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Sample records for asphyxia

  1. 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

  2. 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

  3. 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.

  4. Magnesium for neuroprotection in birth asphyxia

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    Geeta Gathwala

    2010-01-01

    Full Text Available Background : Magnesium ion gates the N-methyl-D-aspartate (NMDA receptor and may protect the brain from NMDA receptor-mediated asphyxial injury. The present study evaluated the neuroprotective role of magnesium in birth asphyxia. Material and Methods : Forty term neonates with severe birth asphyxia were randomized to either the study group or the control group. Neonates in the study group received magnesium sulfate in a dose of 250 mg/kg initially within half an hour of birth followed by 125 mg/kg at 24 and 48 h of birth. Cranial computed tomography (CT scan and electroencephalography (EEG were performed for all the babies. Denver II was used for developmental assessment at the age of 6 months. Results : Two babies in each group died of severe hypoxic ischemic encephalopathy. EEG abnormalities occurred in 43.75% of the cases in the control group compared with 31.25% in the study group. CT scan abnormalities were present in 62.5% of the control group compared with 37.5% of the cases in the study group. The Denver II assessment at 6 months revealed that there were five babies that were either abnormal or suspect in the control group compared with three in the study group. Conclusion : Magnesium is well tolerated and does appear to have beneficial effects in babies with severe asphyxia. More data is however needed and a large multicenter trial should be conducted.

  5. 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.

  6. 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

  7. 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.

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

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    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.

  9. Shenfu injection provides protection for perinatal asphyxia in neonates

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    Yu Jiang

    2016-03-01

    Full Text Available This study aimed to investigate the efficacy of shenfu injection for the protection of neonates with asphyxia. Eighty neonates with asphyxia were randomly divided into two groups, treatment group and control group (n=40. Both groups received interventions such as ventilation, oxygen, and circulation support. Treatment group was administrated with shenfu injection additionally. Serum levels of creatine kinase, alanine aminotransferase, aspartate aminotransferase, creatinine, and neuron-specific enolase were significantly lower but the oxygenation index was significantly higher in treatment group on day 7 and day 14. The neurobehavioral score was significantly higher in treatment group than in control group. On the 14th day, the survival rate of treatment group (77.5% was higher than that of control group (55%. Shenfu injection could protect the function of the brain, heart, lung, liver and kidney by attenuating ischemia reperfusion after severe asphyxia resuscitation, improve neurobehavioral ability and increase the survival of neonates.

  10. 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

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

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    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.

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

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    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.

  13. Adenoid Cystic Carcinoma of the Trachea Resulting in Fatal Asphyxia.

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    Huston, Butch; Froloff, Victor; Mills, Kelly; McGee, Michael

    2017-01-01

    Primary malignant tumors of the trachea are uncommon. The authors report a case of a 72-year-old female who died from asphyxia due to an undiagnosed obstructing adenoid cystic carcinoma of the trachea. The decedent became unresponsive while eating cereal and was pronounced upon arrival at the local hospital. The autopsy revealed a near occlusive tumor mass just superior to the bifurcation of the distal trachea. There was no evidence of aspiration. The death was the result of asphyxia due to obstruction of the trachea by an adenoid cystic carcinoma. This case demonstrates that an obstructive tumor mass may remain undiagnosed until an obstructive episode results in a sudden death.

  14. [Recurrence plot analysis of HRV for brain ischemia and asphyxia].

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    Chen, Xiaoming; Qiu, Yihong; Zhu, Yisheng

    2008-02-01

    Heart rate variability (HRV) is the tiny variability existing in the cycles of the heart beats, which reflects the corresponding balance between sympathetic and vagus nerves. Since the nonlinear characteristic of HRV is confirmed, the Recurrence Plot method, a nonlinear dynamic analysis method based on the complexity, could be used to analyze HRV. The results showed the recurrence plot structures and some quantitative indices (L-Mean, L-Entr) during asphyxia insult vary significantly as compared to those in normal conditions, which offer a new method to monitor brain asphyxia injury.

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

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    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...

  16. Could Perinatal Asphyxia Induce a Synaptopathy? New Highlights from an Experimental Model

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    María Inés Herrera

    2017-01-01

    Full Text Available Birth asphyxia also termed perinatal asphyxia is an obstetric complication that strongly affects brain structure and function. Central nervous system is highly susceptible to oxidative damage caused by perinatal asphyxia while activation and maturity of the proper pathways are relevant to avoiding abnormal neural development. Perinatal asphyxia is associated with high morbimortality in term and preterm neonates. Although several studies have demonstrated a variety of biochemical and molecular pathways involved in perinatal asphyxia physiopathology, little is known about the synaptic alterations induced by perinatal asphyxia. Nearly 25% of the newborns who survive perinatal asphyxia develop neurological disorders such as cerebral palsy and certain neurodevelopmental and learning disabilities where synaptic connectivity disturbances may be involved. Accordingly, here we review and discuss the association of possible synaptic dysfunction with perinatal asphyxia on the basis of updated evidence from an experimental model.

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

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    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.

  18. Risk factors and prognostic models for perinatal asphyxia at term

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    Ensing, S.

    2015-01-01

    This thesis will focus on the risk factors and prognostic models for adverse perinatal outcome at term, with a special focus on perinatal asphyxia and obstetric interventions during labor to reduce adverse pregnancy outcomes. For the majority of the studies in this thesis we were allowed to use data

  19. Quality of general movements in term infants with asphyxia

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    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

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

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    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.

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

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    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.

  2. Renal sympathetic nerve activity during asphyxia in fetal sheep.

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    Booth, Lindsea C; Malpas, Simon C; Barrett, Carolyn J; Guild, Sarah-Jane; Gunn, Alistair J; Bennet, Laura

    2012-07-01

    The sympathetic nervous system (SNS) is an important mediator of fetal adaptation to life-threatening in utero challenges, such as asphyxia. Although the SNS is active well before term, SNS responses mature significantly over the last third of gestation, and its functional contribution to adaptation to asphyxia over this critical period of life remains unclear. Therefore, we examined the hypotheses that increased renal sympathetic nerve activity (RSNA) is the primary mediator of decreased renal vascular conductance (RVC) during complete umbilical cord occlusion in preterm fetal sheep (101 ± 1 days; term 147 days) and that near-term fetuses (119 ± 0 days) would have a more rapid initial vasomotor response, with a greater increase in RSNA. Causality of the relationship of RSNA and RVC was investigated using surgical (preterm) and chemical (near-term) denervation. All fetal sheep showed a significant increase in RSNA with occlusion, which was more sustained but not significantly greater near-term. The initial fall in RVC was more rapid in near-term than preterm fetal sheep and preceded the large increase in RSNA. These data suggest that although RSNA can increase as early as 0.7 gestation, it is not the primary determinant of RVC. This finding was supported by denervation studies. Interestingly, chemical denervation in near-term fetal sheep was associated with an initial fall in blood pressure, suggesting that by 0.8 gestation sympathetic innervation of nonrenal vascular beds is critical to maintain arterial blood pressure during the rapid initial adaptation to asphyxia.

  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. Perinatal asphyxia and medical professional liability: A case series

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    Andrea Verzeletti

    2016-12-01

    Full Text Available In the context of medical professional liability, obstetrics is one of the most involved medical specialties because the unfavorable outcome of a pregnancy is difficult to accept for parents, who tend to reduce it to inappropriate care that occurred during pregnancy or birth. 32 cases of perinatal asphyxia were evaluated by the Institute of Forensic Medicine in Brescia during the period between 1999 and 2014 (13 in Civil Court and 19 in Penal Court. 9 out of the 32 pregnancies were twins, so the considerations were carried out on a total of 41 fetuses/newborns. Profiles of inadequacy were identified in 66% of cases (85% of the cases evaluated in Civil Court; 53% of the cases evaluated in Penal Court. The existence of a causal relationship between the medical conduct and the onset of asphyxia was recognized in 79% of civil cases and in 38% of penal cases. There is a “greater rigor” in the verification of causal relationship and malpractice profiles in penal cases compared to civil ones: this is in harmony with the most recent Italian Court decisions, characterized by compelling suspect’s protection in the presence of a reasonable doubt in criminal matters and by victim’s protection in civil ones.

  5. TIME COURSE MODIFICATIONS INDUCED BY PERINATAL ASPHYXIA IN RAT CNS

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    Francisco Capani

    2015-04-01

    Full Text Available Perinatal asphyxia (PA induced short and long term biochemical, synaptic, cytoskeletal and astrocytes alterations that has been associated with neuronal cell death following hypoxia . The lack of knowledge about the mechanisms underlying this dysfunction prompted us to investigate the changes in the synapse and neuronal cytoskeleton and related structures. For this study we used a well established murine model of PA. Full-term pregnant rats were rapidly decapitated and the uterus horns were placed in a water bath at 37 °C for different time of asphyxia. When their physiological conditions improved, they were given to surrogate mothers. One month, four month, 6 month and 18 month after PA rats were included in this study. Modifications were analyzed using photooxidation with phalloidin-eosin, conventional electron microscopy (EM, inmunocytochemistry and ethanolic phosphotungstic acid (E-PTA staining combining with electron tomography and 3-D reconstruction techniques and molecular biology studies. After one month of the PA insult, an increase in the F-actin staining in neostriatum and hippocampus synapses was observed using correlative fluorescent electron microscopy for phalloidin-eosin. Mushroom-shaped spines showed the most consistent staining. Strong alterations in the dendrite and astroglial cytoskeleton were found at four months of PA (1. After six months of PA, postsynaptic densities (PSDs of the rat neostriatum are highly modified . We observed an increment of PSDs thickness related with the duration and severity of the hypoxic insult. In addition, PSDs showed and increase in the ubiquitination level. Using 3-d reconstruction and electron tomography we observed showed clear signs of damage in the asphyctic PSDs. These changes are correlated with intense staining for ubiquitin (2. Finally, in 18 months old rat was observed a reduction in the number of synapses in the PA animals related with a decrease in BDNF staining.(3 Using protocols

  6. Environmental Enrichment Decreases Asphyxia-Induced Neurobehavioral Developmental Delay in Neonatal Rats

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    Kiss, Peter; Vadasz, Gyongyver; Kiss-Illes, Blanka; Horvath, Gabor; Tamas, Andrea; Reglodi, Dora; Koppan, Miklos

    2013-01-01

    Perinatal asphyxia during delivery produces long-term disability and represents a major problem in neonatal and pediatric care. Numerous neuroprotective approaches have been described to decrease the effects of perinatal asphyxia. Enriched environment is a popular strategy to counteract nervous system injuries. The aim of the present study was to investigate whether enriched environment is able to decrease the asphyxia-induced neurobehavioral developmental delay in neonatal rats. Asphyxia was induced in ready-to-deliver mothers by removing the pups by caesarian section after 15 min of asphyxia. Somatic and neurobehavioral development was tested daily and motor coordination weekly. Our results show that rats undergoing perinatal asphyxia had a marked developmental delay and worse performance in motor coordination tests. However, pups kept in enriched environment showed a decrease in the developmental delay observed in control asphyctic pups. Rats growing up in enriched environment did not show decrease in weight gain after the first week and the delay in reflex appearance was not as marked as in control rats. In addition, the development of motor coordination was not as strikingly delayed as in the control group. Short-term neurofunctional outcome are known to correlate with long-term deficits. Our results thus show that enriched environment could be a powerful strategy to decrease the deleterious developmental effects of perinatal asphyxia. PMID:24232451

  7. Environmental Enrichment Decreases Asphyxia-Induced Neurobehavioral Developmental Delay in Neonatal Rats

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    Peter Kiss

    2013-11-01

    Full Text Available Perinatal asphyxia during delivery produces long-term disability and represents a major problem in neonatal and pediatric care. Numerous neuroprotective approaches have been described to decrease the effects of perinatal asphyxia. Enriched environment is a popular strategy to counteract nervous system injuries. The aim of the present study was to investigate whether enriched environment is able to decrease the asphyxia-induced neurobehavioral developmental delay in neonatal rats. Asphyxia was induced in ready-to-deliver mothers by removing the pups by caesarian section after 15 min of asphyxia. Somatic and neurobehavioral development was tested daily and motor coordination weekly. Our results show that rats undergoing perinatal asphyxia had a marked developmental delay and worse performance in motor coordination tests. However, pups kept in enriched environment showed a decrease in the developmental delay observed in control asphyctic pups. Rats growing up in enriched environment did not show decrease in weight gain after the first week and the delay in reflex appearance was not as marked as in control rats. In addition, the development of motor coordination was not as strikingly delayed as in the control group. Short-term neurofunctional outcome are known to correlate with long-term deficits. Our results thus show that enriched environment could be a powerful strategy to decrease the deleterious developmental effects of perinatal asphyxia.

  8. 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.

  9. Neuroprotective properties of melatonin in a model of birth asphyxia in the spiny mouse (Acomys cahirinus).

    Science.gov (United States)

    Hutton, Lisa C; Abbass, Mahila; Dickinson, Hayley; Ireland, Zoe; Walker, David W

    2009-01-01

    Birth asphyxia is associated with disturbed development of the neonatal brain. In this study, we determined if low-dose melatonin (0.1 mg/kg/day), administered to the mother over 7 days at the end of pregnancy, could protect against the effects of birth asphyxia in a precocial species - the spiny mouse (Acomys cahirinus). At 37 days of gestation (term is 38-39 days), pups were subjected to birth asphyxia (7.5 min uterine ischemia) and compared to Cesarean section-delivered controls. At 24 h of age, birth asphyxia had increased markers of CNS inflammation (microglia, macrophage infiltration) and apoptosis (activated caspase-3, fractin) in cortical gray matter, which were reduced to control levels by prior maternal melatonin treatment. Melatonin may be an effective prophylactic agent for use in late pregnancy to protect against hypoxic-ischemic brain injury at birth.

  10. Polyuria and impaired renal blood flow after asphyxia in preterm fetal sheep.

    Science.gov (United States)

    Quaedackers, J S; Roelfsema, V; Hunter, C J; Heineman, E; Gunn, A J; Bennet, L

    2004-03-01

    Renal impairment is common in preterm infants, often after exposure to hypoxia/asphyxia or other circulatory disturbances. We examined the hypothesis that this association is mediated by reduced renal blood flow (RBF), using a model of asphyxia induced by complete umbilical cord occlusion for 25 min (n = 13) or sham occlusion (n = 6) in chronically instrumented preterm fetal sheep (104 days, term is 147 days). During asphyxia there was a significant fall in RBF and urine output (UO). After asphyxia, RBF transiently recovered, followed within 30 min by a secondary period of hypoperfusion (P preterm fetus was associated with evolving renal tubular dysfunction, as shown by transient polyuria and natriuresis. Despite a prolonged increase in RVR, there was only a modest effect on glomerular function.

  11. 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.

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

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    Susanti Halim

    2015-11-01

    Full Text Available Background An electroencephalogram (EEG is an electroimaging tool used to determine developmental and electrical problems in the brain. A history of severe asphyxia is a risk factor for these brain problems in infants. Objective To evaluate the prevalence of abnormal EEGs infull term neonates and to assess for an association with severe asphyxia, hypoxic ischemic encephalopathy (HIE, and spontaneous delivery. Methods This cross-sectional study was conducted at the Pediatric Outpatient Department of Sanglah Hospital, Denpasar, from November 2013 to January 2014. Subjects were fullterm infants aged 1 month who were delivered and/or hospitalized at Sanglah Hospital. All subjects underwent EEG. The EEGs were interpreted by a pediatric neurology consultant, twice, with a week interval between readings. Clinical data were obtained from medical records. Association between abnormal ECG and severe asphyxia were analyzed by Chi-square and multivariable logistic analyses. Results Of 55 subjects, 27 had a history of severe asphyxia and 28 were vigorous babies. Forty percent (22/55 of subjects had abnormal EEG findings, 19/22 of these subjects having history of severe asphyxia, 15/22 had history of hypoxic-ischemic encephalopathy (HIE, and 20/22 were delievered vaginally. There were strong correlations between the prevalence of abnormal EEG and history of severe asphyxia, HIE, and spontaneous delivery. Conclusion Prevalence of abnormal EEG among full-term neonates referred to neurology/growth development clinic is around 40%, with most of them having a history of severe asphyxia. Abnormal EEG is significantly associated to severe asphyxia, HIE, and spontaneous delivery.

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

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    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.

  14. 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.

  15. 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.

  16. 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.

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

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    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. Observations on increased accidental asphyxia deaths in infancy while cosleeping in the state of Maryland.

    Science.gov (United States)

    Li, Ling; Zhang, Yang; Zielke, Ron H; Ping, Yan; Fowler, David R

    2009-12-01

    The Office of the Chief Medical Examiner (OCME) has recorded a significant increase of accidental asphyxia deaths in infancy associated with cosleeping in the state of Maryland in 2003. A total of 102 infants died suddenly and unexpectedly during 2003 in the state of Maryland. Of the 102 infants, 46 (45%) were found cosleeping. The frequency of cosleeping among these 102 infants was 28% (29/102) for black infants and 15% (15/102) for white infants. Ten of the 46 cosleeping infant deaths (20%) were determined to be the result of accidental asphyxia, and 28 cosleeping infant deaths (59%) were classified as "undetermined" because the possibility of asphyxia due to overlay while cosleeping could not be ruled out. Only 21 cases were determined to be Sudden Infant Death Syndrome (SIDS), which is consistent with the continuous decline of SIDS death in Maryland since 1994. The age of asphyxiated cosleeping infants ranged from 15 days to 9 months. Nine out of the 10 asphyxia deaths were black infants. The most common sleeping location of the asphyxia infants was on a couch/sofa, followed by an adult bed. Crib availability was documented in all of the cosleeping cases. A majority (61%) of the cosleeping infants (28/46) had an available crib or bassinet at home and 9 out of 10 asphyxiated cosleeping infants had a crib at home at the time of the incident. This report focuses on the detailed scene investigation findings of infant victims who died of asphyxia while cosleeping. The shift of diagnosis in sudden infant death investigation is also addressed.

  19. 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...

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

    OpenAIRE

    Chiabi, Andreas; Nguefack, Seraphin; Evelyne MAH; NODEM, Sostenne; Mbuagbaw, Lawrence; Mbonda, Elie; TCHOKOTEU, Pierre-Fernand; Anderson DOH

    2013-01-01

    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 asphyx...

  1. 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

  2. Fatores associados à asfixia perinatal Factors associated with perinatal asphyxia

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    Alfredo de Almeida Cunha

    2004-12-01

    stepwise logistic regression model. RESULTS: there were 39 (14% depressed newborns which were compared to 238 (86% not depressed babies. The final analysis (multivariate showed an association between low Apgar score and previous case of stillbirth (OR=52.6, preterm labor threat (OR=33.8, low birth weight, less than 2,500 g body weight (OR=11.2 and previous cesarean section (OR=7.4. Some factors acted as a protection, including birth weight, in grams (OR=0.9, female sex of the newborn (OR=0.1, medical complications (OR=0.4 and prematurity (gestational age < 37 weeks, OR=0.1. CONCLUSION: the study may help in the identification of fetuses at great risk of asphyxia, allowing proper reference within the health system and planning of effective assistance in neonatal intensive care units.

  3. Correlation between clinical and histologic findings in the human neonatal hippocampus after perinatal asphyxia

    NARCIS (Netherlands)

    Schiering, I.A.M.; de Haan, T.R.; Niermeijer, J.M.F.; Koelman, J.H.; Majoie, C.B.L.M.; Reneman, L.; Aronica, E.

    2014-01-01

    Hypoxic ischemic encephalopathy after perinatal asphyxia is a major cause of mortality and morbidity in infants. Here, we evaluated pathologic changes in the hippocampi of a cohort of 16 deceased full-term asphyxiated infants who died from January 2000 to January 2009. Histochemical and immunocytoch

  4. 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

    in saline for 19 min. Pro- and anti-inflammatory cytokine expression were assessed by real-time PCR and immunohistochemistry in cerebella of newborn rats. We found that tumor necrosis factor alpha and interleukin-10 mRNA were increased 12 h after fetal asphyxia, while the inflammatory cytokine response...

  5. 25 years of research on global asphyxia in the immature rat brain.

    Science.gov (United States)

    Barkhuizen, M; van den Hove, D L A; Vles, J S H; Steinbusch, H W M; Kramer, B W; Gavilanes, A W D

    2017-02-01

    Hypoxic-ischemic encephalopathy remains a common cause of brain damage in neonates. Preterm infants have additional complications, as prematurity by itself increases the risk of encephalopathy. Currently, therapy for this subset of asphyxiated infants is limited to supportive care. There is an urgent need for therapies in preterm infants - and for representative animal models for preclinical drug development. In 1991, a novel rodent model of global asphyxia in the preterm infant was developed in Sweden. This method was based on the induction of asphyxia during the birth processes itself by submerging pups, still in the uterine horns, in a water bath followed by C-section. This insult occurs at a time-point when the rodent brain maturity resembles the brain of a 22-32 week old human fetus. This model has developed over the past 25 years as an established model of perinatal global asphyxia in the early preterm brain. Here we summarize the knowledge gained on the short- and long-term neuropathological and behavioral effects of asphyxia on the immature central nervous system.

  6. Long-lasting effects of perinatal asphyxia on exploration, memory and incentive downshift.

    Science.gov (United States)

    Galeano, Pablo; Blanco Calvo, Eduardo; Madureira de Oliveira, Diêgo; Cuenya, Lucas; Kamenetzky, Giselle Vanesa; Mustaca, Alba Elisabeth; Barreto, George Emilio; Giraldez-Alvarez, Lisandro Diego; Milei, José; Capani, Francisco

    2011-10-01

    Perinatal asphyxia remains as one of the most important causes of death and disability in children, without an effective treatment. Moreover, little is known about the long-lasting behavioral consequences of asphyxia at birth. Therefore, the main aim of the present study was to investigate the motor, emotional and cognitive functions of adult asphyctic rats. Experimental subjects consisted of rats born vaginally (CTL), by cesarean section (C+), or by cesarean section following 19 min of asphyxia (PA). At three months of age, animals were examined in a behavioral test battery including elevated plus maze, open field, Morris water maze, and an incentive downshift procedure. Results indicated that groups did not differ in anxiety-related behaviors, although a large variability was observed in the asphyctic group and therefore, the results are not completely conclusive. In addition, PA and C+ rats showed a deficit in exploration of new environments, but to a much lesser extent in the latter group. Spatial reference and working memory impairments were also found in PA rats. Finally, when animals were downshifted from a 32% to a 4% sucrose solution, an attenuated suppression of consummatory behavior was observed in PA rats. These results confirmed and extended those reported previously about the behavioral alterations associated with acute asphyxia around birth.

  7. Polwarth and Texel ewe parturition duration and its association with lamb birth asphyxia.

    Science.gov (United States)

    Dutra, F; Banchero, G

    2011-10-01

    The objective of the present study was to test the hypothesis that parturition duration is related to birth asphyxia in lambs and that asphyxia affects newborn lamb viability and vigor. Two sire and dam genotypes (Texel: TX; Polwarth: PW) and their crosses were represented in the study. Eighty lambs (25 PW sire × PW dam, 13 TX × TX, 25 TX × PW, and 17 PW × TX) born to 69 grazing ewes were used. At birth, the log₁₀ length of the second stage of parturition, birth weight, placental weight, and several body measurements were recorded on all lambs, and jugular blood samples were analyzed with the i-Stat Portable Clinical Analyzer (Abbott, Montevideo, Uruguay). A modified Apgar viability score at birth and lamb behavior during their first hour of life were recorded. Brain weight, muscle:bone ratio, and bone density were recorded in 20 male lambs (5 from each breed group) that were euthanized and dissected 24 h after birth. Data were analyzed by linear regression, least squares ANOVA, and ordinal and binary logistic regressions. Mean blood gas and acid-base variables were 7.21 ± 0.09 for pH, 18.4 ± 9.8 mmHg for partial pressure of oxygen, 53 ± 12.5 mmHg for partial pressure of carbon dioxide, and -4 ± 5.1 mmol/L for extracellular fluid base excess. Parturition duration increased with birth weight (P lambs (P lambs were born asphyxiated (pO₂ risk of asphyxia (P lambs presented at birth a 16-fold greater risk of asphyxia (P lambs appeared immature at birth, with less bone density (P lambs, suggesting that birth asphyxia is an important risk factor in perinatal lamb mortality.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. Application of a classification system focusing on potential asphyxia for cases of sudden unexpected infant death.

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    Randall, Brad; Donelan, Kent; Koponen, Mark; Sens, Mary Ann; Krous, Henry F

    2012-03-01

    Current classification schemes for sudden unexpected infant death (SUID) may not be optimal for capturing scene events that potentially predispose to asphyxia. (1) To compare causes of death in a group of SUID cases assigned by multiple reviewers using our recently published classification scheme for SUID that is based on asphyxial risk at the death scene, and (2) To compare these newly assigned causes of death to that originally assigned by the medical examiners of record who performed the autopsies. Five reviewers independently assigned causes of death for 117 cases of SUID, including 83 originally diagnosed as sudden infant death syndrome (SIDS), accessioned into the San Diego SIDS/SUDC Research Project from the San Diego County Medical Examiner's Office. The diagnostic categories are: A: SIDS; B: Unexplained-Potentially Asphyxia; C: Unexplained-Other Potential Causes of Death; D: Unclassified-Other; E: Unclassified; and F: Known Cause of Death. The reviewers collectively opined that conditions at the death scene contributed to or caused death in 32-50% of all of the 117 cases as well as in 40-59% of the 83 originally diagnosed SIDS cases. Another cause of death was considered plausible in 2-12% of the SIDS cases. Application of this new classification system resulted in 55-69% decrease in SIDS diagnoses. Asphyxia as a potential contributor to, or as the specific cause of death, appears to exist in a large percentage of cases designated as SIDS using other classification schemes. When certifiers use a classification system that focuses upon potential asphyxia in determining the cause of death the incidence of SIDS dramatically declines.

  14. The "Bermuda triangle" of neonatal neurology: cerebral palsy, neonatal encephalopathy, and intrapartum asphyxia.

    Science.gov (United States)

    Shevell, Michael I

    2004-03-01

    The terms "cerebral palsy," "neonatal encephalopathy," and "intrapartum asphyxia" are frequently used in pediatric neurology. This article presents concise, verifiable definitions for each of these entities based on our current understanding and formulates the nature of the interrelationships between them. The aim is to provide a level of clarity that will enhance diagnostic and pathogenetic precision and minimize conceptual misunderstanding. This should aid future therapeutic and research efforts in this important area.

  15. Discussion on Therapeutic Effect of Intratracheal Intubation on Asphyxia Neonatorum in Plateau Tibetans( Attached Reports of 48 Cases)

    Institute of Scientific and Technical Information of China (English)

    DEJI Meiduo; ZHOU Cuojie

    2002-01-01

    Objective To discuss the indications for intratracheal intubation in plateau tibetans with asphyxia neonatorum, clinical therapeutic effect relationship, changes of beta2- microglobulin( β2-MC) and creatinine( Cr). Methods 48 cases of asphyxia neonatorum were divided into several groups and underwent intratracheal intubation. Radioimmunoassay was used to determined plasmaβ2- MC level in different groups which were divided according to the severity and onset time of asphyxia neonatorum.And their serum Cr level was also determined by using HTT- ACHI7060 automatic biochemical analyzer.The results were compared with those of 20 healthy mature neonates. Results The incidence of complications of the second group with asphyxia neonatorum was higher than that of the first group. The changing degrees ofβ2 - MC and Cr were parallel with the degree of asphyxia and hypoxia. Conclusion Serumβ2- MC and Cr are the sensitive indications reflecting glomerular filtration function in asphyxia neonatorum. Popularizing novel resuscitation is the key to decrease prevalence and mortality.

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

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    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.

  17. 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.

  18. Effect of naloxone on level of plasma beta-endorphin in neonates with severe asphyxia

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: β-endorphin is the most actively endogenous substance of cerebral endorphin. When combined with opiate receptor specially, it manifests a strong morphine-like activity and can decrease sensitivity of central nervous system to carbon dioxide so as to inhibit breath.OBJECTIVE: To observe the changes of content of plasma β -endorphin in neonates with severe asphyxia after naloxone treatment in a large dosage.DESIGN: Randomized controlled observation.SETTINGS: Department of Pediatrics, Shenzhen Shajing People's Hospital; Center of Pediatrics,Guangzhou Zhujiang Hospital.PARTICIPANTS: A total of 97 neonates with severe asphyxia including 57 boys and 40 girls were selected from Neonatal Intensive Care Unit, Department of Pediatrics, Shenzhen Shajing People's Hospital from January 2004 to November 2005. Their gestational age was (38 ±3) weeks, body mass was (3.2± 1.7) kg,and hospitalization duration was (2.8±2.3) hours. All neonates met the diagnostic criteria of with severe asphyxia and all their parents provided the confirmed consent.METHODS: All neonates were treated with inspired oxygen, sedation, stopping terror, decreasing cranial pressure, maintaining a well blood perfusion and normal level of blood glucose (about 5.0 mmol/L). After hospitalization, 0.1 mg/(kg ·d) naloxone hydrochloride (Beijing Sihuan Pharmaceutical Technology Co., Ltd.;certification: H10900021; bullet preparation; 0.4 mg/ampoule) was intravenously dribbled into neonates for 4 - 6 hours, 14 days in total. 2 mL blood was collected from radial artery in neonates at the beginning of hospitalization and at 3 days after naloxone treatment, put in aprotinin-pre-cool tube, mixed evenly, and centrifuged at hypothermia. Plasma was maintained in refrigerator at - 70 ℃. The kit was provided by Neurobiology Department of Shanghai Second Military Medical University of Chinese PLA. Concentration of plasma β -endorphin was measured by using radio-immunity assay.All data were expressed as Mean

  19. Maternal Creatine Supplementation during Pregnancy Prevents Long-Term Changes in Diaphragm Muscle Structure and Function after Birth Asphyxia.

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    Domenic A LaRosa

    Full Text Available Using a model of birth asphyxia, we previously reported significant structural and functional deficits in the diaphragm muscle in spiny mice, deficits that are prevented by supplementing the maternal diet with 5% creatine from mid-pregnancy. The long-term effects of this exposure are unknown. Pregnant spiny mice were fed control or 5% creatine-supplemented diet for the second half of pregnancy, and fetuses were delivered by caesarean section with or without 7.5 min of in-utero asphyxia. Surviving pups were raised by a cross-foster dam until 33±2 days of age when they were euthanized to obtain the diaphragm muscle for ex-vivo study of twitch tension and muscle fatigue, and for structural and enzymatic analyses. Functional analysis of the diaphragm revealed no differences in single twitch contractile parameters between any groups. However, muscle fatigue, induced by stimulation of diaphragm strips with a train of pulses (330 ms train/sec, 40 Hz for 300 sec, was significantly greater for asphyxia pups compared with controls (p<0.05, and this did not occur in diaphragms of creatine + asphyxia pups. Birth asphyxia resulted in a significant increase in the proportion of glycolytic, fast-twitch fibres and a reduction in oxidative capacity of Type I and IIb fibres in male offspring, as well as reduced cross-sectional area of all muscle fibre types (Type I, IIa, IIb/d in both males and females at 33 days of age. None of these changes were observed in creatine + asphyxia animals. Thus, the changes in diaphragm fatigue and structure induced by birth asphyxia persist long-term but are prevented by maternal creatine supplementation.

  20. 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

  1. Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes.

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    Hosein Dalili

    Full Text Available To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes.This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped and a blood samples was obtained from the umbilical artery for blood gas analysis, meanwhile on the 1- , 5- and 10- minutes Conventional, Specified, Expanded, and Combined Apgar scores were recorded. Then the neonates were followed and intracranial ultrasound imaging was performed, and the following information were recorded: the occurrence of birth asphyxia, hypoxic Ischemic Encephalopathy (HIE, intraventricular hemorrhage (IVH, and neonatal seizure.The Combined-Apgar score had the highest sensitivity (97% and specificity (99% in predicting birth asphyxia, followed by the Specified-Apgar score that was also highly sensitive (95% and specific (97%. The Expanded-Apgar score was highly specific (95% but not sensitive (67% and the Conventional-Apgar score had the lowest sensitivity (81% and low specificity (81% in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02 and IVH (B = 2.8, P = 0.01.The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates.

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

    DEFF Research Database (Denmark)

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

    2002-01-01

    Information on the consequences of perinatal asphyxia (PA) on brain morphology and function in the aging rat is missing although several groups have hypothesized that PA may be responsible for neurological and psychiatric deficits in the adult. We therefore decided to study the effects of PA...... on the central nervous system (CNS) in terms of morphology, immunohistochemistry, neurology and behavior in the aging animal. Hippocampus and cerebellum were evaluated morphologically by histological, immunohistochemical and magnetic resonance imaging and cerebellum also by stereological tests. Neurological...... for understanding CNS pathology in the aging subject, animal or human....

  3. 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.

  4. Urinary Uric Acid/Creatinine Ratio - A Marker For Perinatal Asphyxia

    Science.gov (United States)

    Patel, Kinjal Prahaladbhai; Makadia, Mayur Goradhanbhai; Patel, Vishwal Indravardan; Nilayangode, Haridas Neelakandan

    2017-01-01

    Background Perinatal hypoxia is one of the leading causes of perinatal mortality in developing countries. Both apgar score and arterial blood pH predict the neonatal mortality in asphyxia. Apgar score alone does not predict neurologic outcome and as it is influenced by various factors. This study was conducted to evaluate the utility and sensitivity of urinary uric acid to creatinine ratio (UA/Cr ratio) in asphyxia diagnosis, compared to invasive Arterial Blood Gas (ABG) analysis. Aim To assess the urinary uric acid/creatinine ratio as an additional marker for perinatal asphyxia compared with ABG analysis in apgar score monitoring. Materials and Methods The present case control study was conducted at a teaching hospital in Central Gujarat. Data of 40 healthy newborns and 40 asphyxiated newborns were collected. In absence of regional estimates, a sample of size 39 was required to attain a power of 80% at 5% alpha (type I error) considering a moderate effect size of 0.65. (UA/Cr) ratio was measured from the spot urine sample collected during 24-72 hours of birth. Statistical analysis was performed by Independent t-test, Pearson’s correlation coefficient (r) and Receiver Operating Characteristic (ROC) plots. Results The mean (UA/Cr ratio) (2.75±0.18 vs 1.78±0.23) is significantly higher in asphyxiated group than in the control group (p0.05). Urinary UA/Cr ratio with criterion of >2.3 had 100% sensitivity, 100% specificity with AUC of 1 (p<0.0001) had a better predictive value. Conclusions Apgar score is usually reduced in neonates with congenital anomalies and premature neonates. Hence, it is preferable that the clinical diagnosis of asphyxia by apgar scores be supported by other investigations so that early decision can be taken about the level of care the baby needs. pH, lactates and base deficits change with establishment of respiration following resuscitation. However, pH, lactate, base deficit estimations are invasive and need rapid estimations. Non

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

    Directory of Open Access Journals (Sweden)

    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

  6. Neuropathology and functional deficits in a model of birth asphyxia in the precocial spiny mouse (Acomys cahirinus).

    Science.gov (United States)

    Hutton, Lisa C; Ratnayake, Udani; Shields, Amy; Walker, David W

    2009-01-01

    Birth asphyxia can result in sensory impairment, learning and memory deficits without gross brain injury and severe motor deficits. We developed a model of birth asphyxia resulting in mild neurological injury and cognitive impairment using a long-gestation species with precocial fetal development. Spiny mice (Acomys cahirinus) underwent caesarean-section delivery or 7.5 min of asphyxia at 37 days gestational age (term is 39 days). Brain histology was examined at 1 and 7 days of age, and behaviour was evaluated to 28 days of age. Asphyxiated offspring showed significant impairment in non-spatial memory and learning tasks, accompanied by central nervous system inflammation and increased apoptotic cell death but without the presence of large necrotic or cystic lesions.

  7. Correlation between clinical and histologic findings in the human neonatal hippocampus after perinatal asphyxia.

    Science.gov (United States)

    Schiering, Irene A M; de Haan, Timo R; Niermeijer, Jikke-Mien F; Koelman, Johannes H; Majoie, Charles B L M; Reneman, Liesbeth; Aronica, Eleonora

    2014-04-01

    Hypoxic ischemic encephalopathy after perinatal asphyxia is a major cause of mortality and morbidity in infants. Here, we evaluated pathologic changes in the hippocampi of a cohort of 16 deceased full-term asphyxiated infants who died from January 2000 to January 2009. Histochemical and immunocytochemical results for glial and neuronal cells were compared between cases with or without seizures and to adult and sudden infant death syndrome cases (n = 3 each). All asphyxiated infants displayed neuronal cell damage and reactive glial changes. Strong aquaporin-4 immunoreactivity was seen on astroglial cells within hippocampi in 50% of cases. In patients with seizures, the expression of metabotropic glutamate receptors was increased in glial cells. Cases with seizures displayed increased microglial activation and greater expression of the inflammatory markers interleukin 1β and complement 1q compared with those in cases without seizures. All cases with seizures displayed alterations in the blood-brain barrier, as assessed by immunohistochemistry for albumin. These findings confirm the complex cascade of cellular and molecular changes occurring in the human neonatal hippocampus after perinatal asphyxia. These changes may contribute to seizure development leading to secondary brain damage. These data may aid in the development of therapeutic targets for neonatal seizures.

  8. 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.

  9. 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.

  10. CDP-choline (citicoline) attenuates brain damage in a rat model of birth asphyxia.

    Science.gov (United States)

    Fiedorowicz, Michał; Makarewicz, Dorota; Stańczak-Mrozek, Kinga I; Grieb, Paweł

    2008-01-01

    To estimate protective potential of citicoline in a model of birth asphyxia, the drug was given to 7-day old rats subjected to permanent unilateral carotid artery occlusion and exposed for 65 min to a hypoxic gas mixture. Daily citicoline doses of 100 or 300 m/kg, or vehicle, were injected intraperitoneally for 7 consecutive days beginning immediately after the end of the ischemic-hypoxic insult, and brain damage was assessed by gross zorphology score and weight deficit two weeks after the insult. Caspase-3, alpha-fodrin, Bcl-2, and Hsp70 levels were assessed at 0, 1, and 24 h after the end of the hypoxic insult in another group of rat pups subjected to the same insult and given a single dose of 300 m/kg of citicoline or the vehicle. Citicoline markedly reduced caspase-3 activation and Hsp70 expression 24 h after the insult, and dose-dependently attenuated brain damage. In the context of the well-known excellent safety profile of citicoline, these data suggest that clinical evaluation of the efficacy of the drug in human birth asphyxia may be warranted.

  11. 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

    Cerebral blood flow (CBF) was studied in non-exteriorized near-term sheep fetuses using the radioactive microsphere technique. By partially occluding the umbilical vessels for a period of 1--1 1/2 hours a progressive and severe asphyxia with a final arterial pH of 6.90 was achieved. Varying...

  12. 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

  13. Autopsy reenactment--a useful technique in the evaluation of adhesive tape asphyxia.

    Science.gov (United States)

    Herbst, Jonathon; Stanley, Wayne; Byard, Roger W

    2014-05-01

    A 19-year-old woman was found dead with her face and head wrapped in plastic adhesive tape in a cupboard beside an opened helium cylinder. Despite the alleged presence of a suicide message on a social networking website, the unusual circumstances raised the possibility at the time of autopsy of either accidental death from sexual asphyxia or homicide. A carefully monitored reenactment demonstrated, however, that the type of commercial adhesive tape that had been used did not cause complete airway obstruction and that it was possible to wrap a considerable length of tape around the head and neck with the breath held. All of the features at autopsy were, therefore, compatible with self-infliction. Asphyxial death was attributed to the combined effects of smothering from tape and anoxia from helium, an extremely rare combination in young females.

  14. 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.

  15. Nonoliguric hyperkalemia in a late preterm infant with severe birth asphyxia.

    Science.gov (United States)

    Xiong, Xiaoyu; Chen, Dan; Zhang, Jing; Mao, Jian; Li, Juan

    2013-01-01

    Nonoliguric hyperkalemia (NOHK) is common during the first days after birth in premature infants with gestational age term or late preterm infants. We present a case of a 3 hours baby at 34 weeks and 3 days' gestational age who was delivered of severe birth asphyxia by cesarean section for failing to vaginal delivery. Serum potassium reached to 8.3 mmol/L at 12 hours age, with normal urinary output and serum urea and creatinine. Abnormal ECG of tall peaked T waves was developed. Marked fall in serum Ca(2+) of 0.6 mmol/L and total calcium of 1.13 mmol/L was also noted. Cerebral lesions in the head MRI demonstrated extensive periventricular white matter injury.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. PHENOBARBITAL FOR THE PREVENTION OF INTRACRANIAL DAMAGE IN CHINESE NEONATES WITH SEVERE ASPHYXIA

    Institute of Scientific and Technical Information of China (English)

    陈惠金; 吴圣楣; 黄萍; 孙建华; 陈冠仪; 储凇雯

    2000-01-01

    Objective To evaluate the effect of phenobarbital on preventing intracranial damage and seizure in Chinese neonates with severe asphyxia. Methods A control trial was carried out in 60 Chinese neonates with severe asphyxia. 30 neonates received loading dose of phenobarbital on an average of 5.6h of age. Results The mean value of phenobarbital serum level obtained at the 4th day after birth was 21.9μg/ml. No significant difference was observed in the two groups in terms of birth weight, gestational age, Apgar scores, sex, etc. The imaging diagnosis within 3d of age in all subjects showed normal brain in 14, brain edema in 9 and intraventricular hemorrhage (IVH) in 7 in the treated group with a 53.3% of total complication rate, and normal brain in 5, brain edema in 15, IVH in 9 and subarachnoid hemorrhage (SAH) in 1 in the untreated group with a 83.3% of total complication rate. The incidence of intracranial damage in the untreated group was significantly higher than that in the treated group (83.3% vs 53.3%, P<0.05). In the treated group, 4 neonates with seizure symptom were effectively controlled soon, and none of the other 26 developed seizure. The period of seizure in the treated group was significantly shorter than that in the untreated group (P<0. 05). Other clinical symptoms were also sooner improved and no side effects were observed among the neonates treated with phenobarbital. Conclusion The incidence of postasphyxiated intracranial damage was obviously decreased, and seizure could be prophylactically intervened by phenobarbital. It is recommended that early application of preventive phenobarbitalin severely asphyxiated neonates is reasonable in reducing the incidence of intracranial lesions and subsequent seizures.

