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Neonatal Perinatal Asphyxia

Z X Yang, Z H Wei, X Zou, H Yu, T Wang, Y Hu, J B Li, R K Tang
OBJECTIVES: To analyze the causes of perinatal death and related factors from the perspective of forensic medicine, and to provide references for reducing perinatal mortality and guidance for forensic identification. METHODS: A retrospective analysis was performed on 102 cases of perinatal autopsy with clinical data from the Department of Forensic Medicine of Chongqing Medical University in 2004-2016. RESULTS: Of the 102 cases of perinatal deaths, 66 (64...
February 2019: Fa Yi Xue za Zhi
Anadeijda J E M C Landman, Saskia T Immink-Duijker, Eduard J H Mulder, Maria P H Koster, Serena Xodo, Gerard H A Visser, Floris Groenendaal, Anneke Kwee
BACKGROUND: Although the evidence regarding the benefit of using ST waveform analysis of the fetal electrocardiogram is conflicting, ST waveform analysis is considered as adjunct to identify fetuses at risk for asphyxia in our center. Most randomized controlled trials and meta-analyses have not shown a significant decrease in umbilical metabolic acidosis while some observational studies have shown a gradual decrease of this outcome over a longer period of time. Observational studies can give more insight into the effect of implementation of the ST technology in daily clinical practice...
February 28, 2019: American Journal of Obstetrics and Gynecology
Tujare Tunta Orsido, Netsanet Abera Asseffa, Tezera Moshago Berheto
BACKGROUND: The first one month of life; the neonatal period is the most risky time for child survival. In Ethiopia, neonatal mortality is unacceptably high, and the trend in reduction is slower as compared to infant and child mortality. The magnitude and associated factors of neonatal mortality in a tertiary care facility were not well documented. Therefore, the aim of this study was to determine neonatal mortality and predictors among neonates admitted to neonatal intensive care unit of Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia...
February 28, 2019: BMC Pregnancy and Childbirth
Shiraz Badurdeen, Calum Roberts, Douglas Blank, Suzanne Miller, Vanesa Stojanovska, Peter Davis, Stuart Hooper, Graeme Polglase
Brain injury in the asphyxic newborn infant may be exacerbated by delayed restoration of cardiac output and oxygen delivery. With increasing severity of asphyxia, cerebral autoregulatory responses are compromised. Further brain injury may occur in association with high arterial pressures and cerebral blood flows following the restoration of cardiac output. Initial resuscitation aims to rapidly restore cardiac output and oxygenation whilst mitigating the impact of impaired cerebral autoregulation. Recent animal studies have indicated that the current standard practice of immediate umbilical cord clamping prior to resuscitation may exacerbate injury...
February 27, 2019: Brain Sciences
Himani Bhasin, Charu Kohli
BACKGROUND: In perinatal asphyxia, hypoxia often leads to myocardial ischaemia. Few studies have assessed the degree of myocardial dysfunction in severely asphyxiated term neonates. AIM: To assess the extent of myocardial damage in newborns with severe perinatal asphyxia. METHODS: A case-control study was conducted in asphyxiated newborns with hypoxic ischaemic encephalopathy (HIE) and in controls who were term non-asphyxiated newborns. Total (T) creatinine kinase (CK), CK-MB, troponin-T and 12-lead electrocardiography (ECG) and echocardiography were performed in both groups within 24-48 h after birth...
February 27, 2019: Paediatrics and International Child Health
Lixia Ye, Xue Wang, Chenchen Cai, Shanshan Zeng, Junjie Bai, Kaiming Guo, Mingchu Fang, Jian Hu, Huan Liu, Liyun Zhu, Fei Liu, Dongxue Wang, Yingying Hu, Shulin Pan, Xiaokun Li, Li Lin, Zhenlang Lin
Perinatal asphyxia often results in neonatal cerebral hypoxia-ischemia (HI), which is associated with high mortality and severe long-term neurological deficits in newborns. Currently, there are no effective drugs to mitigate the functional impairments post-HI. Previous studies have shown that fibroblast growth factor 21 (FGF21) has a potential neuroprotective effect against brain injury. However, the effect of FGF21 on neonatal HI brain injury is unclear. In the present study, both in vivo and in vitro models were used to assess whether recombinant human FGF21 (rhFGF21) could exert a neuroprotective effect after HI and explore the associated mechanism...
February 22, 2019: Experimental Neurology
Patrícia Maidana Miguel, Bruna Ferrary Deniz, Heloisa Deola Confortim, Loise Peres Bronauth, Bruna Chaves de Oliveira, Márcio Bonesso Alves, Patrícia Pelufo Silveira, Lenir Orlandi Pereira
Perinatal complications such as birth asphyxia were associated with a higher risk for Attention-Deficit/Hyperactivity Disorder (ADHD) in humans. Data from a rat model of neonatal hypoxia-ischemia (HI) have revealed inattention, impulsive behavior and dopamine (DA) disturbances in the prefrontal cortex (PFC), confirming the face validity and construct validity for ADHD study. However, the predictive validity (similar therapeutic efficacy of the pharmacological treatment available in the clinic) should be considered...
