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Intraventricular Haemorrhage

Daniel F Hanley, Richard E Thompson, Michael Rosenblum, Gayane Yenokyan, Karen Lane, Nichol McBee, Steven W Mayo, Amanda J Bistran-Hall, Dheeraj Gandhi, W Andrew Mould, Natalie Ullman, Hasan Ali, J Ricardo Carhuapoma, Carlos S Kase, Kennedy R Lees, Jesse Dawson, Alastair Wilson, Joshua F Betz, Elizabeth A Sugar, Yi Hao, Radhika Avadhani, Jean-Louis Caron, Mark R Harrigan, Andrew P Carlson, Diederik Bulters, David LeDoux, Judy Huang, Cully Cobb, Gaurav Gupta, Ryan Kitagawa, Michael R Chicoine, Hiren Patel, Robert Dodd, Paul J Camarata, Stacey Wolfe, Agnieszka Stadnik, P Lynn Money, Patrick Mitchell, Rosario Sarabia, Sagi Harnof, Pal Barzo, Andreas Unterberg, Jeanne S Teitelbaum, Weimin Wang, Craig S Anderson, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Wendy Ziai, Mario Zuccarello, Issam A Awad
BACKGROUND: Acute stroke due to supratentorial intracerebral haemorrhage is associated with high morbidity and mortality. Open craniotomy haematoma evacuation has not been found to have any benefit in large randomised trials. We assessed whether minimally invasive catheter evacuation followed by thrombolysis (MISTIE), with the aim of decreasing clot size to 15 mL or less, would improve functional outcome in patients with intracerebral haemorrhage. METHODS: MISTIE III was an open-label, blinded endpoint, phase 3 trial done at 78 hospitals in the USA, Canada, Europe, Australia, and Asia...
February 6, 2019: Lancet
Stephan Schmidt, Mikael Norman, Bjorn Misselwitz, Aurélie Piedvache, Lene D Huusom, Heili Varendi, Henrique Barros, Hendrik Cammu, Béatrice Blondel, Joachim Dudenhausen, Jennifer Zeitlin, Tom Weber
OBJECTIVE: Caesarean section (CS) may reduce mortality and morbidity for very preterm breech infants, but evidence is inconclusive. We evaluated neonatal outcomes for singleton breech infants by mode of delivery in a European cohort. STUDY DESIGN: Data come from the EPICE population-based cohort of very preterm births in 19 regions in 11 European countries (7770 live births). The study population was singleton spontaneous-onset breech births at 24-31 weeks gestational age (GA) without antenatal medical complications requiring caesarean delivery (N = 572)...
January 11, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
S D Mandondo, G J Hofmeyr, F Mbengo, N T Mshweshwe-Paleka, T R Mavundla
BACKGROUND: Little is known about the outcomes of self-induced pregnancy termination after 24 weeks' gestation, as previous studies have concentrated on outcomes before 24 weeks. OBJECTIVES: To investigate the gestational age, misoprostol dosage, source of information on misoprostol, reasons for termination and outcomes of self-induced pregnancy termination after 24 weeks' gestation. METHODS: A quantitative, retrospective case series observational research design was utilised...
October 26, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Robert Spaull, Bryony McPherson, Andriana Gialeli, Aled Clayton, James Uney, Axel Heep, Óscar Cordero-Llana
BACKGROUND: Preterm infants are at risk of germinal matrix haemorrhage-intraventricular haemorrhage (GMH-IVH) which leads to post-haemorrhagic hydrocephalus (PHH) in 30% of infants; this is associated with moderate-severe neurodevelopmental impairment and confers significant risk of cerebral palsy. There are however no predictive indicators of the severity or long-term outcome after GMH-IVH. In recent years, endosome-derived extracellular vesicles (EVs) or exosomes have been isolated from biofluids and shown to mediate intercellular communication via selective enrichment in proteins and micro-RNAs...
January 9, 2019: International Journal of Developmental Neuroscience
Nicole R van Veenendaal, Wieke H Heideman, Jacqueline Limpens, Johanna H van der Lee, Johannes B van Goudoever, Anne A M W van Kempen, Sophie R D van der Schoor
BACKGROUND: The effect of the hospital environment on health and specifically neurodevelopment in preterm infants remains under debate. We assessed outcomes of preterm infants hospitalised in single family rooms compared with common open bay units. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycInfo, CENTRAL (the Cochrane Central Register of Controlled Trials), Web of Science, and from inception to Aug 13, 2018, using controlled terms (ie, MeSH terms) and text words related to prematurity and neonatal intensive care unit design...
January 7, 2019: Lancet Child & Adolescent Health
Rene O Pérez-Ramírez, Juan Carlos Lona-Reyes, Cesar A Ochoa-Meza, Larissa M Gómez-Ruiz, Ruth Y Ramos-Gutiérrez, E Elizabeth Camarena-Pulido, J Antonio Gallegos-Marín
INTRODUCTION: Prenatal corticosteroids reduce neonatal mortality and morbidity; however, there are few studies in developing countries, and with inconsistent results. The purpose of this study was to quantify the frequency of the use of prenatal corticosteroids and to estimate its effect on the morbidity and mortality of premature newborns. METHODS: A retrospective cohort study was performed on premature newborns selected from a census conducted between January 2016 and August 2017...