  18. Feasibility of Implementing an Early Intervention Program in an Urban Low-Income Setting to Improve Neurodevelopmental Outcome in Survivors Following Birth Asphyxia

    OpenAIRE

    2011-01-01

    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 rand...

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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...... was associated with a marked profibrillatory effect. Increasing gap junction intracellular communication using the antiarrhythmic peptide analogue AAP 10 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...

  1. 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...

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. Serum cortisol concentrations during induced hypothermia for perinatal asphyxia are associated with neurological outcome in human infants.

    Science.gov (United States)

    Scaramuzzo, Rosa T; Giampietri, Matteo; Fiorentini, Erika; Bartalena, Laura; Fiori, Simona; Guzzetta, Andrea; Ciampi, Mariella; Boldrini, Antonio; Ghirri, Paolo

    2015-01-01

    Birth asphyxia is a cause of neonatal death or adverse neurological sequelae. Biomarkers can be useful to clinicians in order to optimize intensive care management and communication of prognosis to parents. During perinatal adverse events, increased cortisol secretion is due to hypothalamo-pituitary-adrenal axis activation. We aimed to investigate if cortisol variations during therapeutic hypothermia are associated with neurodevelopmental outcome. We compared 18 cases (neonates with birth asphyxia) with 18 controls (healthy term newborns) and confirmed increased serum cortisol concentrations following the peri-partum adverse event. Among cases, we stratified patients according to neurological outcome at 18 months (group A - good; group B - adverse) and found that after 24 h of therapeutic hypothermia serum cortisol concentration was significantly lower in group A vs group B (28.7 ng/mL vs 344 ng/mL, *p = 0.01). In group B serum, cortisol concentration decreased more gradually during therapeutic hypothermia. We conclude that monitoring serum cortisol concentration during neonatal therapeutic hypothermia can add information to clinical evaluation of neonates with birth asphyxia; cortisol values after the first 24 h of hypothermia can be a biomarker associated with neurodevelopmental outcome at 18 months of age.

  6. A STUDY OF EFFECT OF PERINATAL ASPHYXIA ON THYROID HORMONE IN NEONATES

    Directory of Open Access Journals (Sweden)

    Rajesh

    2015-08-01

    Full Text Available AIMS AND OBJECTIVE: To study the effect of perinatal asphyxia on thyroid hormones of term neonates . MATERIAL AND METHOD S : It was a prospective case control study and it was conducted in department of pediatrics, Kamala Nehru Hospital Gandhi Medical College, Bhopal. Total 60 full term neonates who have completed 37 wks of gestation at birth included in study, 30 asphyxiated newborn taken as cases and 30 healthy neonates as control. For inclusion of cases criteria was, 1 and 5 minute APGAR score 7 and no sepsis setting. Classification of HIE done on the bases of Sarnat and Sarnat staging. Blood samples were collected for determination of thyroid profile (T 4, T 3 and TSH, first within 6 hours of birth and seconds 18 to 24hour of age. RESULT: Out of 30 cases, 13.13% were HIE - I, 50% were HIE - II and 36.67% were HIE - III. Mean value of TSH was low at 6 hours as well as at 18 - 24 hours between case and control group while mean value of T 3 andT 4 were low at only 18 - 24hrs of a ge. CONCLUSION : The mean T 3, T 4 and TSH levels at birth of asphyxiated newborn was significantly lower than the control group at 18 - 24 hours . Due to low TSH surge, asphyxiated babies could not increase their T 3 and T 4 level significantly

  7. Moderate and severe perinatal asphyxia induces differential effects on cocaine sensitization in adult rats.

    Science.gov (United States)

    Galeano, Pablo; Romero, Juan Ignacio; Luque-Rojas, María Jesús; Suárez, Juan; Holubiec, Mariana Inés; Bisagno, Verónica; Santín, Luis Javier; De Fonseca, Fernando Rodríguez; Capani, Francisco; Blanco, Eduardo

    2013-09-01

    Perinatal asphyxia (PA) increases the likelihood of suffering from dopamine-related disorders, such as ADHD and schizophrenia. Since dopaminergic transmission plays a major role in cocaine sensitization, the purpose of this study was to determine whether PA could be associated with altered behavioral sensitization to cocaine. To this end, adult rats born vaginally (CTL), by caesarean section (C+), or by C+ with 15 min (PA15, moderate PA) or 19 min (PA19, severe PA) of global anoxia were repeatedly administered with cocaine (i.p., 15 mg/kg) and then challenged with cocaine (i.p., 15 mg/kg) after a 5-day withdrawal period. In addition, c-Fos, FosB/ΔFosB, DAT, and TH expression were assessed in dorsal (CPu) and ventral (NAcc) striatum. Results indicated that PA15 rats exhibited an increased locomotor sensitization to cocaine, while PA19 rats displayed an abnormal acquisition of locomotor sensitization and did not express a sensitized response to cocaine. c-Fos expression in NAcc, but not in CPu, was associated with these alterations in cocaine sensitization. FosB/ΔFosB expression was increased in all groups and regions after repeated cocaine administration, although it reached lower expression levels in PA19 rats. In CTL, C+, and PA15, but not in PA19 rats, the expression of TH in NAcc was reduced in groups repeatedly treated with cocaine, independently of the challenge test. Furthermore, this reduction was more pronounced in PA15 rats. DAT expression remained unaltered in all groups and regions studied. These results suggest that moderate PA may increase the vulnerability to drug abuse and in particular to cocaine addiction.

  8. 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.

  9. Modulation of Postnatal Neurogenesis by Perinatal Asphyxia: Effect of D1 and D2 Dopamine Receptor Agonists.

    Science.gov (United States)

    Tapia-Bustos, A; Perez-Lobos, R; Vío, V; Lespay-Rebolledo, C; Palacios, E; Chiti-Morales, A; Bustamante, D; Herrera-Marschitz, M; Morales, P

    2017-01-01

    Perinatal asphyxia (PA) is associated to delayed cell death, affecting neurocircuitries of basal ganglia and hippocampus, and long-term neuropsychiatric disabilities. Several compensatory mechanisms have been suggested to take place, including cell proliferation and neurogenesis. There is evidence that PA can increase postnatal neurogenesis in hippocampus and subventricular zone (SVZ), modulated by dopamine, by still unclear mechanisms. We have studied here the effect of selective dopamine receptor agonists on cell death, cell proliferation and neurogenesis in organotypic cultures from control and asphyxia-exposed rats. Hippocampus and SVZ sampled at 1-3 postnatal days were cultured for 20-21 days. At day in vitro (DIV) 19, cultures were treated either with SKF38393 (10 and 100 µM, a D1 agonist), quinpirole (10 µM, a D2 agonist) or sulpiride (10 μM, a D2 antagonist) + quinpirole (10 μM) and BrdU (10 μM, a mitosis marker) for 24 h. At DIV 20-21, cultures were processed for immunocytochemistry for microtubule-associated protein-2 (MAP-2, a neuronal marker), and BrdU, evaluated by confocal microscopy. Some cultures were analysed for cell viability at DIV 20-21 (LIVE/DEAD kit). PA increased cell death, cell proliferation and neurogenesis in hippocampus and SVZ cultures. The increase in cell death, but not in cell proliferation, was inhibited by both SKF38393 and quinpirole treatment. Neurogenesis was increased by quinpirole, but only in hippocampus, in cultures from both asphyxia-exposed and control-animals, effect that was antagonised by sulpiride, leading to the conclusion that dopamine modulates neurogenesis in hippocampus, mainly via D2 receptors.

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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.

  12. 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.

  13. 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

    NARCIS (Netherlands)

    van Doormaal, Pieter Jan; Meiners, Linda C.; ter Horst, Hendrik J.; van der Veere, Christa N.; Sijens, Paul E.

    2012-01-01

    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

  14. Rescue and Nursing of 110 Cases of Neonatal Asphyxia%110例新生儿窒息的抢救护理

    Institute of Scientific and Technical Information of China (English)

    李碧霞; 万弘

    2014-01-01

    Objective To improve the rescue and nursing of neonatal asphyxia. Methods We retrospectively analyzed the nursing method for 110 cases of asphyxia neonatorum in our hospital from 2013 April to 2014 March. Results 109 in 110 asphyxia children were successful rescue(success rate 99.09%).Conclusion Only active prevention, health care workers closely, timely recovery can ensure the rescue effect of asphyxia neonatorum.%目的:探讨完善新生儿窒息的抢救护理措施。方法选择2013年4月~2014年3月期间我院收治的窒息新生儿110例为研究对象,回顾性总结分析护理方法。结果110例患儿中抢救成功109例,抢救成功率99.09%。结论只有积极预防,医护人员紧密配合、及时复苏,才能确保窒息新生儿的救治效果。

  15. 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.

  16. 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

  17. 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.

  18. Relationship between evolving epileptiform activity and delayed loss of mitochondrial activity after asphyxia measured by near-infrared spectroscopy in preterm fetal sheep.

    Science.gov (United States)

    Bennet, L; Roelfsema, V; Pathipati, P; Quaedackers, J S; Gunn, A J

    2006-04-01

    Early onset cerebral hypoperfusion after birth is highly correlated with neurological injury in premature infants, but the relationship with the evolution of injury remains unclear. We studied changes in cerebral oxygenation, and cytochrome oxidase (CytOx) using near-infrared spectroscopy in preterm fetal sheep (103-104 days of gestation, term is 147 days) during recovery from a profound asphyxial insult (n= 7) that we have shown produces severe subcortical injury, or sham asphyxia (n= 7). From 1 h after asphyxia there was a significant secondary fall in carotid blood flow (P < 0.001), and total cerebral blood volume, as reflected by total haemoglobin (P < 0.005), which only partially recovered after 72 h. Intracerebral oxygenation (difference between oxygenated and deoxygenated haemoglobin concentrations) fell transiently at 3 and 4 h after asphyxia (P < 0.01), followed by a substantial increase to well over sham control levels (P < 0.001). CytOx levels were normal in the first hour after occlusion, was greater than sham control values at 2-3 h (P < 0.05), but then progressively fell, and became significantly suppressed from 10 h onward (P < 0.01). In the early hours after reperfusion the fetal EEG was highly suppressed, with a superimposed mixture of fast and slow epileptiform transients; overt seizures developed from 8 +/- 0.5 h. These data strongly indicate that severe asphyxia leads to delayed, evolving loss of mitochondrial oxidative metabolism, accompanied by late seizures and relative luxury perfusion. In contrast, the combination of relative cerebral deoxygenation with evolving epileptiform transients in the early recovery phase raises the possibility that these early events accelerate or worsen the subsequent mitochondrial failure.

  19. 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

    2014-01-01

    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.

  20. 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.

  1. Effect of dopamine combined with dobutamine on target organ function indicators and molecular indicators in children with renal damage after neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    Cheng-Yuan Li

    2016-01-01

    Objective:To analyze the effect of dopamine combined with dobutamine on target organ function indicators and molecular indicators in children with renal damage after neonatal asphyxia.Methods: A total of 40 cases of children with renal damage after neonatal asphyxia were randomly divided into observation group and control group, control group received conventional therapy, observation group received conventional therapy + dopamine + dobutamine therapy, and then differences in levels of renal blood flow parameters, urine trace proteins and serum renal function-related parameters were compared between two groups after the treatment.Results:Vmax, Vmin and TAMX levels of observation group after treatment were higher than those of control group while RI and PI values were lower than those of control group; urine 1-MG, Alb, RBP, IgG and TRF levels were lower than those of control group; serum BUN, Cr, ET-1 and Cystatin C levels were lower than those of control group. Conclusion: Dopamine combined with dobutamine is a reliable way to treat renal damage after neonatal asphyxia, and plays a positive role in the optimizing renal blood flow and renal function.

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

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    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.

  3. 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.

  4. 北京密云地区264例新生儿窒息的产科因素分析%Obstetric factors of 264 cases of neonatal asphyxia in Miyun County of Beijing

    Institute of Scientific and Technical Information of China (English)

    杨淑君

    2013-01-01

    Objective To investigate the obstetric factors of neonatal asphyxia in past 10 years and their changes in Miyun District ,so as to provide basis for reducing the incidence of neonatal asphyxia and improving the obstetric quality .Methods Retrospective analysis was conducted on the data of 264 cases of neonatal asphyxia from January 2003 to December 2012 in Miyun County .The trend of neonatal asphyxia incidence in these 10 years was explored as well as the obstetric factors of neonatal asphyxia and changes .Results During these 10 years, neonatal asphyxia rate decreased significantly (χ2 =102.46, P<0.001).The major obstetric factors of neonatal asphyxia were amniotic fluid contamination , labor abnormalities , gestational hypertension and shoulder dystocia .The constitute of neonatal asphyxia caused by shoulder dystocia increased (P =0.026).Conclusion Amniotic fluid contamination, labor abnormalities, gestational hypertension and shoulder dystocia are major factors leading neonatal asphyxia .The neonatal asphyxia caused by shoulder dystocia should obtain more attention.%目的探讨近10年密云地区新生儿窒息的产科因素及变化,为降低新生儿窒息发生率、提高产科质量提供依据。方法回顾性分析2003年1月至2012年12月在北京市密云县妇幼保健院分娩的264例新生儿窒息的病例资料,探讨10年间新生儿窒息发生率的变化趋势,以及造成新生儿窒息的产科因素及变化。结果10年间新生儿窒息率明显下降(χ2=102.46,P<0.001);新生儿窒息的主要产科因素分别为羊水污染、产程异常、妊娠期高血压疾病和肩难产,肩难产导致新生儿窒息的构成比上升(确切概率法P=0.026)。结论羊水污染、产程异常、妊娠期高血压疾病和肩难产是导致新生儿窒息的主要因素,肩难产导致新生儿窒息应引起产科重视。

  5. 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.

  6. 咪达唑仑在窒息后惊厥新生儿中的应用%Application of midazolam in convulsion newborn after asphyxia

    Institute of Scientific and Technical Information of China (English)

    陈卫; 杨志雄

    2015-01-01

    Objective:To explore the anticonvulsant action of midazolam in perinatal severe asphyxia.Methods:21 cases of convulsion newborns after severe asphyxia were selected.They were randomly divided into the experimental group with 11 cases and the control group with 10 cases.The experimental group was given midazolam treatment,and the control group was given phenobarbital treatment.The anticonvulsant effects and respiratory inhibition effects of two groups were compared.Results:The anticonvulsant effect of the experimental group was better than that of the control group.There was no respiratory inhibition in the experimental group,and the control group had 1 case of respiratory inhibition.Conclusion:The effect of midazolam in the treatment of convulsion after newborn asphyxia is much better than that of phenobarbital.%目的:探讨咪达唑仑在新生儿重度窒息中抗惊厥作用。方法:收治重度窒息后惊厥新生儿21例,随机分为试验组11例和对照组10例。试验组给予咪达唑仑治疗,对照组给予苯巴比妥治疗。比较两组抗惊厥效果及呼吸抑制作用。结果:试验组抗惊厥效果优于对照组,试验组中未见呼吸抑制,对照组中1例发生呼吸抑制。结论:咪达唑仑在新生儿窒息后惊厥治疗中效果明显优于苯巴比妥。

  7. 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.

  8. Effect of pregnant week and delivery route on neonatal asphyxia in twin pregnancy%双胎妊娠分娩孕周及分娩方式对新生儿窒息的影响

    Institute of Scientific and Technical Information of China (English)

    何辉

    2011-01-01

    目的 探讨双胎妊娠的孕周及分娩方式与新生儿窒息的关系.方法 对101例双胎分娩的产妇分别按孕周及胎位各分为两组,对其资料进行回顾性分析.结果 0.05),而非头-头位的阴道产组新生儿窒息率显著高于剖宫产组(P<0.05),第二出生新生儿中阴道产组的窒息率显著高于剖宫产组(P<0.05).结论 正确选择双胎妊娠的分娩方式,将有助于降低新生儿窒息率.%Aim To explore the relationship between pregnant week and delivery route and neonatal asphyxia in twin pregnancy. Methods 101 cases of twin pregnancy women were divided into two groups from pregnant week and fetal presentation, and were analyzed retrospectively. Results The incidence of neonatal asphyxia of women with pregnant week shorted than 34 weeks was higher than those longer than 34 weeks( P < 0.05 ). When the fetal presentation were head head, no significant difference was shown in neonatal asphyxia of cesarean section or vaginal delivery( P > 0.05 ), however, when the fetal presentation was not head-head, the incidence of neonatal asphyxia of vaginal delivery was higher than that of cesarean section( P < 0.05 ). The incidence of neonatal asphyxia of second neonatal in vaginal delivery was higher than that in cesarean section( P < 0.05 ). Conclusion The right route of delivery can lower the incidence of neonatal asphyxia.

  9. 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.)

  10. Analysis on maternal and infantile high risk factors of neonatal asphyxia%新生儿窒息母婴高危因素分析

    Institute of Scientific and Technical Information of China (English)

    王凤敏

    2011-01-01

    Objective: To analyze the maternal and infantile high risk factors of neonatal asphyxia, explore the key point of maternal and infantile health care during perinatal period in the region. Methods: A retrospective analysis was used to statistically analyze the maternal and infantile high risk factors of neonates with asphyxia who were bom in obstetrical department of the hospital from January to December in 2009. Results: 9 632 neonates were born in obstetrical department of the hospital in 2009, 157 neonates were found with asphyxia,the incidence was 1.63%. All the neonates with asphyxia had high risk factors during perinatal period, the proportions of maternal factors,fetal and neonatal factors, placental and umbilical factors and intrapartum factors were 24. 84%, 66. 24%, 25.48% and 24. 84%, respectively. Fetal and neonatal factors ranked the first among the neonates with asphyxia, including 91 premature infants, 85 low birth weight infants and 13 infants of retarded birth, twin pregnancy, macrosomia and congenital malformations. 7 neonates were found with severe asphyxia, accounting for 0. 07%. 3 neonates were born at 29 gestational weeks, 1 neonate was born at 35 gestational weeks whose body weight was 1 300 g, 1 neonate was born at 34 gestational weeks and found with placental abruption and thin umbilical cord, 2 neonates were found with congenital malformations (congenital pulmonary hypoplasia, pleural effusion) . Conclusion: Premature infants and low birth weight infants become to be the principal cause of neonatal asphyxia in the region, resuscitation of premature infants should become the key point of resuscitation training. Congenital malformation is a main factor of severe neonatal asphyxia, watching out for the existence of congenital malformations in the course of resuscitation can improve prognosis and prevent medical disputes.%目的:分析新生儿室息母婴高危因素,探讨该地区围产期母婴保健重点.方法:采用

  11. Efeitos da asfixia perinatal sobre os hormônios tireoidianos Effect of perinatal asphyxia on thyroid hormones

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    Denise N. Pereira

    2001-06-01

    Full Text Available OBJETIVO: verificar o efeito da asfixia perinatal sobre os hormônios tireóideos. MÉTODOS: Foi realizado um estudo de caso-controle, no hospital de Clínicas de Porto Alegre, envolvendo 17 recém-nascidos a termo asfixiados (A e 17 não-asfixiados (N, pareados conforme a cor, sexo, tipo de parto, idade gestacional e peso de nascimento. Foram coletados T4, T3, T4 livre, T3 reverso e TSH do sangue do cordão e do recém-nascido com 18 a 24 horas de vida, entre os que sofreram ou não asfixia perinatal. RESULTADOS: No sangue de cordão, não houve diferença na dosagem dos hormônios tireóideos, com exceção do T3 reverso, que foi mais elevado no grupo que sofreu asfixia [mediana (percentis 25-75 :A= 2(1,4-2; N= 1,41(1,13-1,92; p=0,037]. Com 18 a 24 horas de vida, foram significativamente menores no grupo de asfixiados, com exceção do T3 reverso, que foi semelhante entre os dois grupos [média ± DP: T4 A= 9,79 ± 2,59; N=14,68 ± 3,05; p OBJECTIVE: to verify the effect of perinatal asphyxia on thyroid hormone levels in term newborn infants. METHODS: We carried out a case-control study with 17 term and asphyxiated (A and 17 term and control (N newborn infants at the Hospital de Clínicas de Porto Alegre. Patients were paired according to color of skin, sex, type of delivery, gestational age, and weight at birth. We collected umbilical cord plasma T4, T3, free T4, reverse T3, and TSH after 18 to 24 hours of life and from asphyxiated and control newborn infants. RESULTS: There were no differences in thyroid hormones of cord blood, with the exception of reverse T3, which was higher in A than in controls [median (25th-75th percentile: A= 2(1.4-2; N= 1.41 (1.13-1.92; P=0.037]. Thyroid hormone levels were lower in A than in controls on samples collected within 18-24 hours after birth, except for reverse T3, which was similar in both groups [average ± SD: T4 A= 9.79 ± 2.59; N=14.68 ± 3.05; P<0.001; median T3 A= 40.83 (37.4-80.4; N= 164 (56

  12. 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.

  13. Clinical Significance of Umbilical Artery Blood Gas Analysis on Diagnosis of 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)

    孙玉梅; 肖绪武; 刁敬军

    2013-01-01

    Objective To explore the clinical diagnostic value of umbilical arterial blood gas diagnosis on neonatal asphyxia. Methods Select 120 cases of our birth babies, after born analyze umbilical artery blood gas analysis and Apgar score. Results Apgar score and blood gas analysis pH value, PO2, BE were positively correlated, and blood gas analysis PCO2 was negatively correlated, severe asphyxia children pH acuities were 7.20 cases is obviously higher than that of the mild asphyxia group and normal group. Conclusion The umbilical artery blood gas analysis can accurate evaluation of diagnosis neonatal asphyxia, and improve the diagnostic accuracy rate of neonatal asphyxia.%  目的 探讨脐动脉血气检查对于新生儿窒息的临床诊断价值.方法选取我院出生的新生儿120例,出生后行脐动脉血气分析并进行Apgar评分.结果 Apgar评分与血气分析pH值、PO2、BE呈正相关,而与血气分析PCO2呈负相关,重度窒息患儿pH≤7.20病例明显高于轻度窒息组和正常组.结论脐动脉血气分析可以客观准确地评价诊断新生儿窒息,有助于提高新生儿窒息的诊断准确率.

  14. 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.

  15. 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。

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 纳美芬对新生儿窒息后血浆β-内啡肽表达的影响%Effect of Nalmefene on the expression of β-Endorphin in blood plasma after neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    包长顺; 包文朝

    2016-01-01

    目的:观察纳美芬对新生儿窒息后的血浆β-内啡肽(β-EP)表达的影响.方法:选择40例出生后发生轻重度窒息的足月新生儿,随机分为2组,纳美芬组和对照组(常规治疗组),每组20例.对照组仅给予常规复苏治疗,纳美芬组在常规复苏治疗基础上给予脐静脉注射纳美芬0.02 mg/kg,两组窒息后均经脐静脉采血检测血浆β-EP,于复苏后6、12、24、48 h分别静脉采血检测血浆β-EP及血气分析.结果:两组窒息即刻β-EP及血气分析无统计学意义(P>0.05),纳美芬组6、12、24 h与对照组及组内比较β-EP显著性降低(P<0.01),对照组6h后组内比较β-EP较窒息后显著增高(P<0.05),48 h后两组组间及组内比较β-EP均下降明显(P<0.05).结论:用纳美芬治疗新生儿窒息可以显著性降低β-EP,并改善血气从而减轻缺氧后对心脑细胞再灌注损伤.%AIM:To observe the effect of nalmefene on the expression of β-endorphin (β-EP)in the plasma after neonatal asphyxia.METHODS:40 cases of full-term infant with slight and severe asphyxia after birth were randomly divided into two groups,the nalmefene group and the control group (conventional treatment).There were 20 cases in each group.The control group received conventional resuscitation treatment while the observation group was injected with 0.02 mg/kg nalmefene to umbilical vein in addition to receiving conventional resuscitation treatment.β-endorphin in the plasma by umbilical veins blood collection at the time of asphyxia happened immediately and β-endorphin in the plasma by umbilical veins blood collection and the results of blood gas analysis at 6,12,24,48 h after resuscitation were examined.RESULTS:β-endorphin and results of blood gas analysis had no statistical significance at the time of asphyxia happened immediately in both of the groups (P >0.05).β-endorphin was reduced significantly in observation group at the time of 6,12,24 h compared with control group and

  3. 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

  4. 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

  5. Relationship between neonatal asphyxia blood gastrin,gastric pH and gastrointestinal dysfunction%新生儿窒息后血胃泌素、胃液pH值与胃肠功能障碍的探讨

    Institute of Scientific and Technical Information of China (English)

    刘春红

    2012-01-01

    目的 探讨新生儿窒息后血胃泌素(GAS)、胃液pH值与胃肠功能障碍发生的关系以及早期处理减少并发症的方法.方法 分别测定非窒息新生儿胃液pH值及血GAS20例及窒息新生儿50例,采取动态监测及分析窒息新生儿血GAS、胃液pH值.结果 窒息后发生胃肠功能障碍患儿GAS明显高于无障碍组和对照组,胃液pH值明显低于无障碍组和对照组;早期处理后在72h血GAS明显降低,而胃液pH值明显升高并接近正常.结论 新生儿窒息后早期进行GAS、胃液pH值动态监测可早期干预,减少胃肠功能障碍发生及并发症.%Objective To investigate the relationship between serum gastrin after asphyxia ( GAS ) , gastric pH and gas-trointestinal dysfunction and early treatment to reduce complications. Methods Determination of non - asphyxia neo-natal gastric juice pH,and blood GAS20 cases and 50 cases of asphyxia,take a dynamic monitoring and analysis of asphyxia blood GAS, gastric juice pH. Results Suffocation after gastrointestinal dysfunction in children with GAS was significantly higher than that of the barrier - free group and the control group, gastric pH was significantly lower than that of the barrier - free group and the control group; Blood GAS significantly reduced 72 hours after early treatment, and the pH of gastric juice significantly higher and close to normal. Conclusions Early detection of GAS, gastric pH dynamic monitoring and early intervention can reduce gastrointestinal dysfunction and complications.

  6. Changes of Maternal and Neonatal Plasma Prolactin Levels in Neonatal Asphyxia%新生儿窒息母儿血浆催乳素水平变化的研究

    Institute of Scientific and Technical Information of China (English)

    李占魁; 冯晋兴; 段钊; 刘明; 刘雅; 李静; 薛翔

    2003-01-01

    目的目前发现催乳素(PRL)与缺氧缺血性脑病(HIE)的严重程度密切相关,PRL与新生儿窒息的关系较少报道,该文探讨窒息新生儿母儿血浆催乳素(PRL)水平变化与相关性及其意义.方法采用放射免疫分析法对25例围产期窒息新生儿(窒息组,其中轻度窒息14例,重度窒息¨例)及20例正常新生儿(对照组)母血、脐血及新生儿血浆PRL水平进行测定并进行动态观察.结果窒息组母血、脐血及新生儿血浆PRL水平[(362.5±127.1),(984.6±262.3),(386.3±216.2)μg/L]均显著高于对照组[(96.4±26.2),(92.3±18.4),(68.7±7.27)μg/L](P均<0.01);重度窒息组母血、脐血及新生儿血浆PRL水平[(445±216),(996±284),(412±221)μg/L]均高于轻度窒息组[(298±102),(612±221),(309±19.2)μg/L](P<0.01或0.05).轻、重度窒息组中脐血与新生儿血浆PRL水平具有显著的正相关关系(r=0.54,0.63,P<0.05).窒息新生儿复苏后血浆PRL水平高于对照组(P<0.01);生后第2天PRL水平逐渐下降,但仍高于对照组(P<0.05);生后第10天血浆PRL水平与对照组差异无显著性(P>0.05).结论围产期窒息时新生儿血浆、脐血及母血PRL水平显著增高,血浆PRL水平可作为判断新生儿窒息程度的一项参考指标.%Objective Some research has shown that prolactin (PRL) is closely related to severity of hypoxic-ischemic encephalopathy (HIE). However, the role of maternal and neonatal plasma PRL levels in neonatal asphyxia has not been reported so far. This paper aims at studying the changes of PRL levels in the cord blood, maternal blood and plasna of newborns in neonatal asphyxia. Methods The maternal blood, cord blood and neonatal plasma PRL levels in 25 neonates with asphyxia (asphyxia group) and 20 normal ones (control group) were detected by radioimmunoassay.Results The maternal blood, cord blood and neonatal plasma PRL levels [(362.5 + 127.1), (984.6 + 262.3) and(386.3+216.2) μg/L, respectively] in the asphyxia

  7. 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

  8. 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.

  9. 新生儿窒息血常规结果分析及其临床意义%Analysis of Blood Routine Examination for Asphyxia Neonatorum and Its Clinical Significance

    Institute of Scientific and Technical Information of China (English)

    常正义; 马迎教; 潘云; 陈碧艳; 曾冬云

    2014-01-01

    Objective To investigate the changes of the 29 parameters of blood routine in asphyxia newborns ,and to study the clinical significance .Methods The automatic blood cell analyzer Sysmex XE-5000 was used to analyze the parameters ,such as leukocytes ,erythrocytes and platelets in 40 asphyxia newborns ( asphyxia group ) and 38 normal newborns ( control group ) .The results and clinical significance were analyzed as well .Results ① The parameters of leukocytes:The neutrophil ratio(NEUT%) was significantly higher(P0.05).②The parameters of erythrocytes:The mean hemoglobin concentration (MCHC) and low fluorescent reticulocyte percentage in the asphyxia group were significantly lower than those in the control group ( P0.05).③The parameters of platelets:The platelet count(PLT) and plateletcrit(PCT) in the asphyxia group were significantly lower than those in the control group (P0.05).Conclusion Dynamic monitoring of blood routine can help to learn the changes of asphyxia neonatorum.And it is of great significance to screening and diagnosis of the severity of neonatal asphyxia in time so as to intervene and rescue the patients in the early stage .%目的:探讨新生儿窒息血常规29项参数的变化及其临床意义。方法利用Sysmex XE-5000全自动血细胞分析仪对新生儿窒息40例(窒息组)和正常新生儿38例(对照组)进行白细胞、红细胞及血小板等参数检测,分析其结果和临床意义。结果(1)白细胞参数:窒息组中性粒细胞比率明显高于对照组(P<0.05),淋巴细胞比率、单核细胞比率明显低于对照组(P<0.05),白细胞计数、嗜酸性粒细胞比率、嗜碱性粒细胞比率比较,差异无统计学意义(P>0.05)。(2)红细胞参数:窒息组红细胞平均血红蛋白浓度、低荧光网织红细胞比率明显低于对照组( P<0.05),红细胞分布宽度CV、红细胞分布宽度SD、网织红细胞计数、网织红细胞百

  10. 新生儿窒息后血乳酸及血气分析变化的临床意义%Clinical significance of analysis changes of blood lactic acid and blood gas after neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    林文朝

    2015-01-01

    ObJective To analyze the changes of lactic acid concentration in blood of asphyxia neonates,and to investigate the correlation of the severity of asphyxia,organ damage with prognosis of the patients. Methods One hundred and fifty infants born in central people’s hospital of Zhanjiang from August 2013 to July 2014 were selected as contrast ex-periment objects,among whom 100 infants appearing choking phenomenon when born were in the experimental group,while 50 infants not appearing choking phenomenon were in the control group. After birth for half an hour,the content of lactic acid in the blood was measured,and then the infants were divided into groups according to the severity of asphyxia,organ damage and prognosis. The differences of blood lactic acid concentration,pH value and the 1 min Apgar scores and the BE in each group were compared. Results The blood lactate concentration of the infants in mild asphyxia group and severe as-phyxia group were significantly higher than that of control group( P﹤0. 05),and the blood lactate concentration enhanced with the increasing in the degree of asphyxia. The 1 min Apgar scores,pH value and BE of the infants were reduced with increasing the concentration of blood lactic acid. The blood lactic acid content in multiple organ damage group[ blood lac-tate concentration(4.8 ±2.9)mmol/L]and death group[blood lactate concentration(5.7 ±1.5)mmol/L]was higher than that in the single organ damage respectively[blood lactate concentration(2. 1 ± 0. 9)mmol/L]and cure group [blood lactate concentration(2. 2 ± 1. 2)mmol / L]. Conclusions Observing the concentration of lactic acid in blood of the infants in observation group can predict the degrees of asphyxia and prognosis.%目的:分析窒息新生儿血液中的乳酸浓度变化,并探究其和窒息严重度、器官损坏以及预后情况之间的关系。方法选择2013年8月至2014年7月在湛江市中心人民医院出生的150例新生儿,其中

  11. 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

  12. 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

  13. Value of neonatal behavioral and neurological assessment in prognostic evaluation of full-term neonates with birth asphyxia%新生儿行为神经测定对足月窒息儿预后的评价

    Institute of Scientific and Technical Information of China (English)

    李宏; 赵倩; 周细中; 方素珍

    2008-01-01

    Objective To evaluate the prognosis of full-term neonates with birth asphyxia usingneonatal behavioral and neurological assessment (NBNA). Methods A total of 326 full-term neonateswith birth asphyxia were evaluated using NBNA 12-14 days and 25-28 days after birth. The infants werefollowed up till 24 months old and a developmental assessment was made according to the CDCC Scalesof Infant Development. Results The incidence of developmental retardation (with mental developmentindex ≤69 or psychomotor development index ≤69) was significantly higher in the infants with NBNAscores ≤35 than in those with NBNA scores >35. Conclusion The NBNA score provides a valuablereference for prognostic evaluation of the full-term neonates with birth asphyxia, and may serve as asensitive indicator for cerebral lesions.%目的 探讨新生儿行为神经测定(NBNA)对新生儿重症监护室(Mcu)足月窒息儿预后的预测意义.方法 对NICU住院治疗的326例足月窒息儿分别在12~14d龄、25~28d龄行NBNA测定,并随访至24月龄,行婴幼儿智能发育测定(CDCC)评估.结果 12~14d龄、25~28d龄NBNA评分异常(≤35分)组患儿在24月龄时行CDCC发育评估,智力发育落后[智力发育指数(MDI)≤69]发生率分别为61.54%、75.81%;运动发育落后[精神运动发育指数(PDI)≤69]发生率分别为65.38%、79.03%,与NBNA评分>35分组相比,差异均有统计学意义(P<0.05).且行为能力中的视听定向项目以及主动肌张力是NBNA的敏感指标.结论 NBNA评分对足月窒息儿的预后有较好的预测意义,对于12~14d龄后NBNA≤35分患儿,特别是视听定向及主动肌张力反应差的患儿需特别注意,要尽早对这些患儿行早期干预治疗.

  14. 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

  15. 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

    OpenAIRE

    2011-01-01

    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 ...

  16. The influence of different asphyxia time on the reproduction of multiply organ dysfunction model after cardiopulmonary resuscitation following cardiac arrest in rabbit%不同窒息时间对心搏骤停家兔心肺复苏后多器官功能障碍发生的影响

    Institute of Scientific and Technical Information of China (English)

    张东; 王育珊; 李南; 陈颖

    2011-01-01

    了可能性和可行性.%Objective To explore the effects of different asphyxia time on the reproduction of multiply organ dysfunction syndrome in rabbit after cardiopulmonary resuscitation (CPR-MODS) for cardiac arrest,in order to provide a method to reproduce an animal model of CPR-MODS for further research of cardiopulmonary resuscitation (CPR).Methods The rabbit cardiac arrest was caused by asphyxia as a result of clamping the trachea.Thirty rabbits were divided into 7-minute asphyxia group and 8-minute asphyxia group by means of random number table with 15 rabbits in each group.The rate of resumption of spontaneous circulation(ROSC),the mortality at different time points and the occurrence incidence of systemic inflammatory response syndrome (SIRS) of two groups were observed after CPR and the ROSC.The levels of serum tumor necrosis factor-a (TNF-a),myocardial MB-isoenzyme of creatine kinase (CK-MB),alanine aminotransferase (ALT),creatinine (Cr),glucose (Glu) and arterial partial pressure of oxygen (PaO2) before resuscitation and 12,24 and 48 hours after ROSC were measured simultaneously in the two groups.The incidence of CPR-MODS was calculated.Results The CPR time (seconds) in 7-minute asphyxia group was significantly shorter than that in 8-minute asphyxia group(147.60±22.09 vs.193.08±23.07,P<0.01).The ROSC rate of 7-minute asphyxia group and 8-minute asphyxia group was 100.00% and 86.67%,respectively,and there was no significant difference.The incidence of MODS in the rabbits surviving more than 24 hours after ROSC was 1 00% in both groups.The mortality at 6 hours after ROSC in 7-minute asphyxia group was remarkably lower than that of 8-minute asphyxia group(6.67% vs.46.67%,P<0.05).All the rabbits in 8-minute asphyxia group died at 48 hours.The incidence of SIRS after ROSC was 100% in both groups.Compared with that before asphyxiation,the 1evel of serum TNF-a(ng/L)as well as CK-MB(U/L) increased significantly at 12 hours after ROSC in both groups(TNF-a in 7-minute asphyxia group:100.71±20

  17. Study on the intervention effect of continuous fetal heart monitoring at the second stage of labor on neonatal asphyxia%第二产程连续胎心监护干预新生儿窒息的效果研究

    Institute of Scientific and Technical Information of China (English)

    戴洁; 林小莉

    2011-01-01

    目的:观察第二产程连续胎心监护干预新生儿窒息的效果.方法:将该院2008年诊治的孕产妇368例遵照知情同意原则分为两组,对照组180例采用常规方法进行胎心监护,观察组188例采用第二产程连续胎心监护干预,比较两组新生儿窒息发生情况.结果:观察组的新生儿窒息发生率为2.13%,明显低于对照组的6.11%,两组间差异有统计学意义(P<0.05).结论:第二产程连续胎心监护干预能够有效防止新生儿窒息的发生,值得临床推广应用.%Objective: To observe the intervention effect of continuous fetal heart monitoring at the second stage of labor on neonatal asphyxia. Methods: 368 pregnant women who were diagnosed and treated in the hospital in 2008 were divided into two groups according to the principle of informed consent, 180 pregnant women in control group received routine fetal heart monitoring, and 188 pregnant women in observation group received continuous fetal heart monitoring at the second stage of labor; the incidences of neonatal asphyxia in the two groups were compared. Results: The incidence of neonatal asphyxia in observation group was 2. 13%, which was significantly lower than that in control group ( 6. 1 1% ) ( P < 0. 05 ) . Conclusion: Continuous fetal heart monitoring at the second stage of labor may prevent the occurrence of neonatal asphyxia effectively, which is worth popularizing.

  18. 脐动脉血pH值对评价新生儿窒息及预后的临床意义%The Guiding Sense of Umbilical Artery Blood pH in the Evaluation of Neonatal Asphyxia Diagnosis and Prognosis

    Institute of Scientific and Technical Information of China (English)

    王瑞云; 周怀君

    2009-01-01

    目的 通过分析新生儿脐动脉血pH值、Apgar评分之间的相关性,探讨脐动脉血pH值在评价新生儿窒息及新生儿窒息预后中的作用.方法 从2007年11月~2008年5月于我院阴道分娩的新生儿中随即抽取108例正常新生儿(对照组)及51例窒息新生儿(窒息组),对其脐血血气pH值及Apgar评分进行分析,并对结果 进行比较.结果 新生儿窒息的发生随脐血pH值降低而升高,正常评分的发牛率随pH值降低而减少,两者呈显著性差异(P<0.01).结论 Apgar与新生儿窒息无显著相关性;但脐血血气分析pH值能更客观、更灵敏地反映胎儿缺血缺氧程度及新生儿出生时状态,对窒息新生儿预后有指导意义.%Objective To explore the effect of umbilical artery blood pH on the diagnosis of neonatal asphyxia and the evaluation of its prognosis. Methods Blood samples were obtained from 108 normal newborns and 51 asphyxial newborns,who were randomly chosen among newborns delivered in our hospital from november 2007 to may 2008. Umbilical artery blood gas was measured and compared with apgur rating. Results With the degression of umbilical blood pH, the incidence rate of neonatal asphyxia increased and the normal apgar rating decreased(P < 0.01), which suggesting that there was tight relevant between umbilical blood pH and neonatal asphyxia. Conclusion Compared with apgur rating, umbilical artery blood pH could reflect the asphyxia degree of newborns more objectively andsensitively and it might play a guiding role in the prognosis of neonatal asphyxia.

  19. 血清NSE对晚期早产儿窒息脑损伤早期评价的意义%Significance of serum neuron-specific enolase in the early evaluation of brain damage of late preterm with perinatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    王士杰; 李晓春; 孔少云

    2013-01-01

    Objective To investigate the value of serum neuron-specific enolase ( NSE )levels in the diagnosis of neonatal asphyxia Methods 154 late- preterm neonates were enrolled in the study, including 94 with neonatal asphyxia for experimental group,52 with perinatal asphyxia,42 without brain damage and 60 normal ones for control group. For all the research objects blood samples were obtained for NSE detecting and Apgar scores were evaluated on proper time. MRI was performed 3 ~ 7 days after birth in experimental group. Results The levels of serum NSE in 52 with perinatal asphyxia were significantly higher than those in ones without brain damage and in control group. There were no significant difference between the levels in ones without brain damage and in control group. Conclusion Serum NSE level can be used as the early objective markers for evaluating the prognosis of brain damage due to late preterm perinatal asphyxia.%目的 探讨新生儿窒息后血清神经元特异性烯醇化酶(NSE)水平变化对判断晚期早产儿脑损伤的价值.方法 选取154例晚期早产儿为研究对象,其中出生时有窒息的患儿94例为实验组,于出生后3~7 d行颅脑MRI检查,依据颅脑MRI分为无脑损伤组42例和脑损伤组52例;正常的60例为对照组,所有患儿均在其出生后24 h内检测血清NSE浓度.结果 窒息脑损伤组血清NSE值较窒息无脑损伤组和对照组增高,差异具有统计学意义(P0.05).结论 外周血清NSE值可作为临床早期评价晚期早产儿窒息后脑损伤的参考指标.

