umbilical artery blood flow%护理干预对异常脐动脉血流影响的临床作用

    Institute of Scientific and Technical Information of China (English)

    张蓉萍; 唐明霞; 蔡秋香; 汪萍

    2012-01-01

    Objective To explore the effect of nursing interventions on the changes of S/D ratio of umbilical artery blood flow with different sleeping postures and pregnancy outcomes. Methods A total of 99 pregnant women with a gestational duration of 28 to 42 weeks, who had abnormal S/D ratios in umbilical artery blood flow were randomly divided into intervention group and control group. The intervention group was asked to take different sleeping postures based the different S/D ratios including horizontal posture, left - lateral posture and right - lateral posture while the control group was not told in terms of sleeping postures. Results 39.6% pregnant women (19/48) in the intervention group had S/D ratios return to the normal range after proper instructions in sleeping postures, which was higher than the 17.6% (9/51) in the control group. The difference was statistically significant (P<0.05). The rates of cesarean section, fetal growth restriction, premature delivery, fetal distress, asphxia neonatorum, oligohysramnios, cloudy amniotic fluid in the intervention group were reduced (F<0.05). Conclusion To take proper sleeping postures may improve umbilical artery blood flow, bring S/D ratio back to the normal range, lower rates of cesarean section, reduce pregnancy complications and improve the perinatal infants prognosis.%目的 探讨护理干预下不同睡眠体位脐动脉血流S/D比值的变化及对妊娠结局的影响.方法 将99例妊娠28-42周经多普勒超声检测脐动脉血流S/D比值异常增高的孕妇随机分为干预组和对照组,干预组根据在平卧位、左侧卧位及右侧卧位3个不同体位时的S/D比值,对孕妇睡眠体位进行指导,而对照组未特意嘱咐睡眠体位.结果 干预组经指导采取正确睡眠体位后,有39.6%(19/48)的孕妇异常S/D比值降至孕周正常值,明显高于对照组的17.6%(9/51),差异有统计学意义(P<0.05);剖宫产、胎儿宫内生长受限、早产

  7. 70例妇产科失血性休克的抢救护理

    Institute of Scientific and Technical Information of China (English)

    许云

    2013-01-01

    Objective To explore the nursing methods of maternal hemorrhagic shock. Methods 70 cases of hemorrhagic shock were randomly divided into two groups, the control group conventional nursing, the research group selected the holistic nursing, comparative analysis of two groups of perinatal and maternal outcomes. Results The study group of perinatal mild asphyxia, severe asphyxia, fetal death, stillbirth occurring rate is lower than the control group, the maternal uterus resection rate, mortality was lower than that of the control group, the two groups differed signiifcantly, there were statistical signiifcance (P<0.05 ). Conclusion The holistic nursing care on hemorrhagic shock can change the maternal, perinatal outcome, reduce the maternal uterus resection rate and mortality, and have important signiifcance to the perinatal and maternal.%  目的探讨孕产妇失血性休克的抢救护理方法。方法将70例失血性休克产妇随机分为两组,对照组选择常规护理,研究组选择整体护理,对比分析两组围产儿与孕产妇的结局。结果研究组围产儿轻度窒息、重度窒息、死胎、死产的发生率均低于对照组,孕产妇子宫切除率、病死率均低于对照组,两组差异明显,存在统计学意义(P<0.05)。结论对失血性休克产妇给予整体护理,可改变围产儿结局,降低孕产妇的子宫切除率及病死率,对围产儿与孕产妇有重要的意义。

  8. 缩宫素在足月妊娠引产中的应用%Application of oxytocin induction in treatment of full-term pregnancy induced labor

    Institute of Scientific and Technical Information of China (English)

    王月丽

    2011-01-01

    目的 探讨缩宫素在足月妊娠引产中的临床效果.方法 将2007年3月-2011年1月收治的90例初产妇应用缩宫素进行晚期妊娠引产,观察其临床疗效.结果 本研究结果显示宫颈评分的高低与引产成功率成正比,用药12h后宫颈成熟度为(8.72±2.31)分,其中有效77例(85.6%),用药至临床时间为10.6h,发生新生儿窒息4例(4.44%),表明缩宫素静脉滴注引产并不增加新生儿窒息的发生.结论 缩宫素是一种安全有效、方便的促宫颈成熟和计划引产药物,且对新生儿无明显不良反应.%Objective To investigate the clinical effect of oxytocin induction of labor in term pregnancy. Methods The hospital from March 2007 to January 2011 totally 90 patients were treated by early application of oxytocin to maternal late pregnancy labor induction, observe the clinical efficacy. Results The results showed that the level of cervical score is proportional with the success rate of labor induction, cervical ripening 12 hours after administration degree(8. 72 ± 2. 31) points, effective 77 cases ( 85. 6% ) , medication to 10.6 hours of clinical time, 4 cases of neonatal asphyxia (4. 44% ) , indicating that the intravenous oxytocin induction of labor does not increase the incidence of neonatal asphyxia. Conclusions Oxytocin is a safe, effective and convenient program for cervical ripening and labor induction drugs and no significant adverse effects on the newborn.

  9. Early Identification and Intervention of Head Position Dystocia%头位难产早期识别和干预

    Institute of Scientific and Technical Information of China (English)

    王稳玉

    2016-01-01

    目的:探讨头位难产早期识别和干预方法。方法:本研究选取笔者所在医院产科2013年4月-2015年4月进行分娩的165例头位难产产妇作为研究对象,对其采用头位难产干预处理,观察干预处理后的临床效果。结果:165例头位难产产妇中,剖宫产116例(70.3%),阴道分娩49例(29.7%)。产后出血5例(3.0%),阴道撕裂伤1例(0.6%),新生儿轻度窒息6例(3.6%),重度窒息2例(1.2%),无产妇及新生儿死亡。结论:早期准确识别头位难产,并进行及时干预处理对提高安全分娩具有重要意义。%Objective:To investigate the early identification and intervention of head position dystocia.Method:165 puerpera with head position dystocia were selected from April 2013 to April 2015 in our hospital,which were treated with intervention against head position dystocia.Observed the clinical efficacy of the intervention.Result:In the 165 cases of puerpera,116 cases(70.3%) were treated with cesarean section,49 cases(29.7%) were treated with vaginal delivery.5 cases(3.0%) occured postpartum hemorrhage,1 case(0.6%) occured vaginal laceration,6 cases(3.6%) occured mild neonatal asphyxia,2 cases(1.2%) occured severe neonatal asphyxia.No puerpera and neonatal dead.Conclusion:Identify the head position dystocia early and accurately,and intervening the puerpera timely is important to improve the safety of childbirth.

  10. Pilot randomized trial of therapeutic hypothermia with serial cranial ultrasound and 18-22 month follow-up for neonatal encephalopathy in a low resource hospital setting in uganda: study protocol

    Directory of Open Access Journals (Sweden)

    Costello Anthony

    2011-06-01

    Full Text Available Abstract Background There is now convincing evidence that in industrialized countries therapeutic hypothermia for perinatal asphyxial encephalopathy increases survival with normal neurological function. However, the greatest burden of perinatal asphyxia falls in low and mid-resource settings where it is unclear whether therapeutic hypothermia is safe and effective. Aims Under the UCL Uganda Women's Health Initiative, a pilot randomized controlled trial in infants with perinatal asphyxia was set up in the special care baby unit in Mulago Hospital, a large public hospital with ~20,000 births in Kampala, Uganda to determine: (i The feasibility of achieving consent, neurological assessment, randomization and whole body cooling to a core temperature 33-34°C using water bottles (ii The temperature profile of encephalopathic infants with standard care (iii The pattern, severity and evolution of brain tissue injury as seen on cranial ultrasound and relation with outcome (iv The feasibility of neurodevelopmental follow-up at 18-22 months of age Methods/Design Ethical approval was obtained from Makerere University and Mulago Hospital. All infants were in-born. Parental consent for entry into the trial was obtained. Thirty-six infants were randomized either to standard care plus cooling (target rectal temperature of 33-34°C for 72 hrs, started within 3 h of birth or standard care alone. All other aspects of management were the same. Cooling was performed using water bottles filled with tepid tap water (25°C. Rectal, axillary, ambient and surface water bottle temperatures were monitored continuously for the first 80 h. Encephalopathy scoring was performed on days 1-4, a structured, scorable neurological examination and head circumference were performed on days 7 and 17. Cranial ultrasound was performed on days 1, 3 and 7 and scored. Griffiths developmental quotient, head circumference, neurological examination and assessment of gross motor function were

  11. 未足月胎盘早剥保守治疗的效果%Clinical analysis of conservative treatment of premature placental abrup-tion

    Institute of Scientific and Technical Information of China (English)

    王小兰; 王振玲

    2015-01-01

    Objective To evaluate the clinical value of conservative treatment of premature placental abruption. Meth-ods 62 pregnant women who were diagnosed as 0-玉 level of premature placental abruption and treated in Meitan Genenral Hospital from January 2004 to June 2014 were recruited in this study. According to the treatment methods, they were assigned into conservative treatment group (34 patients ) and non-conservative treatment group (28 patients). The delivery mode and pregnancy outcomes of the two groups were compared. Results Compared with the non-conser-vative treatment group, the pregnant weeks and neonatal weight were increased and the incidence of severe neonatal asphyxia and neonatal death were decreased in conservative treatment group, the differences were statistically signifi-cant (P 0.05). Conclusion The patients with 0-Ⅰ level of premature placental abruption can be treated by conservative method. The conservative treatment method has a positive effect in extending the pregnant weeks, increasing the neonatal weight and decreasing the incidence of severe neonatal asphyxia and neonatal death.%目的:探讨未足月胎盘早剥行保守治疗的临床价值。方法选择2004年1月~2014年6月煤炭总医院住院收治0~玉级未足月胎盘早剥患者62例,根据治疗方式的不同将其分为其保守治疗34例,非保守治疗28例。比较两组患者的分娩方式和母婴结局。结果与非保守治疗组比较,保守治疗组患者分娩孕龄延长,新生儿体重增加,新生儿重度窒息发生率和病死率降低,差异均有统计学意义(P0.05)。结论0~玉级未足月胎盘早剥患者可行保守治疗,能够延长孕龄,增加新生儿体重,减少重度窒息发生率,降低新生儿病死率。

  12. 未足月胎盘早剥保守治疗的效果%Clinical Analysis of Conservative Treatment of Premature Placental Abruption

    Institute of Scientific and Technical Information of China (English)

    王冉

    2016-01-01

    Objective To explore the clinical value of conservative treatment of premature placental abruption.Methods 69 pregnant women who were diagnosed as 0 toⅠlevel of premature placental abruption and treated in our hospital were recruited in this study, according to the treatment methods, they were assigned into conservative treatment group (36 patients ) and non-conservative treatment group (33 patients), the delivery mode and pregnancy outcomes of the two groups were compared.Results Compared with the non-conservative treatment group, the pregnant weeks and neonatal weight were increased and the incidence of severe neonatal asphyxia and neonatal death were decreased in conservative treatment group, the differences were statistically signiifcant (P0.05).Conclusion The patients with 0 toⅠlevel of premature placental abruption can be treated by conservative method. The conservative treatment method has a positive effect in extending the pregnant weeks, increasing the neonatal weight and decreasing the incidence of severe neonatal asphyxia and neonatal death.%目的探讨未足月胎盘早剥行保守治疗的临床价值。方法选择我院收治的0~Ⅰ级未足月胎盘早剥患者69例,根据治疗方式的不同将其分为其保守治疗36例,非保守治疗33例,比较两组患者的分娩方式和母婴结局。结果与非保守治疗组比较,保守治疗组患者分娩孕龄延长,新生儿体重增加,新生儿重度窒息发生率和病死率降低,差异均有统计学意义(P均<0.05),而两组新生儿轻度窒息发生率、剖宫产率和产后出血、弥散性血管内凝血及急性肾功能衰竭的发生率比较,差异无统计学意义(P>0.05)。结论0~Ⅰ级未足月胎盘早剥患者可行保守治疗,能够延长孕龄,增加新生儿体重,减少重度窒息发生率,降低新生儿病死率。

  13. Analysis of 37 cases of placenta previa risk factors and pregnancy outcome%前置胎盘危险因素及妊娠结局37例研究

    Institute of Scientific and Technical Information of China (English)

    龚俊; 马海燕; 董芳芳

    2013-01-01

    Objective To investigate the risk factors and pregnancy outcome of placenta previa. Methods 39 cases of placenta previa cases in the hospital were retrospectively analyzed,and made the same period 50 cases of normal maternal as control group.Results In placenta previa group,maternal age,maternal time and the number of abortions were higher than control group,the proportion of maternal with history of cesarean section and placenta previa history was also significantly higher(P<0.05 or 0.01),the rate of cesarean section,obstetric complications and neonatal asphyxia rate were higher than that of the control group (P<0.05). Conclusion Variety of factors related to the formation of placenta previa,and placenta previa could lead to adverse pregnancy outcomes.Strengthen prenatal care could reduce the incidence of placenta previa,and also help to reduce the rate of preterm birth,cesarean section rate and neonatal asphyxia.%  目的探讨前置胎盘的危险因素及对妊娠结局的影响.方法对我院收治的37例前置胎盘病例进行回顾性分析,并与同期50例正常产妇作对照.结果研究组孕产妇年龄、孕产次、流产次数均高于对照组,有剖宫产史者和前置胎盘史者所占比例也明显高于对照组(P<0.05或P<0.01),剖宫产率、产科并发症以及新生儿窒息率等均高于对照组(P<0.01).结论前置胎盘的形成与多种因素有关,可导致不良的妊娠结局,加强产前保健可以降低前置胎盘发生率,也有利于降低早产率、剖宫产率以及新生儿窒息率.