February 13, 2019: Experimental Neurology
Laurent M A Favié, Floris Groenendaal, Marcel P H van den Broek, Carin M A Rademaker, Timo R de Haan, Henrica L M van Straaten, Peter H Dijk, Arno van Heijst, Jeroen Dudink, Koen P Dijkman, Monique Rijken, Inge A Zonnenberg, Filip Cools, Alexandra Zecic, Johanna H van der Lee, Debbie H G M Nuytemans, Frank van Bel, Toine C G Egberts, Alwin D R Huitema
OBJECTIVE: Morphine is a commonly used drug in encephalopathic neonates treated with therapeutic hypothermia after perinatal asphyxia. Pharmacokinetics and optimal dosing of morphine in this population are largely unknown. The objective of this study was to describe pharmacokinetics of morphine and its metabolites morphine-3-glucuronide and morphine-6-glucuronide in encephalopathic neonates treated with therapeutic hypothermia and to develop pharmacokinetics based dosing guidelines for this population...
2019: PloS One
Pedro Jesús Saturno-Hernández, Ofelia Poblano-Verástegui, Sergio Flores-Hernández, Daniel Ángel-García, Gabriel Jaime O Shea-Cuevas, Víctor Manuel Villagrán-Muñoz, María Elizabeth Halley-Castillo, Verónica Delgado-Sánchez
OBJECTIVE: Develop and pilot indicators of quality of care to neonates with relevant conditions in Mexico (prematurity, neonatal sepsis, perinatal asphyxia, and intrauterine hypoxia). MATERIALS AND METHODS: Own indicators were built based on key recommendations of national clinical practice guidelines and indicators found in international repositories. With previous search, selection and prioritization, the indicators were piloted within two hospitals. The feasibility of measuring, (kappa index) reliability and usefulness was analyzed to detect quality problems...
2019: Salud Pública de México
Iliana Bersani, Fabrizio Ferrari, Licia Lugli, Giorgio Ivani, Alessandra Conio, Bashir Moataza, Hanna Aboulgar, Hala Mufeed, Iman Iskander, Maria Kornacka, Darek Gruzfeld, Andrea Dotta, Immacolata Savarese, Natalia Chukhlantseva, Lucia Gabriella Tina, Francesco Nigro, Giovanni Livolti, Fabio Galvano, Laura Serpero, Micaela Colivicchi, Patrizia Ianniello, Francesca Pluchinotta, Luigi Anastasia, Ekaterina Baryshnikova, Diego Gazzolo
Background Perinatal asphyxia is a major cause of mortality and morbidity in neonates: The aim of the present study was to investigate, by means of longitudinal assessment of urinary S100B, the effectiveness of hypothermia, in infants complicated by perinatal asphyxia and hypoxic-ischemic encephalopathy. Methods We performed a retrospective case-control study in 108 asphyxiated infants, admitted to nine tertiary departments for neonatal intensive care from January 2004 to July 2017, of whom 54 underwent hypothermia treatment and 54 did not...
February 12, 2019: Clinical Chemistry and Laboratory Medicine: CCLM
Michael Hayman, Gerda van Wezel-Meijler, Henrica van Straaten, Eva Brilstra, Floris Groenendaal, Linda S de Vries
BACKGROUND: Punctate white matter lesions (PWMLs) are small focal patches of increased signal intensity (SI) on T1- and decreased SI on T2-weighted magnetic resonance imaging (MRI). To date, there have been few reports of PWMLs in term born infants. OBJECTIVE: To identify associated diagnoses and factors predictive of clinical outcome in (near) term infants with PWMLs. METHODS: MRI studies and clinical records of (near) term infants, with PWMLs on MRI scans performed in two institutions in the first 28 postnatal days were reviewed...
January 26, 2019: European Journal of Paediatric Neurology: EJPN
P Sg, A Kadam, S Kadam, U Vaidya, P Kumar, I Bhagat, A Pandit, N Chouthai
BACKGROUND: Perinatal asphyxia is a prominent cause of neonatal mortality in the developing world. Growth in head circumference is associated with improved neurodevelopment. Previous studies found a positive correlation between additional dietary supplementation and growth in head circumference among newborns with perinatal brain injury. This study aims to evaluate the association between anthropometric parameters and developmental outcomes in newborns with hypoxic ischemic encephalopathy (HIE)...
February 4, 2019: Journal of Neonatal-perinatal Medicine
Ladan Younesi, Mostafa Ghadamzadeh, Ghazaleh Amjad, Zeinab Safarpour Lima
Intrauterine growth restriction is associated with a significant increase in morbidity and perinatal mortality, and increases the likelihood of fetal death, asphyxia, meconium aspiration, hypoglycemia, and neonatal hypothermia. The aim of this study was to determine aortic isthmus flow difference by using color doppler sonography in Intrauterine growth restriction and normal fetuses. The data presented were obtained from 30 mothers, who referred to the radiology department of Akbarabadi Hospital of Tehran with a diagnosis of intrauterine growth restriction...