  20. 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

  1. 脐动脉血血气分析在新生儿窒息诊断中的临床意义%Clinical significance of umbilical artery blood gas on neonatal asphyxia diagnosis

    Institute of Scientific and Technical Information of China (English)

    王红兵; 俞岑妍; 赵菲菲; 吴凡; 朱华静; 秦锦龙

    2011-01-01

    Objective To study the reference range of umbilical artery blood gas and the clinical significance of umbilical artery blood pH on the diagnosis of neonatal asphyxia. Methods Umbilical artery blood gas was measured in 183 full-term infants in the Tenth People's Hospital from Jan. 2009 to Aug. 2009. Reference range of umbilical artery blood gas was studied and its correlation between umbilical artery blood pH and Apgar scores with organ damage were analyzed. Results The average of umbilical artery blood pH, paO2, paCO2 and BE were 7.28 ±0.05, (2.99 ±0.83) kPa and (6.30 ± 1.37)kPa and (8.10 ±4.37) mmol/L respectively. Cases with organ damage were 5 and 3 respectively in Apgar score 4 -7 group and Apgar score 1 - 3 group. There were 3 cases with organ damage in pH 7.00-7.19 group and 4 cases in pH <7.00 group. The umbilical artery blood pH and Apgar score were negatively correlated with organ damage. Conclusion Low Apgar score with umbilical artery blood pH < 7.00 is helpful in neonatal asphyxia diagnosis..%目的 研究新生儿脐动脉血血气参考值,探讨其在新生儿窒息诊断中的临床意义.方法 对2009年1月-2009年8月在本院分娩的183例足月活产新生儿进行脐动脉血血气测定,分析脐动脉血pH与Apgar评分、脏器损伤之间的关系.结果 171例正常新生儿脐动脉血气pH平均值为7.28±O.05,PaO2为2.99±0.83 kPa;PaCO2为6.30±1.37 kPa,BE为8.10±4.37 mmol/L.Apgar评分4~7分和1~3分的脏器损伤分别为5例和3例,脐动脉血pH值7.00~7.19和pH<7.00的脏器损伤分别为3例和4例.脐动脉血血气的pH值及Apgar评分,与脏器损伤呈负相关.结论 低Apgar评分结合脐动脉血pH<7.00有助于诊断新生儿窒息.

  2. 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

  3. 尿乳酸/肌酐比值在新生儿窒息预后评估中的应用价值%Application value of urinary lactate/creatinine ratio in prognosis evaluation of neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    刘晓丹; 高玉先; 任静; 张敏敏; 严超英

    2014-01-01

    目的:探讨尿乳酸/肌酐比值与新生儿窒息发生的关系,阐明尿乳酸/肌酐比值在预测新生儿缺氧缺血性脑病(HIE)中的应用价值。方法:采用病例-对照研究设计方法,选取40例发生窒息的新生儿患者为窒息组,40名健康新生儿作为对照组。检测出生后1 d 新生儿尿乳酸/肌酐比值、尿 N-乙酰-β-D-氨基葡萄糖苷酶(NAG)/肌酐比值和 Apgar评分,分析窒息组与对照组新生儿尿乳酸/肌酐比值、尿 NAG/肌酐比值与新生儿HIE发生的关系。结果:窒息组新生儿1-min和5-min Apgar评分明显低于对照组(P<0.01);窒息组新生儿生后1 d尿乳酸/肌酐比值及尿 NAG/肌酐比值明显高于对照组(P<0.01);窒息组新生儿生后1 d尿乳酸/肌酐比值与1-min和5-min Apgar评分均呈负相关关系(r=-0.636,P<0.01;r=-0.883,P<0.01),窒息组新生儿生后1 d尿乳酸/肌酐比值与尿 NAG/肌酐比值呈正相关关系(r=0.433,P<0.01)。结论:尿乳酸/肌酐比值对新生儿窒息的预后评估具有重要作用,同时可作为早期预测新生儿 HIE的重要依据。%Objective To explore the association between urinary lactate/creatinine ratio and neonatal asphyxia,and to clarify the application value of urinary lactate/creatinine ratio in forecasting the hypoxie-ischemic encephalopathy (HIE)in neonates.Methods Using case-control study design method,40 cases of neonatal asphyxia infants were selected as asphyctic group and 40 healthy infants were used as control group.The urinary lactate/creatinine ratio in the first day after birth, urinary N-Acetyl-β-D-glucosaminidase (NAG)/creatinine and the score of Apgar of 80 infants were detected.The relationship between the urinary lactate/creatinine ratio,urinary NAG/creatinine ratio, as well as the score of Apgar and HIE were analyzed and compared in asphyctic group and control group.Results The Apgar scores

  4. 围生期高危因素与新生儿窒息的关系分析%Analysis on the Relationship between Perinatal Risk Factors and Neonatal Asphyxia

    Institute of Scientific and Technical Information of China (English)

    曾丽萍; 梁秋红; 何苑苑

    2015-01-01

    目的:分析围生期高危因素与新生儿窒息之间的关系。方法选取140例宫内窘迫胎儿,后续出现新生儿窒息症状患儿68例,无症状72例,依据娩出后是否出现窒息症状分成研究组(68例)和对照组(72例),分析和对比产妇高危因素、胎儿高危因素和分娩高危因素。结果研究组产妇高危因素:贫血症(16.2%)、妊娠期合并症(8.8%)、胎盘异常(16.2%)和胎膜早破(19.1%),胎儿高危因素:羊水污染(51.5%)、胎动消失(25.0%)、脐带异常(52.9%)和胎心率异常(23.5%);分娩高危因素:剖宫产(48.5%)和产程延长(14.7%),对照组分别为16.7%、8.3%、5.6%、16.7%,30.6%、9.7%、30.6%、16.7%,22.2%和4.2%。两组在胎盘异常、羊水污染、胎动消失、脐带异常、剖宫产及产程延长方面比较差异有统计学意义(P <0.05),其余比较差异无统计学意义( P>0.05)。结论胎儿高危因素是导致围生期新生儿窒息症状的主要原因,其次为分娩高危因素,再次为产妇高危因素(仅胎盘异常)。%Objective To analyze the correlation between perinatal risk factors and neonatal asphyxia . Methods A total of 140 cases of intrauterine fetal distress were selected as research objects,including 68 cases with following symptoms of neonatal asphyxia,and 72 cases of asymptomatic,according to whether had asphyxial symptoms the cases were divided into study group(68 cases) and control group(72 cases),mater-nal risk factors,fetal risk factors and delivery risk factors were analyzed between the two groups .Results The maternal risk factors of the study group included complication of anemia(16.2%) pregnancy(8.8%), abnormal placenta(16.2%),and premature rupture of membranes(19.1%);fetal risk factors included amniotic fluid pollution(51.5%),quickening disappearance(25.0%),abnormal umbilical cord(52.9%) and fetal

  5. 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.

  6. 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.

  7. 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

  8. Thermopharmacology of anticonvulsive treatment after perinatal asphyxia

    OpenAIRE

    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 effects on physico-chemical properties of the drugs, such as lipophilicity, pharmacokinetic and pharmacodynamic parameters may change. Depending on the mode of action and the route of inactivation/eli...

  9. Effect of leptin on expression of calpain-1 and Bcl-2 and apoptosis in myocardial tissue of neonatal rats after asphyxia%瘦素对窒息新生大鼠心肌组织calpain-1和Bcl-2的表达及细胞凋亡的影响

    Institute of Scientific and Technical Information of China (English)

    吴丹丹; 吴星恒; 张丽娜

    2016-01-01

    ObjectiveTo study the effect of leptin on the expression of calcium-activated neutral protease 1 (calpain-1) and B cell lymphoma-2 (Bcl-2) and apoptosis in the myocardial tissue of neonatal rats after asphyxia. MethodsA total of 48 neonatal rats were randomly and equally divided into normal control group, asphyxia group, leptin treatment groups, and calpain-1 inhibitor (CAI-1) group. The neonatal rat model of asphyxia under normal atmospheric condition was established in all groups except the control group. For the leptin treatment groups, rats received 20, 80, and 160 μg/kg leptin by intraperitoneal injection immediately after model establishment, respectively. For the CAI-1 group, rats received 10 mg/kg CAI-1 by intraperitoneal injection immediately after model establishment. For all the groups, the myocardial tissue was collected at 2 hours after model establishment. Immunohistochemistry was used to measure the expression of calpain-1 and Bcl-2. The TUNEL method was used to evaluate apoptosis of myocardial cells.ResultsThe expression of calpain-1 and Bcl-2 and apoptosis index (AI) were signiifcantly higher in the asphyxia group than in the normal control group (P˂0.05). The leptin treatment groups and the CAI-1 group had signiifcantly lower expression of calpain-1, signiifcantly lower AI, and signiifcantly higher expression of Bcl-2 than the asphyxia group (P˂0.05). The CAI-1 group had the largest changes in all the indices compared with the asphyxia group. However, there were no signiifcant differences in all indices between the 160 μg/kg leptin treatment group and the CAI-1 group. After asphyxia, the expression of calpain-1 was positively correlated with AI, while the expression of Bcl-2 was negatively correlated with AI and the expression of calpain-1 (P˂0.05).ConclusionsLeptin reduces apoptosis of myocardial cells in asphyxiated neonatal rats by the inhibition of calpain-1 activation and upregulation of Bcl-2 expression.%目的:研究瘦素对窒息

  10. Neonatal resuscitation technique to reduce neonatal asphyxia rate and mortality rate in China:a Meta-analysis%复苏技术降低我国新生儿窒息发生率和死亡率的 Meta分析

    Institute of Scientific and Technical Information of China (English)

    李鸿斌; 顾建明; 冯海娟; 沈莉

    2015-01-01

    目的:评价新生儿复苏技术对我国新生儿窒息发生率和死亡率下降的效果。方法检索万方数据库、知网数据库资料,收集有关新生儿复苏项目现状与效果的相关文献,并根据纳入标准及排除标准筛选文献,采用非随机前后对照试验的二分类数据Meta分析法判断复苏实施效果。结果最终纳入文献3篇。 Meta分析结果显示,项目地区推广应用新生儿复苏技术促进了新生儿窒息发生率和死亡率的下降,新生儿窒息发生率降低46%,RR=0.54,95%CI:0.33~0.91,P=0.02;新生儿窒息死亡率降低45%,RR=0.55,95%CI:0.35~0.86,P=0.009。结论新生儿复苏技术有助于降低新生儿窒息发生率和死亡率,建议向农村、基层医院普及推广。%Objective To evaluate the effect of neonatal resuscitation technique on reducing the neonatal asphyxia rate and mortality in China.Methods Wanfang data and CNKI-CAJD were retrieved to collect the literatures of neonatal resuscitation, and they were screened according to inclusion criteria and exclusion criteria.Meta-analysis of two-category data of non-randomized control study was conducted to evaluate the effect of neonatal resuscitation technique.Results Finally three articles were recruited.Meta-analysis showed that neonatal resuscitation technique applied in program areas reduced the neonatal asphyxia rate and mortality.The neonatal asphyxia rate decreased by 46%(RR=0.54,95%CI:0.33-0.91,P=0.02), and the mortality rate decreased by 45% (RR=0.55,95%CI:0.35-0.86, P=0.009) .Conclusion Neonatal resuscitation technique helps to reduce neonatal asphyxia rate and mortality, so it is suggested to be promoted in countryside and basic-level hospitals.

  11. Relations between pre-pregnancy body mass index,gestational weight gain,and the occurrence of neonatal asphyxia%孕前体重指数、孕期体重增加与新生儿窒息的关系

    Institute of Scientific and Technical Information of China (English)

    刘英惠; 潘玉娟; 陈浩; 任爱国; 李松; 李竹; 刘建蒙; 刘伟宏; 马蕊; 叶荣伟; 陈华; 薛明君; 成伶春; 吴立民

    2008-01-01

    asphyxia.Methods Data was collected in 6 counties/cities covered by Peri-natal Health Care Surveillance System which was part of a Sino-American cooperative project on neural tube defects prevention established in 1992.The study population consisted of 83 030 women who attended premarital/preconception medical physical examination program and had delivered single live birth with at least 20 gestational weeks from 1995 to 2000 in Jiaxing area,Zhejiang province.Results from the Chi-square test were employed to test the differences in the rates of neonatal asphyxia between groups with different BMI and other characteristics.Multivariate logistic regression method was conducted to examine the association between pre-pregnancy BMI,gestational weight gain,and the risk of asphyxia.Results The average rate of neonatal asphyxia was 11.3%(95% CI:11.1%-11.6%).The rates of neonatal asphyxia among women with BMI<18.5 kg/m2,18.5-22.9 kg/m2,23.0-24.9 kg/m2,and≥25.0 kg/m2 were 11.0%(95% CI:10.5%-11.5%),11.3%(95% CI:11.1%-11.6%),11.8%(95% CI:11.0%-12.6%),and 12.9%(95% CI:11.6%-14.4%)respectively.The rates of neonatal asphyxia were 12.4% among women with weight gain<0.3 kg/wk.higher than women with higher weight gain.After adjusting for residencial area,maternal age,educational level,occupation,parity,times of prenatal visit,high-risk experiences during pregnancy,high-risk experiences at time of delivery,gestational week and birth weight,the estimated ORs were 1.03(95% CI:0.97-1.09),1.06(95% CI:0.96-1.16)and 1.14(95% CI:1.00-1.31),respectively.These ORs became 1.02(95% CI:0.95-1.09),1.01(95% CI:0.90-1.13)and 1.08(95% CI:0.92-1.28)after further adjusting the variable "gestational weight gain".The estimated ORs for neonatal asphyxia were 1.06(95% CI:1.01-1.12)for women with weight gain at 0.3-kg/wk and 1.09(95% CI:1.02-1.20)for women with weight gain<0.3 kg/wk when compared to those with weight gain≥0.5 kg/wk.Conclusion Lower weight gain seemed to have the effect of increasing the

  12. 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

  13. Application effect of written consent of education and guidance for the prevention of asphyxia and aspiration of hospitalized patients in patients with cerebral apoplexy complicated with dysphagia%预防住院患者窒息及误吸宣教指导同意书在脑卒中吞咽障碍患者中的应用效果

    Institute of Scientific and Technical Information of China (English)

    王建华; 杨秀兰; 张宏; 袁莉; 王丽英

    2015-01-01

    Objective To explore the application effect of written consent of education and guidance for the prevention of asphyxia and aspiration of hospitalized patients in patients with cerebral apoplexy complicated with dysphagia. Methods 120 patients of cerebral apoplexy complicated with dysphagia from January 2011 to January 2014 in our hos-pital were selected and randomly divided into the experiment group and the control group,60 cases in each group.The control group was given regular treatment and nursing,and the experiment group was given different diet guidance and training of swallowing function according to the levels of swallowing function on the basis of the control group.The ef-fect in two groups was compared. Results The total effective rate of the experiment group was 54.4%,which was higher than 30.4%of the control group,with significant difference(P<0.05).The incidence rate of aspiration pneumonia and mal-nutrition in the experiment group was lower than that the control group,with significant difference(P<0.05). Conclusion The application effect of written consent of education and guidance for the prevention of asphyxia and aspiration of hospitalized patients in patients with cerebral apoplexy complicated with dysphagia is significant,which can reduce the incidence rate of complication,inprove swallow dysfunction,it is worthy of clinical promotion and application.%目的:探讨预防住院患者窒息及误吸宣教指导同意书在脑卒中吞咽障碍患者中的应用效果。方法选取本院2011年1月~2014年1月收治的120例脑卒中吞咽障碍患者作为研究对象,随机分为实验组和对照组,各60例。对照组给予常规治疗和护理,实验组在对照组的基础上,根据吞咽功能级别分别依照指导同意书给予不同的饮食指导和吞咽功能训练,比较两组的效果。结果实验组的总有效率为54.4%,显著高于对照组的30.4%,差异有统计学意义(P<0.05)。实验组的吸入性肺

  14. Traumatic asphyxia--fatal accident in an automatic revolving door.

    Science.gov (United States)

    Cortis, J; Falk, J; Rothschild, M A

    2015-09-01

    Due to continuing modernisation, the number of automatic doors in routine use, including powered revolving doors, has increased in recent years. Automatic revolving doors are found mostly in department stores, airports, railway stations and hospitals. Although safety arrangements and guidelines concerning the installation of automatic doors are in existence, their disregard in conjunction with obsolete or incorrect installation can lead to fatal accidents. In this report, a 19-month-old boy is described whose right arm was caught between the elements of an automatic revolving door. As a direct result of rescue attempts, the child's body was drawn further into the narrow gap between elements of the door. To get the boy's body out of the 4-cm-wide gap between the fixed outer wall of the revolving door and the revolving inner, back-up batteries had to be disconnected so as to stop the electrical motor powering the door. Cardiopulmonary resuscitation was begun immediately after the rescue but was unsuccessful; the child was declared dead at the hospital he was taken to. The cause of death was a combination of compression-related skull and brain injury together with thoracic compression. This case shows an outstanding example of the preventive aspect as a special task of forensic medicine. Additionally, it serves as a warning for the correct installation and use of automatic revolving doors. Even so, small children should not use these doors on their own, but only with an alert companion, so as to prevent further fatal accidents of this sort.

  15. 戊巴比妥钠和水合氯醛对窒息性心跳骤停大鼠心肺复苏后脑损伤的影响%Influence of pentobarbital and chloral hydrate on cerebral injury after cardiopulmonary resuscitation in a rat model of cardiac arrest induced by asphyxia

    Institute of Scientific and Technical Information of China (English)

    李章平; 陈寿权; 程俊彦; 章杰; 李惠萍; 黄唯佳; 王万铁

    2009-01-01

    Objective To investigate the influence of choral hydrate and pentobarbital on cerebral injury after cardiopulmonary resuscitation (CPR) in a rat model of cardiac arrest induced by asphyxia.Methods One hundred and sixty male 70-95 day old SD rats weighing 300-400 g were randomly divided into 2 anesthetic groups ( n = 80 each) : chloral hydrate group (CH) and pentobarbital group (PB).Each group was further divided into 2 subgroups ( n = 40 each) : control subgroup underwent no cardiac arrest and CPR subgroup.Anesthesia was induced with intraperitoneal (IP) 5% chloral hydrate 0.35 g/kg followed by intermittent IP 5% chloral hydrate 0.1 g/kg every hour in group CH and with IP 0.35% pentobarbital 35 mg/kg followed by intermittent IP 0.35% pentobarbital 10 mg/kg every hour in group PB.Left femoral vein and right carotid artery were cunnulated for drug and fluid administration and BP monitoring.The animals were tracheostomized and mechanically ventilated.Cardiac arrest was induced by occlusion of tracheal tube and verified by disappearance of pulse wave on BP tracing and asystole/ventricular fibrillation/systolic BP 60 mm Hg lasting for more than 10 min were used as criteria for recovery of spontaneous circulation (ROSC).Eight animals were decapitated and their brains were immediately removed at 0.5,3,6,9 and 24 h (T1-5) after BOSC respectively.2% Evans blue 2 ml/kg was injected Ⅳ 15 min before each time point.Brain water content (wet weight dry weight/wet weight × 100% ) and Evan's brain content in the brain tissue were determined.Results The two groups were comparable with respect to body weight,amount of adrenaline given,duration of precordial cardiac massage and BOSC time.The brain water content and Evan's blue content in the brain tissue were significantly increased after ROSC in beth groups.The cerebral water content was significantly higher after BOSC in group CH than in group PB.There was no significant difference in Evan's blue content in the brain tissue

  16. 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

  17. 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

  18. 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

  19. Early postnatal allopurinol does not improve short term outcome after severe birth asphyxia

    NARCIS (Netherlands)

    Benders, MJNL; Bos, AF; Radernaker, CMA; Rijken, M; Torrance, HL; Groenendaal, F; van Bel, F

    2006-01-01

    Objective: To investigate whether postnatal allopurinol would reduce free radical induced reperfusion/reoxygenation injury of the brain in severely asphyxiated neonates. Method: In an interim analysis of a randomised, double blind, placebo controlled study, 32 severely asphyxiated infants were given

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

    DEFF Research Database (Denmark)

    Greisen, Gorm

    2014-01-01

    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...

  1. Study of Myocardial Involvement and Lactic Acid Production in Perinatal Asphyxia

    Directory of Open Access Journals (Sweden)

    Asutosh P Chauhan

    2013-02-01

    Full Text Available Purpose: A Study of newborn infants to evaluate extent of hypoxia from Apgar score and correlate it with biochemistry parameters & to evaluate the presence and extent of cardiac involvement in asphyxiated new born infants along with estimation of the extent of lactic acidosis in asphyxiated new born infants. Methods: A Study of 52 newborn infants, free from congenital heart diseases were included in the study. After their through clinical examination, they were subdivided into three groups according to their Apgar score. Blood was collected from a stasis free vein in plain bulb. Serum separated after centrifugation was used for estimation of CK-MB and LDH activity. Results: serum CK-MB levels in group II as compared to group I was significantly raised (P< 0.0001. Similarly the comparison of CK-MB between group II and group III and also between group I and group III was highly significant with a p value of <0.0001. Serum lactate levels were also significantly elevated in cases as compared with controls with a p value of <0.0001. Conclusions: Our study shows a clear relationship between clinical pattern of asphyxiated newborn infants and alterations of serum cardiac enzymes (CK-MB and LDH and lactic acid production. [Natl J of Med Res 2013; 3(1.000: 76-79

  2. 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.

  3. 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.

  4. PHENOBARBITAL FOR THE PREVENTION OF INTRACRANIAL DAMAGE IN CHINESE NEONATES WITH SEVERE ASPHYXIA

    Institute of Scientific and Technical Information of China (English)

    陈惠金; 吴圣楣; 黄萍; 孙建华; 陈冠仪; 储淞雯

    2000-01-01

    R6sumeobjectiIPOurevaiuerlletprdventifduphenobarbitalsurleslesionsintracrdniennesasPhyxiquesainsiquelemalePilePtiquedesnouveau'nes.MdthodesUnessatcontr6leaeteportesur6onouveau-nesgravementasPhyxies.Ladose-chargedephenobarbitals,estfaitesur3Onouveau-ndsavantlngemOyende5.6heures.R/suItatsPasdedJfdrencesignilicativen'aetetrouveeconcernantpoidscorPorel,dgegestationel,scoresAPgaretsexneonataldesdeuxgrouPesdesnouveau-nes.LaconcentrationseriquedephdnobarbitalaetdenmOyenne21.9Pg/ml4joursaPrbslanaissance.Lesimagesso...

  5. Effect of Hypothermia on Amplitude-Integrated Electroencephalogram in Infants With Asphyxia

    NARCIS (Netherlands)

    Thoresen, Marianne; Hellstrom-Westas, Lena; Liu, Xun; de Vries, Linda S.

    2010-01-01

    OBJECTIVES: Amplitude-integrated electroencephalogram (aEEG) at METHODS: Seventy-four infants were recruited by using the CoolCap entry criteria, and their outcomes were assessed by using the Bayley Scales of Infant Development II at 18 months. The aEEG was recorded for 72 hours. Patterns and voltag

  6. 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

  7. Oxygen Consumption Rate and Asphyxia Point in Topmouth Gudgeon,Pseudorasbora parva%麦穗鱼耗氧率和窒息点的测定

    Institute of Scientific and Technical Information of China (English)

    杨坤; 祝东梅; 王卫民

    2013-01-01

    为研究麦穗鱼的基础代谢水平和特点,将暂养7d的麦穗鱼停食24 h后,放入自行设计的封闭流水式呼吸室内,调节水位及进出口流量,测定两种规格麦穗鱼的耗氧率、耗氧量和窒息点.试验结果表明,平均体长(9.24±3.06) cm、体质量(12.32±1.44)g的麦穗鱼在水温为(24.0±0.1)℃时的耗氧率和耗氧量分别为(0.16±0.01)mg/(g·h)、(1.54±0.83)mg/(尾·h);平均体长(4.10±0.06)cm、体质量(0.53±0.09)g的麦穗鱼在温度为(16.5±0.5)℃时耗氧率和耗氧量分别为(0.59±0.24)mg/(g·h)、(0.31±2.01)mg/(尾·h),平均体质量(12.32±1.44)g,平均体长(9.24±3.06)cm的麦穗鱼在水温(24.0±0.1)℃,pH 7.4的条件下,窒息点为0.58 mg/L.麦穗鱼的耗氧率夜间略高于白天,但差异不显著;麦穗鱼的耐低氧能力属中等偏弱水平.

  8. 脑缺血缺氧HRV信号的复原图分析%Recurrence Plot Analysis of HRV for Brain Ischemia and Asphyxia

    Institute of Scientific and Technical Information of China (English)

    陈晓鸣; 邱意弘; 朱贻盛

    2008-01-01

    心率变异信号(HRV)是人体心脏搏动周期的微小变异,反映了自主神经系统的平衡协调关系.在证实心率变异信号的非线性特征后,可利用基于复杂度的非线性动力学分析方法-复原图(recurrence plot)来进行分析.通过复原图及其量化分析方法,发现与正常情况相比,缺血缺氧阶段HRV信号的复原图和量化指标L-Mean、L-Entr均有显著的变化,为监测缺血缺氧脑损伤提供了新的途径.

  9. 新生儿肺出血的抗内窒息治疗%Anti-intra-asphyxia therapy of pulmonary hemorrhage of the newborn

    Institute of Scientific and Technical Information of China (English)

    陈克正

    2003-01-01

    @@ 动物实验证实,在缺氧/复氧诱导下,肺组织中肺血管内皮细胞(PVEC)合成与分泌内源性内皮素-1(ET-1)异常升高[1],ET-1为强烈缩血管活性肽,可通过自分泌途径,导致氧自由基(OFR)生成增加.

  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. 纳美芬对窒息后新生儿转归的影响探讨%Nalmefene to Improving Outcome of Neonatal Serious Asphyxia

    Institute of Scientific and Technical Information of China (English)

    张茜; 程欣茹

    2010-01-01

    目的 探讨应用纳美芬对新生儿窒息后转归的影响.方法 随机将98例重度窒息新生儿分为两组,治疗组50例加用纳美芬治疗,48例为对照组.比较两组并发症的发生率、呼吸机使用时间及死亡率.结果 治疗组抢救成功率明显高于对照组(P0.5).结论 纳美芬的应用降低了HIE、RDS、PH、HF、NEC、shock等并发症的发生率,减少了因窒息而导致的死亡率,并有可能有效避免由于窒息而造成的颅脑损伤等后遗症,是救治新生儿窒息的理想药物.

  12. 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.

  13. The Clinical Significance of Umbilical Artery Blood's PH Value in Evaluating Newborn Infants Asphyxia%脐动脉血pH值评价新生儿窒息的临床意义

    Institute of Scientific and Technical Information of China (English)

    刘溯

    2002-01-01

    目的用脐动脉血pH值来评价新生儿出生状况.方法从2001年9月1日~2002年4月31日在我院分娩的1 619例新生儿中抽取75例行脐动脉血pH值测定,研究其与其它指标的相互关系.结果脐动脉血pH值与出生后1 min的Apgar评分关系密切.结论脐动脉血pH值可以客观反映新生儿出生时的状况,对监测新生儿预后有指导意义.

  14. Study on the changes in blood gas and neurologic injury in newborn infants with perinatal asphyxia%围生期窒息新生儿血气分析与神经系统损害

    Institute of Scientific and Technical Information of China (English)

    肖春香

    2005-01-01

    目的探讨围生期窒息新生儿PaCO2及pH快速变化及其与神经系统损害之间的关系.方法将55例新生儿分为3组:组1 pH>7.00,无神经系统异常,无需呼吸支持;组2 pH≤7.00,余同组1;组3,pH≤7.00,神经系统异常,需辅助呼吸支持.采集脐动脉血、产后1 h和2 h桡动脉血进行血气分析并观察Apgar评分和临床经过.结果脐动脉血pH值和PaCO2各组间有显著差异;产后1 h动脉血pH组1、3间和组2、3间有显著差异;产后1 h动脉血pH、 PaCO2分别和脐动脉血pH、PaCO2比较,有显著差异;3组间有不同的神经系统表现;Apgar评分组3较低.结论在严重酸中毒时,胎儿出生后pH、PaCO2会发生显著改变,需持续辅助机械通气的患儿有不同的神经系统后遗症.

  15. 成都市婴儿意外窒息死亡影响因素研究%A STUDY ON INFLUENCE FACTORS ON DEATH OF INFANT WITH SUDDEN ASPHYXIA IN CHENGDU CITY

    Institute of Scientific and Technical Information of China (English)

    张学莉; 李亚斌; 刘光莉

    2003-01-01

    目的:探讨婴儿意外窒息死亡的影响因素,寻求降低婴儿死亡率的有效对策.方法:以填写调查表、查阅出生登记、个别访谈形式调查成都市19个区(市)县1996年至1997年死于意外窒息的婴儿70例及对照组婴儿70例.结果:女性婴儿、早产儿、喂奶技巧差、未接受医疗保健人员指导等为窒息死亡婴儿的主要死因,与对照组相比差异有显著性.结论:加强孕产期保健和科学育儿健康教育是降低婴儿死亡率的有效措施.

  16. 妊娠期肝内胆汁淤积症致胎儿宫内窘迫的经验教训%Intrauterine Asphyxia due to Cholestasis in Pregnancy:Experience and lesson

    Institute of Scientific and Technical Information of China (English)

    马俊如

    2006-01-01

    妊娠期肝内胆汁淤积症(intrahepatic chol estasis of pregnancy,ICP)是妊娠期严重并发症之一,以妊娠中、晚期全身瘙痒、黄疸为特征,可导致早产、胎儿窘迫及胎儿死亡,因其早产率及围产儿死亡率高,近年因ICP导致围产儿死亡的医疗纠纷逐渐增多,给产科工作者带来一定的工作压力。现报告2例ICP致胎儿宫内窘迫并死亡的病例,结合文献资料,总结ICP处理过程中的经验教训。

  17. 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.

  18. 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.

  19. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis

    OpenAIRE

    Daripa, Mandira [UNIFESP; Caldas,Helena Maria G.; Flores, Luis Patricio O.; Waldvogel,Bernadette Cunha; Guinsburg, Ruth; de Almeida, Maria Fernanda Branco

    2013-01-01

    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 2003. Perinatal asphyxia was considered if intrauterine hypoxia, birth asphyxia, or meconium aspiration syndrome were written in any line of the original...

  20. Pengaruh Karakteristik Individu dan Motivasi Terhadap Kompetensi Bidan Dalam Manajemen Asfiksia Bayi Baru Lahir di Rumah Sakit Ibu dan Anak Pemerintah Aceh Kota Banda Aceh Tahun 2011

    OpenAIRE

    Safrina

    2012-01-01

    The data from the RSIA (Mother and Child Hospital) of Aceh government in 2010, showed that 62 newborn babies were affected by asphyxia, and ten of them died by this disease and other complications. In order to reduce the mortality in newborn babies caused by asphyxia, childbirth should be handled by midwives who had competence in asphyxia management in newborn babies. The research was aimed to analyze the influences of individual characteristics (education, length of service, working expe...

  1. 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.

  2. 多巴胺联合甲磺酸酚安妥拉明预防新生儿窒息致持续肺动脉高压的临床研究%Dopamine and phentolamine therapy in the prevention of persistent pulmonary hypertension in patients with neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    陆俏群

    2006-01-01

    目的观察多巴胺联合甲磺酸酚安妥拉明(商品名:立其丁)预防新生儿窒息复苏后持续肺动脉高压的临床疗效.方法我院2003年1月至2005年12月收治的新生儿窒息82例,入院时随机分成治疗组和对照组,并立即抽血检查血气分析,对照组给予常规治疗,治疗组在此基础上,给予多巴胺3~5 μg/(kg·min)、立其丁1~2 μg/(kg·min),治疗24 h后复查血气分析.结果治疗组持续肺动脉高压(PPHN)的发生率及死亡率明显低于对照组(P《0.05).治疗组血气分析结果明显优于治疗前(P《0.01)和对照组(P《0.05).结论多巴胺联合立其丁预防新生儿窒息复苏后持续肺动脉高压有良好的疗效,值得临床推广.

  3. 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

    OpenAIRE

    Mandira Daripa; Caldas,Helena Maria G.; Flores, Luis Patricio O.; Bernadette Cunha Waldvogel; Ruth Guinsburg; Maria Fernanda B. de Almeida

    2013-01-01

    OBJETIVO: Comparar o perfil epidemiológico dos óbitos neonatais precoces evitáveis associados à asfixia perinatal conforme a região de ocorrência do óbito no Estado de São Paulo. MÉTODOS: Coorte populacional constituída por 2.873 óbitos evitáveis até seis dias de vida associados à asfixia perinatal ocorridos entre janeiro de 2001 e dezembro de 2003. Considerou-se como asfixia perinatal a presença de hipóxia intraútero, asfixia ao nascer ou síndrome de aspiração de mecônio em qualquer linha da...

  4. 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.

  5. 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.

  6. 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.

  7. [Adrenal hemorrhage in a newborn with factor V Leiden--a clinical case].

    Science.gov (United States)

    Vulkova, A; Kovacheva, K; ionov, M; Rosmanova, R; Atanasova, V; Slavkova, N; Ivanov, P

    2009-01-01

    Neonatal adrenal hemorrhage is frequently associated with birth trauma, perinatal asphyxia, septicemia, coagulation defects and thromboembolism. We report a case of bilateral adrenal hemorrhage in newborn baby with perinatal asphyxia. Ultrasound findings of subacute adrenal hemorrhage draw attention to its presumable antenatal genesis. DNA analysis for thrombophilic mutations identifies factor V Leiden.

  8. Lack of evidence for a causal relationship between hypoxic-ischemic encephalopathy and subdural hemorrhage in fetal life, infancy, and early childhood

    DEFF Research Database (Denmark)

    Byard, Roger W; Blumbergs, Peter; Rutty, Guy

    2013-01-01

    ), intrauterine/delivery asphyxia (N = 8), congenital disease (N = 6), aspiration of food/gastric contents (N = 4), inflicted asphyxia (N = 3), epilepsy (N = 1), dehydration (N = 1), drug toxicity (N = 1), complications of prematurity (N = 1), and complications of anesthesia (N = 1). The initiating event...

  9. The role of the sympathetic nervous system in postasphyxial intestinal hypoperfusion in the pre-term sheep fetus.

    Science.gov (United States)

    Quaedackers, Josine S; Roelfsema, Vincent; Heineman, Erik; Gunn, Alistair J; Bennet, Laura

    2004-06-15

    Asphyxia in utero in pre-term fetuses is associated with evolving hypoperfusion of the gut after the insult. We examined the role of the sympathetic nervous system (SNS) in mediating this secondary hypoperfusion. Gut blood flow changes were also assessed during postasphyxial seizures. Preterm fetal sheep at 70% of gestation (103-104 days, term is 147 days) underwent sham asphyxia or asphyxia induced by 25 min of complete cord occlusion and fetuses were studied for 3 days afterwards. Phentolamine (10 mg bolus plus 10 mg h(-1)i.v.) or saline was infused for 8 h starting 15 min after the end of asphyxia or sham asphyxia. Phentolamine blocked the fall in superior mesenteric artery blood flow (SMABF) after asphyxia and there was a significant decrease in MAP for the first 3 h of infusion (33 +/- 1.6 mmHg versus vehicle 36.7 +/- 0.8 mmHg, P fall in SMABF. In conclusion, the present study confirms the hypothesis that postasphyxial hypoperfusion of the gut is strongly mediated by the SNS. The data highlight the importance of sympathetic activity in the initial elevation of blood pressure after asphyxia and are consistent with a role for the mesenteric system as a key resistance bed that helps to maintain perfusion in other, more vulnerable systems.

  10. Acute kidney injury in asphyxiated neonates

    Directory of Open Access Journals (Sweden)

    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.].

  11. 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

  12. 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

  13. Anticonvulsant Effectiveness and Hemodynamic Safety of Midazolam in Full-Term Infants Treated with Hypothermia

    NARCIS (Netherlands)

    van den Broek, MPH; Van Straaten, Henrica L M; Huitema, Alwin D R; Egberts, Toine; Toet, MC; De Vries, Linda S.; Rademaker, Karin; Groenendaal, Floris

    2015-01-01

    Background: Midazolam is used as an anticonvulsant in neonatology, including newborns with perinatal asphyxia treated with hypothermia. Hypothermia may affect the safety and effectiveness of midazolam in these patients. Objectives: The objective was to evaluate the anticonvulsant effectiveness and h

  14. Anticonvulsant effectiveness and hemodynamic safety of midazolam in full-term infants treated with hypothermia

    NARCIS (Netherlands)

    Van Den Broek, Marcel P H; Van Straaten, Henrica L M; Huitema, Alwin D R; Egberts, Toine|info:eu-repo/dai/nl/162850050; Toet, Mona C.; De Vries, Linda S.; Rademaker, Karin; Groenendaal, Floris

    2015-01-01

    Background: Midazolam is used as an anticonvulsant in neonatology, including newborns with perinatal asphyxia treated with hypothermia. Hypothermia may affect the safety and effectiveness of midazolam in these patients. Objectives: The objective was to evaluate the anticonvulsant effectiveness and h

  15. 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...

  16. Assessment of levels of otoacoustic emission response in neonates with perinatal asphyxia☆

    OpenAIRE

    Georgea Espindola Ribeiro; Daniela Polo Camargo da Silva; Jair Cortez Montovani

    2014-01-01

    Objective: To evaluate the effects of perinatal asphyxia on the level of the response to transient otoacoustic emissions in infants.Methods: Otoacoustic emissions in 154 neonates were performed: 54 infants who suffered asphyxia at birth, measured by Apgar score and medical diagnosis, and 100 infants without risk were compared. Scores less than 4 in the first minute and/or less than 6 in the fifth minute were considered as low Apgar. Statistical analysis of the data was performed using the Kru...

  17. Methylene blue prevents retinal damage in an experimental model of ischemic proliferative retinopathy.

    Science.gov (United States)

    Rey-Funes, Manuel; Larrayoz, Ignacio M; Fernández, Juan C; Contartese, Daniela S; Rolón, Federico; Inserra, Pablo I F; Martínez-Murillo, Ricardo; López-Costa, Juan J; Dorfman, Verónica B; Martínez, Alfredo; Loidl, César F

    2016-06-01

    Perinatal asphyxia induces retinal lesions, generating ischemic proliferative retinopathy, which may result in blindness. Previously, we showed that the nitrergic system was involved in the physiopathology of perinatal asphyxia. Here we analyze the application of methylene blue, a well-known soluble guanylate cyclase inhibitor, as a therapeutic strategy to prevent retinopathy. Male rats (n = 28 per group) were treated in different ways: 1) control group comprised born-to-term animals; 2) methylene blue group comprised animals born from pregnant rats treated with methylene blue (2 mg/kg) 30 and 5 min before delivery; 3) perinatal asphyxia (PA) group comprised rats exposed to perinatal asphyxia (20 min at 37°C); and 4) methylene blue-PA group comprised animals born from pregnant rats treated with methylene blue (2 mg/kg) 30 and 5 min before delivery, and then the pups were subjected to PA as above. For molecular studies, mRNA was obtained at different times after asphyxia, and tissue was collected at 30 days for morphological and biochemical analysis. Perinatal asphyxia produced significant gliosis, angiogenesis, and thickening of the inner retina. Methylene blue treatment reduced these parameters. Perinatal asphyxia resulted in a significant elevation of the nitrergic system as shown by NO synthase (NOS) activity assays, Western blotting, and (immuno)histochemistry for the neuronal isoform of NOS and NADPH-diaphorase activity. All these parameters were also normalized by the treatment. In addition, methylene blue induced the upregulation of the anti-angiogenic peptide, pigment epithelium-derived factor. Application of methylene blue reduced morphological and biochemical parameters of retinopathy. This finding suggests the use of methylene blue as a new treatment to prevent or decrease retinal damage in the context of ischemic proliferative retinopathy.

  18. Color Doppler ultrasound evaluation of asphyxial neonatal left ventricular function and its correlation with target organ damage

    Institute of Scientific and Technical Information of China (English)

    Cheng-Cai Chen; Li-Zhen Li; Qi-Sheng Lu; Yan-Ling Lang

    2017-01-01

    Objective:To study the color Doppler ultrasound parameters of asphyxial neonatal left ventricular function and the correlation with target organ damage.Methods: Normal neonates, mildly asphyxial neonates and severely asphyxial neonates born in our hospital between January 2014 and December 2015 were selected as the control group (n = 46), mild asphyxia group (n= 37) and severe asphyxia group (n = 23) respectively. On the 1st day after birth, color Doppler ultrasound was used to evaluate left ventricular function, and serum was collected to determine myocardial tissue injury, brain tissue injury and brain tissue metabolism indexes. Results: Color Doppler ultrasound parameters cardiac output (CO), ejection fraction (EF) and left ventricular fraction shortening (FS) as well as serum folate and vitamin B12 content of mild asphyxia group and severe asphyxia group were significantly lower than those of control group (P<0.05) while serum creatine kinase isoenzyme (CK-MB), troponin I (cTnI), troponin T (cTnT), S100B, neuron-specific enolase (NSE), creatine kinase BB (CK-BB), glycogen phosphorylase BB (GPBB), and homocysteine (Hcy) content were significantly higher than those of control group (P<0.05); CO, FS and EF as well as serum folate and vitamin B12 content of severe asphyxia group were significantly lower than those of mild asphyxia group (P<0.05) while serum CK-MB, cTnT, cTnI, S100B, NSE, CK-BB, GPBB and Hcy content were significantly higher than those of mild asphyxia group (P<0.05).Conclusions:Color Doppler ultrasound can accurately assess asphyxial neonatal left ventricular function damage degree and is closely related to myocardial tissue injury and brain tissue injury degree.

  19. 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.

  20. 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).

  1. 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.)