  14. 产前护理干预对分娩方式的影响%Influence of prenatal nursing intervention on delivery way

    Institute of Scientific and Technical Information of China (English)

    郑婉文; 邱益娟; 林燕芬; 林丽霞

    2015-01-01

    目的:探讨产前护理干预对分娩方式的影响。方法回顾性分析1350例产妇的临床资料。将所有产妇随机分为对照组(623例)和干预组(727例),对照组接受常规检查和护理,干预组接受产前护理干预。比较两组产妇分娩方式、产后出血、新生儿窒息等发生情况。结果干预组剖宫产率为17.33%,明显低于对照组的54.74%,差异具有统计学意义(P<0.05);干预组的产后出血率为2.06%,新生儿窒息率为2.20%,明显低于对照组的5.94%、6.26%,差异具有统计学意义(P<0.05)。结论产前护理干预有助于提高产科质量,保证母婴安全,降低剖宫产率,值得临床推广应用。%Objective To investigate influence of prenatal nursing intervention on delivery ways. Methods Clinical data of 1350 puerpera were retrospectively analyzed. All puerpera were randomly divided into control group (623 cases) and intervention group (727 cases). The control group received conventional examination and nursing, and the intervention group received prenatal nursing intervention. Delivery ways, and status of postpartum hemorrhage and neonatal asphyxia were compared between the two groups. Results The intervention group had much lower cesarean section rate as 17.33% than 54.74% of the control group, and their difference had statistical significance (P<0.05). The intervention group also had obviously lower postpartum hemorrhage rate as 2.06% and lower neonatal asphyxia rate as 2.20% than 5.94% and 6.26% of the control group. The difference had statistical significance (P<0.05). Conclusion Prenatal nursing intervention is helpful for improving obstetric quality, ensuring maternal and child safety, and reducing cesarean section rate. It is worthy of clinical promotion and application.

  15. Discuss the intrapartum amniotic fluid meconium contamination by amniotic fluid%经宫颈羊水置换术治疗产时羊水胎粪污染探讨

    Institute of Scientific and Technical Information of China (English)

    刘海梅

    2013-01-01

    Objective To estimate the intrapartum amniotic fluid meconium contamination by amniotic fluid. Methods 37 cases with intrapartum amniotic fluid meconium contamination were collected ,all of them were treated by amniotic fluid. The cura-tive effect were recorded. Results The intrapartum amniotic fluid meconium contamination were got improved,29 cases of amniot-ic fluid clarification,no occurrence degree of amniotic fluid pollution;there was no MAS,only 1 case appeared neonatal asphyxia, and no complications. Conclusion It can improve the conditions for the intrapartum amniotic fluid meconium contamination by amniotic fluid,and it can reduce the occurrence rate for MAS and neonatal asphyxia rate.%目的:评价经宫颈羊水置换术治疗产时羊水胎粪污染的疗效。方法我院在2010年1月-2013年1月期间共收治了37例羊水胎粪污染的孕妇,对所有孕妇均采取了羊水置换术治疗,统计治疗后的疗效。结果37例接受羊水置换术的孕妇在分娩羊水污染程度得到了极大的改善,其中29例羊水澄清,无1例出现羊水Ⅲ°污染;所有新生儿中均未出现MAS症,仅有1例出现了新生儿窒息,且没有1例出现术后并发症。结论经宫颈羊水置换术,可有效改善胎儿宫内羊水胎粪污染的状况,降低MAS的发生率和新生儿的窒息率。

  16. 地塞米松防治羊水栓塞的效果探究%Explore the effect of dexamethasone on prevention and cure of amniotic fluid embolism

    Institute of Scientific and Technical Information of China (English)

    李淑青

    2015-01-01

    Objective:To explore the effect of dexamethasone on prevention and cure of amniotic fluid embolism.Methods:300 women with cesarean section were selected from January 2011 to January 2014.According to the different preoperative medication, they were divided into the control group and the observation group.The control group was given 5% sodium bicarbonate before operation,and the observation group was given dexamethasone before surgery.We observed the probability of prodromal symptoms of amniotic fluid embolism of the two groups.Results:Mild chills,severe chills,chills rate,chills time,operation time,amount of bleeding during operation,risk of postpartum hemorrhage and neonatal asphyxia of the two groups were compared,and the difference was statistically significant(P<0.05).Conclusion:Before caesarean operation,intravenous injection of dexamethasone can effectively prevent the amniotic fluid embolism and postpartum hemorrhage,but also can prevent neonatal asphyxia,and it had high clinical value.%目的:探讨地塞米松对羊水栓塞的防治效果.方法:2011年1月-2014年1月收治剖宫产产妇300例,按照术前用药的不同分为对照组与观察组,对照组术前给予5%碳酸氢钠处理,观察组术前给予地塞米松处理,观察两组产妇发生羊水栓塞前驱症状的几率.结果:比较两组产妇的轻度寒颤、重度寒颤、总寒颤率、寒颤时间、手术时间、术中出血量、产后出血率及新生儿窒息情况,差异有统计学意义(P<0.05).结论:剖宫产手术前静脉注射地塞米松能有效防止羊水栓塞及产后出血的发生,还能预防新生儿窒息,具有较高的临床推广价值.

  17. Analysis of Inlfuence Factors of Neonatal Hyperbilirubinemia%新生儿高胆红素血症的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    曲岩杰

    2015-01-01

    目的:研究新生儿发生高胆红素血症的危险因素。方法入选2010年1月~2014年1月在我院出生的240例足月新生儿,出生后7天内测量胆红素水平,达到国家推荐的光疗干预标准的110例为黄胆组,同期未达标准的130例为对照组,分别对两组出生体重、性别、生产方式等15项潜在危险进行统计并分析。结果黄胆组与对照组相比,窒息率、胎头吸引助产率、禁食率,G-6-PD缺陷明显增高(P<0.05)。窒息率、禁食率、G-6-PD是发生高胆红素血症的危险因素(P<0.05)。结论产后禁食、窒息、G-6-PD是发生高胆红素血症的独立危险因素,分娩方式可能与黄疸的发生相关。%Objective To investigate the risk factors of neonatal hyperbilirubinemia. Methods 240 cases of full-term infants born in our hospital from measuring bilirubin level, within 7 days after birth, to achieve national standards recommend phototherapy intervention of 110 cases of jaundice group over the same period, not up to standard 130 cases as control group, two groups respectively on birth weight, sex, mode of production and other 15 potential risk statistics and analysis. Results Compared with jaundice group and control group, asphyxia, fetal head suction delivery rate, fast rate of defects, G-6-PD increased signiifcantly, but the difference was not statistically signiifcant (P<0.05). Conclusion Fasting, postpartum asphyxia, G-6-PD is an independent risk factor for the occurrence of hyperbilirubinemia, related to mode of delivery may be associated with jaundice.

  18. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    International Nuclear Information System (INIS)

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  19. 高龄孕妇早发型重度先兆子痫对新生儿及围生结局影响分析%THE EFFECT OF EARLY ONSET SEVERE PRE- ECLAMPSIA OF ADVANCED AGE PREGNANT WOMEN ON NEONATAL AND PERINATAL OUTCOMES

    Institute of Scientific and Technical Information of China (English)

    胡水珍; 叶春波

    2011-01-01

    目的 分析高龄孕妇早发型重度先兆子痫对新生儿及围生结局的影响.方法 回顾性分析1997年1月-2010年1月早发型重度先兆子痫孕妇86例,其中年龄>35岁40例,设为研究组,年龄0.05).终止妊娠时间及孕妇严重并发症,差异有统计学意义(P<0.01).研究组围生儿病死率及颅内出血,新生儿窒息明显高于对照组(P<0.01).研究组新生儿出生体质量及新生儿Apgar评分明显小于对照组(P<0.01).结论 年龄>35岁孕妇发生早发性重度子痫,更易导致孕妇及围生儿预后不良.%Objective To analyze the effect of early onset severe pre - eclampsia( EOSP ) of advanced age pregnant women on neonatal and perinatal outcomes. Methods Eighty - six pregnant women with EOSP from Jan 1997 to Jan 2010 were chosen and analysed. According to the maternal age, 86 pregnant women with EOSP were classified into two groups, research group( the maternal age was up to 35 years and 40 patients were involved ) and control group( the maternal age was under 35 years and 46 patients were involved ). The parity, gestational age on admission, systolic pressure( SP ) and diastolic pressure( DP ) were recorded. And the pregnant outcomes of gravidas ( such as placental abruption, pneumonedema, heart failure ) and complications of perineal infants( such as perinatal mortality ratio, low birth weight, intracranial hemorrhage, neonatal asphyxia, Apgar score ) were recorded and compared between two groups. Results The parity, gestational age on admission, SP and DP had no different between two groups( P > 0.05 ). The duration of pregnancy termination and severe complication were different between two groups (P < 0. 01 ). Compared to control group, the perinatal mortality ratio, intracranial hemorrhage and neonatal asphyxia in research group were higher ( P < 0.01 ), and the birth weight, Apgar score in research group were lower ( P < 0.01 ). Conclusion The EOSP of advanced age pregnant women could

  20. Observation on Effect of Drug Intervention on Gestational Hypertension%高血压孕妇妊娠期实施药物干预的效果观察

    Institute of Scientific and Technical Information of China (English)

    梁惠萍

    2012-01-01

    目的观察高血压孕妇在妊娠期实施早期药物干预的临床治疗效果.方法 选取2007年1月至2012年1月在深圳市龙岗区平湖人民医院就诊的妊娠期高血压患者300例作为研究对象,其中2007年1月至2008年5月就诊的125例患者作为在妊娠期未进行药物干预的对照组,2008年6月至2012年1月就诊的175例患者作为在妊娠期进行早期药物干预的观察组,对比分析两组患者在产后出血、剖宫产、早产、胎儿窘迫及新生儿窒息方面的疗效情况.结果 观察组患者的产后出血、剖宫产、早产、胎儿窘迫及新生儿窒息发生率与对照组相比明显降低,差异有统计学意义(P<0.05).结论 在临床实践中,对妊娠期高血压患者进行早期药物干预,能降低不良妊娠结局的发生率,从而改善妊娠结局,值得临床推广使用.%Objective To observe the curative effert of drug intervention on gestations! hypertension. Methods From Jan. 2007 to Jan. 2012 ,300 gestational hypertension patients had been treated in Pinghu Hospital of Longgang District. Among these patients, 125 rases treated with drug intervention were enrolled into this study as control group( from Jan. 2007 to May 2008 ), while the other 175 cases treated with drug intervention were enrolled as observation group( from Jun. 2008 to Jan. 2012 ). The following parameters were compared and analyzed: postpaitum hemorrhage, cesarean section, premature labor, fetal distress and neonatal asphyxia. Results Compared with the control group, the rates of postpaitum hemorrhage, cesarean section, premature labor , fetal distress and neonatal asphyxia were significantly lower in observation group, the differences were statistically significant P<0.05 ). Conclusion For patients with gestational hypertension, drug intervention is effective to reduce the rates of adverse pregnancy outcomes and worthy of clinically application.

  1. MORTALITY PATTERN OF HOSPITALIZED CHILDREN IN A REFERRAL HOSPITAL FROM UPPER ASSAM, NORTH EAST INDIA: A RECORD BASED RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Rita Panyang

    2016-04-01

    Full Text Available OBJECTIVE Mortality rate of children is one of the important indicator of health status of country. India is one of the major contributor of under 5 mortality of the world. The present study was aimed at finding the causes of mortality among children admitted in paediatric ward of Assam Medical College Hospital during last two years and provides epidemiological information related to mortality. MATERIALS AND METHODS A retrospective cross-sectional descriptive study over 2 years’ period from 1st July 2013 to 31st June 2015 using data retrieved from the Hospital’s Admission and Death Record Register. Data collected was entered into a spreadsheet using SPSS software package version 16.0. RESULTS A total of 10970 children comprising of 4873 (44.4% males and 6097 (55.5 % of females were admitted to the Paediatric Department during this 24 months’ period. A total number of children died during this period was 814 comprising of 474 (58.2% males and 334 (41% females. Overall mortality among males and females were 9.72% and 5.47% respectively. An overall mortality of 7.42% was noted in cases admitted to the Paediatric ward. Out of total 814 paediatric deaths, 460 (57.9% were infant and more than 1/3rd (35.8% of infants died in new-born period; 186 (23.4% died in age group 1-5 years and 148 (18.1% died in age group >5 years. Majority of neonatal mortality was due to birth asphyxia (33.1% followed by septicaemia (31.4% and prematurity, LBW (18.5%. The common cause of post neonatal death was septicaemia (24% and respiratory tract infection (24% followed by meningitis (22.4%. Septicaemia (17.8% was the leading cause of death among infant. Acute encephalitis syndrome is the most common cause of death in 1-5 yrs. (24.1% and >5 yrs. (25% age group. CONCLUSION The pattern of childhood mortality has been documented in the present study. The results from this study confirm that high neonatal deaths were mainly due to birth asphyxia, while after neonatal

  2. Clinical anlysis on 198 cases by Doula with delivery%导乐陪伴分娩198例临床分析

    Institute of Scientific and Technical Information of China (English)

    项蔚; 尉文功

    2011-01-01

    Objective: To investigate the effects of Doula with delivery on maternal and newborn. Methods: 198 cases by the Doula primiparae vaginal delivery were taken as the observation group in our hospital in 2010, and 186 cases by the initial traditional maternal vaginal delivery were taken as the control group in our hospital in 2010, forceps delivery rate, labor time, postpartum hemorrhage and newborn asphyxia between the two groups were analysed retrospectively. Results: Compared with the control group, first stage of labor time (287.90±81.16) m and second stage of labor time (36.0±13.4) m in observation group were significantly shorter (P<0.05), postpartum hemorrhage (124.3 ±41.6) ml in observation group also reduced (P<0.05), forceps delivery rate (1.01%) and neonatal asphyxia rate (0.51%) in observation group were significantly lower (P<0.05). Conclusion: Doula with delivery is a new, more humane mode of delivery care. It can effectively reduce forceps delivery rate, improve the quality of production time, promote the health of maternal and newborn, and deserve the clinical expansion.%目的:探讨导乐陪伴分娩对产妇及新生儿的影响.方法:以2010年在我院由导乐陪伴经阴道分娩的初产妇198例为观察组,以2010年在我院传统经阴道分娩的初产妇186例为对照组,回顾性分析两组的产钳产率、产程时间、产后出血量和新生儿窒息情况.结果:与对照组相比,观察组的第一产程时间(287.90±81.16)min和第二产程时间(36.0±13.4)min明显缩短(P<0.05),产后出血量(124.3±41.6)ml减少(P<0.05),产钳产率(1.01%)和新生儿窒息发生率(0.51%)明显降低(P<0.05).结论:导乐陪伴分娩是一种新近的更人性化的分娩护理模式,可有效降低产钳产率,提高产时质量,促进母婴健康,值得临床推广.