November 2, 2018: European Journal of Translational Myology
Xiuhua Yang, Tao Meng
OBJECTIVE: The admission of full-term neonates in the Neonatal Intensive Care Unit (NICU) is not an uncommon occurrence. All newborns admitted to the NICU attain benefits, such as highly specialized care, but there are also associated risks and high cost. This study aimed at identifying the patterns of full-term neonatal admissions at the NICU. METHODS: A hospital-based retrospective cross-sectional study was carried out among all full-term neonates (≥ 37-week gestation) admitted to the NICU at the First Hospital of China Medical University from 1 January, 2009 to 30 June, 2018...
January 9, 2019: Journal of Maternal-fetal & Neonatal Medicine
Marc Paul O'Sullivan, Ann Marie Looney, Gerard M Moloney, Mikael Finder, Boubou Hallberg, Gerard Clarke, Geraldine B Boylan, Deirdre M Murray
Importance: Neonatal hypoxic-ischemic encephalopathy (HIE) remains a significant cause of neurologic disability. Identifying infants suitable for therapeutic hypothermia (TH) within a narrow therapeutic time is difficult. No single robust biochemical marker is available to clinicians. Objective: To assess the ability of a panel of candidate microRNA (miRNA) to evaluate the development and severity of encephalopathy following perinatal asphyxia (PA). Design, Setting, and Participants: This validation study included 2 cohorts...
December 28, 2018: JAMA Neurology
Pankaj Kumar Mohanty, Tapas Kumar Som, Suvendu Purkait, Amit Kumar Satapathy
Difficult intubation in neonates has innumerable aetiologies. It especially poses a formidable challenge to save a newborn baby immediately after birth where antenatal details are unavailable. A late preterm neonate was born limp and apnoeic. Several attempts to intubate the baby were unsuccessful. Possibility of subglottic obstruction was considered. The baby died of severe perinatal asphyxia. Autopsy showed a mass around the airway which turned out to be ectopic thymus on histopathology. Ectopic thymus can present as periglottic mass without externally visible cervical swelling and can cause difficult intubation which may lead to serious adverse outcome including death if not anticipated early and managed accordingly...
November 28, 2018: BMJ Case Reports
Xinning Chen, Qiongjie Zhou, Xirong Xiao, Xiaotian Li
PURPOSE: To investigate the value of ultrasound approaching delivery to predict isolated inter-twin discordance and adverse perinatal outcomes. METHODS: We retrospectively included twin pregnancies with sonography approaching delivery in ten maternal-foetal medicine centres in China from 2013 to 2014. Estimated foetal weight (EFW) and inter-twin EFW disparity (EFWD) were calculated based on biometry parameters. Percentage errors between EFW and actual birthweight or between EFWD and actual inter-twin disparity were calculated...
December 18, 2018: Archives of Gynecology and Obstetrics
Y Moral, N J Robertson, F Goni-de-Cerio, D Alonso-Alconada
INTRODUCTION: Perinatal asphyxia remains a major cause of both mortality and neurological morbidity. Neonatal encephalopathy affects to 1-3/1,000 newborns, leading to significant brain damage and childhood disability. The only standard therapy is moderate hypothermia, whose efficacy, despite proved, is limited, being partially effective. DEVELOPMENT: The capacity of hypothermia in promoting cell proliferation in the neurogenic niches of the central nervous system remains subject of investigation...
January 1, 2019: Revista de Neurologia
Hayder Al-Momen, Majed Kadhim Muhammed, Ali Abdulhussein Alshaheen
During a daily neonatology practice, seizures are a continuous challenge as a common neurological disease with a wide range of underlying etiologies, and considerable risks of morbidity and mortality. This study aimed to clarify the rate, etiological factors and outcomes of neonatal seizures, and a possible foresight of neonatal death in Iraq. A prospective cohort study was conducted in neonates with seizures admitted to 3 major neonatology centers in Baghdad, Iraq, from 1st of December 2017 till the end of May 2018...
December 2018: Tohoku Journal of Experimental Medicine
Xin Chen, Wansheng Peng, Zhen Zhang, Qian Zhao, Yan Zhou, Li Chen, Jiahua Pan
OBJECTIVE: To evaluate the efficacy and safety of selective brain hypothermia (SBH) in the treatment of neonates with moderate or severe neonatal hypoxic-ischemic encephalopathy (HIE), and the effect of SBH treatment on serum levels of neuron-specific enolase (NSE) and central nervous specific protein S100. METHODS: A prospective randomized controlled trial was conducted. From January 2015 to June 2017, 42 children with moderate to severe HIE in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Bengbu Medical College were enrolled, and they were randomly divided into SBH treatment group and routine treatment group after obtaining the consent of the guardian of the children...
November 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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