  2. Folic Acid, Dietary Patterns and Perinatal Health: The Generation R Study

    NARCIS (Netherlands)

    S. Timmermans (Sarah)

    2010-01-01

    textabstractThe perinatal mortality rate in The Netherlands is among the highest in the European Union, with one in 100 babies dying during pregnancy, at birth or shortly thereafter. Low birth weight, preterm birth, congenital anomalies, perinatal asphyxia, and pre-eclampsia are major contributors t

  3. Profound hypotension and associated electrocardiographic changes during prolonged cord occlusion in the near term fetal sheep

    NARCIS (Netherlands)

    Wibbens, B; Westgate, JA; Bennet, L; Roelfsema, [No Value; De Haan, HH; Hunter, CJ; Gunn, AJ

    2005-01-01

    Objective: To determine whether the onset of fetal hypotension during profound asphyxia is reflected by alterations in the ratio between the T height, measured from the level of the PQ interval, and the QRS amplitude (T/QRS ratio) and ST waveform. Study design: Chronically instrumented near-term fet

  4. Changes in cerebral haemodynamics, regional oxygen saturation and amplitude-integrated continuous EEG during hypoxia-ischaemia and reperfusion in newborn piglets

    NARCIS (Netherlands)

    Ioroi, T; Peeters-Scholte, C; Post, [No Value; Groenendaal, F; van Bel, F

    2002-01-01

    Perinatal asphyxia models are necessary to obtain knowledge of the pathophysiology of hypoxia-ischaemia (HI) and to test potential neuroprotective strategies. The present study was performed in newborn piglets to obtain information about simultaneous changes in cerebral oxygenation and haemodynamics

  5. Prenatal and perinatal striatal injury: a hypothetical cause of attention-deficit-hyperactivity disorder?

    DEFF Research Database (Denmark)

    Toft, P.B.

    1999-01-01

    hemorrhage, intrauterine growth retardation, and asphyxia. An elevated level of lactate suggests tissue hypoxia, which may interfere with the formation of frontostriatal circuits and may play a role in the pathogenesis of the behavioral disturbances observed in a proportion of children with a history...

  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. 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.

  8. [Use of the Heimlich Maneuver on children in the Rhône-Alpes area].

    Science.gov (United States)

    Boussuges, S; Maitrerobert, P; Bost, M

    1985-10-01

    In 27 children suffering from a foreign body in the respiratory tract with asphyxia, the Heimlich manoeuvre, previously described, was successful in saving life of this dramatic situation in all cases, without respiratory complication. While this method is better known by members of first-aid associations than by pediatricians, it may be successfully used in very young children and infants.

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

    DEFF Research Database (Denmark)

    Arrøe, M; Peitersen, Birgit

    1993-01-01

    , 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...

  10. Pulse oximetry : technology to reduce child mortality in developing countries

    NARCIS (Netherlands)

    Duke, T.; Subhi, R.; Peel, D.; Frey, B.

    2009-01-01

    The causes of hypoxaemia in children include the commonest causes of childhood illness: pneumonia and other acute respiratory infections, and neonatal illness, particularly sepsis, low birthweight, birth asphyxia and aspiration syndromes. The systematic use of pulse oximetry to monitor and treat chi

  11. Limitations in the Activity of Mobility at Age 6 Years After Difficult Birth at Term : A Prospective Cohort Study

    NARCIS (Netherlands)

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

    2016-01-01

    Background. A difficult birth at term (DBAT) may manifest as fetal acidosis and low Apgar scores and is often referred to as "perinatal asphyxia," especially when infants show signs of neonatal encephalopathy (NE). In contrast to DBAT resulting in moderate-to-severe NE, which is associated with neur

  12. Congenital heart defects in spinal muscular atrophy type I : A clinical report of two siblings and a review of the literature

    NARCIS (Netherlands)

    Menke, Leonie A.; Poll-The, Bwee Tien; Clur, Sally-Ann; Bilardo, Catia M.; van der Wal, Allard C.; Lenunink, Henny H.; Cobben, Jan Maarten

    2008-01-01

    A newborn girl presented with asphyxia, joint contractures and diminished spontaneous movements. Echocardiography showed hypoplastic left heart. Spinal muscular atrophy type I (SMA I) was diagnosed by detecting a homozygous deletion in the survival motor neuron 1 gene (SMN1). In the first trimester

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

    DEFF Research Database (Denmark)

    Jonsdottir, Fjola; Stokholm, Lonny Merete; 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...

  14. Anticonvulsant treatment of asphyxiated newborns under hypothermia with lidocaine : efficacy, safety and dosing

    NARCIS (Netherlands)

    van den Broek, Marcel P. H.; Rademaker, Carin M. A.; van Straaten, Henrica L. M.; Huitema, Alwin D. R.; Toet, Mona C.; de Vries, Linda S.; Egberts, Antoine C. G.; Groenendaal, Floris

    2013-01-01

    BACKGROUND: Lidocaine is an antiarrythmicum used as an anticonvulsant for neonatal seizures, also during therapeutic hypothermia following (perinatal) asphyxia. Hypothermia may affect the efficacy, safety and dosing of lidocaine in these patients. OBJECTIVE: To study the efficacy and safety of lidoc

  15. Assessment of levels of otoacoustic emission response in neonates with perinatal asphyxia☆

    Science.gov (United States)

    Ribeiro, Georgea Espindola; da Silva, Daniela Polo Camargo; Montovani, Jair Cortez

    2014-01-01

    Objective: To evaluate the effects of perinatal asphyxia on the level of the response to transient otoacoustic emissions in infants. Methods: Otoacoustic emissions in 154 neonates were performed: 54 infants who suffered asphyxia at birth, measured by Apgar score and medical diagnosis, and 100 infants without risk were compared. Scores less than 4 in the first minute and/or less than 6 in the fifth minute were considered as "low Apgar". Statistical analysis of the data was performed using the Kruskal, Wilcoxon, and Mann-Whitney nonparametric tests. Results: Lower levels of response were observed in transient otoacoustic emission in the group that suffered perinatal asphyxia, with significant values for the frequencies 2,000, 3,000, and 4,000 Hz in the right ear, and 2,000 and 4,000 Hz in the left ear. Conclusions: The analysis of the intrinsic characteristics of the otoacoustic emissions evidenced low performance of outer hair cells in neonates who had perinatal asphyxia, which may affect the development of listening skills in this population. PMID:25479848

  16. Burst suppression on amplitude-integrated electroencephalogram may be induced by midazolam : a report on three cases

    NARCIS (Netherlands)

    ter Horst, HJ; Brouwer, OF; Bos, AF

    2004-01-01

    Continuous amplitude-integrated electroencephalogram (aEEG) recording with a cerebral function monitor is a useful tool to evaluate prognoses following perinatal asphyxia in term infants. Drugs may change the pattern of the conventional EEG. This report presents three infants treated with midazolam

  17. Palliation of left main bronchus compression due to malignant tumor by intubation via a tracheostomy tube.

    Science.gov (United States)

    Terada, Y; Matsunobe, S; Nemoto, T; Tsuda, T; Shimizu, Y

    1991-12-01

    Intubation of the left main bronchus via a tracheostomy tube was performed in a patient with local recurrence of lung cancer associated with invasion and obstruction of the left main bronchus after right sleeve pneumonectomy. The result was satisfactory not only for preventing asphyxia, but also for maintaining the patency of the airway after extubation of the endotracheal tube.

  18. 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

  19. 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...

  20. 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…

  1. Preexisting hypoxia is associated with a delayed but more sustained rise in T/QRS ratio during prolonged umbilical cord occlusion in near-term fetal sheep

    NARCIS (Netherlands)

    Wibbens, Bert; Bennet, Laura; Westgate, Jenny A.; De Haan, Harmen H.; Wassink, Guido; Gunn, Alistair J.

    2007-01-01

    There is limited information about whether preexisting fetal hypoxia alters hemodynamic responses and changes in T/ QRS ratio and ST waveform shape during subsequent severe asphyxia. Chronically instrumented near- term sheep fetuses ( 124 +/- 1 days) were identified as either normoxic Pa-O2 > 17 mmH

  2. 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].

  3. Amplitude-integrated electroencephalographic activity is suppressed in preterm infants with high scores on illness severity

    NARCIS (Netherlands)

    ter Horst, Hendrik J.; Jongbloed-Pereboom, Marjolein; van Eykern, Leo A.; Bos, Arend F.

    2011-01-01

    Background: The neonatal acute physiology score. SNAP-II, reflects the severity of illness in newborns. In term newborns, amplitude integrated EEG (aEEG), is depressed following asphyxia. In preterm infants aEEG is discontinuous, and therefore more difficult to assess compared to term infants. Aims:

  4. Impact of hypothermia on predictors of poor outcome : How do we decide to redirect care?

    NARCIS (Netherlands)

    Bonifacio, S. L.; deVries, L. S.; Groenendaal, F.

    2015-01-01

    Therapeutic hypothermia is now considered the standard of care for neonates with neonatal encephalopathy due to perinatal asphyxia. Outcomes following hypothermia treatment are favorable, as demonstrated in recent meta-analyses, but 45-50% of these neonates still suffer major disability or die due t

  5. Allopurinol Reduces Oxidative Stress in the Ovine Fetal Cardiovascular System After Repeated Episodes of Ischemia-Reperfusion

    NARCIS (Netherlands)

    Derks, Jan B.; Oudijk, Martijn A.; Torrance, Helen L.; Rademaker, Carin M. A.; Benders, Manon J.; Rosen, Karl G.; Cindrova-Davies, Tereza; Thakor, Avnesh S.; Visser, Gerard H. A.; Burton, Graham J.; van Bel, Frank; Giussani, Dino A.

    2010-01-01

    In complicated labor, neonatal outcome may depend not only on the extent of fetal asphyxia and acidosis but also on the effects on the fetal cardiovascular system of reactive oxygen species (ROS) generated during the ischemia-reperfusion (I/R) associated with repeated compressions of the umbilical c

  6. 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.

  7. 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…

  8. S100 protein content of umbilical cord blood in healthy newborns in relation to mode of delivery

    NARCIS (Netherlands)

    Wirds, J W; Duyn, A E J; Geraerts, S D; Preijer, E; Van Diemen-Steenvoorde, J A A M; Van Leeuwen, J H Schagen; Haas, F J L M; Gerritsen, W B M; De Boer, A; Leusink, J A

    2003-01-01

    BACKGROUND: Early detection and quantification of brain damage in neonatal asphyxia is important. In adults, S100 protein in blood is associated with damage to the central nervous system. OBJECTIVE: To determine whether S100 protein can be detected in arterial and venous cord blood of healthy newbor

  9. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

    NARCIS (Netherlands)

    de Haan, Timo R.; Bijleveld, Yuma A.; van der Lee, Johanna H.; Groenendaal, Floris; van den Broek, Marcel P. H.; Rademaker, Carin M. A.; van Straaten, Henrica L. M.; van Weissenbruch, Mirjam M.; Vermeulen, Jeroen R.; Dijk, Peter H.; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P.; Gavilanes, Danilo; van Kaam, Anton H.; Offringa, Martin; Mathot, Ron A. A.

    2012-01-01

    Background: In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage) necessitating newborn resuscitation occurs in at least 200 of the 180-185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome with therapeu

  10. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

    NARCIS (Netherlands)

    T.R. de Haan (Timo Robert); Y. Bijleveld (Yuma); J. van der Lee (Jacqueline); F. Groenendaal (Floris); M.P.H. van den Broek (Marcel); C.M.A. Rademaker (Carin); H.L.M. van Straaten (Henrica L M); M.M. van Weissenbruch (Mirjam); R.J. Vermeulen (Jeroen); P.H. Dijk (Peter); J. Dudink (Jeroen); M. Rijken (Monique); A.F.J. van Heijst (Arno); K.P. Dijkman (Koen); D. Gavilanes (Danilo); A.H. van Kaam (Anton); M. Offringa (Martin); R.A. Mathot (Ron)

    2012-01-01

    textabstractBackground: In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage) necessitating newborn resuscitation occurs in at least 200 of the 180-185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome w

  11. 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

  12. Monitoring of neurological parameters in newborns with hypoxic-ischemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Đinđić Jasmina

    2006-01-01

    Full Text Available Asphyxia i a condition caused by lack of oxygen in tissues and organs. The basic pathogenic mechanisms of asphyxia are: 1hypoxemia, 2 ischemia. The effects of perinatal asphyxia on the brain of a neonatal baby are critical in development of hypoxic-ischemic encephalopathy. The diagnosis of hypoxic-ischemic encephalopathy is based on clinical data including course of pregnancy and delivery (Apgar score and especially on the neurological status of the newborn (consciousness, tonus, convulsions, reflexes, vegetative functions, etc. and it can be confirmed by biochemical analysis and neurological examinations. The aim of this paper is to determine the importance of prenatal and perinatal risk factors for hypoxic-ischemic encephalopathy, as well as their effects on the development of neurological complications and further neurological problems. The research included 148 newborn infants born in the period from January 1, 1996 to January 1, 1999, with gestational age of 27 to 42 weeks, with hypoxic ischemic lesions of the central nervosus system. The control group included 58 children of the same age and the same gestation, with generalized hypotonia ("floppy infant" but without any signs of hypoxic ischemic lesions of the central nervous system. In the group of examined newborn infants with hypoxic ischemic lesions, from 149 children 1 (0.67% died, 87 (53.89% had normal findings, whereas the handicap was established in 61 (40.94%. Perinatal asphyxia affects the fetus and newborn infants not by individual factors, but with at least three or four associated factors. The disorders caused by asphyxia are in inverse proportion to the duration and intensity of hypoxic insults and the gestational age of the newborn. .

  13. 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

  14. Effect of Different Delivery Methods on Neonatal Outcomes in Amniotic Flu-id contaminated Pregnant Women%羊水污染孕产妇不同分娩方式对新生儿结局的影响

    Institute of Scientific and Technical Information of China (English)

    陈洵艳

    2016-01-01

    Objective To study the effect of different delivery methods on neonatal outcome in amniotic fluid contaminated pregnant women. Methods Random decimation in 320 cases of meconium stained amniotic fluid of pregnant and lying in women, all personnel are admitted between May 2014 and March 2016, investigation of all patients with amniotic fluid pol-lution degree, and the ways of delivery and neonatal outcomes were investigated. Results Amniotic fluid I pollution degree of patients with neonatal asphyxia rate was 11.6%;pollution second degree amniotic fluid of patients with neonatal asphyxia incidence rate was 33.1%;meconium stained amniotic fluid of patients with neonatal asphyxia rate was 60.9%, three groups compared with the presence of significant difference,P < 0.05. Amniotic fluid I pollution degree of patients with cesarean section newborn asphyxia rate was 62.50% and vaginal delivery; neonatal asphyxia rate was 11.29%; 2nd degree amniotic fluid pollution in patients with cesarean section newborn asphyxia rate was 21.9%, vaginal delivery; neonatal asphyxia rate was 49.01%; meconium stained amniotic fluid of patients with cesarean section birth neonatal asphyxia rate was 49.3%, vaginal delivery;neonatal asphyxia rate was 85.7%. Conclusion Different ways of intervention should be taken to ensure the safety of pregnant women and neonates in different ways for the patients with different degrees of amniotic fluid pollution.%目的:对羊水污染孕产妇不同分娩方式对新生儿结局的影响结果进行研究。方法随机抽选该院320例羊水污染孕产妇,均为2014年5月一2016年3月间入院的产妇,对所有患者羊水污染程度进行调查,并对其分娩方式,新生儿结局进行调查。结果羊水I度污染的患者新生儿窒息率为11.6%;羊水Ⅱ度污染的患者新生儿窒息率发生率为33.1%;羊水Ⅲ度污染的患者新生儿窒息率为60.9%,3组比较差异有统计学意义,P<0.05。羊水I度污染的患者剖

  15. 导乐陪伴分娩对新生儿窒息发生率影响的研究

    Institute of Scientific and Technical Information of China (English)

    庞琼燕

    2012-01-01

    目的观察导乐陪伴分娩对新生儿窒息发生率的影响,同时研究产妇分娩产痛阈对新生儿窒息的影响.方法对2010年1月至2011年12月在我院住院分娩的1770例产妇进行分娩产痛及新生儿窒息发生率的分析.其中800例实行导乐分娩为导乐陪伴分娩组.另970例为对照组.对两组的分娩产痛及新生儿窒息率进行比较.结果导乐组新生儿窒息率明显降低(P<0.01),分娩产痛明显减轻( P <0.01).结论导乐陪伴分娩可降低新生儿窒息率同时使分娩产痛明显减轻,是使分娩回归自然,使母婴更安全健康,非常值得提倡.%Objective To observe effect of Doula delivery on neonatal asphyxia rate influence, at the same time study of maternal birth pain threshold effect on newborn asphyxia. Methods from 2010January to 2011December in our hospital childbirth 1770cases of maternal birth pains and neonatal asphyxia rate analysis.800 cases of Doula delivery for implementation of Doula delivery group. The other 970 cases as control group. On two groups of birth pangs and neonatal asphyxia were compared. Results the rate of neonatal asphyxia doula group decreased significantly ( P<0.01), birth pain significantly reduced ( P <0.01). Conclusion doula may reduce the incidence of neonatal asphyxia and the childbirth labor pain obviously, is to make deliveries to return to nature, the more safe and healthy mother-infant, very worth to advocate.

  16. SURVEI KEMATIAN NEONATAL (STUDI AUTOPSI VERBAL DI KABUPATEN CIREBON, 2004

    Directory of Open Access Journals (Sweden)

    Sarimawar Djaja

    2012-09-01

    Full Text Available In its attempt to realize the intervention program to saving newborn babies with asphyxia, the Ministry of Health will initiate to train midwives in the village in order to that they know how to operate resuscitation equipment to save neonatal baby with asphyxia. The intervention program his dubbed successful if the mortality proportion due if asphyxia decreased to half as targeted. The survey was conducted in the rural area of Cirebon district. The sample was 200 neonatal death babies, calculated using the hypothesis test with different proportion; p1 0.3 (30% neonatal death cause of asphyxia, according household health survey 2001, p2 0.15, α 0.05, β 0.2, (l-β 0.8. Neonatal dead cases happened within 12 months prior to the survey were identified by rural midwives out of their personal records. The death cases were followed up by interviewing the mother of the neonatal baby concerning its birth, illness or disorder histories before death. The diagnosis of the diseases were based on the International Classification of Diseases 10 and Wigglesworth classification, determined in union by NIHRD researchers and neonatologists. The neonatal mortality rate was 13 out of 1,000 live births. The major cause of early neonatal mortality was respiration disorder mainly caused by birth asphyxia (45%, of which 90 percent could be intervened by doing resuscitation (for babies weighed more than 1.000 gram. The second and third order of the mortality causes was infection (22% and congenital disorders (11% respectively. The major cause of late neonatal mortality was infection (56%, followed by low birth weight and prematurely born, as well as neonatal jaundice (14 percent each, and congenital disorder comes in the third place. The option to handle asphyxia with the early neonatal babies is the right effort to decrease the neonatal mortality rate. And to achieve the utmost result, it is necessary that the rural midwives maintain their standard performance (in

  17. 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.

  18. 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.)

  19. An analysis of deaths in portable cribs and playpens: what can be learned?

    Science.gov (United States)

    Jackson, Allison; Moon, Rachel Y

    2008-04-01

    To assess the risk of using portable cribs and playpens as sleep surfaces for infants, data from playpen/portable crib deaths occurring between January 1, 1999, and February 4, 2004, that were reported to the Consumer Product Safety Commission were retrospectively reviewed. Twenty-one playpen/portable crib deaths were identified. Two-thirds of the deaths were in infants. Asphyxia, positional asphyxia, and suffocation were the leading causes of death. Several deaths were the consequence of risks unique to playpens and portable cribs: playpen collapse, modifications to the playpen, and improper assembly. The data demonstrate some unique risks posed by playpens/portable cribs, including risks from improper assembly and setup. Programs recommending and using playpens/portable cribs as routine infant sleep surfaces must be aware of the need for additional guidance regarding use of playpens/portable cribs.

  20. Caso para diagnóstico Case for diagnosis

    Directory of Open Access Journals (Sweden)

    Mariane Corrêa

    2008-06-01

    Full Text Available A necrose gordurosa do subcutâneo do recém-nascido é paniculite rara e auto-limitada, caracterizada por placa eritematosa extensa com nódulos amolecidos no dorso de recém-nascidos a termo ou pós-termo. São fatores desencadeantes de relevância a pré-eclâmpsia materna, asfixia perinatal e hipercalcemia. Relata-se caso de necrose gordurosa do recém-nascido associado a pré-eclâmpsia materna e asfixia perinatal.Subcutaneous fat necrosis of the newborn is an uncommon self-limited panniculitis characterized by large erythematous patches and soft nodules on the back of full-term or post-term infants. Maternal pre-eclampsia, birth asphyxia and hypercalcemia are relevant triggers. We describe a case of subcutaneous fat necrosis in a newborn related to maternal pre-eclampsia and birth asphyxia.

  1. Asphyxial suicide by inhalation of chloroform inside a plastic bag.

    Science.gov (United States)

    Zorro, Andres Rodriguez

    2014-01-01

    Asphyxia suicide by placing a plastic bag over the head in addition with inhalation of gases or use of sedative substances is an unusual method of committing suicide, but frequently referenced by right to die groups in the Internet. This article reports 2 suicides in which chloroform was used to induce unconsciousness and subsequent asphyxia by placing the head in a plastic bag. Case histories of 2 males, ages 23 and 28, are described with special emphasis on characteristics death related to suffocation using plastic bags and chloroform. The final remarkable point in both cases is that the victims previously searched the WEB for instructions of suicide methods. The importance of the phenomenon of misuse of Internet by young people who commit suicide is stressed.

  2. Apolipoprotein E and Cerebral Palsy: A Cross-sectional Study of the Influence of Genetic Variation on Clinical Manifestations of CP

    OpenAIRE

    Lien, Espen

    2015-01-01

    Cerebral palsy (CP) is the most common neurodevelopmental disorder in children, showing varying degrees of motor impairments, activity limitations and accompanying disturbances of function. A long-held belief has been that the cause of CP is birth asphyxia. However, the realization that only a small minority of CP cases can be attributed to a perinatal hypoxicischemic event has led to an extensive search for other causes, among them genetic factors. Although a number of genes h...

  3. Endocrine regulation of gut maturation in early life in pigs

    DEFF Research Database (Denmark)

    Thymann, Thomas

    2016-01-01

    After birth, the newborn must adapt to the acute challenges of circulatory changes, active respiration, thermoregulation, microbial colonization, and enteral nutrition. Whereas these processes normally occur without clinical complications in neonates born at term, birth at a preterm state...... of gestation is associated with high morbidity and mortality. In commercial pig production, perinatal mortality is higher than in any other mammalian species. Asphyxia, hypothermia, hypoglycemia, sepsis, and gut dysmotility, represent some of the most common findings. The intestine is a particularly sensitive...

  4. 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

  5. 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....

  6. 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...

  7. 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.

  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. Incidence of intracranial haemorrhage in low-birth weight infants and its outcome: a hospital based prospective study

    Directory of Open Access Journals (Sweden)

    Rajesh Debbarma

    2016-10-01

    Conclusions: Low gestational age, specially <34 weeks, very low birth weight, male gender, difficult vaginal delivery, birth asphyxia, and hypothermia are risk factors for intracranial hemorrhage, specially intra-ventricular hemorrhage. For better evaluation of risk factors for ICH and its outcome, multicentric study should be performed with large number of simple and longer time period of follow up with the help of newer modalities of investigation. [Int J Res Med Sci 2016; 4(10.000: 4279-4285

  10. 6) 新生児集中管理の立場から(シンポジウム 各科領域におけるIntensive Care, 第418回新潟医学会)

    OpenAIRE

    吉沢, 浩志; Yoshizawa, Hiroshi

    1987-01-01

    Technical advances and improvements in ohstetrics and neonatal care have been mainly responsible for the improved survival of high-rigk neonates and for the accompanying improvement in the quality of the survivors. The incidence of high-risk neonates who require intensive care is approximately 2~3% of all newborns. The conditions requiring neonatal intensive care are as follows; low birth weight(less than 1,500g), respiratory disorder from any cause(RDS, MAS, birth asphyxia etc), infections, ...

  11. Brazilian guidelines for the diagnosis and treatment of hereditary angioedema

    OpenAIRE

    Pedro Giavina-Bianchi; Alfeu T. França; GRUMACH, Anete S.; Abílio A Motta; Fátima R Fernandes; Regis A. Campos; Solange O Valle; Rosário, Nelson A.; Dirceu Sole

    2011-01-01

    Hereditary angioedema is an autosomal dominant disease characterized by edema attacks with multiple organ involvement. It is caused by a quantitative or functional deficiency of the C1 inhibitor, which is a member of the serine protease inhibitor family. Hereditary angioedema is unknown to many health professionals and is therefore an underdiagnosed disease. The causes of death from hereditary angioedema include laryngeal edema with asphyxia. The estimated mortality rate in patients in whom t...

  12. Analyzes 30 cases clinical observations and nursing for the newborn suffocates%新生儿窒息30例临床观察及护理分析

    Institute of Scientific and Technical Information of China (English)

    张昱君

    2013-01-01

    Objective To investigate and analyze clinical observation and nursing experiences of 30 cases of neonatal asphyxia and to summarize its clinical value. Methods From May 2007 to January 2012,30 cases which came to Liulin District Hospital because of neonatal asphyxia were chosen to study clinical observation and nursing experiences. They were rescued and nursed according to guidelines of resuscitation. Results After comprehensive care and resuscitation,28 cases of neonatal asphyxia were successfully cured (93.33%),1 case was died and 1 case was given up treatment by his families .Conclusion Nursing care and resuscitation can improve the success rate of neonatal asphyxia cases,which is worthy of clinical reference and promotion.%  目的探讨新生儿窒息的急救复苏方法和综合护理措施,评价其临床应用价值。方法对30例窒息新生儿实施积极抢救治疗和复苏后护理,观察其临床效果。结果通过积极抢救治疗和综合护理,30例窒息新生儿复苏成功28例,死亡1例,家属放弃1例,复苏成功率达93.33%。结论对窒息新生儿实施正确合理的抢救和治疗,复苏后予以精心优质的护理可提高窒息新生儿复苏的成功率及预后,临床治疗效果明显,值得推广。

  13. 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.

  14. Intravascular "mulberry-like" bodies

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Klebe, J G; Henriques, U V

    1988-01-01

    Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesions...... and fetal death was found, the cause of death being attributed to intrauterine asphyxia. It is concluded, that intravascular "mulberry-bodies" most likely represent artifacts due to red blood cell autolysis....

  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. An evaluation of human placental lactogen levels in hypertension of pregnancy.

    Science.gov (United States)

    Kelly, A M; England, P; Lorimer, J D; Ferguson, J C; Govan, A D

    1975-04-01

    Maternal plasma levels of human placental lactogen (HPL) are decreased in hypertensive pregnancies and the concentration is related to the severity of the condition. Of infants who had HPL concentrations in the fetal danger zone (more than 2 SD's below normal mean) 75 per cent developed fetal distress, neonatal asphyxia or were light for dates. Patients who are identified in this way have lighter infants and placentae than their unidentified counterparts with normal HPL levels.

  17. 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

  18. 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

  19. MRI and US findings of subcutaneous fat necrosis of the newborn

    Energy Technology Data Exchange (ETDEWEB)

    Vasireddy, Syam; Long, Scott D. [Southern Illinois University, Department of Radiology, Springfield, IL (United States); St. John' s Hospital, Department of Radiology, Springfield, IL (United States); Sacheti, Bhavna [Medical College of Wisconsin, Department of Pediatric Critical Care, Milwaukee, WI (United States); Children' s Hospital Wisconsin, Department of Critical Care, Milwaukee, WI (United States); Mayforth, Ruth D. [Southern Illinois University, Department of Surgery, Springfield, IL (United States); St. John' s Hospital, Department of Surgery, Springfield, IL (United States)

    2009-01-15

    Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon, benign disorder found in full-term or post-mature neonates. It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. We present a newborn with abnormal findings on MRI and US within the axilla, neck, and abdominal walls that were pathologically proved via biopsy to be subcutaneous fat necrosis. (orig.)

  20. Comprehensive Histological and Immunochemical Forensic Studies in Deaths Occurring in Custody

    Science.gov (United States)

    Buscemi, Dolores

    2017-01-01

    In-custody deaths have several causes, and these include homicide, suicide, natural death from chronic diseases, and unexplained death possibly related to acute stress, asphyxia, excited delirium, and drug intoxication. In some instances, these deaths are attributed to undefined accidents and natural causes even though there is no obvious natural cause apparent after investigation. Understanding these deaths requires a comprehensive investigation, including documentation of circumstances surrounding the death, review of past medical history, drug and toxicology screens, and a forensic autopsy. These autopsies may not always clearly explain the death and reveal only nonspecific terminal events, such as pulmonary edema or cerebral edema. There are useful histologic and biochemical signatures which identify asphyxia, stress cardiomyopathy, and excited delirium. Identifying these causes of death requires semiquantitative morphologic and biochemical studies. We have reviewed recent Bureau of Justice Statistics on in-custody death, case series, and morphological and biochemical studies relevant to asphyxia, stress cardiomyopathy, and excited delirium and have summarized this information. We suggest that regional centers should manage the investigation of these deaths to provide more comprehensive studies and to enhance the expertise of forensic pathologists who would routinely manage potentially complex and difficult cases. PMID:28386585

  1. 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

  2. Neurological abnormalities in full-term asphyxiated newborns and salivary S100B testing: the "Cooperative Multitask against Brain Injury of Neonates" (CoMBINe international study.

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    Diego Gazzolo

    Full Text Available Perinatal asphyxia (PA is a leading cause of mortality and morbidity in newborns: its prognosis depends both on the severity of the asphyxia and on the immediate resuscitation to restore oxygen supply and blood circulation. Therefore, we investigated whether measurement of S100B, a consolidated marker of brain injury, in salivary fluid of PA newborns may constitute a useful tool for the early detection of asphyxia-related brain injury.We conducted a cross-sectional study in 292 full-term newborns admitted to our NICUs, of whom 48 suffered PA and 244 healthy controls admitted at our NICUs. Saliva S100B levels measurement longitudinally after birth; routine laboratory variables, neurological patterns, cerebral ultrasound and, magnetic resonance imaging were performed. The primary end-point was the presence of neurological abnormalities at 12-months after birth.S100B salivary levels were significantly (P3.25 MoM S100B achieved a sensitivity of 100% (CI5-95%: 89.3%-100% and a specificity of 100% (CI5-95%: 98.6%-100% as a single marker for predicting the occurrence of abnormal neurological outcome (area under the ROC curve: 1.000; CI5-95%: 0.987-1.0.S100B protein measurement in saliva, soon after birth, is a useful tool to identify which asphyxiated infants are at risk of neurological sequelae.

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

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    Anna Coluccia

    2016-01-01

    Full Text Available 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.

  4. 住院新生儿4562例临床分析%Clinical analysis of 4562 cases of hospitalized neonates

    Institute of Scientific and Technical Information of China (English)

    庄泽吟

    2010-01-01

    Objective To understand neonatal morbidity and adopt measures to reduce illness and mortality.Methods From January 2004 to April 2009,a total of 4 562 cases of neonatal cases of hospitalization were analyzed retrospectively.Results The incidence rate of less than 7 days,mainly neonatal asphyxia ontome,more than seven days to infection.Among death and give up therapy cases,neonatal asphyxia and premature birth were the mainly.Conclusion In order to reduce neonatal morbidity and mortality,we must avoid causing neonatal asphyxia,premature infants and infection factors.%目的 了解住院新生儿发病情况,以采取措施降低患病率及死亡率.方法 对2004年1月至2009年4月共4 562例住院新生儿进行回顾性分析.结果 7 d以内发病率以新生儿窒息为主,7 d及以上者以感染为主;死亡及放弃治疗病例中,以新生儿窒息及早产为主.结论 降低新生儿的发病率及死亡率,必须避免引起新生儿窒息、早产儿及感染的因素.

  5. 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.

  6. 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.

  7. 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

  8. Route of delivery and pregnancy outcome in 150 cases of twin pregnancy%双胎妊娠的分娩方式与妊娠结局150例

    Institute of Scientific and Technical Information of China (English)

    李蕙琴

    2008-01-01

    目的 探讨双胎妊娠分娩方式与妊娠结局的关系.方法 将1997年1月至2006年12月,150例双胎妊娠妇女按分娩方式分为阴道分娩组及剖宫产组,对其临床资料进行回顾性分析.结果 两组产后出血率差异无统计学意义,孕周及新生儿体重,剖宫产组显著高于阴道分娩组,新生儿窒息发生率,阴道分娩组显著高于剖宫产组,尤以阴道分娩组第2胎新生儿尤为显著,两胎儿分娩出生时间间隔>15 min者新生儿窒息发生率高.结论 正确选择双胎妊娠的分娩方式,将有助于降低新生儿窒息发生率.%Objective To study the relationship between delivery rout and pregnancy outcome in twin pregnancy.Methods 150 twin pregnancy women were divided into two groups,which were cesarean section and vaginal delivery from January 1998 to December 2005.Their data were analyzed retrospectively.Results There was no difference in postpartum hemorrhage of two groups in pregnant week and neonatal.Weight of cesarean section was higher than that of vagingal detivery the incidence of neonatal asphyxia in vaginal delivery was much highter than in cesarean section that the hightest of neonatal asphyxia of second fetal in vaginal delivery.Conclusion The right route of delivery can lower the incidence of secarean section and neonatal asphyxia.

  9. Karakteristik dan Faktor Risiko Obstetrical Brachial Plexus Palsy pada Bayi Baru Lahir

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    Andreas Vincent Handoyo

    2010-06-01

    Full Text Available Obstetrical brachial plexus palsy (OBPP is an injury of entire or part of brachial plexus correlated with delivery process. Incidence in developing countries is around 0.15%. Risk factors include intrapartum and intrauterine. Three types of OBPP are Duchenne Erb, Klumpke, and whole arm palsy. This was a retrospective study of characteristic and risk factors of OBPP in Hasan Sadikin Hospital, Bandung, period January 2002-April 2007. Data were collected from perinatology ward medical records, and analyzed using binary logistic regression. OBPP incidence was 0.141%. All were Erb palsy and single pregnancy, 68.75% were head-occiput posterior presentation, 50% were spontaneous birth, 18.75% had meconeal staining, 62.5% had birth weight ≥3,500 g, 56.25% were male, 68.75% asphyxia, 12.5% shoulder dystocia, and 6.25% clavicle fracture. Risk factors significantly correlated were foot presentation (OR 9.357; 95%CI, transverse fetal position (OR 5.136; 95%CI, vacuum, forceps, breech/foot extraction (OR 5.240;95%CI, 4.320; 95%CI, 14.411; 95%CI, respectively, birth weight 3,500-3,999 g (OR 4.571;95%CI, birth weight ≥4,500 g (OR 57.759; 95%CI, asphyxia (ORs 5.992; 95%CI, and severe asphyxia (OR 6.094; 95%CI. Sectio cesarea tend to have protective effect {OR 0.244; 95%CI; p=0.062 (>0.05}. The important risk factors of OBPP are foot presentation, breech/foot extraction, and birth weight >4,500 g.

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

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    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.

  11. 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.

  12. 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.

  13. 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.

  14. Non-avalanche-related snow immersion deaths: tree well and deep snow immersion asphyxiation.

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    Van Tilburg, Christopher

    2010-09-01

    Non-avalanche-related snow immersion death (NARSID), or snow immersion asphyxiation, is a significant winter mountain hazard for skiers and snowboarders. This phenomenon occurs predominately in western North America, where large tree wells and deep snowpacks develop. Although statistics are difficult to procure, snow immersion asphyxiation has resulted in more than 70 documented deaths in the past 2 decades. The primary purpose of this review is to examine the existing literature on NARSID to help prevent such dangerous accidents through educating wilderness medicine professionals and fostering public awareness. The exact duration of burial to time of death and the cause of death are not precisely known but can be postulated from accident reports, experimental snow burial studies, and avalanche literature. In most cases, death probably occurs within 15 to 30 minutes from the time of burial. However, survival after prolonged burial in a tree well and deep snow is possible. The cause of death is asphyxiation, probably due to one of the mechanisms that produce asphyxia in avalanche burial victims: positional asphyxia, airway obstruction, or carbon dioxide displacement asphyxia. Prevention of snow immersion asphyxiation begins with skiers and snowboarders staying within the limits of their skills, using the proper tools for deep powder, staying in control at all times, and employing a buddy system. A skier or snowboarder who falls near or into a tree well should tuck, roll, and try to land upright, grab the tree trunk or a branch, and yell or blow a whistle to alert partners. If buried upside down, the person should stay calm and create an air pocket, which is probably of paramount importance. Skiers and snowboarders should use avalanche safety equipment to lessen the risk of snow submersion asphyxiation.

  15. Effect of intrauterine resuscitation on umbilical cord blood parameters of full-term fetal distress and evaluation of neonatal nerve function

    Institute of Scientific and Technical Information of China (English)

    Mei-Hao Luo; Ping Ye

    2016-01-01

    Objective:To study the effect of intrauterine resuscitation on umbilical cord blood parameters of full-term fetal distress and neonatal nerve function.Methods:A total of 74 cases of women who gave birth in Gynecology and Obstetrics Department of our hospital and had fetal distress during labor from February 2008 to October 2010 were selected for study and randomly divided into two groups, observation group received intrauterine resuscitation, control group received conventional treatment, and then contents of umbilical arterial blood gas parameters and cytokines of two groups of patients, contents of serum nerve injury molecules of neonates as well as neonatal asphyxia condition and nerve function were compared. Results:pH value, PO2 and HCO3- in umbilical cord blood of observation group were higher than those of control group, and PCO2 and BE absolute value were lower than those of control group; IL-6, IL-8 and IFN-γ contents in umbilical arterial blood and umbilical venous blood of observation group of patients were significantly lower than those of control group; 1 d, 3 d, 5 d and 7 d after birth, serum NSE and S-100 protein contents of observation group of neonates were significantly lower than those of control group; neonatal asphyxia condition and nerve function were better than those of control group.Conclusion:Intrauterine resuscitation can improve intrauterine fetal anoxia and reduce acidosis while reduce neonatal nerve function injury and prevent neonatal asphyxia, and it is an ideal method to treat full-term fetal distress.

  16. 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

  17. 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

  18. 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.

  19. 米索前列醇终止足月妊娠的临床效果和安全性研究%Clinical efficacy and safety study on full-term pregnancy termination with misoprostol

    Institute of Scientific and Technical Information of China (English)

    任雪琼; 仇春波; 李娜

    2015-01-01

    目的 探究米索前列醇终止足月妊娠的临床效果和安全性.方法 2013年7月~2014年3月来宁波大学医学附属医院妇产科进行终止足月妊娠的孕妇共78例,将上述孕妇随机分为实验组和对照组.实验组采用米索前列醇进行引产,对照组采用缩宫素进行引产.观察对比2组孕妇的引产效果指标:引产成功率、产后2h内出血量、临产时间及胎儿分娩时间、剖宫产率;引产安全指标:产妇并发症及副作用发生情况,新生儿生理状况及Apgar评分.结果 实验组引产成功率为97.44%,对照组引产成功率为82.05%,实验组成功率明显高于对照组(P0.05), the experimental group had one case of mild neonatal asphyxia, there are two cases in the control group and one case of mild asphyxia neonatal asphyxia.Conclusion Effect of misoprostol which is used to terminate the pregnancy term is significant, and has high security, has high clinical value.

  20. 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

  1. Violent sex and suicide.

    Science.gov (United States)

    Danto, B M

    1978-01-01

    Early literature on sexual disorders and suicidiology are reviewed in this paper in the light of relationships between sexual problems, especially violent sexual ones, and suicide. The relationship between guilt feelings and suicide is viewed from the standpoint of current observations about sexually violent behavior and suicide. It was postulated that sexual perversions constitute a defensive means of coping with internal stress. Suicide is viewed as serving the same aim. Specific violent sexual behaviors such as sexual asphyxia and rape are discussed in terms of suicide. Transsexuality and transvestism are treated similarly. It is concluded that sexual violence and preversion in general are forms of self-destruction in themselves.

  2. [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.

  3. Clinical Study on the Mode of Delivery and Pregnancy Outcome in Twin Pregnancy%双胎妊娠的分娩方式与妊娠结局的临床研究分析

    Institute of Scientific and Technical Information of China (English)

    陈丽花

    2014-01-01

    目的:探讨双胎妊娠的不同分娩方式与其妊娠结局的关联。方法:将2009年3月~2013年3月我院产科收治的双胎妊娠孕妇80例随机均分为2组,各40例,其中一组行剖宫产,另一组行阴道产,观察比较两种分娩方式的妊娠结局。结果:(1)两种分娩方式孕妇产后出血机率比较无显著差异(P>0.05);剖宫产组孕周≥37周有29例(72.5%),明显高于阴道分娩组17例,42.5%(P0.05),但在第二胎儿中阴道分娩组窒息率达到27.5%,剖宫产组为7.5%,比较差异有统计学意义(P15min时第二例胎儿窒息发生率明显高于≤15min出生者(P0.05);The pregnant week and birth weight of cesarean section group was significantly greater than the vaginal delivery group. (2)There were no differences about incidence of neonatal asphyxia in first fetal between two groups (P>0.05), but the incidence of neonatal asphyxia of second fetal in vaginal delivery group was higher than that in cesarean section group (P<0.05).(3)The incidence of neonatal asphyxia of second fetal at≥15 minutes was higher than that of at<15 minutes(P<0.05). Conclusion:For twin pregnancy pregnant, making a right choice for the mode of delivery can lower the incidence of neonatal asphyxia.

  4. Ischiopagus tripus conjoined twins in a western lowland gorilla (Gorilla gorilla).

    Science.gov (United States)

    Langer, S; Jurczynski, K; Gessler, A; Kaup, F-J; Bleyer, M; Mätz-Rensing, K

    2014-05-01

    Conjoined twinning is rare in man and non-human primates. The current report describes a case of ischiopagus tripus conjoined Western Lowland gorilla (Gorilla gorilla) twins. The female twins were joined at the umbilical and pelvic region, involving the liver, xiphoid, umbilicus, body wall and skin. Computed tomography revealed two complete spines. The combined pelvic space was formed by two sacra, each connected with two iliac bones. The twins were only conjoined by a common pubis. Cause of death was attributed to cardiac and circulatory collapse resulting from a large patent foramen ovale (8 mm in diameter) of one twin and neonatal asphyxia.