  3. 妊娠合并特发性室性心律失常患者的临床分析%Clinical analysis of pregnancy complicated with idiopathic ventrieular arrhythmia

    Institute of Scientific and Technical Information of China (English)

    王利果; 尹立军

    2014-01-01

    Objective To investigate the clinical features of pregnancy complicated with idiopathic ventrieular arrhythmia (IVA),and its impact on pregnant women and newborn. Methods The clinical data of 110 pregnant patients complicated with IVA and 110 normal pregnant women at the same time were summarized. Results The QTc and QTd in pregnant women with IVA were significantly increased than those in the control group(P < 0. 01). By the health care in pregnancy,the ventricular ar-rhythmia incidence in patients with IVA during late pregnancy was significantly lower than that during the early pregnancy(P <0. 05),and the full term birth rate was 88. 18% . The cesarean section rate in women with IVA(65. 45% )was markedly higher than that in the control group(P < 0. 01). The incidence of neonatal asphyxia was 2. 73% ,and the incidence of low birth weight infants was 3. 6% . Conclusion By the health care in pregnancy,most of IVA puerpera can have full term birth,and has little effect on neonatal asphyxia and neonatal weight.%目的:分析妊娠合并特发性室性心律失常的临床特征,探讨其对母婴的影响。方法回顾性分析浙江大学医学院附属妇产科医院110例妊娠合并特发性室性心律失常(IVA)患者和110例同期门诊产检并住院生产的正常孕产妇的临床资料。结果妊娠合并 IVA 组患者 QTc、QTd 较正常对照组孕产妇显著增加(P 均<0.01)。通过保健处理,IVA 组患者在孕晚期室性心律失常发生率下降(P <0.05),足月生产率为88.18%;IVA 组行剖宫产率(65.45%)明显增高(P <0.01)。新生儿窒息为2.73%,低体质量儿占3.6%。结论通过妊娠期保健处理,IVA 患者能妊娠至足月,对新生儿无明显影响。

  4. 预防性护理干预对产妇分娩的影响%Impact of preventive nursing intervention on delivery

    Institute of Scientific and Technical Information of China (English)

    王栋芝

    2013-01-01

    Objective: To discuss the impact of preventive nursing intervention on delivery mode, birth process and postpartum hemorrhage. Methods: 120 parturient with single intrauterine pregnancy in cephalic presentation were randomly divided into the observation group and the control group( 60 cases in each group ) according to the order in labor. The methods of wet compress of uterine neck with lidocaine hydrochloride cotton ball combined with massaging uterine neck with hand were used in the two groups. The preventive nursing intervention was adopted in the observation group and routine nursing care was taken in the control group. Results:The natural birth rate and effective rate of analgesia was higher in the observation group than the control group( P < 0.05 ); the birth process was obviously shorter in the observation group than the control group( P <0. 05 ) ;the rate of postpartum hemorrhage of puerperant and asphyxia of newborn was lower in the observation group than the control group( P < 0. 05 ). Conclusion: The preventive nursing intervention can obviously shorten birth process, reduce maternal pain, promote parturient confidence in natural delivery, reduce the rate of postpartum hemorrhage and neonatal asphyxia and improve safety of mother and newborn as well.%目的:探讨预防性护理干预对产妇分娩方式、产程时间及产后出血等情况的影响.方法:将我院120例单胎头位产妇按临产先后顺序随机分为观察组和对照组各60例,两组均采用盐酸利多卡因棉球湿敷宫颈协同手推宫颈法,观察组采取预防性护理干预,对照组采取常规护理.结果:观察组自然分娩率高于对照组,产程时间比对照组明显缩短,产妇产后出血率及新生儿窒息率低于对照组,镇痛有效率高于对照组,两组比较差异均有统计学意义(P<0.05).结论:预防性护理干预可明显缩短产程,减轻产妇疼痛,提升产妇自然分娩的信心,降低产后出血率及新生儿窒息率,提高母婴安全.

  5. Evaluation of effect of continuous care provided by midwife groups to pregnant women%助产士组人员为孕妇提供连续性护理的效果评价

    Institute of Scientific and Technical Information of China (English)

    徐名妨; 涂晋梅; 吴素红; 刘瑶; 梁小勤; 郑彩霞; 吴双珍

    2011-01-01

    目的 探讨助产士组人员为孕妇提供连续性护理的效果.方法 将筛选的100例孕妇随机分为研究组和对照组各50例,研究组按照助产士组人员提供连续性护理的要求服务;对照组按照传统护理模式服务,比较不同护理措施对母婴的效果.结果 研究组孕产妇对产前认知行为的依从性高,自然分娩率高,母乳喂养率升高,孕产妇满意度提高,新生儿窒息率降低,产后抑郁症的发生率低,与对照组相比差异显著.结论 助产士组人员提供连续性护理能提高孕妇对产前认知、自然分娩率、母乳喂养率、产妇满意度、护理人员的综合素质,降低新生儿窒息率,减少产后抑郁症发生,提高了围生期保健质量.%Objective To investigate the effect of continuous care provided by midwife group personnel to pregnant women.Methods 100 cases of pregnant women were screened out and divided into the study group and the control group with 50 patients in each group randomly.The study group received continuous care provided by midwife group personnel,the control group received traditional nursing.Effect of different nursing measures on mothers and neonates were compared.Results Antenatal cognition and rate of natural delivery of the study group were higher than the control group.The rate of neonatal asphyxia and postpartum depression occurred in the study group were lower than the control group,Maternal and family sarisfaction and rates of breasffeeding of the study group were higher than the control group.Conclusions Continuoas care provided by midwife group personnel can increase antenatal cognition and rate of natural delivery,maternal and family satisfaction.breast feeding rates and the overall quality of nursing staff,reduce rate of neonatal asphyxia with few postpartum depression,then improve the quality of perinatal care.

  6. 绍兴市2006~2008年5岁以下儿童死亡监测结果分析%Analysis on monitoring result of death of children under 5 years in Shaoxing city from 2006 to 2008

    Institute of Scientific and Technical Information of China (English)

    刘丹; 余红

    2011-01-01

    Objective: To understand the death of children under 5 years in monitoring points of Shaoxing city, put forward corresponding interventional measures, in order to reduce children mortality. Methods: The mortality, causes of death and health service before death of children under 5 years were analyzed in monitoring points of Shaoxing city from 2006 to 2008. Results: The mortality of children under 5 years in Shaoxing from 2006 to 2008 decreased year by year, the top five causes of death were congenital heart disease, premature delivery and low birth weight, drowning, unexpected asphyxia, birth asphyxia and other congenital abnormalities. The treatment before death was mainly in hospital, accounting for 52. 22% , but 21. 85% of the children didn't go to hospital before death. Conclusion: Maternal and child health, training medical staff in basic - level medical organizations should be enhanced, the technical levels of obstetricians and pediatricians should be improved, the consciousness of safety protection should be strengthened among the parents, unexpected death of children should be prevented and reduced, rural cooperative medical system and ability of rural community service should be enhanced to reduce the mortality of children under 5 years.%目的:了解绍兴市监测点5岁以下儿童死亡情况,提出相应干预措施,以有效降低儿童死亡率.方法:对绍兴市2006~2008年监测点5岁以下儿童死亡率、死亡原因、死前保健服务进行分析.结果:2006~ 2008年绍兴市5岁以下儿童死亡率逐年下降,死因前5位依次为先天性心脏病、早产和低出生体重、溺水、意外窒息、出生窒息和其他先天异常.死前治疗以医院为主,占52.22%,但未就医占21.85%.结论:应该加强妇幼保健工作,加强基层培训,提高产科、儿科医生技术水平,提高家长安全防范意识,预防和减少儿童意外死亡,加强农村合作医疗和农村社区服务能力,从而降低5岁以下儿童死亡率.

  7. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

    2010-06-15

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  8. 胎盘早剥48例临床分析%Clinical Analysis of 48 Patients with Placental Abruption

    Institute of Scientific and Technical Information of China (English)

    刘玉昆; 王振花; 黄佩贤; 刘梅兰; 张建平

    2012-01-01

      Objective: To improve the early diagnosis and treatment of placenta abruption and decrease the maternal and fetal complications.Methods:The clinical data of 48 patients with placental abruption were retrospectively analyzed from Jan.2006 to Jun.2011. Results: Premature membrane rupture, pregnancy complicated hypertension, fetal growth restriction were the main risk factors. The main clinical presentations included abdominal pain, uterine hypertonus, vaginal bleeding, uterine tenders, abnormal fetal heart, fetal intrauterine death, bloody amniotic fluid and so on. 30 cases were delivered by cesarean section. 18 cases were delivered by vagina. Maternal complications included 9 cases of post partum hemorrhage,2 cases of DIC and 1 case of subtotal hysterectomy.11 newborns had mild asphyxia. 5 newborns had severe asphyxia. 3 cases complicated with fetal intrauterine death. Conclusions: The clinical presentation of placenta abruption varies widely. Early diagnosis and timely treatment are the keys to improve maternal and neonatal outcomes.%  目的:提高胎盘早剥的早期诊断和及时治疗,降低母儿并发症。方法:回顾性分析我院2006年1月~2011年6月诊治的48例胎盘早剥的临床资料。结果:胎膜早破、妊娠期高血压疾病、胎儿生长受限为胎盘早剥的重要高危因素。主要临床表现为腹痛、子宫张力大、阴道流血、子宫压痛、胎心异常、死胎、血性羊水等。剖宫产30例,阴道产18例,产妇发生产后出血9例,DIC 2例,行次全子宫切除术1例,无孕产妇死亡。新生儿轻度窒息11例,重度窒息5例,死胎3例。结论:胎盘早剥病因多,临床表现个体差异大,及早识别和处理是降低风险,提高母婴结局的关键。

  9. Clinical observation of unprotected perineum delivery technology%无保护会阴接生技术的临床应用观察

    Institute of Scientific and Technical Information of China (English)

    李迎春

    2015-01-01

    Objective To investigate the clinical effect of unprotected perineum delivery technology.Methods Normal vaginal delivery in 300 cases Were randomly divided into two groups,study group and control group,each group of 150 cases, The control group uses the conventional protection of perineum method. The study group using new unprotected perineum delivery technology. Results The study group of 150 cases of maternal vaginal delivery, Perineal resection in 16 cases,50 cases of perineal laceration degree II,60 cases of perineallaceration of perineum type,complete in 24 cases,neonatal asphyxia 0 cases. The control group of 150 cases of maternal vaginal delivery, Perineal resection in 31 cases,the second degree perineal laceration in 84 cases,27 cases ofperineal laceration of perineum type,complete in 8 cases,neonatal asphyxia 0 cases. Conclusion Unprotected perineum delivery technology,to reduce the rate of lateral episiotomy and perineal laceration of perineum II rate,improve the first degree laceration rate and integrity rate,is superior to the traditional protection of perineum method.%目的:探讨无保护会阴接生技术的临床效果。方法正常阴道分娩产妇300例,随机分为研究组和对照组,每组150例,研究组采用新的无保护会阴接生技术进行接生,对照组采用旧的常规保护会阴法进行接生。结果研究组150例产妇正常阴道分娩,会阴侧切16例,会阴Ⅱ度裂伤50例,会阴Ⅰ度裂伤60例,会阴完整24例,新生儿窒息0例;对照组150例产妇正常阴道分娩,会阴侧切31例,会阴Ⅱ度裂伤84例,会阴Ⅰ度裂伤27例,会阴完整8例,新生儿窒息0例。结论无保护会阴接生技术在降低会阴侧切率、会阴Ⅱ度裂伤率,提高会阴完整率方面明显优于常规保护会阴法接生。

  10. The influence of maternal islet beta-cell autoantibodies in conjunction with gestational hyperglycemia on neonatal outcomes.

    Directory of Open Access Journals (Sweden)

    Zhe Li

    Full Text Available To determine the predictive value of the presence of maternal islet beta-cell autoantibodies with respect to neonatal outcomes.A total of 311 pregnant women with abnormal 75 g oral glucose tolerance test (OGTT results were enrolled in this study. Maternal glutamic acid decarboxylase autoantibodies (GADA, islet cell autoantibodies (ICA and insulin autoantibodies (IAA were tested in fasting blood both on the day following the routine OGTT and before delivery. The birth weight, Apgar score, blood glucose and outcomes of each neonate were later evaluated and recorded.1. In this study, 33.9% of the pregnant women with gestational hyperglycemia had detectable levels of one or more types of anti-islet cell antibodies in the third trimester. The proportion of women who produced GADA and/or ICA was significantly higher in the group of women with gestational hyperglycemia than in the control group (P<0.05. The groups similarly differed in the proportion of women who tested positive for any anti-islet cell antibody (P<0.05. 2. Of the patients in our study, those who produced GADA exhibited an increase in uterine and umbilical arterial pulsatility indexes (PIs during the third trimesters compared with the control group (P˂0.05. Additionally, an increased frequency of fetal growth restriction (FGR was observed in the infants of women who produced IAA during pregnancy compared with those without autoantibodies (P˂0.05. 3. The rate of newborn admission to the neonatal intensive care unit (NICU was significantly associated with the presence of maternal ICA during the third trimester (OR, 6.36; 95% CI, 1.22-33.26. 4. The incidence of neonatal asphyxia was associated with the presence of maternal GADA in both the second (OR, 10.44; 95% CI, 1.46-74.92 and the third (OR, 8.33; 95% CI, 1.45-47.82 trimesters.Approximately one-third of the women with gestational hyperglycemia produced anti-islet cell antibodies. The incidence of FGR was higher in women with

  11. Analysis of related factors of abnormal graphics in fetal heart monitoring at the birth process%产程中胎心监护异常图形相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张海霞

    2015-01-01

    Objective:To explore the relationship between the abnormal graphics in fetal heart monitoring at the birth process and perinatal outcome.Methods:300 cases of pregnant women were selected.They were given intrapartum fetal heart monitoring,we observed,record and analyzed monitoring results.Results:During production process,124 cases had CST score and graphic abnormality,176 cases were normal,in the graphic abnormalities,the incidence of fetal distress,neonatal asphyxia was obviously higher than that in the control group(P<0.05).Vaginal operation labor,cesarean section rate were significantly higher than the control group(P<0.05).Common types were FHR tachycardia,FHR bradycardia,severe variable deceleration,late deceleration, FHR flat orderly.Conclusion:During production process,FHR tachycardia,FHR bradycardia,severe variable deceleration,late deceleration,FHR flat were closely related with fetal distress and neonatal asphyxia.They should be pay more attention,in order to discover and handle timely.%目的:探讨产程中异常胎心监护图形与围产儿结局的关系。方法:收治产妇300例,行产程胎心监护,进行观察、记录和分析。结果:产程中CST评分及图形异常124例,正常176例,图形异常胎儿宫内窘迫、新生儿窒息的发生率明显高于对照组(P<0.05),阴道手术产、剖宫产率明显高于对照组(P<0.05)。常见类型依次为 FHR 过速、FHR 过缓、重度变化减速、晚期减速、FHR 平直。结论:产程中 FHR 过速、FHR 过缓、重度变化减速、迟发减速、FHR平直与胎儿宫内窘迫及新生儿窒息的发生关系密切,应予以重视,及时发现和处理。

  12. Reduced miR-659-3p Levels Correlate with Progranulin Increase in Hypoxic Conditions: Implications for Frontotemporal Dementia

    Science.gov (United States)

    Piscopo, Paola; Grasso, Margherita; Fontana, Francesca; Crestini, Alessio; Puopolo, Maria; Del Vescovo, Valerio; Venerosi, Aldina; Calamandrei, Gemma; Vencken, Sebastian F.; Greene, Catherine M.; Confaloni, Annamaria; Denti, Michela A.

    2016-01-01

    Progranulin (PGRN) is a secreted protein expressed ubiquitously throughout the body, including the brain, where it localizes in neurons and is activated microglia. Loss-of-function mutations in the GRN gene are an important cause of familial frontotemporal lobar degeneration (FTLD). PGRN has a neurotrophic and anti-inflammatory activity, and it is neuroprotective in several injury conditions, such as oxygen or glucose deprivation, oxidative injury, and hypoxic stress. Indeed, we have previously demonstrated that hypoxia induces the up-regulation of GRN transcripts. Several studies have shown microRNAs (miRNAs) involvement in hypoxia. Moreover, in FTLD patients with a genetic variant of GRN (rs5848), the reinforcement of miR-659-3p binding site has been suggested to be a risk factor. Here, we report that miR-659-3p interacts directly with GRN 3′UTR as shown by luciferase assay in HeLa cells and ELISA and Western Blot analysis in HeLa and Kelly cells. Moreover, we demonstrate the physical binding between GRN mRNA and miR-659-3p employing a miRNA capture-affinity technology in SK-N-BE and Kelly cells. In order to study miRNAs involvement in hypoxia-mediated up-regulation of GRN, we evaluated miR-659-3p levels in SK-N-BE cells after 24 h of hypoxic treatment, finding them inversely correlated to GRN transcripts. Furthermore, we analyzed an animal model of asphyxia, finding that GRN mRNA levels increased at post-natal day (pnd) 1 and pnd 4 in rat cortices subjected to asphyxia in comparison to control rats and miR-659-3p decreased at pnd 4 just when GRN reached the highest levels. Our results demonstrate the interaction between miR-659-3p and GRN transcript and the involvement of miR-659-3p in GRN up-regulation mediated by hypoxic/ischemic insults. PMID:27199656

  13. Analysis on blood glucose metabolic disorders in critically ill neonates%危重新生儿血糖代谢紊乱相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李艳秋; 赵军

    2012-01-01

    目的:对危重新生儿血糖代谢紊乱的相关因素进行调查分析,为临床治疗提供参考依据.方法:分析2007年6月~2011年6月168例危重新生儿血糖代谢紊乱的形成原因.结果:168例血糖代谢紊乱患者中,低血糖症者97例,高血糖症者42例,二者兼有者29例.血糖代谢紊乱与胎龄和出生体重呈负相关,而且在轻度窒息的情形下低血糖症状较多,重度窒息的情况下高血糖症状较多.结论:对危重新生儿血糖代谢紊乱相关因素的分析,可以及时发现和治疗病症,减少患儿日后的痛苦.%Objective; To investigate and analyze the related factors of blood glucose metabolic disorders in critically ill neonates, provide reference for clinical treatment. Methods; The causes of blood glucose metabolic disorders in 168 critically ill neonates who were treated in the hospital from June 2007 to June 2011 were analyzed. Results; Among 168 neonates with blood glucose metabolic disorders, 97 neonates were found with hypoglycemia, 42 neonates were found with hyperglycemia, and 29 neonates were found with both of the above -mentioned diseases. There was a negative correlation between blood glucose metabolic disorders and birth weight, hypoglycemia was commonly found under the circumstance of mild asphyxia, and hyperglycemia was commonly found under the circumstance of severe asphyxia. Conclusion; Blood glucose metabolic disorders can be diagnosed and cured timely through analyzing the related factors of blood glucose metabolic disorders in critically ill neonates to reduce future pains of the neonates.

  14. Evaluation of the Effect of Vaginal Midwifery Applied to Full-term Parturi-ent Fetal Distress in Uterus%阴道助产术在足月临产胎儿宫内窘迫中的应用效果评价

    Institute of Scientific and Technical Information of China (English)

    何春梅

    2014-01-01

    Objective To explore the effect of vaginal midwifery for full-term fetal distress and the maternal and neonatal out-comes. Methods Vaginal midwifery was adopted at the end of pregnancy of 146 cases in the observation group, and cesarean sec-tion was used in 135 cases in the control group. The total amount of intraoperative blood loss, the incidence of neonatal asphyxia and maternal complications of two groups were compared. Results The rate of implementing cesarean section of the control group was 100%, while that of the observation group was 1.37%; the incidence of neonatal asphyxia of the observation group was 13.01%, and that of the control group was 18.52%; the total amount of intraoperative blood loss, and the number of postpartum hemorrhage patients were significantly less than those of the control group; the statistical results of the indications, P<0.05. Con-clusion Vaginal midwifery adopted in full-term parturient fetal distress can achieve good maternal and neonatal outcome. And im-proving and promoting vaginal midwifery technology is expected to reduce the rate of cesarean section.%目的:探讨足月胎儿宫内窘迫施行阴道助产术的效果及母婴结局。方法146例观察组采用阴道助产术结束妊娠,135例对照组采用剖宫产术,对比两组术中总失血量、新生儿窒息发生率、产妇并发症发生率。结果对照组实施剖宫产术100%,观察组为1.37%;观察组新生儿窒息发生率13.01%,对照组18.52%;观察组总出血量和产后出血患者均明显少于对照组;各项指征统计结果,差异有统计学意义(P<0.05)。结论阴道助产术用于足月临产胎儿宫内窘迫中可获得良好的母婴结局,完善并推广阴道助产技术有望降低剖宫产率。

  15. Safety and efficacy of topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia (NeoNATI

    Directory of Open Access Journals (Sweden)

    Filippi Luca

    2012-09-01

    Full Text Available Abstract Background Despite progresses in neonatal care, the mortality and the incidence of neuro-motor disability after perinatal asphyxia have failed to show substantial improvements. In countries with a high level of perinatal care, the incidence of asphyxia responsible for moderate or severe encephalopathy is still 2–3 per 1000 term newborns. Recent trials have demonstrated that moderate hypothermia, started within 6 hours after birth and protracted for 72 hours, can significantly improve survival and reduce neurologic impairment in neonates with hypoxic-ischemic encephalopathy. It is not currently known whether neuroprotective drugs can further improve the beneficial effects of hypothermia. Topiramate has been proven to reduce brain injury in animal models of neonatal hypoxic ischemic encephalopathy. However, the association of mild hypothermia and topiramate treatment has never been studied in human newborns. The objective of this research project is to evaluate, through a multicenter randomized controlled trial, whether the efficacy of moderate hypothermia can be increased by concomitant topiramate treatment. Methods/Design Term newborns (gestational age ≥ 36 weeks and birth weight ≥ 1800 g with precocious metabolic, clinical and electroencephalographic (EEG signs of hypoxic-ischemic encephalopathy will be randomized, according to their EEG pattern, to receive topiramate added to standard treatment with moderate hypothermia or standard treatment alone. Topiramate will be administered at 10 mg/kg once a day for the first 3 days of life. Topiramate concentrations will be measured on serial dried blood spots. 64 participants will be recruited in the study. To evaluate the safety of topiramate administration, cardiac and respiratory parameters will be continuously monitored. Blood samplings will be performed to check renal, liver and metabolic balance. To evaluate the efficacy of topiramate, the neurologic outcome of enrolled newborns

  16. 拉玛泽呼吸法配合自由体位对产妇分娩的影响%Influence of Ramah ze breathing method combined with free position on maternity

    Institute of Scientific and Technical Information of China (English)

    李利; 涂素华; 何利萍

    2012-01-01

    [目的]探讨拉玛泽呼吸法配合自由体位对产妇分娩的影响.[方法]观察组120例产妇产程中应用拉玛泽呼吸法配合自由体位协助分娩;对照组120例产妇采取常规体位分娩,产程中未使用呼吸技巧,比较两组产妇产程及分娩结局.[结果]两组剧痛、总产程、活跃期的加速期、第二产程时间、胎儿宫内窘迫、新生儿窒息以及剖宫产率比较,差异有统计学意义(P<0.05或P<0.01).[结论]拉玛泽呼吸法配合自由体位能稳定产妇情绪,有效减轻产时疼痛,缩短产程,增加胎儿氧的供给量,降低胎儿宫内窘迫及新生儿窒息的发生,减少剖宫产率,促进自然分娩.%objective: To probe into the influence of Ramah ze breathing method combined with free position on maternity. Methods: 120 cases of maternal in observation group used Ramah ze breathing method combined with free position for assisting childbirth during labor; 120 cases of maternal in control group took conventional position for childbirth, breathing skills were not used during the labor, then the labor and birth outcomes were compared between the two groups. Results: There was statistically significant difference(P<0. 05 or P<0. 0l)in the sharp pain,the total labor, the accelerated phase of active phase,the time of the second stage of labor,fetal distress, neonatal asphyxia, and cesarean section rate between both groups. Conclusion: The Ramah ze breathing method combined with free position can make the maternal's mood stable,effectively alleviate labor pain,shorten labor,increase fetal oxygen supply,so as to reduce the incidence of fetal distress and neonatal asphyxia,reduce the rate of cesarean section and promote natural childbirth.

  17. 169 cases of hypertensive disorders in pregnancy termination of pregnancy timing and mode of delivery clinical analysis%妊娠期高血压疾病169例终止妊娠时机及分娩方式临床分析

    Institute of Scientific and Technical Information of China (English)

    李红

    2012-01-01

    目的:探讨妊娠高血压疾病终止妊娠时机及分娩方式.方法:回顾性分析我院2004年6月至2012年3月169例住院分娩的妊娠期高血压疾病患者,观察产后出血及新生儿窒息率.结果:21例经阴道分娩,148例剖宫产,剖宫产率87.04%;产后出血发生率经阴道分娩者9.50%,剖宫产9.45%(P>0.05);新生儿窒息发生率经阴道分娩者28.57%,剖宫产者8.11%(P< 0.05).结论:妊娠期高血压疾病的终止妊娠时间及分娩方式的选择应视孕周、病情进展、胎儿成熟及药物治疗的效果等情况综合而定.%Objective: To investigate hypertensive disorders of pregnancy termination of pregnancy time and delivery mode.Methods: A retrospective analysis of our hospital in 2004 June to 2012 March, 169 cases of hospital delivery in patients with hypertensive disorders in pregnancy, postpartum hemorrhage and neonatal asphyxia rate observation.Results: 21 cases of vaginal birth, cesarean section in 148 cases, and cesarean section rate was 87.04%; the rate of postpartum hemorrhage of vaginal birth after cesarean section in 9.50%, 9.45% (P > 0.05); the incidence of neonatal asphyxia rate of vaginal birth after cesarean section in 28.57%, and 8.11% (P < 0.05).Conclusion: Hypertensive disorders in pregnancy the time of termination of pregnancy and childbirth way choice should be considered the week of pregnancy, fetal maturation progresses, and effect of drug treatment, comprehensive and.