  5. Impaired autoregulation of cerebral blood flow in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    Cerebral blood flow was measured, using the 133Xe clearance technique, a few hours after birth in 19 infants with varying degrees of respiratory distress syndrome. Ten of these infants had had asphyxia at birth. The least affected infants with normotension (systolic blood pressure 60 to 65 mm Hg...... at birth and infants with RDS only. CBF varied considerably with spontaneous variations in blood pressure, suggesting that autoregulation was lacking. This finding may explain why distressed premature infants are prone to develop massive capillary bleeding in the germinal layer with penetration...

  6. Obstetrical and neonatal outcomes in women following gastric bypass

    DEFF Research Database (Denmark)

    Berlac, Janne Foss; Skovlund, Charlotte Wessel; Lidegaard, Ojvind

    2014-01-01

    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...... weight controls women who had had a gastric bypass had a higher risk of hypertension, gestational diabetes, and acute abdominal pain during pregnancy and their children a lower birthweight and higher incidence of admittance to neonatal intensive care....

  7. Unintentional strangulation by a cervical collar after attempted suicide by hanging.

    Science.gov (United States)

    Lemyze, Malcolm; Palud, Aurore; Favory, Raphael; Mathieu, Daniel

    2011-06-01

    We report the case of a young man who attempted suicide by hanging and whose neurological status deteriorated until the cervical collar, that had been correctly placed by the prehospital team, was removed. We discuss the physiopathological mechanisms leading to death in hanging that is, a blockage of the blood stream to the brain leading to vasogenic and cytotoxic cerebral edema rather than asphyxia or spinal fracture. Our case supports the early removal of neck stabilization devices that can dangerously harm the patient after an attempted suicide by hanging, by increasing intracerebral pressure.

  8. 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.

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

    OpenAIRE

    2015-01-01

    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 pret...

  10. 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.

  11. 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.

  12. 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.

  13. Maximum opening of the mouth by mouth prop during dental procedures increases the risk of upper airway constriction

    Directory of Open Access Journals (Sweden)

    Hiroshi Ito

    2010-05-01

    Full Text Available Hiroshi Ito1, Hiroyoshi Kawaai1, Shinya Yamazaki1, Yosuke Suzuki21Division of Systemic Management, Department of Oral Function, 2Division of Radiology and Diagnosis, Department of Medical Sciences, Ohu University, Post Graduate School of Dentistry, Koriyama City, Fukushima Prefecture, JapanAbstract: From a retrospective evaluation of data on accidents and deaths during dental procedures, it has been shown that several patients who refused dental treatment died of asphyxia during dental procedures. We speculated that forcible maximum opening of the mouth by using a mouth prop triggers this asphyxia by affecting the upper airway. Therefore, we assessed the morphological changes of the upper airway following maximal opening of the mouth. In 13 healthy adult volunteers, the sagittal diameter of the upper airway on lateral cephalogram was measured between the two conditions; closed mouth and maximally open mouth. The dyspnea in each state was evaluated by a visual analog scale. In one subject, a computed tomograph (CT was taken to assess the three-dimensional changes in the upper airway. A significant difference was detected in the mean sagittal diameter of the upper airway following use of the prop (closed mouth: 18.5 ± 3.8 mm, maximally open mouth: 10.4 ± 3.0 mm. All subjects indicated upper airway constriction and significant dyspnea when their mouth was maximally open. Although a CT scan indicated upper airway constriction when the mouth was maximally open, muscular compensation was admitted. Our results further indicate that the maximal opening of the mouth narrows the upper airway diameter and leads to dyspnea. The use of a prop for the patient who has communication problems or poor neuromuscular function can lead to asphyxia. When the prop is used for patient refusal in dentistry, the respiratory condition should be monitored strictly, and it should be kept in mind that the “sniffing position” is effective for avoiding upper airway

  14. Clinical hypoxic-ischemic encephalopathy score of the Iberoamerican Society of Neonatology (Siben: A new proposal for diagnosis and management

    Directory of Open Access Journals (Sweden)

    José Maria Rodriguez Perez

    Full Text Available Summary Hypoxic ischemic encephalopathy is a major complication of perinatal asphyxia, with high morbidity, mortality and neurologic sequelae as cerebral palsy, mostly in poor or developing countries. The difficulty in the diagnosis and management of newborns in these countries is astonishing, thus resulting in unreliable data on this pathology and bad outcomes regarding mortality and incidence of neurologic sequelae. The objective of this article is to present a new clinical diagnostic score to be started in the delivery room and to guide the therapeutic approach, in order to improve these results.

  15. [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.

  16. Fetal and maternal complications in macrosomic pregnancies

    Directory of Open Access Journals (Sweden)

    Cheng YK

    2014-03-01

    Full Text Available Yvonne Kwun-Yue Cheng, Terence T LaoDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong KongAbstract: The prediction and management of fetal macrosomia remains an obstetric challenge. Significant maternal and neonatal complications can result from the birth of a macrosomic infant, and include prolonged labor, operative delivery, postpartum hemorrhage, perineal trauma, shoulder dystocia, birth trauma, chorioamnionitis, meconium aspiration, perinatal asphyxia, low Apgar scores, neonatal hypoglycemia, and perinatal mortality. This review article discusses these maternal and perinatal risks and the management of suspected macrosomia.Keywords: macrosomia, large for gestational age, shoulder dystocia, birth trauma, perineal tear

  17. Cranial birth trauma; Kraniales Geburtstrauma

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Roth, C.; Politi, M.; Zimmer, A.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)

    2009-10-15

    Injuries to an infant that result during the birth process are categorized as birth trauma. Cranial injuries due to mechanical forces such as compression or traction include caput succedaneum, cephalhematoma, subgaleal hematoma and intracranial hemorrhaging. Hypoxic ischemic encephalopathy is the consequence of systemic asphyxia occurring during birth. (orig.) [German] Als Geburtstrauma werden die Verletzungen des Saeuglings bezeichnet, die waehrend der Geburt stattfinden. Zu den Verletzungen, die am Schaedel auftreten koennen und hauptsaechlich durch mechanische Kraefte wie Kompression oder Traktion verursacht werden, gehoeren das Caput succedaneum, das Zephalhaematom, das subgaleale Haematom und die intrakranielle Blutung. Die hypoxisch-ischaemische Enzephalopathie ist die Folge einer systemischen Asphyxie waehrend der Geburt. (orig.)

  18. Medical Surveillance Monthly Report

    Science.gov (United States)

    2016-04-01

    anomalies 1,598 (110) 976 (102) 39 (112) Low birth weight 1,489 (113) 373 (116) 0 (137) Birth asphyxia and birth trauma 178 (136) 79 (129) 71 (103) April...4.7 Pregnancy and delivery (ICD–9: 630–679, relevant V-codes) 11,480 Trauma to perineum and vulva during delivery 2,549 22.2 Late pregnancy 991 8.6...2,605 3.9 Musculoskeletal system (ICD-10: M00–M99) 755,036 Pain in joint 260,351 34.5 Low back pain 143,349 19.0 Pain in limb, hand, foot, fi ngers

  19. 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 ...

  20. 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.

  1. Transition to skilled birth attendance: is there a future role for trained traditional birth attendants?

    Science.gov (United States)

    Sibley, Lynn M; Sipe, Theresa Ann

    2006-12-01

    A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women's use of antenatal care and emergency obstetric care, and small significant decreases in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the newborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4--a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015--through participation in key evidence-based interventions.

  2. Intranasal pyrrolidine dithiocarbamate decreases brain inflammatory mediators and provides neuroprotection after brain hypoxia-ischemia in neonatal rats.

    Science.gov (United States)

    Wang, Zhi; Zhao, Huijuan; Peng, Shuling; Zuo, Zhiyi

    2013-11-01

    Brain injury due to birth asphyxia is the major cause of death and long-term disabilities in newborns. We determined whether intranasal pyrrolidine dithiocarbamate (PDTC) could provide neuroprotection in neonatal rats after brain hypoxia-ischemia (HI). Seven-day old male and female Sprague-Dawley rats were subjected to brain HI. They were then treated with intranasal PDTC. Neurological outcomes were evaluated 7 or 30 days after the brain HI. Brain tissues were harvested 6 or 24 h after the brain HI for biochemical analysis. Here, PDTC dose-dependently reduced brain HI-induced brain tissue loss with an effective dose (ED)50 at 27 mg/kg. PDTC needed to be applied within 45 min after the brain HI for this neuroprotection. This treatment reduced brain tissue loss and improved neurological and cognitive functions assessed 30 days after the HI. PDTC attenuated brain HI-induced lipid oxidative stress, nuclear translocation of nuclear factor κ-light-chain-enhancer of activated B cells, and various inflammatory mediators in the brain tissues. Inhibition of inducible nitric oxide synthase after brain HI reduced brain tissue loss. Our results suggest that intranasal PDTC provides neuroprotection possibly via reducing inflammation and oxidative stress. Intranasal PDTC may have a potential to provide neuroprotection to human neonates after birth asphyxia.

  3. Chemical shift imaging and localised magnetic resonance spectroscopy in full-term asphyxiated neonates

    Energy Technology Data Exchange (ETDEWEB)

    Brissaud, Olivier [Children' s Hospital, Paediatric Intensive Care Unit, Bordeaux (France); Chateil, Jean-Francois; Bordessoules, Martine; Brun, Muriel [Children' s Hospital, Radiology Unit, Bordeaux (France)

    2005-10-01

    Diagnosis of brain lesions after birth anoxia-ischemia is essential for appropriate management. Clinical evaluation is not sufficient. MRI has been proven to provide useful information. To compare abnormalities observed with MRI, including diffusion-weighted imaging (DWI), localised magnetic resonance spectroscopy (MRS) and chemical shift imaging (CSI) and correlate these findings with the clinical outcome. Fourteen full-term neonates with birth asphyxia were studied. MRI, MRS and CSI were performed within the first 4 days of life. Lesions observed with DWI were correlated with outcome, but the apparent diffusion coefficient (ADC) did improve diagnostic confidence. The mean value of Lac/Cr for the neonates with a favourable outcome was statically lower than for those who died (0.22 vs 1.04; P = 0.01). The same results were observed for the Lac/NAA ratio (0.21 vs 1.23; P = 0.01). Data obtained with localised MRS and CSI were correlated for the ratio N-acetyl-aspartate/choline, but not for the other metabolites. No correlation was found between the ADC values and the metabolite ratios. Combination of these techniques could be helpful in our understanding of the physiopathological events occurring in neonates with asphyxia. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Analysis of perinatal mortality and its components: time for a change?

    Science.gov (United States)

    Kramer, Michael S; Liu, Shiliang; Luo, Zhongcheng; Yuan, Hongbo; Platt, Robert W; Joseph, K S

    2002-09-15

    Since the midtwentieth century, stillbirths (late fetal deaths) and early neonatal deaths have often been combined into a single category of "perinatal" deaths. In the past, such a combination was justified by the fact that asphyxia was a common cause of death during labor (intrapartum stillbirth) and shortly after birth and by geographic and temporal differences in classification of livebirths versus stillbirths. In more recent years, however, the etiologic determinants have diverged sharply, with many fewer early neonatal deaths caused by asphyxia and relatively many more caused by congenital anomalies. Moreover, the increasingly common stratification of pregnancy outcome measures by gestational age or birth weight leads to the use of an inappropriate denominator (total livebirths plus stillbirths within each gestational age or birth weight category) for denoting risk for the stillbirth component, because all unborn fetuses (including the majority of those not born within the specified gestational age or birth weight range) are at risk of being stillborn in that range. The authors suggest that, whenever possible, stillbirths and early neonatal deaths should be reported separately, with gestational age-specific risks of stillbirth based on all fetuses at risk, and that antepartum and intrapartum stillbirths be reported separately.

  6. [Maternal and perinatal surgical complications in low platelet count for HELLP syndrome in severe preeclampsia-eclampsia in intensive care].

    Science.gov (United States)

    Basavilvazo Rodríguez, Antonia; Pacheco Pérez, Claudia; Lemus Rocha, Roberto; Martínez Pérez, José Ma; Martínez Martínez, Armando; Hernández-Valencia, Marcelino

    2003-08-01

    The preeclampsia is the first cause of maternal morbility, with increase in the obstetric complications when it is associated to HELLP syndrome, for the low platelets that even involves to the neonate. This study was carried out in the patients accepted in the intensive Adults Cares Unit in the period of one year, surgical complications and the perinatal results were determined in women with low platelet count for HELLP syndrome in preeclampsia-eclampsia. Three groups were formed according to the platelets account and then were analyzed using chi square to determine association among these groups of patients, as well as mean and standard deviation (M +/- DE) to describe results. Forty patients were studied with low platelets by HELLP syndrome in preeclampsia-eclampsia, where the distribution for the group with platelets hipovolemic shock. Also in this group the perinatal mortality was presented in 3 cases (25%) and the asphyxia at the birth with Apgar < 6 was presented in 5 cases (41.7%). A bigger morbility was observed inversely proportional to the account platelets, being the renal failure the cause most frequent of this morbility in the three groups. The low platelets account contribute in a direct way in the obstetric complications, since there are more surgical reinterventions, with bled in the transsurgical and increase in the days of intrahospitalary stay. Also with smaller account platelet, there are bigger prematural index, asphyxia and perinatal mortality in the newborn of mothers with HELLP syndrome.

  7. Sex, drugs and rock and roll: tales from preterm fetal life.

    Science.gov (United States)

    Bennet, Laura

    2017-01-17

    Premature fetuses and babies are at greater risk of mortality and morbidity than their term counterparts. The underlying causes are multifactorial, but include exposure to hypoxia. Immaturity of organs and their functional control may impair the physiological defence responses to hypoxia and the preterm fetal responses, or lack thereof, to moderate hypoxia appear to support this concept. However, as this review demonstrates, despite immaturity, the preterm fetus responds to asphyxia in a qualitatively similar manner to that seen at term. This highlights the importance in understanding metabolism versus homeostatic threat when assessing fetal responses to adverse challenges such as hypoxia. Data are presented to show that the preterm fetal adaptation to asphyxia is triphasic in nature. Phase one represents the rapid institution of maximal defences, designed to maintain blood pressure and central perfusion at the expense of peripheral organs. Phase two is one of adaptive compensation. Controlled reperfusion partially offsets peripheral tissue oxygen debt, while maintaining sufficient vasoconstriction to limit the fall in perfusion. Phase three is about decompensation. Strikingly, the preterm fetus generally performs better during phases two and three, and can survive for longer without injury. Paradoxically, however, the ability to survive can lead to longer exposure to hypotension and hypoperfusion and thus potentially greater injury. The effects of fetal sex, inflammation and drugs on the triphasic adaptations are reviewed. Finally, the review highlights the need for more comprehensive studies to understand the complexity of perinatal physiology if we are to develop effective strategies to improve preterm outcomes.

  8. The post-mortem pink teeth phenomenon: a case report.

    Science.gov (United States)

    Soriano, Evelyne-Pessoa; Carvalho, Marcus-Vitor-Diniz de; Santos, Francisco-Bernardo Dos; Mendoza, Clóvis-César de; Araújo, Maria-do Socorro-Dantas de; Campello, Reginaldo-Inojosa-Carneiro

    2009-07-01

    This study presents the case of the post-mortem pink teeth phenomenon observed during an autopsy procedure performed on the body of a man who was kidnapped and murdered approximately 30 days before the examination. The corpse was in an advanced stage of decomposition and putrefaction. Both maxillary and jaw bones were intact, as well as the permanent teeth which presented the "pink teeth phenomenon", probably due to a haemorrhage in the pulp chambers. The pink discolouration was most pronounced at the neck of the teeth. The cause of death was asphyxia. Although the examiners stressed that post-mortem pink teeth must not be considered as a reliable odontological parameter for determining the cause of death, the results of other studies have shown that the pink teeth phenomenon is a common finding related to cases of asphyxia such as strangulation, drowning or suffocation. Thus, the pink teeth phenomenon must be studied in order to determine its role as a post-mortem finding. As of now, an exact relationship between the cause of death and this phenomenon remains unknown.

  9. Risk factors for hearing loss in neonates

    Directory of Open Access Journals (Sweden)

    Ni Luh Putu Maharani

    2016-11-01

    Full Text Available Background An estimated 6 of 1,000 children with live birthssuffer from permanent hearing loss at birth or the neonatal period.At least 90% of cases occur in developing countries. Hearing lossshould be diagnosed as early as possible so that intervention canbe done before the age of 6 months.Objective To determine risk factors for hearing loss inneonates.Methods We performed a case-control study involving 100neonates with and without hearing loss who were born atSanglah Hospital, Denpasar from November 2012 to February2013. Subjects were consisted of 2 groups, those with hearingloss (case group of 50 subjects and without hearing loss (controlgroup of 50 subjects. The groups were matched for gender andbirth weight. We assessed the following risk factors for hearingloss: severe neonatal asphyxia, hyperbilirubinemia, meningitis,history of aminoglycoside therapy, and mechanical ventilationby Chi-square analysis. The results were presented as odds ratioand its corresponding 95% confidence intervals.Results Seventy percent of neonates with hearing loss had historyof aminoglycoside therapy. Multivariable analysis revealed thataminoglycoside therapy of 14 days or more was a significant riskfactor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040.There were no statistically significant associations betweenhearing loss and severe asphyxia, hyperbilirubinemia, meningitis,or mechanical ventilation.Conclusion as a risk factor for hearing loss in neonates. [

  10. 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.

  11. The effect of Lamaze pain relieving delivery on the outcomes of delivery%拉玛泽减痛分娩法对产妇及新生儿的影响

    Institute of Scientific and Technical Information of China (English)

    尹月娥; 郭霞; 王肖田

    2008-01-01

    Objective To investigate the effect of Lamaze pain relieving delivery on the outcomes of delivery. Methods 1 240 cases of primiparas with no early indications of cesarean section were randomly divided into observation group and control group, n=620. The primiparas in observation group were taken the Lamaze pain relieving delivery on the basis of the conventional care, while the ones in the control group being used conventional maternity care. Then observed the degree of pain, the stage of labor, the incidence of cesarean section, neonatal asphyxia and the incidence of postpartum hemorrhage in the course of maternal production. Results There was no significance of difference in the stage of labor and the incidence of postpartum hemorrhage between the two groups (P>0.05), but the degree of pain, the incidence of cesarean section and neonatal asphyxia of the observation group were significantly lower than of the control group (P0.05),观察组产时疼痛程度,剖宫产率及新生儿窒息均低于对照组(P<0.05).结论 拉玛泽减痛分娩法能够降低产时疼痛的程度,降低剖宫产率及新生儿窒息率,值得推广应用.

  12. Italia-Netherland PhD Program: the I.O. PhD Research Program.

    Science.gov (United States)

    Bellissima, Valentina; Borghesi, Alessandro; Bozzetti, Valentina; Dessì, Angelica; Fabiano, Adele; Risso, Francesco M; Salvo, Vincenzo; Satriano, Angela; Silvagni, Davide; Varrica, Alessandro; van Bel, Frank; Visser, Gerard H A; Vles, Hans Js; Zimmermann, Luc J I; Gavilanes, Antonio D W; Gazzolo, Diego

    2011-10-01

    In the framework of long-term scientific collaboration among the founder members coming from Holland and Italy there was a growing consensus to activate a philosophical doctorate (PhD) program, involving young Italian researchers in the field of perinatal medicine, neonatology and pediatrics. The aims were to promote excellence in research, offering to young Italian physicians the opportunity to maturate an International research experience leading to PhD degree, and to promote human and technological improvement energies in perinatal, neonatal and pediatrics research. Thus, an official collaboration among the Dutch Universities from Maastricht and Utrecht and the Italian Children's Hospital from Alessandria, has been activated on March 1st 2010, finalized to the PhD program. The experimental phase included the selection of projects and relative candidates after an interview-selection focusing on their scientific attitudes and the availability on their research projects. Candidates' selection started on May 2010 and on September 29th ten projects and candidates have been approved by the scientific commission. Research topics included: perinatal asphyxia, aging and the origin of adulthood neurodegenerative disease, neuroprotective strategies, biochemical pulmonology, intrauterine growth retardation and perinatal teratology. To date, all projects have been approved by local Ethics Committee from the University/Hospital of origin of the candidates. Five manuscripts have been published and/or submitted to international Journals regarding pneumology, perinatal asphyxia and teratology, whilst about 60-70% of data regarding clinical studies have already been collected.

  13. Impact of cerebral visual impairments on motor skills : implications for developmental coordination disorders.

    Directory of Open Access Journals (Sweden)

    Sylvie Chokron

    2016-10-01

    Full Text Available 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 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 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 categorise 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 perinatal asphyxia whether or not they have been diagnosed with cerebral palsy or DCD.

  14. Clinical Analysis of the Epiglottis Cyst%会厌囊肿的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘辉; 郝茂林

    2013-01-01

    目的探索会厌囊肿安全快捷有效的治疗方法。方法应用专利器械会厌囊肿切吸器及会厌囊肿撑吸器治疗会厌囊肿33例。结果手术治疗中均未发生误吸窒息,术后无复发。结论使用会厌囊肿切吸器及会厌囊肿撑吸器治疗会厌囊肿,有效避免了术中因囊肿液的突然大量涌出引起误吸窒息。%Objective To explore the safe, ef icient and ef ective treament method for epiglot is cyst . Method Using patent instrument epiglot is cyst cut inhaler and support inhaler to treat 33 cases epiglot is cyst. Results Aspiration asphyxia did not occur in the surgical treatment, no postoperative recurrence. Conclusion Using epiglot is cyst cut inhaler and support inhaler to treat epiglot is cyst could ef ectively avoid aspiration asphyxia caused by the sudden gush suf ocation of cyst fluid.

  15. 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.

  16. Acute on chronic exposure to endotoxin is associated with enhanced chemoreflex responses in preterm fetal sheep.

    Science.gov (United States)

    Booth, Lindsea C; Drury, Paul P; Muir, Cameron; Jensen, Ellen C; Gunn, Alistair J; Bennet, Laura

    2013-05-15

    There is increasing evidence that exposure to infection can sensitize the fetus to subsequent hypoxic injury. However, it is unclear whether this involves compromise of the fetal cardiovascular adaptation to acute asphyxia. Chronically instrumented 103-day-old (0.7 gestational age, term is 147 days) fetal sheep in utero were randomized to receive either gram-negative lipopolysaccharide (LPS) as a continuous low-dose infusion for 120 h plus boluses of 1 μg LPS at 48, 72, and 96 h with asphyxia at 102 h (i.e., 6 h after the final LPS bolus) induced by umbilical cord occlusion for 15 min (LPS treated, n = 8), or the same volume of saline plus occlusion (saline treated, n = 7). Fetuses were killed 5 days after occlusion. LPS was associated with a more rapid fall in fetal heart rate at the onset of occlusion (P fall in CaBF to similar values as saline controls during occlusion. There were no differences between the groups in femoral blood flow before or during occlusion. Contrary to our initial hypothesis, acute on chronic exposure to LPS was associated with more rapid cardiovascular adaptation to umbilical cord occlusion.

  17. 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

  18. Does maternal behaviour influence the risk of perinatal death in Jamaica?

    Science.gov (United States)

    Greenwood, R; McCaw-Binns, A

    1994-04-01

    Features of behaviour of mothers of singleton perinatal deaths collected over the 12-month period from 1 September 1986 to 31 August 1987 were compared with 9919 mothers of singleton infants born in September and October 1986 and surviving the first week of life, as part of the Jamaican Perinatal Mortality Survey. For perinatal deaths as a whole, and in the presence of maternal age and social and environmental features, logistic regression analyses showed that the following were independently related with higher risk of mortality: (1) deliberately trying to get pregnant; (2) ever having used Depo Provera; (3) not drinking alcohol in pregnancy; and (4) smoking cigarettes in pregnancy. There were no associations with coital frequency, ever using the contraceptive pill or smoking ganja (cannabis). Deaths were classified using the Wigglesworth scheme, and separate analyses carried out for the three major groups--antepartum fetal deaths, deaths from immaturity and deaths from intrapartum asphyxia. Antepartum fetal deaths were at increased risk if (1) mothers were deliberately trying to get pregnant or (2) they had ever used Depo Provera. Deaths from immaturity were not associated with any health behaviour variables. Deaths from intrapartum asphyxia were more likely if (1) the mother was deliberately trying to get pregnant or (2) she had never used an intrauterine contraceptive device.

  19. 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.

  20. Efficacy and safety of lamivudine treatment for chronic hepatitis B in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Guan-Guan Su; Kong-Han Pan; Nian-Feng Zhao; Su-Hua Fang; Dan-Hong Yang; Yong Zhou

    2004-01-01

    AIM: To evaluate the efficacy and safety of lamivudine treatment of chronic hepatitis B disease in pregnancy.METHODS: The study group was comprised of 38 chronic HBV patients who were diagnosed pregnant duringlamivudine treatment and voluntary to continue the same therapy. The control group was from documented patient data in the literatures. We compared the following parameters with those of a control group: anti-HBV efficacy, complications of pregnancy (abortion, preterm birth, neonatal asphyxia, fetal death, and congenital anomaly), incidence of HBV-positive babies and developmental anomalies in pregnant women treated with lamivudine. RESULTS: The blocking rate of lamivudine treatment was significantly higher than that of active vaccine immunization for babies with double-positive (HBsAg/HBeAg) mothers with 30-30-10 μg doses of vaccine (74.07%) and with 30-20-10 μg (64.87%). The natural vertical HBV transmission from mother to infant of "double-positive" mothers was 100% (10/10). No pregnancy complication was noted during the observation period, but in the control group the incidences of pregnancy complication were 16.67% (abortion), 43.02%(preterm), 15.62% (neonatal asphyxia), and 4.49% (fetal death), 10.0% (congenital anomaly). No HBV-positive newborn was detected and no developmental anomaly was found in the study group.CONCLUSION: Lamivudine is helpful to prevent maternal infant HBV transmission and may reduce the complications of HBV-infected pregnant patients.

  1. Twin pregnancy childbirth way with gestational age of pregnancy outcome%双胎妊娠分娩方式与孕龄对妊娠结局的探讨

    Institute of Scientific and Technical Information of China (English)

    陈晓妮

    2014-01-01

    Twin pregnancy childbirth way and gestational age influence on pregnancy outcome.Methods:In twin pregnancy, 240 cases of maternal childbirth obstetrics and gynecology hospital as the research object.Through self-made form col ection of maternal clinical data were retrospectively analyzed. analyze the different gestational age and birth weight, the relationship between neonatal asphyxia, and different position and the way of delivery and neonatal asphyxia. Result: This group of neonatal asphyxia in 15.83% (76/480). Gestational age 28~34 weeks and of 39 weeks or a newborn, the incidence of asphyxia were significantly higher than that of 35~38 weeks gestational age neonates (al P<0.05). First position as head of the women, the vaginal trial production success of newborns, the incidence of first and second child suffocation were significantly higher than that of elective cesarean section newborn (3.67%, 6.42%vs0.00%, 3.67%), statistical y significant difference (P<0.05). Conclusion:Cesarean section can effectively reduce the incidence of postpartum hemorrhage, twin pregnancy maternal extend gestational age can effectively improve the newborn weight, reduce the incidence of neonatal asphyxia, the cutting head first recommended palace childbirth.%探讨双胎妊娠分娩方式和孕龄对妊娠结局的影响。方法:选择在我院妇产科分娩的双胎妊娠产妇240例为研究对象。通过自制的表格收集产妇的临床资料进行回顾性分析。分析不同的孕龄和新生儿体重、新生儿窒息的关系以及不同胎位和分娩方式与新生儿窒息发生的关系。结果:本组新生儿窒息共计15.83%(76/480)。孕龄28~34周和≥39周的新生儿,窒息的发生率均显著高于孕龄35~38周的新生儿(均P<0.05)。第一胎胎位为头位的产妇中,阴道试产成功的新生儿,第一胎和第二胎窒息的发生率均显著高于择期剖宫产的新生儿(3.67%、6.42%vs0.00%、0.92%),

  2. 比格犬严重多发伤动物模型的研制%Establishment of an animal model of severe multiple trauma in Beagle dogs

    Institute of Scientific and Technical Information of China (English)

    李庆新; 郑军; 张世范; 孟辉; 杨俊峰; 高炜; 刘传兰

    2012-01-01

    目的:研制严重多发伤动物模型,探讨动物模型的稳定性及其救生效应.方法:选健康比格犬31只,随机分组,制备严重多发伤、出血性休克模型和严重多发伤、胸腹联合伤、上呼吸道梗阻窒息模型,探讨模型指标在不同分组间的敏感度及特异度.结果:2种动物模型成型率均可满足不同实验要求,用本装置行自体输血+液体复苏,动物全部存活,单一液体复苏半数死亡;窒息组总病死率为23.1%,窒息≤6 min动物全部存活,≥9 min成活率为60%.结论:严重多发伤、上气道梗阻窒息模型、出血性休克模型符合现场临床实际,有较高的成型率和稳定性,基本涵盖了重危伤情多个层面,半数致死率和预期概率接近,为研究现场救护技术、救护装备、评价救护效能提供了依据.%Objective;To establish an animal model of severe multiple trauma, and to explore its stability and rescuing effect. Methods; Thirty - one healthy Beagle dogs were randomly divided into two groups. One was the group of severe multiple trauma, haemorrhegic shock model and another was the group of severe multiple trauma, thoraco - abdominal combined trauma, upper respiratory tract obstruction asphyxia model. Sensibility and specificity between the two groups were compared. Results; Shaping rates of two groups could meet with all the requirement of different experiments. All the animals survived when autologous blood transfusion plus fluid resuscitation were taken by our patented equipment. Half of the animals survived when single fluid resuscitation was applied. The general mortality of asphyxia was 23. 1 % . All the animals with asphyxia for less than 6 min survived and the survival rate of animals with asphyxia for more than 9 min was 60%. Conclusion; Severe multiple trauma, upper respiratory tract obstruction asphyxia and haemorrhegic shock model is fit for on - site clinical reality with a higher shaping rate and stability. It

  3. 高危新生儿眼底出血临床分析%Clinical analysis of retinal hemorrhages in high-risk infants

    Institute of Scientific and Technical Information of China (English)

    朱文珲; 骆荣江; 刘韶瑞

    2012-01-01

    目的 观察高危新生儿眼底出血的发生情况,探讨其相关危险因素.方法 早产或有窒息史、其母有高危分娩史的860例出生后1~5 d高危新生儿纳入研究.其中,经阴道分娩498例,剖宫产362例.经阴道分娩的498例新生儿中,顺产407例,产钳助产91例;产程正常298例,阴道产中滞产102例,急产98例.均散瞳后进行眼底检查,观察眼底出血发生情况,并将出血程度分为Ⅰ、Ⅱ、Ⅲ3种.根据Apgar评分观察眼底出血者的窒息发生情况及窒息程度.分析眼底出血与分娩方式、产程的关系,眼底出血程度与窒息程度的关系.结果 860例高危新生儿中,眼底出血202例,占23.5%.202例眼底出血者中,Ⅰ度眼底出血75例,占37.1%;Ⅱ度眼底出血75例,占37.1%;Ⅲ度眼底出血52例,占25.8%.202例眼底出血者中,曾发生窒息172例,占85.1%.172例曾发生窒息者中,轻度窒息119例,占69.2%;重度窒息53例,占30.8%.轻重度窒息高危新生儿发生眼底出血的程度比较,差异有统计学意义(x2=34.61,P<0.01).经阴道分娩者眼底出血的发生率明显高于剖宫产者,差异有统计学意义(x2=30.73,P<0.01).顺产者眼底出血的发生率明显低于产钳助产者,差异有统计学意义(x2=62.78,P<0.01).阴道产中滞产、急产者眼底出血的发生率明显高于产程正常者,差异均有统计学意义(x 2 =45.86、71.51,P<0.01).窒息、分娩方式、急产、滞产均是眼底出血的危险因素(r=7.46、4.87、15.03、6.47,P<0.01).结论 高危新生儿眼底出血的发生率为23.5%.窒息、分娩方式、急产、滞产是导致眼底出血的可能危险因素.%Objective To investigate the related factors of the retinal hemorrhage in high-risk infants (HRI).Methods Eight hundred and sixty HRI with histories of high-risk pregnancy and/or neonatal asphyxia after 1-5 days of birth were enrolled in this study.In 860 cases of HRI,498 infants were vaginal delivery and

  4. 新生儿重度窒息65例临床研究分析

    Institute of Scientific and Technical Information of China (English)

    党嘉文; 董文斌; 李清平; 王胜会

    2013-01-01

    Objective: Clinical studies of severe neonatal asphyxia were analyzed and discussed. Methods: The clinical study in severe neonatal asphyxia 65 cases in our hospital in May 2011 to May 2013 were treated for the study, al patients in clinical studies were analyzed. Results: After treatment, children with complications, including hypoxic-ischemic encephalopathy, intracranial hemorrhage, aspiration pneumonia, meconium aspiration syndrome, neonatal pulmonary hemorrhage, neonatal respiratory distress syndrome, and gastrointestinal bleeding. The number of cases of death in 4 cases. Conclusion: The etiology of severe neonatal asphyxia is more complicated and relatively more complications, maternal and therefore the need for timely basis for observation and treatment of disease, thereby reducing the mortality rate of children.%目的:对新生儿重度窒息的临床研究进行分析和探讨。方法:此次临床研究主要以我院在2011年5月份到2013年5月份收治的65例重度窒息患儿为研究对象,对所有患儿的临床研究进行分析。结果:经治疗,患儿并发症包括了缺氧缺血性脑病、颅内出血、吸入性肺炎、胎粪吸入综合征、新生儿肺出血、新生儿呼吸窘迫综合征以及消化道出血。死亡例数为4例。结论:新生儿重度窒息的病因较为复杂,且并发症相对较多,因此需要及时对产妇的基础病进行观察和治疗,从而降低患儿的死亡率。

  5. Analysis on the risk factors and preventive measures for neonatal intracranial hemorrhage%新生儿颅内出血的危险因素及预防措施分析

    Institute of Scientific and Technical Information of China (English)

    余连芝; 盛学梅; 余曼玲

    2012-01-01

    目的 探讨引起新生儿颅内出血的危险因素及预防措施.方法 选择2006年1月至2010年12月在本院出生的138例颅内出血新生儿,对颅内出血的病因进行回顾性分析,并选择同期在本院出生的140例正常新生儿进行对照研究.结果 278例新生儿中,早产儿颅内出血发生率为67.3%,窒息率为69.8%;母亲因素中高龄为66.7%,妊高症为70.0%,贫血为59.6%,急产为66.7%;脐带绕颈为60.8%,羊水异常为64.7%.结论 新生儿颅内出血的危险因素包括早产、窒息、母亲因素、脐带绕颈、羊水异常等,早产、窒息和母亲因素是其主要危险因素.%Objective To investigate the risk factors and preventive measures in neonatal intracranial hemorrhage.Methods 138 cases of newborns with intracranial hemorrhage were chosen in our hospital from January 2006 to December 2010,the cause of intracerebral hemorrhage was retrospectively analyzed,in the same period,140 newborns of normal childbirth without intraeerebral hemorrhage were chosen as control group,which were compared to experiment group.Results 278 newborns were compared factors of incidence of intracerebral haemorrhage,incidence of intracerebral haemorrhage of premature was 67.3%,asphyxia was 69.8%; in mother factors,advanced age was 66.7%,hypertension during pregnancy was 70.0%,anemia was 59.6%,precipitate labor was 66.7%; cord around neck was 60.8%,abnormality in amniotic fluid was 64.7%,there was a statistical significant difference(P<0.05).Conclusion Risk factors of neonatal intracranial hemorrhage are premature,asphyxia,mother factors,cord around neck,abnormality in amniotic fluid and so on,premature,asphyxia and mother factors are main risk factors.

  6. 初产妇在基层医院分娩过程中实施健康教育效果临床分析%Clinical Analysis of Effect of Health Education Puerperant in Delivery in the Basic Hospital

    Institute of Scientific and Technical Information of China (English)

    秦秀妹; 秦素芳; 韦绚; 李志勤; 黄静; 骆美芳; 张晨

    2015-01-01

    Objective:To study the puerperant in the basic hospital on the duration of labor, maternal and child health education conditions.Method:321 puerperant in our hospital health education during childbirth from January 2014 to July 2014 were selected as observation group, 320 cases of health education had not served as the control group. The duration of labor, method of delivery, the incidence rate of postpartum hemorrhage and newborn baby asphyxia were observed.Result:The duration of labor, method of delivery, the incidence rate of postpartum hemorrhage and newborn baby asphyxia were significant differences between the two groups(P<0.05).Conclusion:Puerperant at the basic hospital of the maternal health education during childbirth to shorten labor, reduce the rate of caesarean section, newborn baby asphyxia and postpartum hemorrhage rates, thereby enhancing quality of obstetrics department security.%目的:探讨健康教育对基层医院初产妇的产程、母婴状况的影响。方法:选取2014年1-11月在本院分娩过程中实施健康教育的初产妇321例作为观察组,对未实施健康教育的初产妇320例作为对照组,分别观察产程时间、分娩方式和产后出血、新生儿窒息的发病率。结果:两组产程时间、分娩方式和产后出血、新生儿窒息的发病率比较差异均有统计学意义(P<0.05)。结论:初产妇在基层医院分娩过程中实施健康教育能缩短产程、降低剖宫产率、新生儿窒息率及产后出血率,从而提高产科质量安全。

  7. 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.

  8. Paternal and maternal age at pregnancy and autism spectrum disorders in offspring

    Directory of Open Access Journals (Sweden)

    Luh Putu Rihayani Budi

    2016-11-01

    Full Text Available Background The prevalence of autism spectrum disorders(ASDs has increased 10 times over the past half century,while paternal and maternal age at pregnancy has alsoincreased. Studies looking for an association between paternalor maternal age at pregnancy and ASDs in offspring have notbeen conclusive.Objective To assess for possible associations between paternaland maternal age at pregnancy and ASDs in offspring.Methods This case-control study had 50 case and 100control subjects, each case was matched for age and genderto two controls. Case subjects were obtained by consecutivesampling of patients aged 18 months to 7 years who visited theDevelopmental Behavioral & Community Pediatrics OutpatientClinic and private growth and development centers from Januaryto April 2013, while control group were children of the sameage range and same gender who visited pediatric outpatientclinic at Sanglah Hospital mostly due to acute respiratory tractinfection, without ASDs as assessed by the DSM-IV-TR criteria.We interviewed parents to collect the following data: maternaland paternal age at pregnancy, child’s birth weight, historyof asphyxia, hospital admission during the neonatal period,pathological labor, maternal smoking during pregnancy, paternalsmoking, and gestational age. Data analysis was performed withChi-square and Fisher’s exact tests.Results Multivariable analysis showed that higher paternal ageat pregnancy was associated with ASDs in offspring (OR 6.3;95%CI 2.0 to 19.3; P 0.001. However, there was no significantassociation between maternal age during pregnancy and theincidence of ASDs. Asphyxia and paternal smoking were alsoassociated with higher incidence of ASDs in the offspring (OR10.3; 95%CI 1.9 to 56.5; P 0.007 and OR 3.2; 95%CI 1.5 to 6.9;P 0.003, respectively.Conclusion'in offspring by 6.3 times. In addition, paternal smoking increased the risk of ASDs in offspring by 3.2 times and asphyxia increasedthe risk of ASDs in offspring by 10

  9. The Application of Water Birth at the Grassroots Level Hospital%水中分娩在基层医院的应用思考

    Institute of Scientific and Technical Information of China (English)

    雷金菊

    2014-01-01

    目的:探讨水中分娩对分娩过程中疼痛程度、产程时间、产后出血量及新生儿情况,评估其临床应用的价值。方法:抽取水中分娩的产妇120例为水中分娩组,抽取同期经阴道自然分娩的产妇140例为对照组,比较两组产妇的疼痛程度、产程时间、产后24 h出血量及新生儿窒息情况。结果:水中分娩组产妇疼痛程度及产程时间显著少于对照组(P0.05)。结论:水中分娩可以减轻疼痛、缩短产程,而产后出血量及新生儿窒息并无增加。%Objective: To explore the advantages of water birth during childbirth pain, duration of labor, postpartum hemorrhage and neonatal conditions, assess its value in clinical applications.Method: 120 cases birth mothers were extracted as water delivery group,140 cases of women who natural vaginal delivery in the same period were extracted as the control group. The maternal pain levels, labor time, 24 hours postpartum hemorrhage and newborn asphyxia were compared between the two groups.Result: The maternal pain levels and labor time in the water birth group were significantly less than the control group(P<0.05). While there were no significant difference of postpartum hemorrhage after 24 hours and newborn asphyxia between the water birth group and the control group.Conclusion: The water birth can reduce pain, shorten labor, postpartum hemorrhage and newborn asphyxia does not increase.

  10. 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.

  11. 双胎妊娠分娩方式与妊娠结局120例临床分析%Impact of delivery on pregnancy outcome in twin pregnancy.

    Institute of Scientific and Technical Information of China (English)

    何建风; 王彩霞

    2011-01-01

    目的 探讨双胎妊娠的不同分娩方式对妊娠结局的影响.方法 对2008-2010年于我院分娩的120例双胎妊娠资料进行回顾性分析,其中剖宫产76例,阴道产44例.结果 孕周<34周的新生儿窒息率、病死率显著高于孕周>34周者,两者差异有统计学意义(P<0.01);阴道分娩组第2胎窒息率、死亡率显著高于第1胎,且与剖宫产组比较差异亦有统计学意义(P<0.01);两组孕周、产后出血差异无统计学意义(P>0.05).结论 与阴道产相比,双胎妊娠剖宫产可减少新生儿窒息率及死亡率.%Objective To explore the influence of delivery route on pregnancy outcome in twin pregnancy.Methods The date of 120 cases of twin pregnancy from 2008 to 2010 were retrospectively analyzed, among which 76 cases performed cesarean section and 44 underwent vaginal delivery. Results The rate of neonatal asphyxia and case fatality at 34 weeks of gestation, with statistical meaning (P<0.01); the rate of neonatal asphyxia and case fatality of second fetal were higher than that of first fetal,and had significantly difference with cesarean section cases (P<0.01); the weeks of gestation and postpartum hemorrhage had no striking difference between the two groups. Conclusion Compared with vaginal delivery, cesarean section for twin pregnancy can decrease the rate of neonatal asphyxia and case fatality.