  18. Electroencephalogram and brainstem auditory evoked potential in 539 patients with central coordination disorder

    Institute of Scientific and Technical Information of China (English)

    Huijia Zhang; Hua Yan; Paoqiu Wang; Jihong Hu; Hongtao Zhou; Rong Qin

    2008-01-01

    BACKGROUND: Electroencephalogram (EEG) and brainstem auditory evoked potential (BAEP) are objective non-invasive means of measuring brain electrophysiology.OBJECTIVE: To analyze the value of EEG and BAEP in early diagnosis, treatment and prognostic evaluation of central coordination disorder.DESIGN, TIME AND SETTING: This case analysis study was performed at the Rehabilitation Center of Hunan Children's Hospital from January 2002 to January 2006.PARTICIPANTS: A total of 593 patients with severe central coordination disorder, comprising 455 boys and 138 girls, aged 1--6 months were enrolled for this study.METHODS: EEG was monitored using electroencephalography. BAEP was recorded using a Keypoint electromyogram device. Intelligence was tested by professionals using the Gesell scale.MAIN OUTCOME MEASURES: (1) The rate of abnormal EEG and BAEP, (2) correlation of abnormalities of EEG and BAEP with associated injuries, (3) correlation of abnormalities of EEG and BAEP with high risk factors.RESULTS: The rate of abnormal EEG was 68.6% (407/593 patients), and was increased in patients who also had mental retardation (P < 0.05). The rate of abnormal BAEP was 21.4% (127/593 patients). These 127 patients included 67 patients (52.8%) with peripheral auditory damage and 60 patients (47.2%) with central and mixed auditory damage. The rate of abnormal BAEP was significantly increased in patients who also had mental retardation (P < 0.01). Logistic regression analysis showed that asphyxia (P < 0.05), jaundice,preterm delivery, low birth weight and the umbilical cord around the neck were closely correlated with abnormal EEG in patients with central coordination disorder. Intracranial hemorrhage, jaundice (P < 0.05),low birth weight and intrauterine infection (P < 0.05) were closely correlated with abnormal BAEP in patients with central coordination disorder.CONCLUSION: Central coordination disorder is often associated with abnormal EEG and BAEP. The rate of EEG or BAEP abnormality

  19. Analysis on effects of fetal age and birth weight on prognosis of premature infants%胎龄和出生体重对早产儿预后影响分析

    Institute of Scientific and Technical Information of China (English)

    卫雅蓉; 章恒; 许兵

    2011-01-01

    目的:探讨胎龄及出生体重对早产儿预后的影响.方法:回顾性分析无锡市妇幼保健院2008年1月~2009年12月间分娩的217例早产儿资料.结果:早产儿并发症的发生率和死亡率分别为43.8%和2.3%.早产儿并发症和死亡主要发生于胎龄<32周或出生体重<1 500 g的极低体重儿.缺氧缺血性脑病、窒息、呼吸窘迫综合症发生率和死亡率随胎龄或出生体重增加均呈下降趋势.结论:出生前加强孕期保健,尽可能延长胎龄,促进肺成熟;出生后防止早产儿窒息和加强低出生体重儿监护,将降低早产儿并发症发生率和死亡率.%Objective: To explore the effects of fetal age and birth weight on prognosis of premature infants. Methods: The clinical data of 217 premature infants born in the hospital from January 2008 to December 2009 were analyzed retrospectively. Results: The incidence of complication and mortality of premature infants were 43.8% and 2. 3%, respectively; the premature infants less than 32 gestational weeks or birth weight < 1 500 g had high incidence of complication and high mortality; the incidences of complications ( including hypoxic ischemic encephalopathy, asphyxia and respiratory distress syndrome) and mortality of premature infants showed a decreasing trend with fetal age and the increase of birth weight. Conclusion: Enhancing pregnant health care before delivery, prolonging fetal age as far as possible,promoting fetal lung maturity, preventing neonatal asphyxia and strengthening the monitoring on low birth weight infants may reduce the incidence of complication and mortality of premature infants.

  20. 早产儿Apgar评分与脐动脉血气值相关性44例分析%Correlation between Apgar Score and Umbilical Artery Blood Gas Values of Premature Infant:Analysis on 44 Cases

    Institute of Scientific and Technical Information of China (English)

    杨静波; 隋广涛

    2011-01-01

    [Objective] To study the correlation between Apgar score and blood gas analysis among premature infant, so as to guide the clinical diagnosis and treatment of asphyxia in premature infants. [ Methods ] By using i-STAT blood gas analyzer, the blood gas analysis was conducted in umbilical arterial blood of 44 premature infants and 36 full-term infants at 1 and 5 minutes after birth, and correlation between the results and Aptgar score was analyzed. [ Results ] The blood pH in the premature infant group and the full-term infant group was 7.24 ± 0.04 and 7.22 ± 0.04, respectively. In the premature infant group, there were 13 infants whose l-min Apgar score was ≤7, which accounted for 29.5%, there were 7 infants whose 5-min Apg ar score was ≤7, which accounted for 15.9%. In the full-term infant group, there were 3 infants whose l-min and 5-min Apgar score was ≤7, which accounted for 8. 3%. [ Conclusion ] Apgar score should be combined with umbilical artery blood gas values in diagnosis of asphyxia in premature infants, and the umbilical artery blood gas values is more important.%目的:研究早产儿生后Apgar评分与血气分析的相关性,以指导临床对早产儿窒息的诊断及处理.方法:用i-STAT型血气分析仪对44例早产儿及36例足月儿生后1、5 min脐动脉血进行血气分析,并与Apgar评分进行相关分析.结果:血pH值:早产儿组为7.24±0.04,足月儿组为7.22±0.04.Apgar评分:早产儿组1 min Apgar评分≤7分的有13名,占总数的29.5%;5 min Apgar评分47分的有7名,占总数的15.9%;足月儿1 min和5 min Apgar评分≤7分的共有3名,占总数的8.3%.结论:诊断早产儿窒息时应将Apgar评分与脐动脉血气值相结合,且以脐动脉血气结果为主.

  1. [Premature rupture of membranes and chorioamnionitis].

    Science.gov (United States)

    Lopez Garcia, R

    1988-01-01

    Despite advances in perinatal medicine in the past decade, the diagnosis and treatment of premature rupture of membranes remain controversial. Premature rupture occurs in 2.7-7.0% of pregnancies and most cases occur spontaneously without apparent cause. The disparity in reported rates of premature rupture is due to differences in the definition and diagnostic criteria for premature rupture and lack of comparability in the populations studied. Mexico's National Institute of Perinatology has adopted the definition of the American COllege of Gynecology and Obstetrics which views premature rupture as that occurring before regular uterine contractions that produce cervical dilation. 8.8% of its patients have premature rupture according to this definition. 20% of cases occur before the 36th week of pregnancy. Treatment of rupture occurring before 37 weeks must balance the threat of amniotic infection with the dangers of premature birth. Infections appear more common in low income patient populations. Chorioamnionitis is a serious complication of pregnancy and is the main argument against conservative treatment of premature rupture. The rate of maternal infection is directly related to the time elapsing between rupture of the membranes and birth. The rate increases after the 1st 24 hours and is at least 10 times higher after 72 hours. But recent studies suggest that there is no considerable increase in infection if vaginal explorations are avoided and careful techniques are used in treating the patient. Those who advise conservative treatment believe that prenatal outcomes are better because respiratory disease syndrome due to prematurity is avoided. Conservative management requires a white cell count at least every 24 hours and measurement of pulse, maternal temperature, and fetal heart rate ideally every 4 hours. Perinatal mortality rates due to premature rupture of membranes range from 2.5-50%. The principal causes are respiratory disease syndrome, infection, asphyxia

  2. Analysis of Effectiveness and Safety of Assisted Delivery

    Directory of Open Access Journals (Sweden)

    Kozlova T.U.

    2014-06-01

    Full Text Available Aim: to study the outcomes of labour after the application of «KIWI» vacuum-system. Materials and Methods. Retrospective analysis of labour records with vacuum-extraction of fetus (main group: n=35 and with emergency cesarean section (comparison group: n=18on indications similar to those in the main group, has been undertaken. Results. High rate of extragenital pathology in groups (70,7% and 72,3% as well as aggravated obstetric-gynecologic anamnesis (36,9% and 55,6% has been revealed. Pregnancies of 50,7% women of the main group have been complicated by placentofetal insufficiency and chronic fetal hypoxia; in the comparison group 27,7% threatened miscarriage has been observed accordingly in 20% and 33,3%. Conditions for vacuum extraction have been the following: fetus asphyxia (52,3%, labour pains weakness (47,7%. Having evaluated the state of health of the new-born children of the main groupstraight complications (cephalohematomas, cervical injury, subaponeurotic hemorrhage, Duchen-Erb paresis, intraventricularhemorrage have been observed in 53,8% of children. In the comparison group direct complications have been marked in 22,3% of cases. Conclusions. Comparatively high rate of labour traumatism in the main group may be explained by violations in conditions and techniques of vacuum-extractions as well as by non-observance of indications and contra-indications for the application of this operational method during the labour of pregnant women of high risk groups.

  3. Surgical Treatment of Neonatal Necrotic Enterocolitis: An Analysis of 17 Cases%新生儿坏死性小肠结肠炎的外科处理(附17例报告)

    Institute of Scientific and Technical Information of China (English)

    陈永田; 谷兴琳

    1983-01-01

    @@ 新生儿坏死性小肠结肠炎(简写NNE)是新生儿严重的消化道疾病.虽然近年来外科处理有很大进展,但手术死亡率仍高达39~68(1~5)%.%Neonatal necrotic enterocolitis, a lethal disease in premature infancy, is common in newborns. This report details surgical treatment of 17 infants (13 males and 4 females) in the past 10 years.Asphyxia -was noted only in 2 cases. All the patients had abdominal distension. Other physical findings include: vomiting (6 cases), diarrhea (2), lower abdomen mass (1), blood in stool (6)and fiery swelling in the abdominal wall (8).In 16 cases, the X-rays demonstrated intestinal distension with fluid levels resulting from:pneumoperitoneum (12 cases), pneu-motosis (4), portal vein gas (2) and ascites (2).Surgical interventions were indicated to 11 patients with pneumoperitoneum, 2 with clinical deterioration and 1 with positive paracentesis findings.Procedures applied in this series consist of: simple repairing of restricted perforation (4), simple explorative laparotomy or colonic resection followed by primary anastomosis or enterostomy. But in one case, the necrosis was not clearly bordered, so only the completely necrotic segment of the intestine was resected while the less affected part left untouched. Then, an anastomosis. Yet, short-bowel syndrome developed afterwards.Mortality was recorded as 30%.

  4. Hereditary angioedema: classification, pathogenesis, and diagnosis.

    Science.gov (United States)

    Banerji, Aleena

    2011-01-01

    Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder associated with a deficiency in C1 inhibitor. More than 200 mutations in this gene, located on chromosome 11, have been identified. Although HAE is often inherited, 20-25% of cases are from new spontaneous mutations and they have no family history of swelling. Decreased C1 inhibitor activity leads to inappropriate activation of multiple pathways, including the complement and contact systems and the fibrinolysis and coagulation systems. Reduced C1 inhibitor activity results in increased activation of plasma kallikrein-kinin system proteases and increased bradykinin levels. Bradykinin is felt to be the main mediator of symptoms in HAE. Patients with HAE have recurrent episodes of swelling of the extremities, abdomen, face, and upper airway. Angioedema involving the gastrointestinal tract can lead to intestinal wall edema, which results in abdominal pain, nausea, vomiting, and diarrhea. Laryngeal swelling is life-threatening and may lead to asphyxia. Common triggers of an attack include trauma, stress, infection, menstruation, oral contraceptives, hormone replacement therapy, and angiotensin-converting enzyme inhibitors. Laboratory testing including C4, C1 inhibitor level, and function is needed to confirm or rule out the diagnosis of HAE. The treatment of HAE has improved significantly in recent years with the availability of several safe and effective therapies. Several consensus guidelines have been created to further assist in the management of HAE patients. This review will provide an update on the classification, pathophysiology, clinical presentation, and diagnosis of HAE. PMID:22221432

  5. Perinatal mortality and socio-spatial inequalities

    Directory of Open Access Journals (Sweden)

    Eunice Francisca Martins

    2013-09-01

    Full Text Available OBJECTIVE: to analyze the social inequalities in the distribution of perinatal mortality in Belo Horizonte. MATERIAL AND METHODS: the perinatal deaths of residents in Belo Horizonte in the period 2003 to 2007 were studied on the basis of the Information Systems on Mortality and Newborns. The space analysis and the Health Vulnerability Index were used to identify existing inequalities in the sanitary districts regarding coverage and risk, determined by the Odds Ratio and a value p<0.05. The multivariate analysis was used to describe a model for perinatal mortality. RESULTS: there was a proved variation in the numbers of perinatal mortality per one thousand total births in the sanitary districts (12.5 to 19.4, coverage areas (5.3 to 49.4 and areas of risk (13.2 to 20.7. The mortality rate diminished as the maternal schooling increased. The death rates deriving from asphyxia/hypoxia and non-specified fetal death grew with the increase of risk in the area. CONCLUSION: it was verified that the perinatal deaths are distributed in a differentiated form in relation to the space and the social vulnerabilities. The confrontation of this complex problem requires the establishment of intersecting partnerships.

  6. Giant fibrovascular polyp of the esophagus: report of a case.

    Science.gov (United States)

    Goenka, Ajit Harishkumar; Sharma, Sanjay; Ramachandran, Vijay; Chattopadhyay, Tushar K; Ray, Ruma

    2011-01-01

    A fibrovascular polyp is a peculiar nonepithelial tumor of the esophagus that invariably arises in the cervical esophagus at the level of the thoracic inlet and grows distally into a massive elongated, pedunculated, intraluminal lesion. Although it is a benign lesion that is eminently resectable, it is a dramatic entity owing to its tendency to cause bizarre complications such as asphyxia and sudden death when it regurgitates into the pharynx and causes laryngeal impaction. This report describes the multimodality imaging appearance of an archetypal case of a giant fibrovascular polyp in a patient with a seemingly innocuous presentation for the size of the lesion. The essential role of cross-sectional imaging in establishing a prompt diagnosis, defining the tissue elements of the mass, and delineation of the exact extent of the lesion in guiding the treatment approach is highlighted. The appearance of fibrovascular polyp in a single patient with a combination of barium swallow, multidetector computed tomography, and high-resolution contrast-enhanced magnetic resonance imaging has not been reported previously. PMID:21191703

  7. Impact of Cerebral Visual Impairments on Motor Skills: Implications for Developmental Coordination Disorders

    Science.gov (United States)

    Chokron, Sylvie; Dutton, Gordon N.

    2016-01-01

    Cerebral visual impairment (CVI) has become the primary cause of visual impairment and blindness in children in industrialized countries. Its prevalence has increased sharply, due to increased survival rates of children who sustain severe neurological conditions during the perinatal period. Improved diagnosis has probably contributed to this increase. As in adults, the nature and severity of CVI in children relate to the cause, location and extent of damage to the brain. In the present paper, we define CVI and how this impacts on visual function. We then define developmental coordination disorder (DCD) and discuss the link between CVI and DCD. The neuroanatomical correlates and aetiologies of DCD are also presented in relationship with CVI as well as the consequences of perinatal asphyxia (PA) and preterm birth on the occurrence and nature of DCD and CVI. This paper underlines why there are both clinical and theoretical reasons to disentangle CVI and DCD, and to categorize the features with more precision. In order to offer the most appropriate rehabilitation, we propose a systematic and rapid evaluation of visual function in at-risk children who have survived preterm birth or PA whether or not they have been diagnosed with cerebral palsy or DCD. PMID:27757087

  8. A clinically relevant model of perinatal global ischemic brain damage in rats.

    Science.gov (United States)

    Yang, Ting; Zhuang, Lei; Terrando, Niccolò; Wu, Xinmin; Jonhson, Mark R; Maze, Mervyn; Ma, Daqing

    2011-04-01

    We have designed a clinically relevant model of perinatal asphyxia providing intrapartum hypoxia in rats. On gestation day 22 SD rats were anesthetized and the uterine horns were exteriorized and placed in a water bath at 37°C for up to 20min. After this, pups were delivered from the uterus and manually stimulated to initiate breathing in an incubator at 37°C for 1 h in air. Brains were harvested and stained with cresyl violet, caspase-3, and TUNEL to detect morphological and apoptotic changes on postnatal days (PND) 1, 3, and 7. Separate cohorts were maintained until PND 50 and tested for learning and memory using Morris water maze (WM). Survival rate was decreased with longer hypoxic time, and 100% mortality was noted when hypoxia time was beyond 18min. Apoptosis was increased with the duration of hypoxia with neuronal loss and cell shrinkage in the CA1 of hippocampus. The time taken for the juveniles to locate the hidden platform during WM was increased in animals subjected to hypoxia. These data demonstrate that perinatal ischemic injury leads to neuronal death in the hippocampus and long-lasting cognitive dysfunction. This model mimics hypoxic ischemic encephalopathy in humans and may be appropriate for investigating therapeutic interventions. PMID:21281606

  9. 窒息新生儿225例血糖分析%Analysis of the blood sugar in asphyxial neonates

    Institute of Scientific and Technical Information of China (English)

    吴起武

    2009-01-01

    目的 探讨窒息新生儿血糖的变化.方法 对225例窒息新生儿和43例对照组新生儿进行血糖检测和分析.结果 窒息组和对照组血糖水平比较差异无统计学意义[(3.85±2.01)与(4.37±1.01),P>0.05],重度窒息组血糖水平和高血糖发生率均显著高于轻度窒息组(均P 0.05]. The quantity of blood sugar and the incidence rate of hyperglycosemia in seriously asphyxial group were more greater than slightly asphyxial group(P <0.01). The quantity of blood sugar in slighdy asphyxial group was less than the control group (P < 0.05). The quantiy of blood sugar in asphyxial premature infants was significantly less than asphyxial full-term infants(P < 0.05). Conclusions The blood sugar level in asphyxial neonates is relative to the degree of asphyxia and gestational age. The blood sugar in highly asphyxial neonates rise whereas in slightly as-phyxial neonates and asphyxial premature infants reduce.

  10. Animal experimentation in forensic sciences: How far have we come?

    Science.gov (United States)

    Cattaneo, C; Maderna, E; Rendinelli, A; Gibelli, D

    2015-09-01

    In the third millennium where ethical, ethological and cultural evolution seem to be leading more and more towards an inter-species society, the issue of animal experimentation is a moral dilemma. Speaking from a self-interested human perspective, avoiding all animal testing where human disease and therapy are concerned may be very difficult or even impossible; such testing may not be so easily justifiable when suffering-or killing-of non human animals is inflicted for forensic research. In order to verify how forensic scientists are evolving in this ethical issue, we undertook a systematic review of the current literature. We investigated the frequency of animal experimentation in forensic studies in the past 15 years and trends in publication in the main forensic science journals. Types of species, lesions inflicted, manner of sedation or anesthesia and euthanasia were examined in a total of 404 articles reviewed, among which 279 (69.1%) concerned studies involving animals sacrificed exclusively for the sake of the experiment. Killing still frequently includes painful methods such as blunt trauma, electrocution, mechanical asphyxia, hypothermia, and even exsanguination; of all these animals, apparently only 60.8% were anesthetized. The most recent call for a severe reduction if not a total halt to the use of animals in forensic sciences was made by Bernard Knight in 1992. In fact the principle of reduction and replacement, frequently respected in clinical research, must be considered the basis for forensic science research needing animals.

  11. The etiology of neonatal sepsis and patterns of antibiotic resistance

    International Nuclear Information System (INIS)

    Objective: To study the patterns of causative bacteria and antibiotic resistance in neonatal sepsis. Results: Among 228 cases included in the study, the male to female ratio was 2.1 to 1. The gestational age was less than 36 weeks in 68 (30%) cases and low birth weight babies were 143 (62.6%). History of birth asphyxia was present in 103 (45%) cases. There were 142 (62.3%) cases of early onset (7 days). Out of 233 positive blood cultures Escherichia coli was found to be commonest (47.8%, n =111, p<0.05) both in early onset (47.8%, n=68, p <0.05) and late onset sepsis (47.3%,n=43, p<0.05). Staphylococcus aureus was the most common among gram positive organism. Resistance to cefotaxime, ceftazidime and amikacin was 34% to 80% and to ciprofloxacin 13% to 72%. A total of 64 cases (28%) died. Mortality was four times higher in early onset sespis. Conclusion: Gram negative bacteria are the commenst cause of neonatal sepsis. The resistance to the commonly used antibiotics is alarmingly high. Mortality is four times higher in early one set sepsis. (author)

  12. Pregnancy outcome analysis of 73 cases of placental abruption%胎盘早剥73例妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    马善朵

    2014-01-01

    Objective:To investigate the clinical manifestations of placental abruption and pregnancy outcome of perinatal and maternal with placental abruption.Methods:73 patients with placental abruption were selected from November 2010 to May 2014. The clinical data were retrospectively analyzed.Results:The severity of placental abruption had different effects on the perinatal outcome and maternal prognosis.Perinatal mortality,neonatal asphyxia and the incidence of maternal complications were increased significantly.Conclusion:Placental abruption is harmful to fetal health.It should be timely diagnosed and treated.%目的:探讨胎盘早剥的临床表现及胎盘早剥的围产儿及母体的妊娠结局影响。方法:2010年11月-2014年5月收治胎盘早剥患者73例,回顾性分析其临床资料。结果:胎盘早剥严重程度对围产儿结局及母体的预后有明显不同,围产儿死亡率、新生儿窒息及产妇发生并发症明显增多。结论:胎盘早剥严重危害母胎健康,应及时诊治。

  13. Advances in pediatrics in 2014: current practices and challenges in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Sciorio, Elisa; Povesi-Dascola, Carlotta; Bernasconi, Sergio

    2015-01-01

    Major advances in the conduct of pediatric practice have been reported in the Italian Journal of Pediatrics in 2014. This review highlights developments in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses. Investigations endorse a need to better educate guardians and improve nutritional management in food allergy. Management of hyperbilirubinemia in neonates and of bronchiolitis have been improved by position statements of scientific societies. Novel treatments for infant colic and inflammatory bowel diseases have emerged. Studies suggest the diagnostic utility of ultrasonography in diagnosing community-acquired pneumonia. Progress in infectious diseases should include the universal varicella vaccination of children. Recommendations on asphyxia and respiratory distress syndrome have been highlighted in neonatology. Studies have evidenced that malnutrition remains a common underestimated problem in developing countries, while exposure to cancer risk factors in children is not negligible in Western countries. Advances in our understanding of less common diseases such as cystic fibrosis, plastic bronchitis, idiopathic pulmonary hemosiderosis facilitate diagnosis and management. Researches have led to new therapeutic approaches in patent ductus arteriosus and pediatric malignancies.

  14. Effects of preoperative other diseases on the complications of senile cervical vertebral operation in perioperative period%术前并存疾病对老年颈椎手术围术期并发症的影响

    Institute of Scientific and Technical Information of China (English)

    王成才; 袁红斌; 田谋利; 王新华; 贾连顺

    2003-01-01

    AIM:To investigate the effects of preoperative other diseases on the complications of senile cervical vertebral operation in perioperative period.METHODS:800 senile cervical vertebral cases were divided into two group: group A included the cases without other comorbidities,and group B included the cases with hypertension, diabetes mellitus,coronary heart disease(CHD) or chronic obstructive pulmonary disease(COPD).We retrospectively analyzed the changes of BP,oxygen saturation(SaO2) and the incidence of cardiac arrhythmia during operation of group A and B.RESULTS:In perioperative period, the incidence of BP reduction or rising and cardiac arrhythmia in group B was more than that of group A.Incidence of SaO2 decreasing increases apparently in each stage and incidence of cerebrovascular, pulmonary complications and asphyxia led by incision bleeding increases apparently.CONCLUSION:The hypertension, CHD, diabetes mellitus and COPD were the main reasons of complications of the heart,the cerebral vessels and the lung, kidney and the incision bleeding in perioperative period of senile patients.

  15. "Inhumanly brought back to life and misery": Mary Wollstonecraft, Frankenstein, and the Royal Humane Society.

    Science.gov (United States)

    Williams, C

    2001-01-01

    While thorough investigation of many aspects of contemporary scientific developments and Mary Shelley's personal history have provided illuminating contexts for the study of Frankenstein, the activities of the Royal Humane Society, and other bodies and individuals who pioneered and publicized resuscitation techniques, have been comparatively neglected. Here we find a richly documented, highly conspicuous area of scientific endeavour, which generated much excitement in life and literature from the last quarter of the eighteenth century onwards. There are three major points of contact with Frankenstein: Victor Frankenstein's revival of dead tissue to make his creature; the frequent occurrences of unconsciousness and asphyxia, both in the novel and in Mary Shelley's family during the period leading up to its composition, and the widely differing degrees of competence and success with which they are treated; and the possibility that resuscitative techniques were used to revive Mary Shelley's mother, Mary Wollstonecraft, after a suicide attempt. The impact on Frankenstein of Mary Shelley's lifelong distress at the role she played in bringing about her mother's death in childbirth has been thoroughly canvassed by other critics, notably Anne Mellor, but the thought that Mary Shelley, who was herself conceived after her mother's second suicide attempt, might be, in a sense, a child of the dead adds a further turn to the Gothic screw. This study traces a hitherto unexplored intersection between Mary Shelley's first novel and her family history, as well as showing how it launches a formidable attack on the shady ethics and inconsiderate arrogance of some early resuscitators.

  16. Severe anemia and hydrops in a neonate with parvovirus B19 infection: a case report

    Directory of Open Access Journals (Sweden)

    Negar Sajjadian

    2013-12-01

    Full Text Available Background: Anemia at the time of birth may cause some problem like asphyxia, heart failure shock or even death in a neonate. Different etiologies can be considered for this problem. Parvovirus B19, as a viral organism, can cause hydrops fetalis and neonatal anemia and consequent complications. We present here a case of newborn infant with severe anemia who had human parvovirus B19 infection.Case Presentation: A male newborn with gestational age of 36 week was born from a mother with poor prenatal care and history of contact with domestic animal. The neonate was very pale with Apgar score 2 at 1 min and received resuscitation, mechanical ventilation and repeated blood transfusion The hemoglobin level was significantly low. Analysis was made based on the clinical presentations. According to the case history, physical and laboratory findings, neonatal severe anemia induced by parvovirus B19 infection was suggested and Laboratory work up documented his infection with parovirus B19.Conclusion: Parvovirus B19 (B19 virus is the smallest single strand linear DNA virus in animal viruses, which is the only strain of parvovirus that is pathogenic in humans. Human parvovirus B19 may cross the placenta and result in fetal infection, morbidity and death. Parvovirus is an uncommon cause of neonatal anemia and hydrops fetalis so this etiology must be considered in differential diagnosis of anemia at birth.