  12. 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.

  13. 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.

  14. 经阴道分娩初产妇行会阴侧切术85例分析%Analysis of 85 cases of primiparas with vaginal delivery treated with lateral episiotomy

    Institute of Scientific and Technical Information of China (English)

    蒋玉

    2016-01-01

    Objective:To analyze the effect of lateral episiotomy on the delivery outcome of primiparas with vaginal delivery. Methods:170 cases of primiparas with vaginal delivery were divided into two groups randomly.The observation group was given lateral episiotomy,and the control group was given traditional protection of perineum.The second stage of labor time,perineal laceration,postpartum 2 h hemorrhage volume and neonatal asphyxia incidence of two groups were compared.Results:The second stage of labor time in the observation group was shorter than that of the control group;the postpartum 2 h hemorrhage volume was less than that of the control group(P<0.05).The incidence of perineal laceration in observation group was lower than that in control group,and the neonatal asphyxia Apgar score was better than that of the control group(P<0.05).Conclusion:Lateral episiotomy could reduce the occurrence of perineal laceration and neonatal asphyxia,shorten the process of labor,reduce the amount of postpartum hemorrhage,which protect the pelvic muscles.%目的:分析会阴侧切术对经阴道分娩初产妇分娩结局的影响。方法:收治阴道分娩初产妇170例,随机分为两组。观察组行会阴侧切术,对照组行传统的单纯会阴保护,比较两组第二产程时间、会阴裂伤、产后2 h出血量及新生儿窒息发生情况。结果:观察组第二产程短于对照组,产后2 h出血量少于对照组(P<0.05)。观察组会阴裂伤发生率低于对照组,且新生儿窒息Apgar评分优于对照组(P<0.05)。结论:会阴侧切术可减少会阴裂伤和新生儿窒息的发生,缩短产程,减少产后出血量,保护盆底肌肉。

  15. 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.

  16. 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。

  17. Application of portable and functional chair in labor process%便捷功能椅在分娩进程中的应用效果

    Institute of Scientific and Technical Information of China (English)

    匡玲; 匡志华; 唐芳

    2016-01-01

    Objective To explore application results of portable and functional chair in labor process.Methods A total of 240 predelivery pregnant women were assigned to two groups of 120 ones each according to voluntary principle.Intervention group used portable and functional chair to help childbirth and control group adopted traditional childbirth mode.Pain degrees,birth process time,labor modes,neonatal asphyxia,postpartum hemorrhage etc.were observed.Results Compared with control group first and total birth process time were significantly shorter (P <0.01),vaginal delivery rate higher (P <0.01), mild pain and neonatal asphyxia lower (P <0.01)and postpartum hemorrhage fewer in observation group.Con-clusion Portable and functional chairs used to help childbirth could effectively lessen childbirth pain,shorten birth process,boost spontaneous delivery rate,lower neonatal asphyxia rate,and make the birth process safe and comfortable.%目的:探讨便捷功能椅在分娩进程中的应用效果。方法将240例待分娩产妇根据自愿原则分为两组,每组120例。干预组采用便捷功能椅协助分娩,对照组采用传统分娩方式分娩。观察两组产妇分娩时的疼痛程度、产程时间、分娩方式、新生儿窒息、产后出血量等。结果干预组第一产程时间及总产程时间均显著短于对照组(P <0.01),阴道分娩率显著高于对照组(P <0.01),轻度疼痛率、新生儿窒息率显著低于对照组(P <0.01),产后平均出血量少于对照组。结论应用便捷功能椅辅助分娩,可有效减轻患者分娩疼痛,缩短产程,提高自然分娩率,减低新生儿窒息率,使分娩过程更为安全、舒适。

  18. 128例新生儿血糖代谢紊乱相关因素分析%Analysis of Related Factors of Blood Glucose Metabolic Disorders in 128 Newborns

    Institute of Scientific and Technical Information of China (English)

    蔡丽梅

    2014-01-01

    Objective To study and analysis of related factors of blood glucose metabolic disorders in newborns.Methods Selected 128 cases of newborns with glucose metabolism disorder from March 2012 to March 2014,and investigated the reason of glucose metabolism disorder.Results The disorder of glucose metabolism and neonatal gestational age,birth weight was negatively cor elated(P<0.05).In the degree of asphyxia,neonatal hypoglycemia was more in mild asphyxia,while hyperglycemia was more in severe neonatal asphyxia (P<0.05).Conclusion Analyzing the related factors to glucose metabolism can take ef ective treatment in time,reduce the pain of children and avoid occurrence of sequelae.%目的探讨和分析新生儿血糖代谢紊乱的相关因素。方法选取我院2012年3月~2014年3月收治的新生儿血糖代谢紊乱的患儿128例,对其血糖代谢紊乱的原因进行调查分析。结果经调查分析可知,血糖代谢紊乱与新生儿胎龄、出生体重呈负相关(<0.05);在窒息程度方面,轻度窒息新生儿的低血糖症状较多,重度窒息新生儿的高血糖症状较多(<0.05)。结论对新生儿血糖代谢紊乱的相关因素进行有效分析,能够及早发现疾病,并及时采取切实有效的治疗措施,减少患儿痛苦,避免后遗症发生。

  19. 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.).

  20. 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?

  1. 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.

  2. 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.

  3. Opercular syndrome: A case report and review

    Directory of Open Access Journals (Sweden)

    Soaham Dilip Desai

    2013-01-01

    Full Text Available We present a 9-year-old boy with history of perinatal asphyxia and neonatal seizures; who presented with delayed development of speech, with predominant dysarthria, dysphagia, and drooling of saliva and unable to protrude tongue along with delayed motor and mental milestones. He had complex partial seizures since last 3 years requiring multiple anti-epileptic drugs. He had dysarthria, nasal twang, and drooling of saliva with difficulty in chewing and swallowing. Hearing and understanding were normal. Bilateral trigemino-facio-linguo-pharyngeal palsy was noticed on voluntary movements with normal jaw jerk with preserved automatic and emotional motor movements. Electroencephalography revealed focal left fronto-temporal epileptiform discharges and brain imaging was suggestive of bilateral cortical and subcortical region encephalomalacia, predominantly involving bilateral opercular region. The clinical and neuroimaging features correspond to bilateral opercular syndrome which could have resulted from the perinatal insult in this case.

  4. 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.

  5. Ichthyosis prematurity syndrome: a well-defined congenital ichthyosis subtype

    DEFF Research Database (Denmark)

    Bygum, Anette; Westermark, Per; Brandrup, Flemming

    2008-01-01

    . The parents recalled that his elder sister had similar but milder skin changes and respiratory distress syndrome at birth. Ichthyosis prematurity syndrome was suggested and the diagnosis supported by electron microscopy of a skin biopsy specimen showing pathognomonic trilamellar membrane aggregations...... birth he developed respiratory distress and needed intubation. Remarkable skin changes were noticed with universal red, edematous and desquamating, spongy skin giving an impression of excessive vernix caseosa. Marked regression of the edema and ichthyotic scaling was observed within a few weeks......Ichthyosis prematurity syndrome is a rare syndrome characterized by the clinical triad of premature birth, thick caseous desquamating epidermis, and neonatal asphyxia. We describe two siblings with ichthyosis prematurity syndrome. The index patient was born at gestational week 34. Immediately after...

  6. 妊娠期高血压疾病终止妊娠时机及分娩方式212例临床探讨%Hypertensive Disorder Complicating Pregnancy Termination of the Clinical Study of 212 Cases of Pregnancy and Delivery Time

    Institute of Scientific and Technical Information of China (English)

    王骧; 陈艺菲

    2013-01-01

    Objective: To investigate the best time in patients with pregnancy induced hypertension and termination of pregnancy,as wel as the correct mode of delivery. Methods: from 2011June to 2013 June in patients with hypertension of pregnancytreated in our hospital, a total of 212 cases, the clinicaltreatment, these patients track record, combined with asphyxia,neonatal birth after uterine bleeding were analyzed. Results: 212 cases of patients, 31 cases of delivery mode for vaginal delivery, 182 cases of cesarean section, Caesarean birth 85.85%; vaginal delivery occurred postpartum hemorrhage in 13 cases, accounting for 6.12% of the total, cesarean deliveryin patients with postpartum hemorrhage in 16 cases, accounting for 7.54% of the total. 30.24% appear in vaginal delivery,neonatal asphyxia, cesarean section in 12.31%newborns with asphyxia. Vaginal delivery in neonatal asphyxia is higher than that of cesarean section (P> 0.05). Conclusion: for the patients with hypertensive disorder complicating pregnancy, when is the best time for termination of pregnancy is inconclusive, according to the research results and research data shows, in patients with pregnancy induced hypertension of pregnancy termination timing according to clinical manifestations, gestational weeks,the progression of the disease, drug treatment and fetal development comprehensively evaluation and discussion.%目的:探讨妊娠期高血压患者终止妊娠的最佳时机,以及正确的分娩方式。方法选取2011年6月~2013年6月在我院治疗的妊娠期高血压患者,共212例,对这些患者的临床治疗情况、跟踪记录情况,结合分娩后子宫出血情况、新生儿的窒息情况进行全面分析。结果212例患者中,31例分娩方式为阴道分娩,182例为剖宫产,剖宫产占85.85%;阴道分娩的发生产后出血13例,占总数的6.12%,剖宫产分娩的患者发生产后出血16例,占总数的7.54%。阴道分娩中30.24%出现

  7. 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.

  8. 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.

  9. 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.

  10. [Study of intellectual activity in twins. I. Developmental features].

    Science.gov (United States)

    Kantonistova, N S

    1980-01-01

    The investigation of 234 twins and 100 singletons at the age from 7 till 16 years old was carried out by WISC method. The intellectual development of twins was established to fall behind singletons at the expense of lower level of verbal intellectual functions. It is due to organic changes of nervous system, arising as the result of the action of unfavourable factors during antenatal period. Slight asphyxia and prematurity as well as the order of birth do not exert essential effect on intellectual development of twins. Low weight at birth combines with lower intellectual index only in cases when lowering of weight is due to the action of unfavourable factors during intrauterine period. "Twins situation" apparently renders positive influence on twins intellectual activity during school are, distracting children's attention in cases of unfavourable psychological situation in family. Intellectual environment renders positive influence on intellectual development of twins.

  11. Comparative clinical study of preterm and full-term newborn neonatal seizures

    Directory of Open Access Journals (Sweden)

    Holanda Manoel R.R.

    2006-01-01

    Full Text Available OBJECTIVE: To compare the characteristics of neonatal seizures between preterm and full-term infants in intensive care unit. METHOD: A prospective study was developed with 104 high-risk newborn, 30 preterm and 74 full-term infants, with clinical seizures. The dependent variable was gestational age. Statistical analyses: Fisher's exact test, odds-ratio and Mann Witney U test. RESULTS: There were significant differences (p<0.05: i premature neonates develop neonatal seizures later, probably related to the etiologies of the seizures; ii etiologically, there is a predominance of peri-intraventricular hemorrhage in preterm and of asphyxia in full term neonates; iii clonic seizures are most frequent in preterm and subtle seizures in full term neonates. CONCLUSION: Although the study had a clinical basis, it was possible to identify differences when the dependent variable was gestational age.

  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

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Ewan [Bristol Royal Hospital for Children, Department of Pediatric Radiology, Bristol (United Kingdom); Andronikou, Savvas [Bristol Royal Hospital for Children, Department of Pediatric Radiology, Bristol (United Kingdom); University of Bristol, CRICBristol, Bristol (United Kingdom); Vedajallam, Schadie; Chacko, Anith; Thai, Ngoc Jade [University of Bristol, CRICBristol, Bristol (United Kingdom)

    2016-09-15

    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. (orig.)

  13. Evaluation of reported fatality data associated with workers using respiratory protection in the United States (1990-2012).

    Science.gov (United States)

    Cowan, Dallas M; Benson, Stacey M; Cheng, Thales J; Hecht, Shelby; Boulos, Nancy M; Henshaw, John

    2016-06-24

    OSHA revised the 1971 respiratory protection standard in 1998 to add guidance for selecting and maintaining respirators. Fatality reports from 1990 to 2012 were used to characterize historical trends in fatalities associated with respirators. Industry- and time-specific trends were evaluated to determine the effect of the revision to the standard on respirator-related fatalities; 174 respirator-related deaths were reported. The majority of fatalities were associated with using an airline respirator (n = 34) or the absence of using a respirator in required spaces (n = 38). Overall, 79% of fatalities were associated with asphyxia. Fatalities were associated with improper employee use or lack of employer compliance. Reductions in fatality rates over time appeared to be associated with the revisions to the respirator standard, although other variables may influence rates (eg, controls). Recommendations for employers and employees regarding maintaining safe use of respirators are provided.

  14. Metabolomics application in maternal-fetal medicine.

    Science.gov (United States)

    Fanos, Vassilios; Atzori, Luigi; Makarenko, Karina; Melis, Gian Benedetto; Ferrazzi, Enrico

    2013-01-01

    Metabolomics in maternal-fetal medicine is still an "embryonic" science. However, there is already an increasing interest in metabolome of normal and complicated pregnancies, and neonatal outcomes. Tissues used for metabolomics interrogations of pregnant women, fetuses and newborns are amniotic fluid, blood, plasma, cord blood, placenta, urine, and vaginal secretions. All published papers highlight the strong correlation between biomarkers found in these tissues and fetal malformations, preterm delivery, premature rupture of membranes, gestational diabetes mellitus, preeclampsia, neonatal asphyxia, and hypoxic-ischemic encephalopathy. The aim of this review is to summarize and comment on original data available in relevant published works in order to emphasize the clinical potential of metabolomics in obstetrics in the immediate future.

  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. 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.

  17. 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.

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

    Science.gov (United States)

    Kobek, Mariusz; Skowronek, Rafał; Jabłoński, Christian; Jankowski, Zbigniew; Pałasz, Artur

    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.

  19. Histological appearance of postmortem pink teeth: Report of two cases.

    Science.gov (United States)

    Gowda, Bk Charan; Sivapathasundharam, B; Chatterji, Ananjan; Chatterji, B L

    2015-01-01

    This article presents images and histological changes in the dentin of two cases involving posmortem pink teeth. Postmortem pink teeth were noted among two deceased male individuals. Pink teeth were noted during autopsy examination after twelve days in one corpse, and eight days following death in the second case. During the examination decomposition and putrefaction of the body was noted. Cause of death was drowning in one case and haemorrhages and shock in another. A central incisor tooth was obtained from each body. Both teeth exhibited a pink appearance and the intensity was more pronounced in the cervical region. Although pink teeth can be noted in death due to asphyxia, carbon monoxide poisoning and so on, it is necessary to study the exact role behind the appearance of pink teeth and try to incorporate the finding medico legally.

  20. 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.

  1. Imaging findings of avalanche victims

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, Alexandra B.; Grosse, Claudia A.; Anderson, Suzanne [University Hospital of Berne, Inselspital, Department of Diagnostic, Pediatric and Interventional Radiology, Berne (Switzerland); Steinbach, Lynne S. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Zimmermann, Heinz [University Hospital of Berne, Inselspital, Department of Trauma and Emergency Medicine, Berne (Switzerland)

    2007-06-15

    Skiing and hiking outside the boundaries remains an attractive wilderness activity despite the danger of avalanches. Avalanches occur on a relatively frequent basis and may be devastating. Musculoskeletal radiologists should be acquainted with these injuries. Fourteen avalanche victims (11 men and 3 women; age range 17-59 years, mean age 37.4 years) were air transported to a high-grade trauma centre over a period of 2 years. Radiographs, CT and MR images were prospectively evaluated by two observers in consensus. Musculoskeletal findings (61%) were more frequent than extraskeletal findings (39%). Fractures were most commonly seen (36.6%), involving the spine (14.6%) more frequently than the extremities (9.8%). Blunt abdominal and thoracic trauma were the most frequent extraskeletal findings. A wide spectrum of injuries can be found in avalanche victims, ranging from extremity fractures to massive polytrauma. Asphyxia remains the main cause of death along with hypoxic brain injury and hypothermia. (orig.)

  2. 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.

  3. Clinical characteristics of fulminant hepatitis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Mao Li; Lin Ma; Yue-Bo Yang; Zhong-Jie Shi; Shui-Sheng Zhou

    2005-01-01

    AIM: To investigate the clinical characteristics of fulminant hepatitis in pregnancy.METHODS: We compared and analyzed the etiology,clinical characteristics, and laboratory examinations of 25 cases of fulminant hepatitis in pregnancy and 30 cases of fulminant hepatitis not in pregnancy.RESULTS: HBV infection and chronic fulminant hepatitis were most common both in the pregnant and in the non-pregnant groups. Jaundice, digestive tract symptoms,increase of bilirubin and thrombinogen activity were the main manifestations. The incidence of hepatic encephalopathy (HE) and hepato-renal syndrome (HRS) was significantly different between the two groups. The incidence of preterm labor, dead fetus and neonatal asphyxia was high.CONCLUSION: Fulminant hepatitis is likely to occur in late pregnancy with more severe complications, which significantly influences maternity, perinatal fetus, and newborn.

  4. [Multinodular goitre: not always harmless].

    Science.gov (United States)

    Dam, Lyanne; in 't Hof, Klaas H; Smit, Natalie; Nieveen van Dijkum, Els J M

    2014-01-01

    Multinodular goitre has a slow and progressive growth. The clinical presentation of patients with multinodular goitre is variable and dependent on size, location and the functional state of the thyroid tissue. The most frequent clinical symptoms are caused by compression and deviation of the trachea and range from dyspnoea to acute asphyxia. Imaging is important to confirm the size of the multinodular goitre. Timing of the treatment can be critical. However, a good treatment guideline is lacking. There are two treatment options: radioactive iodine and surgical resection. The best treatment option and timing of treatment for patients with multinodular goitre should be assessed and decided on an individual basis. In this clinical report we present two patients who had a multinodular goitre with progressive symptoms for years. Patient A, 66 years of age, was successfully treated with radioactive iodine. Patient B, 77 years of age, underwent a total thyroidectomy.

  5. [Giant esophageal fibrovascular polyp].

    Science.gov (United States)

    Palacios, Fernando; Contardo, Carlos; Guevara, Jorge; Vera, Augusto; Aguilar, Luis; Huamán, Manuel; Palomino, Américo; Yabar, Alejandro

    2003-01-01

    Fibrovascular polyps are extremely rare benign neoplasias of the esophagus, which usually originate in the lower cricoid area. They do not produce any discomfort in the patient for a long time, however it may make itself evident by the patient's regurgitation of the polyp, producing asphyxia or, more frequently, dysphagia. The case of a 58 year old male patient is presented herein, with a 9 month record of dysphagia, weight loss and intermittent melena. The barium x-ray showed a distended esophagus, with a tumor running from the upper esophageal sphincter to the cardia. The endoscopy confirmed the presence of a pediculated tumor, implanted in the cervical esophagus. Surgeons suspected the potential malignancy of the tumor and performed a transhiatal esophagectomy. The final pathologic diagnosis was giant fibrovascular esophageal polyp.

  6. Pietro Manni (1778-1839) and the care of the apparently dead in the Age of Positivism.

    Science.gov (United States)

    Cascella, Marco

    2016-08-01

    When can a man be declared 'really dead'? Being able to determine whether an individual's life has ended or not implies two important considerations, whether we can resuscitate him and avoid premature burial, the fear of which is termed 'taphophobia'. By the end of the 18th century, several scientists were involved in the study of apparent death and resuscitation. Pietro Manni was an obstetrician who, affected by his brother's death and his inability to help him, devoted himself to the study of apparent death, which became his aim in life. His Practical handbook for the care of the apparently dead is a detailed essay on resuscitation with a precise arrangement of topics - ventilation, tracheostomy, electricity and asphyxia in newborns - organised into chapters and paragraphs that resemble current texts on resuscitation.

  7. 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.

  8. Fetal outcome of antepartum and intrapartum eclampsia in Aba, southeastern Nigeria.

    Science.gov (United States)

    Onyearugha, Chukwuemeka N; Ugboma, Henry A A

    2012-07-01

    The objective of this study was to evaluate the fetal outcome of antepartum and intrapartum eclampsia. All cases of antepartum and intrapartum eclampsia managed at the Abia State University Teaching Hospital, Aba, Nigeria, between 1 January 2002 and 31 December 2007 were retrospectively analysed. Of the women who were delivered in our hospital over the period studied, 0.80% had ante- or intrapartum eclampsia which started mostly outside the hospital: 85.4% were unbooked; 62.5% nulliparous; and 62.5% aged less than 30 years. Forty-eight babies were delivered by the eclamptic mothers. All of the fetuses were delivered in the last trimester: 68.8% of the fetuses were preterm; and 58.7% had a low birthweight. Stillbirths occurred in 60.4%; 8.3% suffered severe birth asphyxia; and 70.9% were delivered vaginally. Sustained education of pregnant women on the need for early booking and regular antenatal visits is recommended.

  9. 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.

  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. An uncommon shape of epiglottis misleading as acute epiglottitis.

    Science.gov (United States)

    Sasaki, Toru; Nomura, Yasuyuki; Tsunoda, Koichi

    2012-07-27

    We report a case of a 31-year-old Japanese woman with an uncommon shape of epiglottis misleading as acute epiglottitis. She presented with high fever, arthralgia, general fatigue and strong throat pain. Laryngeal fiberscopy showed a markedly swollen epiglottis suggestive of acute epiglottitis, though she had no signs of asphyxia. A careful observation and detailed medical history ruled out acute epiglottitis. However, without clinical discretion, it might have been misinterpreted as acute epiglottitis. She was diagnosed later with Behçet's disease, which is reported to present pharyngeal stenosis. Two years later, a repeat laryngeal fiberscopy showed exactly the same appearance of the epiglottis, suggesting its shape to be permanent. The cause of this misleading shape of the epiglottis in this patient is yet unknown. For similar cases, a possibility of this kind of epiglottis should be considered before diagnosing as acute epiglottitis.

  12. Blindness in schoolchildren: importance of heredity, congenital cataract, and prematurity.

    Science.gov (United States)

    Phillips, C I; Levy, A M; Newton, M; Stokoe, N L

    1987-08-01

    Of 99 children in the Royal Blind School, Edinburgh (which serves Scotland and part of N E England), 15 had optic atrophy (hydrocephalus 4, intracranial haemorrhage 2, prematurity 2, fetal distress 2, birth asphyxia 2, cerebral atrophy 1, cardiac arrest during hernia operation 1, and leukaemia 1). Fourteen had congenital cataract, 12 congenital retinal aplasia (Leber's congenital amaurosis) and 11 retinopathy of prematurity. There were small numbers in many other diagnostic categories, including three with non-accidental head injury. Mental retardation, spasticity, and nystagmus were frequent other correlates in all diagnostic categories. 'Very probably hereditary' was a conservative attribution in 36, while 'probable' seemed appropriate for 12-that is, almost 48% were hereditary. Only about 11 cases might have been prevented through genetic counselling, which testifies to the frequency of autosomal recessive hereditary disease, although no parents were consanguineous.

  13. Value of umbilical arterial blood gas analysis in the treatment of newborn%脐动脉血气分析在新生儿救治中的价值研究

    Institute of Scientific and Technical Information of China (English)

    桂逢春

    2013-01-01

    目的:评价脐动脉血气分析在新生儿救治中的价值。方法对2011年10月年至2013年10月在什邡市妇幼保健院救治的418名新生儿同时进行Apgar评分及脐动脉血气分析,随机抽取200名新生儿根据Apgar评分0.05,1周内不良结局发生率有显著差异,P 0.05,1 weeks, the incidence of adverse outcomes were significantly different, P <0.01. Conclusion: The umbilical arterial blood gas analysis Apgar score than on more objective and reliable diagnosis of neonatal asphyxia, after a week of treatment lead to adverse neonatal outcomes lower incidence of greater clinical value.

  14. Effect of maternal iron deficiency anaemia on foetal outcome.

    Science.gov (United States)

    Rusia, U; Madan, N; Agarwal, N; Sikka, M; Sood, S K

    1995-07-01

    One hundred and two pregnant women and their neonates were examined to evaluate the effect of maternal haemoglobin concentration (Hb. conc) and iron deficiency anaemia on the placental weight and the foetal outcome. Haematological and serum ferritin values were determined. It was observed that 34.3% of the pregnant women were anaemic. Maternal Hb conc. and serum ferritin showed a highly significant correlation (r = 0.40, p < 0.001) indicating that iron deficiency was the most important cause of anaemia amongst them. The maternal Hb conc. showed a significant correlation with placental weight (p < 0.05), birth weight (p < 0.01), Apgar score (p < 0.001) and birth asphyxia. Maternal serum ferritin also correlated positively with cord ferritin (p < 0.001). The study did not reveal any association between high Hb and adverse foetal outcome.

  15. Dysphagia in the high-risk infant: potential factors and mechanisms.

    Science.gov (United States)

    Jadcherla, Sudarshan

    2016-02-01

    Neonatal dysphagia, or abnormalities of swallowing, represent a major global problem, and consequences of dysfunctional feeding patterns carry over into infancy and toddler age groups. Growth, development, and independent feeding skills are all delayed among high-risk infants. Such a group comprises premature birth, low-birth-weight, congenital anomalies, perinatal asphyxia, postsurgical, and sepsis categories. The conflict between pathophysiologic and pragmatic feeding strategies remains a major conundrum and is largely due to a lack of validated diagnostic approaches amid heterogeneity of the patient phenotype. Thus, well-tested feeding management strategies that can be generalizable are lacking. Furthermore, the aerodigestive symptoms and signs, potential risk factors, and contributory etiologies remain nonspecific. This article presents mechanistic evidence related to the pathophysiologic basis of neonatal dysphagia as well as potential opportunities to improve feeding abilities and long-term development.

  16. 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.

  17. Risk factors for premature births: a cross-sectional analysis of hospital records in a Cameroonian health facility.

    Science.gov (United States)

    Chiabi, Andreas; Mah, Evelyn M; Mvondo, Nicole; Nguefack, Seraphin; Mbuagbaw, Lawrence; Kamga, Karen K; Zhang, Shiyuan; Mboudou, Emile; Tchokoteu, Pierre F; Mbond, Elie

    2013-12-01

    The aim of this study was to investigate the risk factors for preterm births in the Yaounde Gynaeco-Obstetric and Pediatric Hospital in Cameroon, and to describe their outcomes. We conducted a cross-sectional analytical study of hospital records over eight years. The incidence of prematurity was 26.5 % of admissions over a period of 7 years 7 months. After controlling for confounding factors, we identified attending antenatal care visits in a health centre (Odds ratio [OR] 6.19; 95% Confidence interval [CI] 1.15 - 33.22; p = 0.033), having a urinary tract infection (OR 39.04; 95% CI 17.19 - 88.62; p causes of death were neonatal infections (27.6%), neonatal asphyxia (11.9%) and congenital malformations (10.3%). We recommend enhanced prenatal care and management of pathologies which arise during pregnancy.

  18. Mortality of children under 5 years old in Hefei city from 2003 to 2008%合肥市2003-2008年<5岁儿童死亡监测分析

    Institute of Scientific and Technical Information of China (English)

    郭锋; 傅苏林; 邵子瑜; 李迎春

    2011-01-01

    Objective To study the mortality trend of children under 5 years old in Hefei city in the past six years, and to provide scientific basis for effective intervention.Methods Data were obtained from the Child Mortality Surveillance Network of Hefei from 2003 to 2008 and analyzed with x2 test.Results The neonatal mortality rate( NMR), infant mortality rate(IMR) ,and moratlity rate under 5 years old (U5MR) were 5.90,8.18,and 9.84 per 1 000 live births in 2008,respectively,which decreased by 40.8% ,34.4%, and 50.7% compared with those of 2003.The infant mortality accounted for 81.5% of the mortality of children under 5 years old and neonatal mortality accounted for 72.2% of infant mortality.The leading causes of the death of the children under 5 years old were accidental asphyxia, birth asphyxia, pneumonia, and drowning in 2003, and preterm birth, birth asphyxia, and congenital heart disease in 2008.The rate of children not treated before the death dereased from 43.75% in 2003 to 23.87% in 2008.Conclusion The mortality rate of the children under 5 years old declined significantly and the control of premature birth, birth asphyxia, and congenital heart disease is the key point to decrease the mortality rate.%目的 了解2003-2008年安徽省合肥市<5岁儿童死亡率流行趋势,为制定有效干预措施和综合防治提供科学依据.方法 利用2003-2008年合肥市<5岁儿童死亡监测资料,采用χ2检验等统计学方法对<5岁儿童死亡情况进行分析.结果 2008年的新生儿死亡率、婴儿死亡率、<5岁儿童死亡率分别为5.90%.、8.18%.和9.84‰,较2003年分别下降了40.8%、34.4%和50.7%;连续6年,合肥市<5岁儿童死亡的年龄构成均以婴儿死亡为主,占81.5%,其中主要为新生儿期死亡,占72.2%;2003年<5岁儿童死因顺位前3位分别为意外窒息、出生窒息、肺炎和溺水,2008年分别为早产、出生窒息和先天性心脏病;儿童死

  19. 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

  20. MRI findings of complete growth hormone deficiency

    Energy Technology Data Exchange (ETDEWEB)

    Ichiba, Yozo [National Hospital of Okayama (Japan)

    1995-10-01

    Magnetic resonance (MR) imaging was performed on the pituitary gland of 20 children (age range, 2-11 years) with short stature due to growth hormone deficiency. Sixteen patients with multiple pituitary hormone deficiency showed disappearance of the pituitary stalk, disappearance of high signal area of the posterior pituitary, presence of ectopic pituitary, and decreased volume of the anterior pituitary. Many of them had a history of perinatal abnormalities such as asphyxia at delivery, breech delivery, and bradytocia. On the contrary, patients with isolated growth hormone deficiency presented no abnormal findings on MR images, and had no history of perinatal abnormalities. The findings of pituitary stalk separation syndrome suggested the presence of multiple hypopituitarism. (S.Y.).

  1. 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

  2. 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.

  3. Imaging Findings of a Survivor of Avalanche without Any Life Support at Very High Altitude and Extreme Low Temperatures

    Directory of Open Access Journals (Sweden)

    Abhishek Dwivedi

    2016-10-01

    Full Text Available Survival at high altitude is very challenging and in spite of adequate training and acclimatization, injuries are frequent. The fate of mountaineers and soldiers at such areas largely depends on the mercy of the climate. An avalanche causes physical trauma, cold injury and asphyxia to the victim. The patient in our report had diffuse cerebral edema, bilateral pulmonary consolidation and pneumothorax. In spite of the best efforts the victim succumbed to the injuries. There are many incidents of high altitude accidents in India. This case report is of a soldier deployed at the high altitude, is a lone ever reported survivor above 5000 meters, under 35 feet snow and below - 45°C for greater than 5 days of exposure to an avalanche

  4. 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...

  5. A successful mountain rescue operation in Yushu Earthquake%A successful mountain rescue operation in Yushu Earthquake

    Institute of Scientific and Technical Information of China (English)

    Wu Tianyi; Li Suzhi; Hou Shike; Ouzhu Luobu

    2012-01-01

    On April 14, 2010, an earthquake reaching 7.1 Richter scale struck Jiegu Town of Yushu. More than 2 698 people were confirmed dead, and 12 135 were injured, of which 1 434 were severely injured. Rescue operation was carried out soon after the disaster; however, the rescue teams face great challenges of altitude hypoxia, freezing temperature and very bad weather. Thus, 1 434 severe injuries were rapidly transported airlifted to hospitals in Xining and neighboring provinces for effective treatment. The extremity trauma (49.9 % ) was the most common patteru of injuries. Asphyxia (40.8 % ) was by far the most important reason for death. A high incidence of acute altitude illness in the lowland rescuers was a special medical problem during the highest earthquake in Yushu. We have learned more lessons from Yushu Earthquake.

  6. 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.

  7. 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

  8. Hearing screenings on children under three years at risk of hearing impairment.

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    Marcelino Lizano Rabelo

    2011-09-01

    Full Text Available This article presents the results of newborn hearing screenings on infants under three years at risk of hearing impairment at Paediatric Hospital of Sancti Spíritus¸on from 2008 to 2010. All children at risk of hearing impairment were tested by an auditory brainstem response (ABR for the positive diagnosis of hearing impairment. Results: Over the period, 398 infants were screened, among whom 36 (8,98% were diagnosed as deaf or hard of hearing. twenty seven children (6,8% had a sensorineural hearing impairment, The most important risk factors for sensorineural hearing loss were: severe birth asphyxia; mechanic ventilation, and antibiotics.Conclusion: Our hearing screening on infants at risk allowed 36 children diagnosed as hearing impairment, all of then received early management.

  9. Brain magnetic resonance imaging of infants exposed prenatally to buprenorphine

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    Kahila, H.; Kivitie-Kallio, S.; Halmesmaki, E.; Valanne, L.; Autti, T. [Dept. of Obstetrics and Gynecology, Dept. of Pediatrics, and Helsinki Medical Imaging Center, Helsinki Univ. Central Hospital (Finland)

    2007-02-15

    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.

  10. 新生儿消化道出血的相关因素临床分析%ClinicalAnalysisofItsCorrelativeFactorsaboutNeonatalGastrointestinalHemorrhage

    Institute of Scientific and Technical Information of China (English)

    王清海; 黄志锋; 梁世山; 黄海云

    2013-01-01

    Objective To investigate the neonatal gastrointestinal hemorrhage clinical related factors, prevention and treatment. Methods 57 cases of neonatal gastrointestinal hemorrhage were retrospectively reviewed the clinical data analysis. Results Prematurity, low birth weight and perinatal asphyxia in children with digestive tract hemorrhage was signiifcantly higher than that of normal full-term infants, birth weight and perinatal asphyxia infants (P<0.01), the other in neonatal hypoxic ischemic encephalopathy, neonatal necrotizing enterocolitis and bleeding risk factors, such as allergic enteritis infection factors can not be ignored. Conclusion Good perinatal health care, active treatment of the original diseases can decrease neonatal gastrointestinal hemorrhage.%  目的探讨新生儿消化道出血的临床相关因素、预防和治疗。方法对57例新生儿消化道出血的临床资料进行回顾性分析。结果早产、低出生体质量及围生期窒息是患儿消化道出血发生率明显高于足月儿、正常出生体质量儿及无围生期窒息史儿(P<0.01),其他新生儿缺氧缺血性脑病、新生儿坏死性小肠结肠炎也是出血高发因素,过敏性肠病发病率呈增加趋势不容忽视。结论新生儿消化道出血是新生儿期常见急症,做好围生期保健、积极治疗原发病可明显减少新生儿消化道出血的发生率。

  11. Negative Modulation of NO for Diaphragmatic Contractile Reduction Induced by Sepsis and Restraint Position

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    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.

  12. Risk factors for patent ductus arteriosus in preterm neonates

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    Novia Bernati

    2014-05-01

    Full Text Available Background The reported prevalences of patent ductus arteriosus (PDA in preterm neonates vary, and are currently unknown in Palembang. Birth weight, gestational age, asphyxia, history of antenatal steroid use, hyaline membrane disease (HMD, race and ethnicity, are potential risk factors for PDA. Objective To determine the prevalence of PDA and its risk factors in preterm neonates at Mmohammad Hoesin Hospital, Palembang. Methods This cross-sectional study was conducted from October 2011 to April 2012. Echocardiographic examinations were performed on 242 preterm neonates aged 15 hours to 7 days. Data was taken from medical records and interviews, and analyzed by Chi square and logistic regression analyses. Results Patent ductus arteriosus was found in 142 (58.7% preterm neonates with a prevalence ratio of 1.43. Neonates with birthweight ≤2,000 grams tended to have 1.9 (95% CI 1.17 to 3.32 times higher risk for PDA (P=0.01. Neonates ≤30 weeks gestation were also at 1.9 times higher risk for PDA (P=0.16. Probabilities for PDA occurrence in neonates with asphyxia, without antenatal corticosteroids and HMD were 1.6 (95% CI 1.13 to 3.36 times, 1.3 (95%CI 0.73 to 2.50 times and 2.2 (95%CI 1.29 to 3.72 times higher risk for PDA, respectively (P=0.22, 0.41, and 0.005, respectively. Conclusion Birth weight and HMD are statistically significant risk factors of PDA, but the more significant one is HMD.

  13. A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy.

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    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.

  14. 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.

  15. 妊娠期糖尿病母亲新生儿早期并发症的临床观察%Clinical observation on early complications of neonates born by women with gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    秦义倩; 刘莉; 周信英; 何国芳

    2013-01-01

    目的:探讨母亲妊娠期糖尿病对早期新生儿的影响.方法:对50例糖尿病母亲婴儿的临床资料进行回顾性分析,并与健康孕妇的新生儿进行对比.结果:糖尿病母亲婴儿低血糖、高胆红素血症、窒息、出生体重异常的发病率均明显高于对照组(P<0.05).结论:母亲妊娠期糖尿病为新生儿高危因素,新生儿低血糖、高胆红素血症、窒息、出生体重异常的发病率不低,值得临床关注.%Objective: To explore the effect of maternal gestational diabetes mellitus (GDM) on early neonates. Methods: The clinical data of 50 infants born by GDM women were analyzed retrospectively, then the results were compared with clinical data of 50 neonates with healthy women. Results: The incidences of hypoglycemia, hyperbilirubinemia, asphyxia, and abnormal birth weight of infants born by GDM women were statistically significantly higher than those in control group (P <0. 05) . Conclusion: Maternal GDM is one of high risk factors of neonates, the incidences of neonatal hypoglycemia, hyperbilirubinemia, asphyxia, and abnormal birth weight are high, which need more clinical attention.

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

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    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

  17. 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

  18. Incidence of acute kidney injury in the neonatal intensive care unit.

    Science.gov (United States)

    Youssef, Doaa; Abd-Elrahman, Hadeel; Shehab, Mohamed M; Abd-Elrheem, Mohamed

    2015-01-01

    The aim of this work is to study the incidence of acute kidney injury (AKI) in neonates admitted to the neonatal intensive care unit (NICU) over a six-month period from September 2011 to March 2012. This prospective study was performed on 250 neonates admitted to the NICU at the Children's Hospital, Faculty of Medicine, Zagazig University. All neonates were subjected to detailed history taking, including pre-natal, natal and post-natal history, with stress on symptoms suggestive of AKI. All neonates were examined thoroughly and the following investigations were performed: Blood urea nitrogen (BUN), serum creatinine, sodium, potassium, calcium, complete blood count, C-reactive protein, arterial blood gases, urine sodium and urine creatinine. AKI was diagnosed in 27 cases (10.8%), including 12 females and 15 males. 40.7% of the AKI cases were born after full-term pregnancy while 59.3% were pre-term babies. 29.6% of the AKI cases had oliguria, and there was male sex predominance, with a male-female ratio of 1.3:1. The cause of AKI was pre-renal in 96.3% and intrinsic renal in 3.7% of the cases. The predisposing factors for AKI were sepsis in 63% of the cases, respiratory distress syndrome in 55.6%, mechanical ventilation in 51.9%, peri-natal asphyxia in 18.5%, dehydration in 14.8%, surgical operation in 11.1%, congenital heart disease in 7.4%, sub-galeal hematoma in 3.7%, polycythemia in 3.7% and intra-ventricular hemorrhage in 3.7% of the cases. Our data suggest that pre-renal failure was the most common form of AKI in our patients. Early recognition of risk factors such as sepsis, peri-natal asphyxia or peri-operative problems and rapid effective treatment of contributing conditions will reduce the incidence of AKI in the neonatal period.

  19. 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.

  20. 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

  1. 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.

  2. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

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    de Haan Timo R

    2012-05-01

    Full Text Available Abstract Background In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage necessitating newborn resuscitation occurs in at least 200 of the 180–185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome with therapeutic hypothermia. During hypothermia neonates receive sedative, analgesic, anti-epileptic and antibiotic drugs. So far little information is available how the pharmacokinetics (PK and pharmacodynamics (PD of these drugs are influenced by post resuscitation multi organ failure and the metabolic effects of the cooling treatment itself. As a result, evidence based dosing guidelines are lacking. This multicenter observational cohort study was designed to answer the question how hypothermia influences the distribution, metabolism and elimination of commonly used drugs in neonatal intensive care. Methods/Design Multicenter cohort study. All term neonates treated with hypothermia for Hypoxic Ischemic Encephalopathy (HIE resulting from perinatal asphyxia in all ten Dutch Neonatal Intensive Care Units (NICUs will be eligible for this study. During hypothermia and rewarming blood samples will be taken from indwelling catheters to investigate blood concentrations of several antibiotics, analgesics, sedatives and anti-epileptic drugs. For each individual drug the population PK will be characterized using Nonlinear Mixed Effects Modelling (NONMEM. It will be investigated how clearance and volume of distribution are influenced by hypothermia also taking maturation of neonate into account. Similarly, integrated PK-PD models will be developed relating the time course of drug concentration to pharmacodynamic parameters such as successful seizure treatment; pain assessment and infection clearance. Discussion On basis of the derived population PK-PD models dosing guidelines will be developed for the application of drugs during neonatal hypothermia treatment. The

  3. 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.

  4. 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.