  17. Antiretroviral treatment induced catatonia in 16-year-old boy

    Directory of Open Access Journals (Sweden)

    Anand Lingeswaran

    2014-01-01

    Full Text Available We present a 16-year-old boy, who had presented to us with catatonic features of mutism, withdrawal, passive negativism, grimacing, gesturing, echopraxia, and excitement of 5 days duration while taking antiretroviral therapy (ART for a period of 2 years. He had history of birth asphyxia and acquired HIV infection from his father when the same syringe and needle was used on both of them in a medical setting where the father and son had consulted for treatment of pyrexia of unknown origin. He was the eldest of a three children family in which the biologic father had acquired HIV through extramarital sexual contact with HIV-infected sex workers but was unaware of his HIV positive status till our patient, the 16-year-old was admitted and treated for pulmonary tuberculosis at 14 years of age. The boy′s mother had only acquired HIV after having three children with the HIV-positive husband, thus leaving the other two children HIV negative. The catatonia completely resolved within 2 days after the ART was withheld, and risperidone 1 mg twice a day was prescribed. This case highlights the risks of ART and breach of universal precautions.

  18. Airtraq喉镜的临床应用与研究进展%The clinical application and research progress of airtraq laryngoscope

    Institute of Scientific and Technical Information of China (English)

    杨广遂

    2013-01-01

    Airtraq喉镜是一次性使用气管插管工具,无需口、咽、气管三轴线的重合即能提供高质量的声门图像.Airtraq在常规或困难气道方面优于传统的Macintosh喉镜.成功应用于大量的困难气道病例,包括病态肥胖、创伤后窒息.此外,该喉镜也成功应用于普通或困难气道的经鼻气管插管及清醒插管.%The Airtraq laryngoscope (Prodol Meditec S.A.,Vizcaya,Spain) is a disposable tracheal intubation device.It was designed to provide a high quality view of the glottis without the need to align the oral,pharyngeal and tracheal axes.A number of reports suggested that use of the Airtraq laryngoscope may be superior to the Macintosh laryngoscope in patients in routine airway management and/or increased risk for difficult intubation.The Airtraq was used successfully in a number of cases with difficult airway management,including morbid obesity,posttraumatic asphyxia.In addition,this device has been used successfully for nasotracheal intubation (NTI) in an uncomplicated or difficult airway,as well as awake tracheal intubation.

  19. Oxygen Saturation Reference Value by Percutaneous Pulse Oximetry in Asymptomatic Newborn Babies in Nigeria: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Obumneme Ezeanosike

    2016-08-01

    Full Text Available About 1/4 of all neonatal deaths in Nigeria are caused by birth asphyxia. Normal values of oxygen saturation vary according to regional altitudes. They are important for the screening of cyanotic congenital heart diseases and during newborn resuscitation. There is a dearth of such information in Nigeria. We determined reference values for oxygen saturation by pulse oximetry (SpO2 in asymptomatic newborns aged ≤7 days in Enugu at an altitude of 180 m. The study was cross-sectional. Neonates weighing ≥1500 g at birth were enrolled consecutively. Pre-and post-ductal oxygen saturation was measured using a Datex-Ohmeda Tuffsat® pulse oximeter with neonatal probes. Five hundred and fourteen babies comprising of 24 (4.4% preterm and 490 (95.3% term neonates were studied. The mean pre-ductal SpO2 of all babies was 96.1% ± 1.4% and higher than mean post-ductal SpO2 of 95.9% ± 1.4% (p = 0.022. The mean pre-ductal SpO2 were 96.1% ± 1.5% and 96.1% ± 1.3%, (p = 1.000 for males and females, respectively. The mean pre-ductal SpO2 values were higher than the mean post-ductal SpO2 for the corresponding post-natal ages.

  20. Design of a Functional Training Prototype for Neonatal Resuscitation

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    Sivaramakrishnan Rajaraman

    2014-11-01

    Full Text Available Birth Asphyxia is considered to be one of the leading causes of neonatal mortality around the world. Asphyxiated neonates require skilled resuscitation to survive the neonatal period. The project aims to train health professionals in a basic newborn care using a prototype with an ultimate objective to have one person at every delivery trained in neonatal resuscitation. This prototype will be a user-friendly device with which one can get trained in performing neonatal resuscitation in resource-limited settings. The prototype consists of a Force Sensing Resistor (FSR that measures the pressure applied and is interfaced with Arduino® which controls the Liquid Crystal Display (LCD and Light Emitting Diode (LED indication for pressure and compression counts. With the increase in population and absence of proper medical care, the need for neonatal resuscitation program is not well addressed. The proposed work aims at offering a promising solution for training health care individuals on resuscitating newborn babies under low resource settings.

  1. Clinical Uses of Melatonin in Pediatrics

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    Emilio J. Sánchez-Barceló

    2011-01-01

    Full Text Available This study analyzes the results of clinical trials of treatments with melatonin conducted in children, mostly focused on sleep disorders of different origin. Melatonin is beneficial not only in the treatment of dyssomnias, especially delayed sleep phase syndrome, but also on sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, and, in general, in all sleep disturbances associated with mental, neurologic, or other medical disorders. Sedative properties of melatonin have been used in diagnostic situations requiring sedation or as a premedicant in children undergoing anesthetic procedures. Epilepsy and febrile seizures are also susceptible to treatment with melatonin, alone or associated with conventional antiepileptic drugs. Melatonin has been also used to prevent the progression in some cases of adolescent idiopathic scoliosis. In newborns, and particularly those delivered preterm, melatonin has been used to reduce oxidative stress associated with sepsis, asphyxia, respiratory distress, or surgical stress. Finally, the administration of melatonin, melatonin analogues, or melatonin precursors to the infants through the breast-feeding, or by milk formula adapted for day and night, improves their nocturnal sleep. Side effects of melatonin treatments in children have not been reported. Although the above-described results are promising, specific studies to resolve the problem of dosage, formulations, and length of treatment are necessary.

  2. A community based study of Infant Mortality in rural Aligarh

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    Shah MS

    2011-01-01

    Full Text Available BackgroundInfant mortality rate is regarded as an important andsensitive indicator of the health status of a community. Italso reflects the living standard of the people and theeffectiveness of interventions for improving maternal andchild health. Multiple factors related to social and economicconditions, health care and environment have a significantrole to play on childhood mortality and improving childhoodmortality is a national priority. The present study wasplanned to 1 determine the mortality rate among neonatesand infants. 2 identification of pattern of various factors inrelation to infant mortality and 3 to identify the causes ofdeath in this age group.MethodAll the deaths in children under 12 months during July 2005to June 2006 in Jawan block of district Aligarh, India wererecorded. The cause of death was ascertained using thestandard verbal autopsy procedure.ResultsIn the study period, 446 live births and 37 deaths in childrenunder one year of age were reported. The neonatal andinfant mortality rates were 49.4 and 83.0 per thousand livebirths respectively. The main causes of infant deaths werebirth asphyxia, diarrhoea, pneumonia, prematurity(including Low birth weight and malnutrition.ConclusionMost of the death among infants are preventable, thoughpromotion of institutional deliveries, strengthening of referralsystem, early recognition of danger signs and periodicretraining of health workers.

  3. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

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    Yadav Sudha

    1998-01-01

    Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

  4. Determining Optimal Strategies to Reduce Maternal and Child Mortality in Rural Areas in Western China: an Assessment Using the Lives Saved Tool.

    Science.gov (United States)

    Jiang, Zhen; Guo, Su Fang; Scherpbier, Robert W; Wen, Chun Mei; Xu, Xiao Chao; Guo, Yan

    2015-08-01

    China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China. PMID:26383598

  5. Discussion of the Diversified Nursing Intervention in the Application of Pregnancy-induced Hypertension Disease%多元化护理干预在妊娠高血压疾病中的应用探讨

    Institute of Scientific and Technical Information of China (English)

    金莉

    2014-01-01

    目的:探讨多元化护理干预对妊娠高血压疾病患者的影响,总结其方法。方法将68例妊高症患者随机分为对照组和干预组各34例,对照组给予常规护理,干预组给予多元化护理措施,比较两组产妇的妊娠结局和新生儿情况。结果干预组孕产妇早产、产后出血、胎盘早剥发生率明显低于对照组(P0.05);干预组新生儿体重及Apgar评分显著高于对照组( P0. 05 ) . While the birth weight and Apgar score of intervention group was significantly higher than the control group (P<0. 01), the incidence of fetal distress and neonatal asphyxia of the intervention group was lower than the control group (P<0. 05), and the difference was statistically significant. Conclusion By implementing diversified nursing intervention in patients with pregnancy-induced hypertension, the pregnancy outcomes can be changed, the incidence of maternal and infant complications can be reduced, and the quality of maternal and child survival rate can be improved, with great clinical application value.

  6. Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

    Science.gov (United States)

    Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

    2015-06-01

    Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. PMID:26115858

  7. 选择性剖宫产儿急性呼吸窘迫综合征发病机制研究进展%Progress in the pathogenesis of acute respiratory distress syndrome in neonate by caesarean section

    Institute of Scientific and Technical Information of China (English)

    赵婷

    2011-01-01

    Acute respiratory distress syndrome is one of the common respiratory diseases in neonates. It is more common in neonates by elective cesarean section. The pathogenesis is complicated, while delayed lung fluid clearance is considered playing a role in it. Meconium aspiration, delayed establishment of respiratory reflex, gestational age, contractions before onset, male baby, perinatal asphyxia, maternal diabetes or asthma are thought to be risk factors.%新生儿急性呼吸窘迫综合征是新生儿较常见的呼吸道疾病,多见于选择性剖宫产儿,具体发病机制复杂,肺液清除延迟是其主要发病机制,同时胎粪吸入、呼吸反射建立延迟、胎龄、宫缩发动、男性患儿、围生期窒息、母亲有糖尿病或哮喘是其危险因素。

  8. [Risk factors of necrotizing enterocolitis].

    Science.gov (United States)

    Tapia-Rombo, C A; Velasco-Lavín, M R; Nieto-Caldelas, A

    1993-09-01

    The purpose of the present study is to compare risk factors of necrotizing enterocolitis (NEC) between two group: group A, newborns with the disease and group B, newborns with other diseases different from NEC, in order to know if these risk factors are more frequent or not in the first group. We assessed the clinical records of all the patients hospitalized in the Neonatal Intensive Care Unit and Neonatology Service of the La Raza General Hospital between 1987 and 1991 with the diagnosis of NEC. They were compared with 65 clinical records chosen at random of patients hospitalized in the same Unit with other diagnosis at the same time, and who were discharged by improvement or deceased. In all of them were look for known risk factors for NEC generally accepted such as: prematurity, neonatal asphyxia, poliglobulia, cyanotic congenital heart disease, patent ductus arteriosus, respiratory distress syndrome, catheterization of umbilical vessels, early feeding of elevated formula increases, exchange exchange transfusion, hypoxic ischemic encephalopathy, infection, etc. Just 25 records of the possible 50 with the diagnosis of NEC full filled inclusion criteria. There were no statistically significant difference in weight, sex, mortality and known risk factors of NEC between both groups. Were concluded that NEC is a disease of unknown etiology that should be studied more thoroughly. The known risk factors must be avoided because the patient susceptibility probably play an important role. PMID:8373546

  9. The Clinical study of the Diagnosis of Amniotic Fluid Infection with theAmniotic Lens%羊水镜检查诊断羊水粪染的临床研究

    Institute of Scientific and Technical Information of China (English)

    戴芙蓉; 邵玉兰; 刘光亚

    2001-01-01

    Objective:By observing the characteristics of the amniotic fluid and choosing adaptable delivering ways to reduce the rate of neonatal mortality and asphyxia. Methods: Using the amniotie fluid lens to diagnose whether the amniotic fluid was infected or not. Results: It showed that the diagnostic rate could reach more than 90%. Conclusion:Using amniotic fluid lens has important and practical significance in treating the parturients.%目的:观察羊水性状,选择恰当的分娩方式,降低新生儿窒息、死亡率。方法:我院1998年1至12月采用沈阳市光学仪器厂生产的YSJ-Ⅰ型羊水镜检查,监测有无羊水粪染,并与B超进行比较。结果:发现羊水镜诊断率高达90%,同时可了解胎先露及胎膜早破情况。结论:对临产时医护人员的监护及处理有重要临床实用价值。

  10. The evidential value of intra-alveolar haemosiderin-macrophages in cases of sudden infant death syndrome (SIDS).

    Science.gov (United States)

    Kernbach-Wighton, G; Albalooshi, Y; Madea, B

    2012-10-10

    Intra-alveolar deposits of haemosiderin have repeatedly been brought into connection with some diagnostic value, such as markers for previous imposed suffocation, smothering due to Munchausen syndrome by proxy or sudden infant death syndrome (SIDS). This study is based on 104 SIDS cases and 14 controls (causes of death, e.g. inflammatory changes, internal haemorrhages, asphyxia, blunt force trauma or acute toxicity). The SIDS group comprised 44 females (aged 7 days to 12 months) and 60 males (aged 12 days to 16 months 8 days) with the ages of the controls ranging from 2 months 3 days to 47 months. Routine histology samples from the lungs were stained with Prussian blue and haemosiderin foci were counted in 20 hpf for each lung lobe by a pathologist blinded to the cause of death. Results were assigned to one of five categories for haemosiderin positivity. Data were analysed by the Levene-test revealing identical variances in both groups and with a two-sample t-test showing the mean values for haemosiderin counts not being significantly different between SIDS and control groups. Although the sizes of both samples differed considerably it is our opinion that the haemosiderin counts did not show sufficient diagnostic value. This outcome supports the latest results of other comparable investigations. Furthermore, it highlights the necessity to assess carefully positive haemosiderin findings to avoid false suspicion. PMID:22704554

  11. Influence of Systematic Management during Oregnancy to the Perinatal Outcome of Gestational Diabetes Mel itus under the New Diagnostic Standard%孕期系统化管理在新标准妊娠期糖尿病围产结局的影响

    Institute of Scientific and Technical Information of China (English)

    朝葵; 郑瑛; 杨承东

    2013-01-01

      目的探讨新的诊断标准下对妊娠期糖尿病(GDM)孕妇进行孕期系统化管理的临床影响。方法对妊娠期糖尿病孕妇进行孕期系统化管理,观察比较两组的妊娠结局。结果孕期系统化管理组的剖宫产,尿道感染,胎儿窘迫,新生儿窒息均明显低于非系统化管理组(p<0.05)。结论对妊娠期糖尿病孕妇加强孕期系统化管理,可以有效改善围产结局。%objective To explore the clinical effect of systematic management during pregnancy for gestational diabetes (GDM) women Under the new diagnostic criteria.Method Pregnant women of gestational diabetes were managed systematical y during pregnancy ,and pregnancy outcome were observed. Results There was different significantly of cesarean delivery, urethral infection, fetal distress, neonatal asphyxia between pregnancy systematic management group and non-systematized management group (p<0.05). Conclusion Which strengthen the systematic management among pregnancy of gestational diabetes women can improve perinatal outcome effectively.