  5. The ontogeny of hemodynamic responses to prolonged umbilical cord occlusion in fetal sheep.

    Science.gov (United States)

    Wassink, Guido; Bennet, Laura; Booth, Lindsea C; Jensen, Ellen C; Wibbens, Bert; Dean, Justin M; Gunn, Alistair Jan

    2007-10-01

    There is evidence that preterm fetuses have blunted chemoreflex-mediated responses to hypoxia. However, the preterm fetus has much lower aerobic requirements than at term, and so moderate hypoxia may not be sufficient to elicit maximal chemoreflex responses; there are only limited quantitative data on the ontogeny of chemoreflex and hemodynamic responses to severe asphyxia. Chronically instrumented fetal sheep at 0.6 (n = 12), 0.7 (n = 12), and 0.85 (n = 8) of gestational age (GA; term = 147 days) were exposed to 30, 25, or 15 min of complete umbilical cord occlusion, respectively. At all ages, occlusion was associated with early onset of bradycardia, profoundly reduced femoral blood flow and conductance, and hypertension. The 0.6-GA fetuses showed a significantly slower and lesser fall in femoral blood flow and conductance compared with the 0.85-GA group, with a correspondingly reduced relative rise in mean arterial blood pressure. As occlusion continued, the initial adaptation was followed by loss of peripheral vasoconstriction and progressive development of hypotension in all groups. The 0.85-GA fetuses showed significantly more sustained reduction in femoral conductance but also more rapid onset of hypotension than either of the younger groups. Electroencephalographic (EEG) activity was suppressed during occlusion in all groups, but the degree of suppression was less at 0.6 GA than at term. In conclusion, the near-midgestation fetus shows attenuated initial (chemoreflex) peripheral vasomotor responses to severe asphyxia compared with more mature fetuses but more sustained hemodynamic adaptation and reduced suppression of EEG activity during continued occlusion of the umbilical cord.

  6. STUDY OF THE MORBIDITY PATTERN IN THE SPECIAL NEW BORN CARE UNIT (SNCU AT A TERTIARY CARE TEACHING HOSPITAL IN KURNOOL DISTRICT , ANDHRA PRADESH, INDIA

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    Sardar Sulthana

    2015-06-01

    Full Text Available OBJECTIVE: To Study the Morbidity Pattern in NICU at a Tertiary Care teaching Hospital Kurnool medical college Kurnool. METHODS: Retrospective study of medical records during the period of July 2014 to Dec. 2014 of all neonates who were admitted to the SNCU were reviewed Data regarding the place of birth , gestational age , birth weight and diagnosis were recorded. SETTINGS: SNCU of Tertiary Care teaching Hospital located in Kurnool District of Andhra Pradesh. Study carried out over 6 months – during July 2014 to Dec. 2014. PARTICIPANTS: Study sampl e 1418 neonates . With some illness who were admitted to NICU. OUTCOME: Study of Pattern of Morbidity among neonates admitted in SNCU during 6 months period. RESULTS: A total of 1418 babies in SNCU were included for data analysis excluding babies who left t he hospital against medical advice. Ratio of inborn ( 28.91 % and out born ( 71.09% neonates was 0.41%. Majority of admissions constitute Term ( 54.8% followed by preterm 25.79% followed by IUGR 19.46%. Major causes of Morbidity were birth Asphyxia with HIE ( 32.07% , pre maturity 25.74%. IUGR ( 23.98% Sepsis ( 23.41% followed by , HMD in premature ( 11.92% . The most common cause of referral from outside were birth Asphyxia with HIE ( 29.76% Neonatal sepsis ( 25.5% , prematurity with RDS ( 11.51% , IUGR ( 7.74% . CONCLUSION: Study identified HIE prematurity ( 25.74% IUGR ( 23.98% Sepsis ( 23.41% as the major cause of morbidity. Adequate antenatal care to the at risk mothers and advances in the neonatal intensive care will improve the neonatal outcome .

  7. Clinical Observation of Epidural Analgesia for Labor Pain%硬膜外阻滞麻醉用于无痛分娩的临床观察

    Institute of Scientific and Technical Information of China (English)

    李仁兰; 周玮

    2012-01-01

      目的探讨分娩镇痛的效果及对产程、母婴的影响.方法采用PECA泵硬膜外腔给药用于分娩镇痛,观察产程时间、分娩方式、产后出血、胎儿宫内窘迫及新生儿窒息情况.结果观察组和对照组产程比较、两组分娩方式比较有显著性差异(P0.05).结论 PECA泵用于持续硬膜外腔给药镇痛,疼痛阻滞完善,加速了产程的进展,降低了剖宫产率阴道难产率,对母婴均无不良影响.%  Objective To study the pain relief effectiveness and its influence on the labor course, and both the mothers and the newborns. Methods The pump of PECA (patient controlled epidural analgesia) was used during labor in the study group. The labor course, the methods of delivery, the incidence of post partum hemorrhage, fetal distress and neonatal asphyxia were observed respectively in the groups. Results There were significant differences between both groups in the stage of labor and delivery modes. There were no significant differences in the incidences of post partum hemorrhage, fetal distress and neonatal asphyxia(P>0.05).Conclusion The pump of PECA during labor is safe and effective, which accelerates course of labor and reduce the rates of cesarean and dystocia.

  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. A 12-month prospective survey of perinatal outcome of liveborn neonates in Julu County, China

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    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.

  10. PREVALENCE AND OUTCOME OF THE MACROSOMIC INFANTS

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    F. Haji Ebrahim Tehrani

    2007-09-01

    Full Text Available The birth weight is one of the important factors affecting the perinatal morbidity and mortality. Fetal macrosomia is associated with increased risks of cesarean section and trauma. To determine prevalence and outcome of the macrosomic infants, this case-control, prospective study is performed in the two university hospitals in Tehran during a 36- month period between 2002 through 2004. 1000 neonates with birth weight of at least 4000g (<90th centile constituted the case group. Another 2000 Cases amongst the newborns delivered in the same period between 2500 and 3999g (10th-90th centile formed the control group. A total of 17236 deliveries occurred during the study period. The prevalence of macrosomic deliveries was 5.8 and prevalence of the deliveries (>4500g or heavier was 0.84%. The mean birth weight of study group was 4254215 and 3245310g of control group (P<0.001.While the cesarean section rate was 35.2% for study group and it was 18.5% for the control group (P<0.001 in the study group. 16 cases of clavicular fracture (1.6%, 13 cases of brachial plexus palsy (1.3%, (p<0.001. No perinatal mortality was recorded in two groups. There were 12 cases (1.2% of asphyxia related to delivery in the study group (p<0.01. The rate of maternal complication, were significantly higher in the study group (p<0.01. The macrosomic infants are in increased risk for birth trauma and asphyxia. The risk of birth trauma for the infants weighing 4500g or more is even greater. The majority of factors which lead to the delivery of macrosomic infants are preventable.

  11. The Mortality Cause Analysis of 57 Neonates and Preventive Measures%57例新生儿死亡原因分析及其相关的预防措施

    Institute of Scientific and Technical Information of China (English)

    王瑞明; 陈为; 黄娟秀

    2015-01-01

    目的:对新生儿的常见死亡原因进行分析,得出新生儿死亡原因相关的影响因素,提出相对应的预防措施,以降低新生儿的病死率。方法对2006-2010年台江区儿童死亡报告卡资料进行回顾性分析。结果新生儿病死率5.28译,早产或者出生时体重低、窒息、先天性畸形以及感染是新生儿死亡的主要原因。结论加强孕期保健和产前检查,防止早产及窒息,同时防治感染是降低新生儿的发病率和死亡率的有效措施。%Objective To analysis the common mortality causes of neonate, then obtain the correlative influential factors of mortality causes, and put forward prevention measures to reduce mortality. Methods Retrospective analysis from 2006 to 2010 the Death Report Card for Children in Taijiang. Results The neonatal mortality was 5.28‰.Premature or low birth weight, asphyxia, congenital malformation and sepsis were the main death causes of neonate. Conclusions To enforce pre-natal care and examination, prevent premature and asphyxia ,and prevent infection are effective measures for reducing the neonate incidence and mortality.

  12. 住院新生儿1395例疾病种类及死亡原因分析

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    周玉

    2013-01-01

    Objective: To analyze and discuss our hospital 1395 cases of neonatal diseases and causes of death. Methods: Statistical analysis of 1395 hospitalized neonates were the main diseases and causes of death. Results: The respiratory system disease, nervous system disease and jaundice has become in the three main diseases in neonatal period, the prevalence of respiratory diseases; respiratory distress syndrome in premature infants, asphyxia and neonatal pulmonary hemorrhage is the main disease of neonatal death. Conclusion: congenital defect is the main cause of neonatal death, premature mortality is very high; asphyxia and neonatal hypoxic ischemic encephalopathy is a major cause of death in ful-term neonates.%  目的:对我院住院新生儿1395例的疾病种类和死亡原因进行分析和探讨。方法:对1395例住院新生儿的主要疾病种类和死亡原因进行统计学分析。结果:呼吸系统疾病、神经系统疾病和黄疸成为人在新生儿时期的三种主要病种,其中呼吸系统疾病的患病率最高;早产儿呼吸窘迫综合征、窒息及新生儿肺出血是新生儿致死的最主要疾病。结论:先天缺陷是造成新生儿死亡的主要原因,早产儿的致死率很高;窒息和新生儿缺血缺氧性脑病是足月新生儿的主要致死原因。

  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. Violent death in a rare peroxisomal disease--Zellweger syndrome.

    Science.gov (United States)

    Malinescu, Bogdan; Martius, Eliza; Pelin, Ana Maria

    2015-10-01

    Peroxisomal diseases are rare (1:50,000), genetically determined disorders (autosomal recessive), systemic, multiorgan illnesses with prominent involvement of the nervous system, caused either by the failure to form or to maintain the peroxisome, or by a defect in the function of a single or multiple peroxisomal enzymes. Peroxisomes contain approximately 50 enzymes which are responsible for many metabolic reactions, and play an important role in the oxidation of saturated very-long-chain fatty acids (VLCFA). The authors present the case of a Romanian boy, who died at the age of 1.6 of one of the peroxisomal diseases-Zellweger syndrome. Newborn infants with Zellweger syndrome have a typical dysmorphic facies, neonatal seizures, profound hypotonia, and eye abnormalities. Major abnormalities are present in the liver (fibrotic), kidney (cortical cysts), and brain (lipid-laden macrophages and histiocytes in cortical and periventricular areas, demyelination, centrosylvian polymicrogyria and pachygyria)-cerebro-hepato-renal syndrome (CHRS) (Zellweger). Infants with Zellweger syndrome rarely live more than a few months, but in this case the survival was longer, and the cause of death was not directly the peroxisomal disease but a violent cause of death-mechanical asphyxia with tracheo-bronchial food aspiration. The authors present the results of investigations carried out during the child's life, but also data collected at the autopsy and hystopathological postnecroptic investigations. By presenting this case, the authors wish to bring to your attention a rare pathology in forensic practice by the paradox of finding a common violent cause of death, asphyxia with food aspiration, in a rare metabolic-genetic disease, which is usually fatal by itself.

  15. 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。

  16. 吸毒孕妇所生新生儿临床结局分析%Clinical outcome analysis of newborn in pregnant women with drug abuse

    Institute of Scientific and Technical Information of China (English)

    张莉; 镇祥繁; 李丹; 胡小燕

    2016-01-01

    Objective To observe the pregnancy outcome of perinatal in drugs abuse pregnant women.Methods The clinical data of 105 cases of newborn in pregnant women with drug abuse were analyzed retrospectively,including premature,neonatal asphyxia,low birth weight,neonatal respiratory distress syndrome (NRDS),intracranial hemorrhage,neonatal congenital malformation and death.Fifty cases of newborn of healthy pregnant women were selected as control group.The occurrence of neonatal withdrawal syndrome was observed.Results There were 80 cases of natural labor,25 cases of cesarean section in 105 cases of pregnant women with drug abuse.Among them,56 cases (53.3 %) of premature delivery,the average birth weight was(2 534 ± 1 234) g,25 cases(23.8%) of neonatal asphyxia,18 cases(17.1%) of neonatal respiratory distress syndrome (NRDS),16 cases (15.2 %) of intracranial hemorrhage,and 3 cases (2.9 %) of congenital malformation.The gestational age and weight of newborn with maternal drug abusing were significantly lower than those of the control group,the incidence of premature infants,low birth weight infants,neonatal asphyxia,NRDS and intracranial hemorrhage were higher than those of the control group,and the differences were significant (P < 0.05).Compared with drug abuse less than 2 years,the proportion of preterm infants,low birth weight,neonatal asphyxia and NRDS were higher than those of drug abuse more than 2 years(P <0.05).The proportion of preterm infants,low birth weight,neonatal asphyxia and NRDS of intravenous drug users were higher than those of oral drug users,the differences were significant (P < 0.05).The red blood cellcount,aspartate amino transferase,white blood cellcount and alanine aminotransferase in the drug abusing group were higher than those in the control group,platelet and albumin were lower than those in the control group (P <0.05).A total of 30 neonates had the manifestations of neonatal withdrawal syndrome.In 105 cases of newborns,99

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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

  3. Degree of Severity on Intellectual Diasbility of Children with Mental Retardation and Its Related Factors%精神发育迟滞患儿的智力障碍程度及其相关因素分析

    Institute of Scientific and Technical Information of China (English)

    陈建民; 黄恩; 李美园

    2009-01-01

    目的 探讨精神发育迟滞患儿的智力障碍程度及其相关因素.方法 在对185例参加计划生育精神医学鉴定的精神发育迟滞患儿开展临床调查的基础上,以智商为因变量,以年龄、热性惊厥史、窒息史、胎次、生产过程、孕期用药史、CT检查结果、脑电图检查结果、中枢神经系统疾病史为自变量进行多元逐步回归分析,探讨各因素对精神发育迟滞患儿智商的影响.结果 185例精神发育迟滞患儿中,轻度精神发育迟滞49例,中度120例,重度16例.韦氏儿童智力量表(C-WISC)测评显示患儿智商为28~69,平均(47.6±11.6).对智商影响有意义的因素依次为脑电图检查结果、中枢神经系统疾病史及窒息史.结论 脑电图检查结果、中枢神经系统疾病及窒息史与儿童智商相关,必须重视孕期、围生期保健及避免中枢神经系统疾病的发生.%Objective To investigate the dysnoesia in mental retardation(MR) children and its related factors.Methods A multiple stepwise regression analysis was performed on IQ (dependent variable),and on age,history of febrile convulsion and asphyxia,parity,production precess,history of drug use during pregnancy,CT and EEG findings,central nervous system disease history(independent variable),to explore the impacts of various factors on IQ in 185 MR children.Results Mild MR was found in 49,moderate in 120 and severe in 16.Wechsler intelligence scale for Children(C-WISC) showed that the IQ of these children were 28~69,averaging (47.6±11.6).The factors having meaningful impact on IQ were EEG findings,the history of central nervous system disease and asphyxia.Conclusion EEG findings,history of central nervous system diseases and asphyxia are associated with children′s IQ.Attention must be paid to health care during pregnancy and perinatal period to avoid central nervous system diseases.

  4. The effect of LMWH on Oligohydramnios at mid and late trimester of pregnancy%低分子肝素在妊娠中晚期羊水过少治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    刘珮瑜

    2012-01-01

    目的 观察低分子肝素用于妊娠中晚期羊水过少的治疗效果.方法 90例妊娠中晚期羊水过少患者随机分为两组,均每天静脉滴注复方氨基酸500 ml,5%葡萄糖注射液500 ml,分次饮水(汤、牛奶、水等)共1000 ml,每天左侧卧位休息不少于10 h,10d为1疗程.观察组加用低分子肝素(法安明)5000 U每天皮下注射1次.治疗后复查羊水指数,比较两组分娩方式、新生儿出生体质量、新生儿窒息、产后出血量等情况.结果 治疗后观察组羊水指数、新生儿出生体质量明显高于对照组,剖宫产率、新生儿轻度窒息明显低于对照组(均P<0.05).两组新生儿重度窒息、病死率及产妇产后出血量差异均无统计学意义(均P>0.05).结论 低分子肝素在妊娠中晚期羊水过少的治疗中可以显著增加羊水量、增加胎儿体质量,改善妊娠结局,且不增加出血风险,使用安全.%Objective To detect the effect of LMWH on Oligohydramnios at mid and late trimester of pregnancy.Methods Patients were divided into two groups.Control group was given Compound amino acids 500ml,5%glucose solution 500ml by intravenous infusion and water 1000ml per oral per day,and rest in bed with left lateral position for 10 days.Test group was given the same treatments as control group,plus Flagmin 5000U by subcutaneous injection per day.Amniotic fluid index was retest after treatment.Delivery mode,newborn birth weight,neonatal asphyxia and amount of postpartum hemorrhage were compared between two groups.Results Amniotic fluid index and newborn birth weight of test group was significantly higher than control group( P < 0.05).Cesarean section rate,mild neonatal asphyxia rate was significantly lower than control group( P < 0.05).Severe neonatal asphyxia rate and amount of postpartum hemorrhage had no significant differences (all P>0.05).Conclusion LMWH treatment could increase amniotic fluid volume and newborn birth weight on

  5. 妊娠合并乙型肝炎对产妇和新生儿的影响分析%Analysis of the Impact of Pregnancy with Hepatitis B on Parturients and Newborns

    Institute of Scientific and Technical Information of China (English)

    王芳; 牛兆仪; 靳晴; 初正敏; 沈冉; 孟海云

    2014-01-01

    Objective To investigate and analyze the impact of pregnancy with hepatitis B on parturients and newborns. Methods 126 pregnant women with hepatitis B admitted in our hospital from January 2009 to June 2014 were randomly selected as the study group, and 40 pregnant women without hepatitis B infection delivered in our hospital during the same period were selected as the control group. The maternal hospitalization days, postpartum hemorrhage, preterm birth, intrauterine distress, infant of low-birth weight, neonatal asphyxia were compared and analyzed between the two groups retrospectively. Results The hospitalization days and the number of patients with postpartum hemorrhage in the study group were much more than those in the control group, the difference was statistically significant (P<0.05). Of the newborns in the study group, there were 40 cases of premature birth, 51 cases of intrauterine distress, 4 infants of low-birth weight, 62 cases of neonatal asphyxia, 64 cases with HBV infection; of the newborns in the control group, there were 4 cases of premature birth, 2 cases of intrauterine distress, 1 infant of low-birth weight, 5 cases of neonatal asphyxia, 0 case with HBV infection, the difference was statistically significant (P<0.05). Conclusion Pregnan-cy with hepatitis B has effects of different degrees on parturients and newborns, so the treatment is needed to be strengthened.%目的:探讨分析妊娠合并乙型肝炎对产妇和新生儿的影响。方法随机抽取2009年1月-2014年6月间在该院收治的妊娠合并乙型肝炎患者126例,设为研究组,再随机抽取同期到我院进行分娩的无乙型肝炎病毒感染的孕妇40例设为对照组,比较两组患者的产妇住院天数﹑产后出血﹑早产﹑宫内窘迫﹑低体重儿﹑新生儿窒息情况,进行回顾性对比分析。结果研究组产妇的住院天数和产后出血显著高于对照组,差异有统计学意义(P<0.05)。研究组中新生儿早产的有40

  6. 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

  7. 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。

  8. The trace elements as indicators of prognosis for gestational mellitus at early pregnancy%妊娠期糖尿病孕早期微量元素检测对预后的指导作用

    Institute of Scientific and Technical Information of China (English)

    李秀琴; 孙影; 景蓉; 薛欢

    2016-01-01

    huge children, postpartum hemorrhage and newborn asphyxia in the treatment group were significantly higher than those in the control group ( P<0. 05) . In the observation group, linear corre-lation analysis showed that the huge children, postpartum hemorrhage and newborn asphyxia were correlated to the serum copper, zinc, calcium, magnesium, and iron levels ( P<0. 05) . Conclusion Gestational diabetes mellitus is showed decreased serum trace elements, the lack rates are higher, and the rates of huge children, increased postpartum hemorrhage and newborn asphyxia are in-creased. The detection of serum trace elements for gestation diabetes mellitus at early pregnancy has guidance for prognosis.

  9. 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

  10. 拉玛泽减痛分娩法联合可行走式腰硬麻醉在分娩镇痛中的临床观察%Clinical observation of Lamaze childbirth method of pain relief plus combined spinal and epidural ambulatory anesthesia in labor analgesia

    Institute of Scientific and Technical Information of China (English)

    李利波; 刘明; 梁丽芬

    2014-01-01

    目的:研究拉玛泽减痛分娩法联合可行走式腰硬联合麻醉的镇痛效果及其对母儿的影响。方法选择初产妇300例,随机分为实验组(拉玛泽联合可行走式腰硬联合麻醉组)、对照组(可行走式腰硬联合麻醉组)各150例,对两组产妇的疼痛程度、总产程时间、产后2h出血量、钳产率及新生儿窒息率等指标进行比较。结果实验组产妇分娩时的疼痛较对照组减轻,总产程时间缩短,产后2h出血量减少,钳产率和新生儿窒息率降低,差异有统计学意义(P<0.05)。结论拉玛泽减痛分娩法联合可行走式腰硬联合麻醉能够有效减轻分娩疼痛,缩短产程,减少产后出血,降低钳产率和新生儿窒息率,值得临床应用推广。%Objective To explore the analgesic effect of Lamaze childbirth method of pain relief plus combined spinal and epidural ambulatory anesthesia and its effect on mother and child. Methods 300 primiparas were selected and randomly allocated to an experimental group (Lamaze childbirth method plus combined spinal and epidural ambulatory anesthesia group) and a control group (combined spinal and epidural ambulatory anesthesia group), with 150 in each group. Indices such as pain degree, total stage of labor, amount of bleeding 2 hours after delivery, rate of forceps delivery and rate of neonatal asphyxia were compared between the two groups. Results Pain in the experimental group was milder than that in the control group during labor, total stage of labor was shorter, the amount of bleeding 2 hours after delivery was smaller, and rates of forceps delivery and neonatal asphyxia were lower than those in the control group. The differences were statistically significant (P<0.05). Conclusion Lamaze childbirth method of pain relief plus combined spinal and epidural ambulatory anesthesia helps effectively reduce labor pain, shorten the stage of labor, lower the amount of postpartum bleeding

  11. Influence of Nursing Intervention and Pain on the Childbirth Process%分娩过程中心理干预及疼痛护理对产程进展的影响

    Institute of Scientific and Technical Information of China (English)

    张秀欣; 王红霞

    2015-01-01

    目的:探析分娩过程中心理干预及疼痛护理对产程进展的影响。方法:选取本院2013年1月-2014年1月收治的84例临产妇,均为产道正常、头位、单胎、足月初产妇。按照随机数字表法分为观察组、对照组,每组42例。观察组进行个体化心理护理及疼痛护理,对照组进行定期听诊胎心、产前会阴备皮、生命体征的监测、产程监护、无菌操作等常规护理,比较两组的产时疼痛、分娩方式、新生儿窒息、产程时间等情况。结果:观察组的产时疼痛程度显著低于对照组,差异有统计学意义(P<0.05);观察组的潜伏期,活跃期,第一、二、三产程时间显著低于对照组,差异有统计学意义(P<0.05);观察组剖宫产、产钳助产、新生儿窒息情况显著低于对照组,差异有统计学意义(P<0.05)。结论:对临产妇进行心理干预及疼痛护理,可有效缩短产程,降低新生儿窒息率及剖宫产率,临床效果确切,值得临床推广。%Objective:To explore the impact of the process of delivery center nursing intervention and pain on the birth process. Method:84 cases of parturient were selected in our hospital from January 2013 to January 2014,whose the birth canal were normal,head position,singleton,term primiparae.They were randomly divided into observation group, control group,42 cases in each group.The observation group of individualized psychological nursing and nursing of pain, the control group were regularly auscultation of fetal heart,prenatal perineal skin preparation,vital sign monitoring, process monitoring,sterile operation routine nursing care,pain,mode of delivery,neonatal asphyxia,labor and time between two groups at birth.Result:The group of intrapartum pain was significantly lower than the control group,the difference was statistically significant(P<0.05).Observation group incubation period,active period,the first and the two or three

  12. Analysis of risk factors in children with cerebral palsy%50例脑性瘫痪患儿高危因素分析

    Institute of Scientific and Technical Information of China (English)

    王春丽; 龙旭浩

    2016-01-01

    目的:分析小儿脑性瘫痪(简称脑瘫)相关高危因素,为预防该病提供参考。方法2013年10月至2015年3月辽宁中医药大学附属医院儿科康复中心收治50例脑瘫患儿,为观察组。同期选择100例非脑瘫患儿和健康儿童进行1∶2匹配,为对照组。通过查阅住院病历及询问儿童父母完成问卷调查。调查项目包括妊娠高血压、多胎、早期破水、早产、低体质量、新生儿窒息、颅内出血。数据采用 Logistic 回归分析。结果单因素分析显示,早产、低体质量、多胎、病理性黄疸、新生儿窒息、羊水早破、缺氧缺血性脑病、感染8项指标是发生小儿脑瘫的危险因素,差异有统计学意义(P <0.05);多因素分析显示,早产、低体质量、病理性黄疸、新生儿窒息、多胎为小儿脑瘫发病的主要危险因素。结论小儿脑瘫病因复杂,做好围产期和分娩期的保健工作是重中之重。%Objective To analyze the relevant risk factors of cerebral palsy(CP)and provide a refer-ence for the prevention of the disease.Methods The 50 children with cerebral palsy hospitalized in Pediatric Rehabilitation Center from October 2013 to March 201 5 were studied as observation group.The 100 healthy children were selected as control group.A 1 ∶ 2 matched case-control study was conducted.Complete the questionnaire by consulting the medical records of the hospital and inquiring the parents of the children.The survey items included pregnancy-induced hypertension,multifetus,premature rupture of the amniotic fluid, premature birth,low weight at birth,neonatal asphyxia and intracranial hemorrhage(ICH).All data were an-alyzed with Logistic regression.Results One-way analysis showed that premature birth,low weight at birth,multifetus,pathological jaundice,neonatal asphyxia,premature rupture of the amniotic fluid,hypoxic-ischemic encephalopathy and infection were risk factors for cerebral palsy in children

  13. Expectant Management of Early Onset Severe Preeclampsia:A Clinical Study%早发型重度子痫前期期待治疗的临床探讨

    Institute of Scientific and Technical Information of China (English)

    钟琳琳; 唐卉; 陈悦

    2014-01-01

    目的:探讨早发型重度子痫前期期待治疗的适宜时间。方法86例早发型重度子痫前期患者,根据其发病孕龄不同分成3组,A 组25例(发病孕龄<28周),B 组33例(发病孕龄为28~31+6周),C 组28例(发病孕龄为32~34周)。比较3组患者并发症的发生率、围产儿死亡率、新生儿窒息率及期待治疗时间等。结果3组患者并发症的发生率比较,差异无统计学意义(P >0.05);3组围产儿死亡率及新生儿窒息率比较,差异有统计学意义(P <0.05),C 组<B 组<A 组(P <0.05)。 B 组期待治疗时间明显长于其他两组(P <0.05)。结论孕28周前发病的患者,采取期待治疗时应慎重考虑;孕28~31+6周发病患者,可以在严密监测下积极期待治疗,适当延长孕周,改善围产儿结局。%Objective To investigate the appropriate time for expectant management of early onset severe preeclampsia. Methods Eighty-six patients with early onset severe pre -eclampsia were assigned to three groups according to their onset gestation age:Group A with 25 patients(gestation age less than 28 weeks),group B with 33 patients (gestation age equivalent to or more than 28 weeks,but less than 32 weeks),and group C with 28 patients(gestation age equivalent to or more than 32 weeks,but less than 34 weeks).The incidence of complications,perinatal mortality,incidence of neonatal asphyxia and expectant management time were compared among three groups.Results No statistically significant differences were found in the incidence of complications among three groups(P >0.05).There were significant differences in the perinatal mortality and incidence of neonatal asphyxia among three groups(P <0.05),the perinatal mortality and incidence of neonatal asphyxia in group C were the lowest while in group A were the highest(P <0.05).The expectant management time in group B was significantly longer than that in other

  14. Clinical analysis of 148 cases of painless labor%无痛分娩148例临床分析

    Institute of Scientific and Technical Information of China (English)

    郑燕; 任玲玲; 张明明; 陈香; 王兆杰; 杨利娟

    2012-01-01

    目的 探讨腰硬联合麻醉(CSEA)用于分娩镇痛对产程、分娩方式、产后出血发生率和新生儿窒息发生率的影响.方法 选择单胎头位足月临产孕妇,行低浓度布比卡因+甲磺酸罗哌卡因+芬太尼腰硬联合麻醉镇痛148例,与同期未使用镇痛药物单胎头位足月临产孕妇115例进行对比,观察其镇痛效果,及其对产程进展、分娩方式、产后出血和新生儿窒息发生率的影响.结果 分娩镇痛组镇痛有效率达99.32%,分娩镇痛组总产程(493.74±150.88分钟)与对照组(381.42±134.97分钟)比较差异有统计学意义(t=-5.256,P0.05).结论 腰硬联合麻醉镇痛用于分娩镇痛效果可靠,可明显降低剖宫产率,虽可使产程时间延长,但未出现产程延长超过正常者,且对产后出血和新生儿窒息发生率均无明显影响.%Objective To evaluate the influence of combined spinal-epidural analgesia ( CSEA ) on labor, delivery mode, incidence of postpartum hemorrhage and incidence of neonatal asphyxia in analgesic delivery. Methods Among primiparae with full term singleton fetus, 148 cases received CSEA with low concentration of bupivacaine, ropivacaine mesylate and fentanyl, who were compared with 115 cases at same period not using analgesic drugs. Then the analgesic effect and the influence on the progress of labor, delivery mode, incidence of postpartum hemorrhage and newborn asphyxia were observed. Results In labor analgesia group, the effective rate was 99. 32% , and there was statistical difference in total stage of labor between labor analgesia group ( 493. 74 ?150. 88 min ) and control group ( 381. 42 ?134. 97 min ) ( t = -5. 256, P 0. 05 ). Conclusion The effect of CSEA for labor analgesia is reliable, and the rate of cesarean section can be significantly reduced. Although the drugs prolong labor, it is not longer than normal labor, and there is no significant influence on the incidence of postpartum hemorrhage and newborn asphyxia.

  15. Analysis of 108 cases of anesthesia for labor analgesia with ropivacaine epidural fentanyl%罗呱卡因联合芬太尼硬膜外阻滞麻醉用于分娩镇痛108例分析

    Institute of Scientific and Technical Information of China (English)

    李丽; 孙建群

    2014-01-01

    Objective To investigate the ropivacaine epidural anesthesia combined with fentanyl analgesia effect and the impact on the safety of mother and child,the incubation period to analyze the feasibility of labor analgesia.Methods Voluntary requirements of lumbar epidural anesthesia for labor analgesia of 108 cases of women in the observation group,did not implement the same period 100 cases of mater-nal pain control group.Comparison of two maternity analgesia,duration of labor,use of oxytocin,neonatal asphyxia,and postpartum hemor-rhage.Analgesic timing of different latencies group active phase group were compared childbirth labor time,oxytocin use,neonatal asphyxia, and postpartum hemorrhage.Results The visual analog scale (Visual analogue scale,VAS)scores were significantly lower than the control group (P0.05);between the timing of different analgesic latencies group and active group of neo-natal asphyxia,postpartum hemorrhage,duration of labor was not statistically significant (P>0.05).Conclusion Ropivacaine fentanyl an-algesia epidural anesthesia effect is good,no adverse effects on mother and child,the incubation period analgesia feasible to meet the needs of the entire production process,is worthy of further promotion.%目的:探讨罗呱卡因联合芬太尼硬膜外阻滞麻醉分娩镇痛的效果及对母儿安全性的影响,潜伏期进行分娩镇痛可行性的分析。方法选择自愿要求硬膜外阻滞麻醉分娩镇痛的108例产妇为观察组,同期未实施镇痛的100例产妇为对照组。比较两组产妇分娩镇痛效果、产程时间、催产素使用、新生儿窒息及产后出血情况。镇痛时机的选择不同的潜伏期组与活跃期组,比较两组分娩产程时间、催产素使用、新生儿窒息及产后出血情况。结果观察组视觉模拟评分明显低于对照组(P<0.05),但增加催产素使用率(P<0.05);两组新生儿窒息、产后出血、产程时间比较差异无统计

  16. 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

  17. Crescimento intra-uterino restrito diagnosticado pelo índice ponderal de Rohrer e sua associação com morbidade e mortalidade neonatal precoce Intrauterine growth retardation diagnosed by Rohrer's ponderal index and its association with morbidity and early neonatal mortality

    Directory of Open Access Journals (Sweden)

    Adehilde Maria Martins Santos

    2005-06-01

    .6% (100/2741 of the cases, while the rate of IGR diagnosed through PI was 15.7% (430/2741, 14.0% being asymmetric and 1.7% symmetric. The most frequent complication among the asymmetric IGRNB was transient tachypnea (8.3%, followed by asphyxia (5.7% and infection (2.6%. Transient tachypnea was present in 6.5% of symmetric IGRNB, followed by asphyxia (4.3%, meconium aspiration syndrome (2.2%, hypoglycemia (2.2% and infection (2.2%. Early neonatal death was similar for NB with restricted IGR and adequate IGR for gestational age, both groups reaching a rate of 0.3%. CONCLUSIONS: Rohrer's PI was able to diagnose the different IGR patterns, which would not be known if the birth weight had been calculated in terms of gestational age. The asymmetric NB presented a higher incidence of transient tachypnea and asphyxia, without statistical significance in relation the other IGR patterns. The frequency of early neonatal death was similar for the asymmetric and adequate for gestational age NB groups.

  18. Clinical Experience on the Treatment of 89 Cases with Intrahepatic Cholestasis During Pregnancy%治疗89例妊娠期肝内胆汁淤积症的临床体会

    Institute of Scientific and Technical Information of China (English)

    刘展

    2013-01-01

    目的:探讨治疗妊娠期肝内胆汁淤积症的临床特点、治疗方法及母婴预后。方法:选取2006年6月-2012年12月本院妇产科病区收治的89例妊娠期肝内胆汁淤积症患者,回顾性分析其诊治方法、分娩方式、产后出血量及围生儿结局。结果:89例患者阴道分娩25例,剖宫产64例,产后出血量150~670 mL;分娩孕周31~38周,早产儿57例;新生儿体重1900~4100 g,其中低体重儿58例;新生儿中轻度窒息24例,重度窒息5例。所有新生儿外观均无畸形,生后均以高危儿立即转新生儿科治疗,1例患儿因早产、窒息合并多脏器功能衰竭死亡。结论:妊娠期肝内胆汁淤积症为妊娠期严重并发症,应进行早期诊断,早期治疗,加强监护,必要时终止妊娠,从而降低围生儿的致残率、病死率,减少产妇产后出血情况的发生,保障母婴健康。%Objective:To research on the clinical characteristics of intrahepatic cholestasis of pregnancy(ICP)and its negative effects on mother and child.Method:Eighty-nine patients with intrahepatic cholestasis of pregnancy from June 2006 to December 2012 in department of obstetrics were selected.The diagnosis and treatment method,mode of delivery,postpartum hemorrhage and perinatal outcomes were retrospectively analyzed.Result:89 cases were 25 cases of vaginal delivery,cesarean section in 64 cases,the amount of 150-670 mL postpartum hemorrhage;pregnant was 31-38 weeks, 57 cases were premature infants;Neonatal weight was 1900-4100 g,including 58 cases of low birth weight infant;24 cases of newborn asphyxia,5 cases of severe asphyxia neonatorum.All neonates were no abnormal appearance,they were transferred to the Neonatal Department for treatment as high-risk infants,1 case died because of premature birth,asphyxia death combined multiple organ function failure.Conclusion:Intrahepatic cholestasis of pregnancy is a serious complication of pregnancy,should be

  19. 助产士主导伙伴式导乐陪伴分娩193例临床观察%Clinical Observation of 193 Cases of Midwife-Led Partnership-Based Doula Childbirth

    Institute of Scientific and Technical Information of China (English)

    杨欢秀; 欧阳友云; 杨璠

    2013-01-01

    Objective:To investigate the clinical results of midwife-led partnership-based doula childbirth.Method:Three hundred and eighty-six cases of maternal childbirth from August 2010 to August 2012 in the hospital were randomly divided into the observation group and the control group, each group of 193 cases. The control group received routine maternity care measures,the observation group on the basis of routine nursing mothers were given partnership-Doula,compared two groups of maternal mode of delivery,postpartum hemorrhage,neonatal asphyxia rate and the total process time.Result:The natural childbirth of the study group was 90.7%while the control group was 65.1%,and the difference between the two groups were statistically significant(P<0.05). The observation group of postpartum hemorrhage,neonatal asphyxia rate and total production process time were significantly lower than the control group,and all the difference between the two groups were statistically significant(P<0.05).Conclusion:Applied midwife-led maternity partnership type Doula,can effectively improve the natural birth rate,shorten the production process,reduce the rate of postpartum hemorrhage and neonatal asphyxia,worthy of clinical application and promotion.%目的:探讨助产士主导伙伴式导乐陪伴分娩的临床效果。方法:选取2010年8月-2012年8月在本院分娩的386例产妇,按照随机数字表法将其分为观察组和对照组各193例。对照组产妇给予常规护理措施,观察组产妇在常规护理基础上加以伙伴式导乐陪伴分娩,比较两组产妇分娩方式、产后出血率、新生儿窒息率及总产程时间。结果:观察组自然分娩率为84.5%,对照组自然分娩率为65.3%;观察组自然分娩率显著高于对照组(P<0.05);观察组产妇产后出血率、新生儿窒息率及总产程时间均显著低于对照组(P<0.05)。结论:在产妇分娩时应用助产士主导伙伴式导乐分娩,可有效提高自

  20. 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

  1. 足月新生儿急性呼吸窘迫综合征高危因素分析%Logistic regression analysis of high risk factors of acute respiratory distress syndrome in full-term newborns

    Institute of Scientific and Technical Information of China (English)

    郭倩

    2013-01-01

    Objective To investigate the risk factors of acute respiratory distress syndrome (ARDS)in full-term newborns,in order to provide references for clinical prevention and treatment .Methods Medical records of 176 full-term newborns with ARDS were discussed and obstetric delivery records of normal full-term newborns were selected randomly with 1∶1 proportion,analysis of factors as-sociated with neonatal ARDS was made .Results ARDS in full-term newborns was associated with the way of giving birth ,cesarean section of social factors,fetal distress and neonatal asphyxia,and amniotic fluid intake( P 0.05).Unconditioned multiariable Logis-tic regression analysis results show that the cesarean section of social factors ,fetal distress ,neonatal asphyxia ,amniotic fluid intake were is independent risk factor of ARDS in full-term newborns( P <0.05 or P <0.01).Conclusion The major risk factors of ARDS in full-term newborns are cesarean section of social factors ,fetal distress,neonatal asphyxia,and amniotic fluid intake.Clinicians should take appropriate measures in prevention and treatment .%目的:探讨引起足月新生儿急性呼吸窘迫综合征( ARDS)的高危因素,以期为临床防治提供参考。方法收集176例ARDS足月新生儿病历资料,以1∶1比例随机抽取产科分娩足月正常新生儿病历资料,分析引起新生儿ARDS的相关因素。结果足月新生儿ARDS的发生与分娩方式、社会因素剖宫产、胎儿宫内窘迫、新生儿窒息、羊水吸入有关( P <0.05或P <0.01),与新生儿性别、分娩孕周、胎位、脐绕颈无关( P >0.05);非条件多因素Logistic回归分析结果显示,社会因素剖宫产、胎儿宫内窘迫、新生儿窒息、羊水吸入是引起足月新生儿ARDS的独立危险因素( P <0.05或P <0.01)。结论引起足月新生儿ARDS的高危因素主要为社会因素剖宫产、胎儿宫内窘迫、新生儿窒息、羊水吸入,应采

  2. 新生儿重症监护室五年死亡病例分析%Analysis of neonatal death in NICU during the latest 5 years

    Institute of Scientific and Technical Information of China (English)

    康文清; 刘大鹏; 陈宇辉; 孙慧清; 熊虹

    2009-01-01

    目的 了解新生儿重症监护室5年新生儿死亡原因及变迁,探讨预防措施,降低病死率.方法 对新生儿重症监护室2004年1月至2008年12月5年间死亡的69例病例进行回顾性分析.结果 (1)男女比例1.7:1,早产儿占34.8%,胎龄≤32周的早产儿占早产儿死亡病例的70.8%;(2)以早期新生儿死亡为主,占59.4%,住院3 d内死亡占69.6%;(3)早产儿前三位死亡原因为呼吸窘迫综合征、败血症、硬肿症,占早产儿死亡数的70.8%;足月儿前三位死亡原因为败血症、重度窒息、肺炎,占足月儿死亡数的77.1%;(4)呼吸窘迫综合征病死率逐年下降,败血症、重度窒息病死率无下降趋势.结论 要降低我省新生儿的病死率,必须加强围生期保健,减少早产儿的出生,深入推广新生儿新法复苏,积极控制感染.%Objective To analyze the cause and change of neonatal death during the latest 5 years,to discuss the ways to decrease the mortality.Methods A retrospective analysis of 69 cases in NICU were performed from Jan 2004 to Dec 2008.Results(1)The sex ratio of male to female was 1.7:1.The preterm infants accounted for 34.8%,preterm infants with gestational ages of less than 32 weeks accounted for 70.8% of the total premature deaths.(2)59.4% of the deaths in newborn infants occurred in the first 7days of life.69.6% occurred within 3 days after admission.(3)The three leading causes of premature infant death were RDS,sepsis and scleredema neonatorum,accounted for 75% of premature death.The three leading canses of full term death were sepsis,neonate severe asphyxia and pneumonia,accounted for 71.1% of all full term death.(4)The newborn who died of RDS were gradually decreasing.Those who died of sepsis and severe asphyxia weren't changing.Condusion Heath care during the perinatal period should be strengthened to decrease the premature birth and asphyxia.The neonatal new resuscitation technique should be widely adovocated and neonatal sepsis should

  3. 妊娠期肝内胆汁淤积症118例的诊治研究及妊娠结局%Clinical research and pregnancy outcome of 118 cases of intrahepatic cholestasis of pregnancy

    Institute of Scientific and Technical Information of China (English)

    梁美燕; 罗一平; 欧阳晓红

    2014-01-01

    Objective:To observe the clinical symptoms of intrahepatic cholestasis of pregnancy(ICP).To analyze its harm of maternal and child and the effective treatments of reducing the fetal death,neonatal asphyxia,premature delivery.Methods:118 cases with intrahepatic cholestasis of pregnancy were selected from January 2008 to June 2013.The clinical data were retrospectively analyzed.The clinical characteristics,delivery mode,postpartum hemorrhage and pregnancy outcome were summarized.Results:In the 118 ICP cases,81 cases were cesarean section,and 37 cases were vaginal delivery.25 cases(21.2%) were premature delivery,19cases (16.1%) were fetal distress,and 12 cases(10.2%) were neonatal asphyxia.ICP onset time was more early.The liver damage was more serious,and the harm was more greater.Neonatal appearance had no abnormalities.1 case high risk infant was died because of multiple organ failure after new pediatric treatment.Through the comparison with another 50 cases of the treatment group,it found that the treatment had significant improvement on the maternal and child health.Conclusion:ICP can cause intrauterine fetal anoxia,premature delivery,fetal distress and neonatal asphyxia,which has a great harm to the maternal and child.The early diagnosis,early treatment,and strengthening of fetal heart rate monitoring and timely termination of pregnancy can effectively reduce the neonatal hazards and improve the maternal and child health.%目的:观察妊娠期肝内胆汁淤积症(ICP)的临床症状,分析其对母婴的危害及降低胎儿宫内死亡、新生儿窒息、早产的有效治疗方法。方法:2008年1月-2013年6月收治ICP患者118例,对其临床资料进行回顾性分析,总结其临床特点、分娩方式、产后出血量及妊娠结局。结果:118例ICP患者中,剖宫产81例,阴道分娩37例。其中早产25例(21.2%),胎儿窘迫19例(16.1%),新生儿窒息12例(10.2%)。ICP发病时间越早,其肝损伤越严重,危害

  4. 889例早产儿的预后及其影响因素分析%Prognosis of 889 premature infants and its influence factors

    Institute of Scientific and Technical Information of China (English)

    麦凤鸣; 钟为平; 王晓萍; 钟柳英

    2013-01-01

    Objective To investigate the prognosis of premature infants and its influence factors. Methods A retrospective study was designed, and a total of 724 pregnant women with premature delivery in the Third Affiliated Hospital of Guangzhou Medical College, Guangzhou Severe Maternal Treatment Center from Jun. 2008 to Dec. 2009 were included in our study, with 889 premature infant. The prognosis of premature infants and its influence factors were analyzed. Results (1) The main complications of premature infant were asphyxia (11.40%), RDS (5.29%), pneumonia (6.64%), anemia (12.37%), acid-base imbalance (27.00%), retinopathy (6.97%). (2) The mortality rate, incidence of asphyxia, NRDS and pulmonary hemorrhage of premature infant were negatively correlated with gestational age and neonatal weight. (3) Plmonary hemorrhage, RDS and MSOF were the main causes of death for premature infant. (4) Factors of unfavourable prognosis for premature infant were gestational age, neonatal weight, asphyxia, RDS, pneumonia, alimentary tract hemorrhage, acid-base imbalance, and PROM, prccclampsia, fetal distress, polyhy-dramnios or oligohydramnios of pregnant woman (P<0.05). Conclusion The control of the risk factors of premature delivery can avoid or delay the occurrence of premature birth, improved maternal and neonatal outcomes.%目的 观察早产儿的预后并探讨其影响因素.方法 选取广州医学院第三附属医院、广州市重症孕产妇救治中心2008年1月至2009年12月间分娩的889例早产儿,分析早产儿的结局及影响早产儿预后的因素.结果 (1)早产儿的主要并发症有窒息(11.4%)、NRDS (5.29%)、肺炎(6.64%)、贫血(12.37%)、酸碱失衡(27%)、视网膜病变(6.97%)等.(2)早产儿胎龄、出生体重与窒息、NRDS、肺出血等并发症发生率和死亡率与呈负相关(P<0.05).(3)早产儿死亡原因前三位分别为肺出血、NRDS及多器官衰竭.(4)早产儿预后不良的相关因素是:早产儿低胎龄、低出生

  5. 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

  6. The causes of death of emergency patients in Xi'an Children's Hospital from 2009 to 2010%2009至2010年西安市儿童医院急诊患儿死亡原因分析

    Institute of Scientific and Technical Information of China (English)

    文俊; 常文毅; 周南

    2012-01-01

    目的 了解近2年西安市儿童医院急诊患者死亡疾病谱变化和直接死亡原因.方法 对2009年至2010年我院收治的130例急诊死亡病例进行回顾性分析.结果 2009年主要死亡疾病依次为:肺炎,先天性心脏病,窒息,新生儿肺出血,颅内出血;2010年主要死亡疾病依次为:肺炎,窒息,病毒性脑炎,先天性心脏病,新生儿肺出血,两年死亡疾病谱发生了明显变化.91例患儿找到直接死亡原因,依次为:呼吸衰竭25例(27.5%),心力衰竭17例(18.7%),休克17例(18.7%),窒息16例(17.5),脑疝16例(17.5%).结论 要降低急诊患儿的病死率,必须加强婴幼儿卫生保健,积极治疗肺部感染和全身感染,积极抗休克治疗,控制心力衰竭,以及预防误吸.%Objective To analyze the change of disease spectrum and the direct cause of death in Xi'an Children's Hospital emergency patients in the past 2 years.Methods The cases of death in 130 emergency cases from 2009 to 2010 were retrospectively analyzed.Results The main causes of death in 2009 were pneumonia,congenital heart disease,asphyxia,neonatal pulmonary hemorrhage and intracranial hemorrhage.Meanwhile,The main cause of death in 2010 were pneumonia,asphyxia,viral encephalitis,congenital heart disease and neonatal pulmonary hemorrhage,which significantly changed compared with 2009.Major direct causes of death were found:respiratory failure in 25 cases (27.5%),heart failure in 17 patients ( 18.7% ),shock in 17patients ( 18.7% ),asphyxia in 16 cases ( 17.5% ),and hernia in 16 cases ( 17.5% ),Conclusion In order to reduce the mortality rate of emergency patients,we should strengthen health care,actively manage pulmonary infection,systemic infection,and shock,control heart failure,and prevent aspiration.