  12. Gas dispersal potential of infant bedding of sudden death cases. (I): CO2 accumulation around the face of infant mannequin model.

    Science.gov (United States)

    Sakai, Jun; Takahashi, Shirushi; Funayama, Masato

    2009-04-01

    We assessed CO(2) gas dispersal potential of bedding that had actually been used by 26 infants diagnosed with sudden unexpected infant death using a baby mannequin model. The age of victims ranged from 1 to 12 months. In some cases, the parents alleged that the infant faces were not covered with bedding when they were found. The parent's memories, however, may not have been accurate; therefore, we examined the potential for gas dispersal based on the supposition that the bedding had covered their faces. The mannequin was connected with a respirator set on the tidal volume and respiratory rates matched with the baby's age. Before measuring, CO(2) flow was regulated in 5%+/-0.1% of end-tidal PCO(2). After the model was placed on each bedding condition, measurements were performed at least five times under each respiratory condition. Four cases showed a plateau of FiCO(2) <4.8%, 15 were 4.8-12%, and the other seven were 12% or more, when they reached a plateau. Of course, our model does not take large tissue stores of CO(2) into account. However, our model could show the potential gas dispersal ability of bedding. Especially, the latter seven bedding could have high rebreathing potential if they covered the infant's faces and the probability of environmental asphyxia should be considered. PMID:19375372

  13. Study of Congenital Malformations in Central Nervous System AND Gastro- Intestinal Tract

    Directory of Open Access Journals (Sweden)

    Saiyad SS

    2012-04-01

    Full Text Available Introduction: Congenital malformations comprise 8% of the perinatal mortality in India. They rank fifth as a cause of perinatal mortality, after asphyxia, respiratory problems, infections and cerebral trauma. However, the pattern is changing rapidly with improvement in health care and living standards. Material & Method: In the present study, authors have tried to study the cases of congenital malformations specially related to Central nervous system and Gastro-intestinal system. 5240 cases of newborn babies were studied and results were analyzed and classified in to various categories. Findings: The results show that malformations are more common in still birth, more in female babies and more in central nervous system In live born babies the percentage of malformation is0.63 % whereas in still born baby it is6.53 %. Conclusions: Chances of having malformations increases as the age advances. Parity of mother also influences the incidence. Exposure to radiation & drugs also influences malformations. Incidence of congenital malformation is highest in central nervous system. [National J of Med Res 2012; 2(2.000: 121-123

  14. [Hereditary angioedema. Treatment of acute attacks in Argentina].

    Science.gov (United States)

    Malbrán, Alejandro; Malbrán, Eloisa; Menéndez, Alejandra; Fernández Romero, Diego S

    2014-01-01

    In the world, hereditary angioedema (HAE) affects 1 every 50000 persons. It is characterized by highly disabling and recurrent episodes of cutaneous, abdominal and laryngeal episodes of angioedema. Asphyxia related mortality ranges from 15 to 50%. In Argentina a plasma derived C1 inhibitor concentrate (pdC1INH) has been available for the treatment of acute attacks for many decades, however, only15 (26%) out of 58 patients had received pdC1INH at least once until 2008, and only2 (3.4%) had used it regularly. After worldwide approval of the new drugs for the treatment of acute HAE attacks, adding icatibant to pdC1INH in Argentina, and after publication of the therapeutic guide for the country, 42 (82%) out of 51 patients from the original group has pdC1INH available to treat their next attack. However, 16 (18%) patients continue without access to medication and other 15 (35.7%) obtain their therapy spuriously through some other affected relative in their environment. Only 12 (28.6%) patients of the group self-treated at home. Access to treatment has greatly improved, but needs to be extended to all patients and self-treatment at home should be encouraged.

  15. One Hundred and One Cases of Plastic Bag Suffocation in the Milan Area Between 1993 and 2013-Correlations, Circumstances, Pathological and Forensic Evidences and Literature Review.

    Science.gov (United States)

    Crudele, Graziano Domenico Luigi; Di Candia, Domenico; Gentile, Guendalina; Marchesi, Matteo; Rancati, Alessandra; Zoja, Riccardo

    2016-03-01

    Plastic Bag Suffocation is a rare cause of death in developed countries and almost unknown in the rest of the world. This study aims to retrospectively evaluate cases of PBS _asphyxia in Milan's Department of Legal Medicine from 1993 to 2013. Cases were selected from the database of 21,472 autopsies performed in the considered timeframe. One hundred and one cases were considered to be cases of Plastic Bag Suffocation, comprised of 100 suicides, no accidental events and 1 homicide. The most relevant elements pertaining to this type of death were evaluated for both the corpses and the crime scenes. From this study the typical PBS victim is an adult male, aged 52.3 years on average, depressed or afflicted by chronic or terminal diseases, and found at home. In 42.6% of cases, the victims were found with the plastic bag still positioned over their head, fastened by tying. Also common among these cases are drugs, alcohol and chemical abuses. According to the collected data, it is impossible to outline a pathognomonic detrimental background that leads to this cause of death. Crime scene investigation is, therefore, the one and only technical resource for evaluating these cases. PMID:27404609

  16. Animal experimentation in forensic sciences: How far have we come?

    Science.gov (United States)

    Cattaneo, C; Maderna, E; Rendinelli, A; Gibelli, D

    2015-09-01

    In the third millennium where ethical, ethological and cultural evolution seem to be leading more and more towards an inter-species society, the issue of animal experimentation is a moral dilemma. Speaking from a self-interested human perspective, avoiding all animal testing where human disease and therapy are concerned may be very difficult or even impossible; such testing may not be so easily justifiable when suffering-or killing-of non human animals is inflicted for forensic research. In order to verify how forensic scientists are evolving in this ethical issue, we undertook a systematic review of the current literature. We investigated the frequency of animal experimentation in forensic studies in the past 15 years and trends in publication in the main forensic science journals. Types of species, lesions inflicted, manner of sedation or anesthesia and euthanasia were examined in a total of 404 articles reviewed, among which 279 (69.1%) concerned studies involving animals sacrificed exclusively for the sake of the experiment. Killing still frequently includes painful methods such as blunt trauma, electrocution, mechanical asphyxia, hypothermia, and even exsanguination; of all these animals, apparently only 60.8% were anesthetized. The most recent call for a severe reduction if not a total halt to the use of animals in forensic sciences was made by Bernard Knight in 1992. In fact the principle of reduction and replacement, frequently respected in clinical research, must be considered the basis for forensic science research needing animals. PMID:26216717

  17. Clinical Analysis of Spasmolysis and Anticoagulant Therapy in Early-Onset Preeclampsia%早发型子痫前期实施解痉抗凝处理的临床分析

    Institute of Scientific and Technical Information of China (English)

    关博敬

    2015-01-01

    目的 对早发型子痫前期实施解痉抗凝处理的临床效果展开对比分析.方法 将54例早发型子痫前期患者分为治疗组和对照组,均为27例,对比治疗效果.结果 治疗后,两组患者平均动脉压和24 h尿蛋白水平显著低于治疗前的,P0.05);治疗组新生儿窒息率为3.70%、病死率为0.00%、并发症发生率为7.41%同对照组患者的22.22%、18.52%和33.33%相比,P0.05); the treatment group was 3.70%, the rate of neonatal asphyxia the mortality rate was 0%, the occurrence rate of complications was 7.41% with the patients in the control group 22.22%, 18.52% and 33.33% compared to,P<0.05.Conclusion The antispasmodic and anticoagulant comprehensive treatment can significantly improve the early onsetpreeclampsia clinical treatment effect, improve the prognosis of the patients.

  18. Medical effects of volcanic eruptions

    Science.gov (United States)

    Baxter, Peter J.

    1990-09-01

    Excluding famine and tsunamis, most deaths in volcanic eruptions have been from pyroclastic flows and surges (nuées ardentes) and wet debris flows (lahars). Information on the causes of death and injury in eruptions is sparse but the available literature is summarised for the benefit of volcanologists and emergency planners. In nuées, thermal injury may be at least as important as asphyxia in causing immediate deaths. The high temperature of the gases and entrained particles readily causes severe burns to the skin and the air passages and the presence of both types of injury in an individual may combine to increase the delayed mortality risk from respiratory complications or from infection of burns. Trauma from missiles or body displacement is also common, but the role of asphyxiant or irritant gases, and steam, remains unclear. The ratio of dead: injured is much higher than in other natural disasters. At the periphery of a nuée being protected inside buildings which remain intact appears to greatly increase the chances of survival. In lahars, infected wounds and crush injury are the main delayed causes of death, and the scope for preventive measures, other than evacuation, is small. The evidence from Mount St. Helens, 1980, and other major eruptions indicates that, although mortality is high within the main zone of devastation and in the open, emergency planning should concentrate on the periphery of a nuée where preventive measures are feasible and could save many lives in densely populated areas.

  19. 区县级医院医务人员新生儿复苏培训效果评估研究%Quality improvement of care delivery of neonatal resuscitation training in a primary health care facility

    Institute of Scientific and Technical Information of China (English)

    王宁; 王宝生; 高科; 王丽丽; 宋明卫; 徐峰; 张勇

    2013-01-01

    目的 探讨新法新生儿窒息复苏技术的合理培训在区县级医院推广的意义.方法 本院于2009年4月开始开展“中澳新生儿窒息复苏在农村地区有效机制探讨”项目,对医务人员进行窒息复苏培训.选择开展项目后(2009年4月至2012年3月)参加培训的医务人员为观察组,培训前为对照组,将培训前后医务人员在新生儿窒息复苏时自信心水平评估和执行新生儿窒息复苏流程评估进行比较,并对培训后医务人员窒息复苏考核合格率进行评估,考核满分38分,及格分33分.结果 观察组各专业医务人员新生儿窒息复苏自信心水平评估分值均高于对照组[儿科医师:(60.7±8.7)比(32.3 ±6.2),产科医师:(64.3±7.7)比(35.7±7.2),助产士/师:(65.0±6.8)比(36.3±7.5),麻醉医师(52.7±6.7)比(24.7±4.8),P均<0.05],执行新生儿窒息复苏流程能力的分值均高于对照组[儿科医师:(14.8±2.9)比(8.0±2.3),产科医师:(16.0±2.3)比(9.0±2.1),助产士/师:(17.0±2.4)比(9.0±2.2);麻醉医师:(14.0±2.7)比(6.3±2.5),P均<0.05].医务人员在规范化培训后新生儿窒息复苏考核平均分分别为:儿科医师(33.1±3.6)分,产科医师(33.4±3.7)分,助产士/师(33.2±2.1)分,麻醉医师(33.1±4.3)分;最终考核总合格率86.7%.结论 我院对新生儿窒息复苏技术的培训方法有效可行,可以在全国范围内推广.%Objective To evaluate the significance in improvement of infant care delivery by promoting Neonatal Resuscitation Training Program in county hospitals.Methods This prospective observational case controlled study is supported by an international grant for "Effective Application of Neonatal Asphyxia.Resuscitation Program in Rural Areas of China & Australia" since April of 2009.The observation and the controlled groups of this study recruited 60 medical providers in each group matched in age,position and year in practice.Baseline confident level of medical providers

  20. Umbilical artery doppler velocimetry: a valuable tool for antenatal fetal surveillance

    International Nuclear Information System (INIS)

    To determine umbilical artery Doppler velocity parameter systolic: diastolic ratio (S/D ratio) relation with fetal well being and outcome. Setting: Department of Obstetrics and Gynecology, Lady Willingdon Hospital, Lahore Duration of study: Six months from 27-02-2008 to 26-08-2008. Subjects and methods: Sixty patients fulfilling the inclusion criteria were included in this study. They were subdivided into two groups. Group 'A' included 30 normal pregnant women with no medical or obstetrical risk factors and group 'B' included 30 pregnant women having risk factors like, hypertension, diabetes, Rhesus incompatibility, discordant twins, intrauterine growth restriction and non immunehydropsfetalis. Results: In comparison of S/D ratio with risk factors it was observed that S/D ratio 3 was present in 19 patients (31.6%) in pregnancy with hypertension/preeclampsia, 3 patients (5%) with diabetes mellitus, 11 patients (18.3%) with intrauterine growth restriction, 15 patients (25.0%) with oligohydramnios and only 1 patient (1.6%) with twin pregnancy. It was observed that women with S/D ratio 3 S/D ratio delivered 10 neonates (16.6%) with <4 Apgar score at 1 minute, 23 (38.3%) with <6 score at 5 minutes and 23 neonates (38.3%) needed resuscitation, 21 (35.0%) were admitted to neonatal unit for asphyxia. Conclusion: Umbilical artery Doppler studies is an integral tool while evaluating health of high risk pregnancies. However, it is not appropriate as a screening tool for low risk pregnancies. (author)