  7. 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

  8. 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 .

  9. Clinical analysis on 114 neonates with gastrointestinal hemorrhage%114例新生儿消化道出血临床分析

    Institute of Scientific and Technical Information of China (English)

    李彤; 林若玲; 李丹

    2011-01-01

    Objective: To explore the related clinical factors, prevention and treatment of neonatal gastrointestinal hemorrhage.Methods: The clinical data of 114 neonates with gastrointestinal hemorrhage were analyzed retrospectively.Results: The incidence rate of gastrointestinal hemorrhage in premature infants, , low birth weight infants and the infants with the history of perinatal asphyxia were significantly higher than that in full - term infants, normal birth weight infants and the infants without the history of perinatal asphyxia (P < 0.05).The most of neonatal gastrointestinal hemorrhage occurred within the first three days after birth, the main causes of neonatal gastrointestinal hemorrhage included neonatal hypoxic ischemic encephalopathy, hyaline membrane disease and severe pneumonia.Conclusion: Stress ulcer is a common cause of neonatal gastrointestinal hemorrhage.Good perinatal health care and active treatment of the original diseases can reduce the incidence of neonatal gastrointestinal hemorrhage obviously.Vitamin K1 combined with thrombin,cimetidine and reptilase is effective in treatment of neonatal gastrointestinal hemorrhage.%目的:探讨新生儿消化道出血的临床相关因素、预防和治疗.方法:对114例新生儿消化道出血临床资料进行回顾性分析.结果:早产儿、低出生体重儿及有围生期窒息史儿消化道出血发生率明显高于足月儿、正常出生体重儿及无围生期窒息史儿(P<0.05).大部分新生儿消化道出血在生后3天内发病,它的主要病因为新生儿缺氧缺血性脑病、肺透明膜病及重症肺炎.结论:应激性溃疡是新生儿消化道出血的最常见原因.做好围产期保健、积极治疗原发病可明显减少新生儿消化道出血的发牛率.联合使用维生素K1、凝血酶、西米替丁及立止血治疗新生儿消化道出血效果好.

  10. An analysis of variations of indications and maternal-fetal prognosis for caesarean section in a tertiary hospital of Beijing

    Science.gov (United States)

    Liu, Yajun; Wang, Xin; Zou, Liying; Ruan, Yan; Zhang, Weiyuan

    2017-01-01

    Abstract In recent decades, we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. According to the World Health Organization (WHO) systematic review, if the increase in CS rate was between 10% and 15%, the maternal and neonatal mortality was decreased. However, above this level, increasing the rate of CS is no longer associated with reduced mortality. To date, no consensus has been reached on the main factors driving the cesarean epidemic. To reduce the progressively increasing rate of CS, we should find indications for the increasing CS rate. The aim of our study was to estimate the change of CS rate of Beijing Obstetrics and Gynecology Hospital and to find the variation of the indications. From January 1995 to December 2014, the CS rate of Beijing Obstetrics and Gynecology Hospital was analyzed. For our analysis, we selected 14,642 and 16,335 deliveries respectively that occurred during the year 2011 and 2014, to analyze the difference of indications, excluding incomplete data and miscarriages or termination of pregnancy before 28 weeks of gestation because of fatal malformations, intrauterine death, or other reasons. The average CS rate during the past 20 years was 51.15%. The highest caesarean delivery rate was 60.69% in 2002; however, the caesarean delivery rate declined to 34.53% in 2014. The obviously different indications were caesarean delivery on maternal request and previous CS delivery. The rate of CS due to maternal request in 2014 was decreased by 8.16% compared with the year 2011. However, the percentage of pregnancy women with a previous CS delivery increased from 9.61% to 20.42% in 3 years. Along with the decline of CS rate, the perinatal mortality and the rate of neonatal asphyxia decreased in 2014 compared with that in 2011. After a series of measures, the CS rate declined indeed. Compared with 2011, the perinatal mortality and the rate of neonatal asphyxia

  11. 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.

  12. 59例双胎妊娠分娩方式与妊娠结局的临床分析

    Institute of Scientific and Technical Information of China (English)

    雷曼

    2013-01-01

      目的观察讨论双胎分娩方式与妊娠结局的关系.方法选取北京市丰台区妇幼保健院2007年1月~2011年12月59例双胎妊娠的孕产妇,依据其分娩方式可分为阴道产组17例和剖宫产组42例,观察对比两组的分娩孕周、产后出血情况、新生儿Apgar评分、新生儿体重、新生儿窒息率等,进行统计学分析.结果两组孕产妇的分娩孕周、产后出血情况、新生儿体重无统计学差异;新生儿Apgar评分对比差异显著(P<0.05),具有统计学意义.结论合理选择双胎妊娠的分娩方式对降低新生儿窒息率,保障母婴安全有重要的临床意义.%Objective To investigate the twin pregnancy delivery and pregnancy outcome in relation. Methods In 59 cases of twin pregnancy maternal cases were statistically analyzed. According to their mode of delivery these cases can be divided into the vaginal delivery group 17 cases and cesarean section in 42 cases. In this paper were compared between two groups of gestational age at delivery, postpartum hemorrhage, neonatal Apgar score, birth weight, neonatal asphyxia rate and so on. Results The results of two groups of maternal gestational weeks for delivery, postpartum hemorrhage, neonatal weight showed no statistically significant difference. However, the newborn Apgar score comparison showed significant difference (P<0.05).Conclusion Reasonable selection of twin pregnancy and mode of delivery for reducing neonatal asphyxia rate, ensure safe motherhood has important clinical significance.

  13. 双胎妊娠与单胎妊娠的并发症及妊娠结局比较%The comparative observation of complications and pregnancy outcomes between twin pregnancy and singleton preg-nancies

    Institute of Scientific and Technical Information of China (English)

    魏景仙; 申更存; 霍强; 赵继广; 李存娟

    2014-01-01

    Objective To comparative observation the complications and pregnancy outcomes between twin pregnancy and singleton pregnancies .Methods Selected 100 patients with twin preanancy ,and 100 patients with singleton pregnancies . After treatment,compared the complications,postpartum hemorrhage,the incidence of low-weight children,neonatal asphyxia rate and the perinatal child mortality of 2 groups .Results The complication rate of twin pregnancy was higher than that of control group,the difference was statistically significant (P<0.05).The postpartum hemorrhage,the incidence of low-weight children,nenoatal asphyxia rate and the perinatal child mortality were higher than that of control group ,the difference was sta-tistically significant(P<0.05).Conclusion The twin pregnancy can improve the complication rate ,increase the adverse out-comes,Strengthen the Prenatal guidance and guardianship has an important significant .%目的:观察双胎妊娠与单胎妊娠孕产妇并发症和妊娠结局的差异。方法选择待产双胎妊娠孕产妇(双胎妊娠组)和单胎妊娠孕产妇(单胎妊娠组)各100例,比较2组孕产妇的并发症、产后出血量、低体质量儿发生率、新生儿窒息率、围生儿病死率,评价单胎妊娠与双胎妊娠并发症、妊娠结局差异。结果双胎妊娠组的并发症发生率高于单胎妊娠组(P<0.05),产后出血量、低体质量儿发生率、新生儿窒息率、围生儿病死率明显高于单胎妊娠组(P<0.05)。结论双胎妊娠使孕产妇并发症增多,增加了新生儿预后不良的出现,加强对双胎妊娠的产前指导和监护,对双胎妊娠结局具有重要意义。

  14. 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.

  15. 未足月临界羊水过少206例临床分析%The clinical analysis of 206 cases for preterm and borderline oligohy dramnios

    Institute of Scientific and Technical Information of China (English)

    张东梅

    2013-01-01

      目的:探讨未足月羊水临界过少治疗效果及对分娩结局的影响。方法:回顾性分析门诊立卡定期产检,妊娠32周后但未足37周发现羊水过少并治疗及分娩的孕妇206例为研究组,同期产检未发生羊水过少206例作为对照组,比较两组孕产妇的胎位异常、胎儿窘迫、羊水Ⅲ度混、自然分娩、急诊剖宫产、早产、新生儿窒息等方面的差异。结果:研究组经过输液治疗能有效改善胎盘血液循环,增加胎儿肾脏血流量,从而增加羊水量、降低剖宫产率及新生儿窒息率。结论:孕晚期临界羊水过少经过积极治疗,适时终止妊娠,能有效改善妊娠结局。%Objective To investigate the therapeutic effect of amniotic fluid too little preterm and critical impact on delivery outcome. Methods A retrospective analysis of clinic filed regular check-ups,after 32 weeks of pregnancy but not enough 37 weeks found that maternal oligohydramnios and treatment and delivery for 206 cases of the study group,at the same time production without oligohydramnios 206 cases as the control group,the difference between the two groups of maternal fetal abnormalities,fetal distress,amniotic fluid of mixing,natural childbirth,emergency cesarean section,premature delivery,neonatal asphyxia,etc.Results The study group after infusion therapy can effectively improve the placenta blood circulation,increase of fetal renal blood flow,thereby increasing the volume of amniotic fluid,reduce the rate of cesarean section and neonatal asphyxia rate.Conclusion Critical oligohydramnios in late pregnancy after active treatment,timely termination of pregnancy,can effectively improve the outcome of pregnancy.

  16. 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。

  17. 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.

  18. Analysis of Clinical Characteristics and Pregnancy Outcomes of 32 Cases of Dangerous Placenta Previa%32例凶险型前置胎盘的临床特征及妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    李小叶

    2013-01-01

    [目的]分析凶险型前置胎盘的临床特点及妊娠结局,以提高对凶险型前置胎盘的诊疗的技术.[方法]以在本院住院分娩的凶险型前置胎盘32例为研究组,随机选择同期在本院住院分娩的普通型前置胎盘70例为对照组,运用统计学方法对其临床资料行回顾性分析.[结果]①研究组与对照组产前大出血发生率相比较差异无显著性(P>0.05);产后大出血、胎盘植入、子宫切除及弥散性血管内凝血(DIC)发生率均高于对照组,且差异有显著性(P0.05);研究组的早产儿发生率、新生儿重度窒息率均明显高于对照组,且差异有显著性(P0. 05). The incidence of postpartum hemorrhage, placen-tal implantation, hysterectomy and disseminated intravascular coagulation(DIC) in the study group were higher than those in the control group, and there was significant difference(P 0. 05). The rates of preterm birth and severe neonatal asphyxia in the study group were obviously higher than those in the control group, and there was significant difference(P <0. 05). [Conclusion]The main risk factors of dangerous placenta previa are postpartum hemorrhage, hysterectomy, preterm delivery and severe newborn asphyxia, which have great harm on pregnant women, parturients and perinatal infants. The prevention of dangerous placenta previa, antenatal care and monitoring, the prophylaxis of postpartum hemorrhage and rescue measures can greatly reduce the hazard for pregnant women, parturients and perinatal infants, and improve pregnancy outcome.

  19. 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.

  20. 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

  1. Incidence of acute kidney injury in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Doaa Youssef

    2015-01-01

    Full Text Available The aim of this work is to study the incidence of acute kidney injury (AKI in neonates admitted to the neonatal intensive care unit (NICU over a six-month period from September 2011 to March 2012. This prospective study was performed on 250 neonates admitted to the NICU at the Children′s Hospital, Faculty of Medicine, Zagazig University. All neonates were subjected to detailed history taking, including pre-natal, natal and post-natal history, with stress on symptoms suggestive of AKI. All neonates were examined thoroughly and the following investigations were performed: Blood urea nitrogen (BUN, serum creatinine, sodium, potassium, calcium, complete blood count, C-reactive protein, arterial blood gases, urine sodium and urine creatinine. AKI was diagnosed in 27 cases (10.8%, including 12 females and 15 males. 40.7% of the AKI cases were born after full-term pregnancy while 59.3% were pre-term babies. 29.6% of the AKI cases had oliguria, and there was male sex predominance, with a male-female ratio of 1.3:1. The cause of AKI was pre-renal in 96.3% and intrinsic renal in 3.7% of the cases. The predisposing factors for AKI were sepsis in 63% of the cases, respiratory distress syndrome in 55.6%, mechanical ventilation in 51.9%, peri-natal asphyxia in 18.5%, dehydration in 14.8%, surgical operation in 11.1%, congenital heart disease in 7.4%, sub-galeal hematoma in 3.7%, polycythemia in 3.7% and intra-ventricular hemorrhage in 3.7% of the cases. Our data suggest that pre-renal failure was the most common form of AKI in our patients. Early recognition of risk factors such as sepsis, peri-natal asphyxia or peri-operative problems and rapid effective treatment of contributing conditions will reduce the incidence of AKI in the neonatal period.

  2. 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.

  3. 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

  4. 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。

  5. Choices of Delivery Ways of Women with Scarred Uterus and Repeated Pregnancy%瘢痕子宫再妊娠分娩方式的选择

    Institute of Scientific and Technical Information of China (English)

    周顺清

    2012-01-01

      目的:探讨瘢痕子宫再妊娠阴道分娩的可行性.方法:对本院收治瘢痕子宫住院分娩的孕产妇174例的临床资料进行回顾性分析,并随机抽取同期非瘢痕子宫孕产妇资料进行比较.结果:经阴道分娩58例,分娩率为33.33%,成功率为69.88%;再次剖宫产116例.瘢痕子宫阴道分娩组在产后出血量、住院天数、新生儿窒息率明显低于再次剖宫产组(P0.05);瘢痕子宫与非瘢痕子宫阴道分娩组产程时间、产后出血量、手术助产率、新生儿窒息率相当(P>0.05).结论:瘢痕子宫孕产妇,只要符合阴道试产条件,严密监护下阴道试产是安全可行的.%  Objective: To discuss the feasibility of vaginal delivery with scarred uterus and repeated pregnancy. Method: Select 174 cases of repeated pregnant women with scarred uterus,who delivery in our hospital,and random selected the pregnancy women with no scarred uterus on the same period to compare. Result: 58 cases of vaginal delivery,the delivery rate was 33.33%,the success ratio was about 69.88%.116 cases of cesarean section. the group of vaginal delivery with scarred uterus in postpartum hemorrhage volume,hospital stay,neonatal asphyxia rate was lower than that the group of secondary cesarean section(P0.05); There was no difference in labor time、postpartum hemorrhage volume、surgical delivery rate、neonatal asphyxia rate between the group of vaginal delivery women with scarred uterus and the group of vaginal delivery women with no scarred uterus. Conclusion: Pregnant women with scarred uterus as long as met conditions of the vaginal trial delivery. Intensive care of vaginal delivery is safe and feasible.

  6. 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.

  7. 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.

  8. Reduced miR-659-3p levels correlate with progranulin increase in hypoxic conditions: implications for frontotemporal dementia.

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    Paola ePiscopo

    2016-05-01

    Full Text Available Progranulin (PGRN is a secreted protein expressed ubiquitously throughout the body, including the brain, where it localizes in neurons and 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 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 24h 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.

  9. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

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    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

  10. Clinical Analysis of 206 Cases of Severe Preeclampsia Terminate the Pregnancy Timing and the Way%206例重度子痫前期终止妊娠时机和方式的临床分析

    Institute of Scientific and Technical Information of China (English)

    赵玉仙

    2012-01-01

      Objective To explore the time and method of pregnancy termination of early onset severe preeclampsia, and the influence on newborns, to research the clinical definition of early onset severe preeclampsia and the meaning of expectant management. Methods A retrospective study was carried out on 206 patients with severe preeclampsia, all the patients were divided into three groups according to week of gestation:Ⅰ(≥34 wks);Ⅱ(32~34 wks);Ⅲ(≤32 wks), observed the effect of gestational age on neonatal survival and the damage of complications to maternal during expectant management. Results 206 patients were all survived , there was no significant differences in the method of delivery ,neonatal asphyxia and death rate(P>0.05); neonatal asphyxia and mortality in groupⅢwas highly significant than groupⅠandⅡ(P0.05).Conclusion Patients with severe preeclampsia should be timely terminated ,termination of pregnancy is one of the most important factors to effect neonatal outcomes , it is much more accurately to defined 32 weeks as the severe preeclampsia which can reflect the relationship between pregnancy termination and the outcomes of neonatal.%  目的探讨重度子痫前期终止妊娠的时机和方式,以及对新生儿的影响,并进一步研究早发型重度子痫前期的临床界定及期待治疗的意义.方法通过对206例重度子痫前期进行回顾性分析,根据入院孕周分为三组:I组≥34周,Ⅱ组≥32周0.05),新生儿窒息率与病死率Ⅲ组明显高于I和Ⅱ组,但Ⅱ组和I组间无显著差异(P>0.05).结论重度子痫前期患者应适时终止妊娠,终止妊娠孕周是影响围生儿结局的重要因素,临床上以32周界定早发型重度子痫前期更能准确反应终止孕周与新生儿结局的关系.

  11. Analysis of 80 cases of Doula combined with Epidural anesthesia in labor analgesia%导乐陪伴联合硬膜外麻醉镇痛分娩80例分析

    Institute of Scientific and Technical Information of China (English)

    张锦华

    2014-01-01

    Objective:To discuss the effectiveness of Doula combined with epidural anesthesia in labor analgesia. Methods: 80 cases of primipara without obvious cephalopelvic disproportion , pregnancy complications or pregnancy complications were selected,they were performed Doula and epidural anesthesia when their cervix open 2-3cm,anal-gesic effect,labor,mode of delivery ,blood losing after delivery,and Apgar's score were recorded.Results: All the cases have good effect of analgesics, high rate of natural delivery , shorter labor,low rate of neonatal asphyxia,and no adverse reaction .Conclusion: Doula combined with epidural anesthesia in labor analgesia can significantly reduce the labor pain, the cesarean section rate ,shorten the labor and reduce bleeding, but does not increase the rate of neonatal as-phyxia, or has side effects on mother and child,so it is worth widely applied .%目的:探讨导乐陪伴联合硬膜外麻醉用于分娩镇痛的效果。方法:选择80例无明显头盆不称,无妊娠并发症和妊娠合并症的初产妇,宫口开大2~3cm时施行导乐陪伴及硬膜外麻醉镇痛,记录镇痛效果、产程、分娩方式、产后出血及新生儿Apgar评分等。结果:所有产妇镇痛效果良好,阴道自然分娩率高,总产程缩短,新生儿窒息率低,无不良反应。结论:导乐陪伴联合硬膜外阻滞镇痛分娩,可显著减轻产时疼痛,降低剖宫产率,缩短产程,减少出血量,但不增加新生儿窒息率,对母婴无副作用,值得推广应用。

  12. 浅谈产妇分娩中的心理护理

    Institute of Scientific and Technical Information of China (English)

    黄文艳; 舒向华; 胡桂荣

    2014-01-01

    目的:观察分析心理护理对产妇分娩过程的影响。方法选取我院分娩的600例产妇,分为两组,传统模式分娩的300例为对照组,现代护理模式分娩的300例为观察组,对两组分娩方式的产程时间、产后出血、剖宫产率、新生儿窒息发生率和满意度进行比较分析。结果进行现代护理模式分娩的产妇产后出血、产程时间、产痛、新生儿窒息发生率明显降低,产妇满意度上升。结论产时心理护理能消除产妇的不良情绪,减轻产痛,减少产后出血,降低剖宫产率。提高产科服务质量和分娩质量。%objective: to observe the analysis of the effect of psychological nursing on puerpera childbirth method: choose 600 cases of puerpera childbirth in our, divided into two groups, the traditional model of delivery of 300 cases as control group, the model of modern nursing 300 cases of child as the observation group, with respect to the manner of two groups of childbirth labor time, postpartum hemorrhage and cesarean section rate, incidence of neonatal asphyxia and satisfaction for comparative analysis. Results: the modern nursing mode of delivery of maternal postpartum hemorrhage, labor time and labor pain, decrease incidence of neonatal asphyxia, maternal satisfaction rise. Compare the difference was statistical y significant (p < 0.05) conclusion: intrapartum psychological nursing can eliminate the unhealthy feelings of the maternal, relieve labor pain, reduce postpartum hemorrhage, reduce the rate of cesarean delivery. Improve the quality of obstetric service quality and delivery.

  13. Fetal Nerve Cell Transplantation in Early Post-Resuscitation Period in Rats

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    Damira Tazhibayeva

    2015-02-01

    Full Text Available Introduction. Fetal cell transplantation is a promising biomedical approach for disease treatment; however, the use of fetal cell therapy is still experimental. This research was deemed a necessity to provide evidence-based research for the application of cell transplantation as a treatment method. The aim of this study was to evaluate the effect of fetal nerve cell transplantation in rat survivors (and non-survivors after clinical death by mechanical asphyxia.Methods. 68 white laboratory rats were divided into two groups of identical age and sex: a control group of 12-month adult male rats (n = 26 and an experimental group (n = 42. Rats were fixed under ether anesthesia. We then blocked the oral and nasal regions with cotton wool soaked in saline solution. A four-minute clinical death though acute mechanical asphyxia was simulated by applying the method of N. Shim. After the 4-minute clinical death, we resuscitated the rats using external cardiac massage and artifical respiration. Suspension of the fetal nerve cells was injected intraperitoneally at 1mm3 per 25g at the time of cardiac activity restoration. Lactate dehydrogenase (LDH and creatine phosphokinase (CPK levels were examined in the homogenate cerebral cortex of reanimated animals. We recorded the survival rate during the post-resuscitation period and analyzed the integrative brain functions using anxiety-phobic status and latent inhibition.Results. After fetal nerve cell transplantation, the enzymatic reactions in the experimental group became normal with a significant decrease in LDH and an increase in CPK levels compared to the control group. In the control group, 10 rats died and 16 lived (62% survival rate, while 7 rats died and 35 lived (83% survival rate in the experimental group during the first 7 days. Rats that did not receive the treatment tended to die sooner than those in the experimental group. As a result of transplantation, the anxiety level in the experimental group

  14. 产科分娩护理中循证护理服务的应用意义探究%Study on the Application of Evidence-Based Nursing in Obstetrics Delivery

    Institute of Scientific and Technical Information of China (English)

    李恬秋

    2015-01-01

    目的:分析产科分娩护理中循证护理服务的应用意义。方法研究选择我院2012年5月~2015年2月100例于我院分娩的产妇为对象,分为对照组和循证组,对照组施以常规护理服务,循证组施以循证护理服务。对比分析两组孕产妇剖宫产率、新生儿窒息率、产后24小时出血量>500 ml例数、各个产程时间。结果循证组孕产妇剖宫产率、新生儿窒息率、产后24小时出血量>500 ml例数、各个产程时间均低于对照组,差异有统计学意义,P<0.05。结论产科分娩护理中循证护理服务的应用意义重大,有助于降低剖宫产率,缩短产程,改善母婴预后。%Objective To analyze the application of evidence-based nursing in obstetrics and delivery care.MethodsFrom February 2015 to May 2012,100 cases of pregnant women in our hospital were selected as the object,divided into control group and evidence-based group,the control group received routine nursing care, the evidence-based nursing service. The two groups were compared with the groups of maternal cesarean section rate,neonatal asphyxia,postpartum hemorrhage volume of 24 hours,500 ml cases,the duration of the process.ResultsThe rate of cesarean section rate, neonatal asphyxia,postpartum hemorrhage volume of 24 hours in the evidence-based group,the number of 500 ml cases,and the time of each stage of labor were lower than those in the control group,the difference was statisticaly significant,P<0.05.Conclusion The application of evidence-based nursing in obstetrics delivery care is of great significance,which helps to reduce the rate of cesarean section,shorten the labor process and improve the prognosis of mother and infant.

  15. Clinical Research of Danshen Injection in the Treatment of Oligohydramnios in Late Pregnancy%丹参滴注液治疗妊娠晚期羊水过少的临床研究

    Institute of Scientific and Technical Information of China (English)

    王晓丽; 杨坤; 赵彦梅; 董高霞; 王昕; 冉淑琴

    2013-01-01

    Objective:To investigate the clinical effect of Danshen injection in the treatment of oligohydramnios in late pregnancy.Methods:117 patients with oligohydramnios in late pregnancy were divided into control group and treatment group according to random number table method,39 cases in each group.The control group was instructed extra water and given 10% glucose 2 000 mL add vitamin C 2 g intravenous drip,1 time daily.The treatment group was given Danshen injection 250 mL,intravenous drip,1 time daily.Compare the amniotic fluid index of two groups before and after treatment and analyze the cesarean section rate,preterm birth rate and neonatal asphyxia rate.Results:Compared with control group,the amniotic fluid index in treatment group increased significantly and the cesarean section rate,preterm birth rate and neonatal asphyxia rate are significantly reduced.The difference was statistically significant (P <0.05).Conclusion:Danshen injection can increase the amniotic fluid amount and improve pregnancy outcome.%目的:探讨丹参滴注液治疗妊娠晚期羊水过少的临床效果.方法:将117例妊娠晚期羊水过少患者,按随机数字表法分为对照组和治疗组,每组各39例.对照组嘱患者多饮水,同时给予10%葡萄糖2000 mL,加维生素C2g静脉滴注,每日1次.治疗组予丹参滴注液250 mL静脉滴注,每日1次.比较两组患者治疗前后的羊水指数,分析两组患者的剖宫产率、早产率、新生儿窒息率.结果:与对照组比较,治疗组羊水指数升高明显,剖宫产率、早产率、新生儿窒息率明显降低,差异均有统计学意义(P<0.05).结论:丹参滴注液能增加羊水量,改善妊娠结局.

  16. 胎膜早破残余羊水量过少对分娩结局的影响%The fetal membrane had broken remains sheep water yield long ago

    Institute of Scientific and Technical Information of China (English)

    毛卫勤

    2009-01-01

    Objective Purpose of premature rupture of membranes sheep residual water is too small to affect the outcome of childbirth. Methods 256 eases of premature rupture of membranes, full - term pregnancy,the first place, no other obstetric complications and complications, labor before the B - line monitoring of both the residual amount of amniotic fluid. One of anmiofic fluid index (AFI) ≤8.0 cm to 86 eases ( amniotic fluid was too small groups), AFI > 8. 0 cm to 170 cases ( amount of amniotic fluid) . Observation of the two groups of patients with fetal distress, neonatal asphyxia, intrauterine infection, surgery production rate. Results The results of amniotic fluid was too small group of cesarean section rate (66. 3 percent), vaginal delivery rate (15. 1 percent), the incidence of fetal distress (26. 7% ), neonatal asphyxia rate (14%) intrauterine infection incidence rate (24. 4% ), Differences between the two groups was significant ( P 8.0cm者170例(羊水适量组).观察分析两组患者的胎儿窘迫、新生儿窒息、宫内感染、手术产率.结果 剖宫产率、阴道助产率、胎儿窘迫发生率、新生儿窒息率、宫内感染发病率,两组间差异具有显著性(P<0.05).结论 胎膜早破残余羊水量与围生儿预后及分娩方式密切相关,羊水残余量过少时,宫内感染率、围生儿发病率及手术产率明显增高.因此,胎膜早破者要及早监测残余羊水量,产程中严密监护,及时发现产程异常、胎儿心率异常及羊水性状气味异常,及时选取正确的分娩方式,以提高产科质量.

  17. Aplicação do escore CRIB como preditor de óbito em unidade de terapia intensiva neonatal: uma abordagem ampliada The use of CRIB score as mortality predictor at neonatal intensive care unit: an extended approach

    Directory of Open Access Journals (Sweden)

    Luiz Fernando C. Nascimento

    2004-06-01

    Full Text Available OBJETIVOS: avaliar o uso do escore CRIB (Clinical Risk Index for Babies em todos os recém-nascidos internados em Unidade de Terapia Intensiva Neonatal (UTIN e comparar seus resultados com peso ao nascer e idade gestacional. MÉTODOS: estudo observacional, envolvendo todos os recém-nascidos internados na UTIN do Hospital Universitário de Taubaté. As variáveis foram escore CRIB, peso ao nascer, idade gestacional, uso de surfactante, cateterização umbilical, asfixia neonatal e óbito. Foram comparadas as médias do escore CRIB, peso ao nascer e idade gestacional segundo óbito. Foram estimados os valores da sensibilidade, especificidade, valores preditivos positivo e negativo e risco relativo e criadas curvas Receiver Operating Characteristic (ROC para CRIB, peso ao nascer e idade gestacional. Utilizou-se da técnica t de Student e qui-quadrado de tendência linear. A significância estatística foi alfa = 5%. RESULTADOS: óbito esteve associado a maiores valores do CRIB; houve tendência de mais casos com asfixia, uso de surfactante, cateterização umbilical e óbitos com as classes maiores do CRIB. A curva ROC relativa ao CRIB foi maior que as relativas ao peso ao nascer e idade gestacional. CONCLUSÕES: o escore CRIB foi bom preditor do óbito quando aplicado em todos os RN.OBJECTIVES: to evaluate the CRIB (Clinical Risk Index for Babies score as mortality predictor in all newborn at Neonatal Intensive Care Unit (NICU and to compare with birthweight and gestational age. METHODS: observational study with newborn admitted at NICU of University Hospital of Taubaté. The variables were CRIB score, birth weight, gestational age, use of surfactant, umbilical catheter, neonatal asphyxia and death. The association between CRIB score and other variables was estimated. The values of sensitivity, specificity, predictive and negative values and relative risk and 95% confidence interval of were estimated and created ROC (Receiver Operating

  18. 降低初产妇分娩会阴侧切率的临床探讨%Clinical study of reducing episiotomy rate in primiparae

    Institute of Scientific and Technical Information of China (English)

    时良芳; 周红; 雷霞

    2014-01-01

    Objectives:To study the impact of reducing episiotomy rate on the delivery outcomes of primip-arae,and evaluate the clinical value.Methods:Statistics related to episiotomy rate,infection,Ⅲ°laceration and neonatal asphyxia of primiparae in our hospital in 2007,2009 and 2011 were studied and analyzed retrospectively. Results:The episiotomy and infection rate in 2007,2009 and 2011 decreased year by year;the difference of episi-otomy rate in the three years was of statistically significances (P0.05).Conclusion:Reducing episiotomy rate can effectively reduces the incidence rate of postpartum perineal infection,Ⅲ°laceration and neonatal asphyxia of primiparae.%目的:探讨降低初产妇会阴侧切率对分娩结局的影响并分析其临床价值。方法:回顾性分析我院2007、2009和2011年初次妊娠分娩孕妇的会阴侧切、感染、Ⅲ°裂伤及新生儿窒息的相关数据。结果:3年间的会阴侧切率及会阴感染率都逐年下降,会阴侧切率的两两年间的比较、会阴感染率在2007和2011年比较及2009和2011年的比较上都有统计学意义(P<0.05),而2009和2011年的感染率和3年间新生儿窒息发生率对比均无统计学意义(P>0.05),会阴Ⅲ°裂伤数保持为0。结论:降低会阴侧切率可有效减少产后会阴感染率、会阴Ⅲ°裂伤及新生儿窒息发生率。

  19. 濮阳市2003~2007年5岁以下儿童死亡监测结果分析%Analysis of the mortality in children under 5 of puyang city from 2003 ~ 2007

    Institute of Scientific and Technical Information of China (English)

    豆筱敏; 张超

    2010-01-01

    目的 分析河南省濮阳市5岁以下儿童死亡状况和特点,为降低5岁以下儿童死亡率制定可行的干预措施.方法 收集2003~2007年5岁以下儿童死亡报告卡,对5岁以下儿童死亡情况进行回顾性的分析.结果 2003~2007年濮阳市5岁以下儿童死亡率呈下降趋势,2003年为18.06%,2007年为15.58%,各年龄组死亡构成无明显变化,5岁以下儿童死因顺位前5位依次为早产和低体重、出生窒息、肺炎、先天性心脏病,其他先天性缺陷和意外伤害.结论 降低5岁以下儿童死亡率的关键是加强妇幼保健工作,提高妇幼保健技术人员的业务素质和全社会的妇幼保健意识.%Objective To comprehend the condition and characteristic of the mortality in children under 5 of Puyang, Henan and then work out practical Intervention Measures to cut down the mortality rate of children under 5. Methods Collecting the Death Report Cards of the children under 5 from 2003 to 2007 and making a retrospective analysis of them. Results The mortality rate of the children under 5 in Puyang is descendlng,such as 18.06% in 2003 and 15.58% in 2007. And no obvious changes could be found in the composition of the mortality in different ages. The first five causes of the mortality of the children under 5 are premature delivery,low birth weight, asphyxia of newborn,pneumonia, congenital heart disease,other inborn errors and unexpressive asphyxia. Conclusion The key to cut down the mortality rate of the children under 5 is to strengthen the Women and Children' s Health care,improve the professional competence of technicians and raise the awareness for the Women and Children's Health care of the whole society.

  20. 缺氧缺血性脑损害患儿血小板参数变化的临床研究%Changes of platelet parameters in children with hypoxic-ischemic brain damage*

    Institute of Scientific and Technical Information of China (English)

    罗世永; 苏国生; 劳炳焕

    2012-01-01

    Objective To investigate the clinical significance of changes of platelet parameters in children with hypoxic ischemic brain damage. Methods 63 cases of children with hypoxic ischemic encephalopathy were enrolled as experiment group,and 60 cases of asphyxia children without brain damage were enrolled as control group. Changes of platelet parameters in these two groups were compared. Results Platelet counts(PLT) in experiment group in acute stage and convalescent period were significantly lower than that in control group,but mean platelet volume(MPV) and platelet distribution width(PDW) were significantly higher. Conclusion There might be changes of platelet parameters in children with hypoxic ischemic encephalopathy and those asphyxia children without brain damage,and changes might be more obvious in former. Detection of platelet parameters could be helpful for monito ring disease condition.%目的 探讨缺氧缺血性脑损害患儿血小板参数变化的临床意义.方法 选取临床确诊缺氧缺血性脑病患儿63例作为实验组,同时选取同期发生窒息但无脑损害的患儿60例作为对照组,比较两组急性期和恢复期血小板参数的变化情况.结果 实验组血小板计数急性期和恢复期均低于对照组,两组比较差异具有统计学意义(P<0.05);平均血小板体积及血小板分布宽度急性期和恢复期均高于对照组,两组比较差异具有统计学意义(P<0.05).结论 缺氧缺血性脑病和窒息但无脑损害患儿血小板参数均有不同程度的变化,但缺氧缺血性脑病患儿变化程度较明显,临床可作为一个辅助的监测指标.

  1. 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。

  2. 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.

  3. 腰硬联合阻滞麻醉在分娩镇痛中的应用分析%Application of combined splnal - epidural analgesia for labor pain relief

    Institute of Scientific and Technical Information of China (English)

    王天文

    2011-01-01

    目的 观察120例腰硬联合阻滞麻醉在分娩镇痛中的临床效果.方法 以120例腰硬联合阻滞麻醉镇痛的分娩产妇为治疗组,观察其临床疗效,并与对照组120例未行任何麻醉的产妇相比较,观察其产程、产后情况及胎儿情况.结果 两组在产后出血、新生儿窒息、胎儿窘迫、窒息方面无显著差异(P>0.05),在分娩方式及产程方面差异显著,有统计学意义(P<0.05).结论 腰硬联合麻醉分娩镇痛的方法能够加速第二产程快速进展,降低了阴道难产率及剖宫产率,对胎儿情况及产妇产后情况无明显影响,是消除分娩疼痛的有效措施.%Objective To assess the Application of combined splnal - epidural analgesia for labor pain relief. Methods 120 cases of lumbar epidural anesthesia for the treatment of maternal labor analgesia group, clinical efficacy and 120 patients with the control group of mothers received no anesthesia, compared to observe the birth process, post - natal conditions and fetal conditions. Results Two groups of postpartum hemorrhage, neonatal asphyxia, fetal distress, asphyxia no significant difference( P > 0.05 ), in the mode of delivery and birth process or its significant difference was statistically significant( P < 0.05 ). Conclusion Analgesia lumbar epidural anesthesia method can accelerate the second stage of rapid progress in reducing the rate of vaginal childbirth and planing Palace yield of postpartum fetal conditions and no significant effect on the situation, is an effective measure to eliminate labor pain.

  4. 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.

  5. 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

  6. 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 ar