January 3, 2019: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Mohamed Shalabi Ahmed, Regan E Giesinger, Mohamed Ibrahim, Michelle Baczynski, Deepak Louis, Karl P McNamara, Amish Jain, Dany E Weisz, Patrick J McNamara
AIM: To evaluate the clinical and echocardiography modulators of treatment response in hypoxemic preterm infants exposed to inhaled nitric oxide (iNO). METHODS: In this multicentre retrospective study, clinical parameters, including oxygenation, ventilation and haemodynamics, were collected for preterm infants <36 weeks gestation before and 2 h after initiation of iNO for acute hypoxemia. Comprehensive echocardiography, performed near the time iNO initiation, was analysed by experts blind to the clinical course...
December 8, 2018: Journal of Paediatrics and Child Health
Ajay Hegde, Girish Menon
Background: Published literature on intracerebral haemorrhage (ICH) from the Indian subcontinent is very scarce. The study aims to assess the prognostic factors influencing outcome and validating the ICH score which is widely used to prognosticate the disease in this financially constraint population. Prognosticating the outcome at the time of admission is important to customize treatment in a cost-effective manner. Materials and Methods: We conducted a prospective study of all Spontaneous ICH patients admitted from February 2015 to May 2016...
October 2018: Annals of Indian Academy of Neurology
Sanja Zivanovic, Alexandra Scrivens, Raffaella Panza, Peter Reynolds, Nicola Laforgia, Kevin N Ives, Charles C Roehr
AIM: To evaluate the effectiveness of nasal high-flow therapy (nHFT) as primary respiratory support for preterm infants with respiratory distress syndrome (RDS) in two tertiary neonatal units. METHODS: A retrospective outcome analysis of initial respiratory support strategies was performed in two tertiary neonatal units in the UK: John Radcliffe Hospital (JRH), Oxford and St Peter's Hospital (SPH), Chertsey. Infants born between 28+0 and 36+6 weeks gestational age (GA) between May 2013 and June 2015 were included...
December 4, 2018: Neonatology
Srinivas Bolisetty, Mudita Tiwari, Lee Sutton, Timothy Schindler, Barbara Bajuk, Kei Lui
AIM: This study aimed to provide updated information on gestation-specific neurodevelopmental outcomes of extremely to very preterm infants 23-28 weeks' gestation admitted to neonatal intensive care units (NICUs). METHODS: This was a population-based retrospective cohort study of infants born between 23+0 and 28+6 weeks' gestation and admitted to a network of NICUs between 2007 and 2012 in a well-defined geographic area of New South Wales (NSW) and the Australian Capital Territory (ACT)...
November 30, 2018: Journal of Paediatrics and Child Health
Lisa Molines, Simon Nusinovici, Marie Moreau, Mathilde Remy, Pascale May-Panloup, Cyril Flamant, Jean-Christophe Roze, Patrick Van Bogaert, Pierre-Emmanuel Bouet, Géraldine Gascoin
STUDY QUESTION: Is assisted conception associated with neonatal morbidity and mortality and with neurodevelopmental impairment at 2 years of corrected age in preterm infants born before 34 weeks of gestational age? SUMMARY ANSWER: Assisted conception is not associated with an increase in neonatal morbidity and mortality and is even significantly associated with a better 2-year neurodevelopmental outcome in preterm infants. WHAT IS KNOWN ALREADY: Assisted conception appears to increase the rate of preterm births, though few studies have analysed outcomes for these preterm infants...
November 29, 2018: Human Reproduction
Fenella J Kirkham, Dimitrios Zafeiriou, David Howe, Philippa Czarpran, Ashley Harris, Roxanna Gunny, Brigitte Vollmer
Fetal stroke is an important cause of cerebral palsy but is difficult to diagnose unless imaging is undertaken in pregnancies at risk because of known maternal or fetal disorders. Fetal ultrasound or magnetic resonance imaging may show haemorrhage or ischaemic lesions including multicystic encephalomalacia and focal porencephaly. Serial imaging has shown the development of malformations including schizencephaly and polymicrogyra after ischaemic and haemorrhagic stroke. Recognised causes of haemorrhagic fetal stroke include alloimmune and autoimmune thrombocytopaenia, maternal and fetal clotting disorders and trauma but these are relatively rare...
September 11, 2018: European Journal of Paediatric Neurology: EJPN
Suma B Hoffman, Yun-Ju Cheng, Laurence S Magder, Narendra Shet, Rose M Viscardi
OBJECTIVE: To test the hypothesis that impaired cerebral autoregulation (ICA) increases the susceptibility of premature infants to adverse outcomes, we determined the relationship of ICA and cerebral reactivity (CR) measured in the first 96 hours of life to the outcome of grade 3 or 4 intraventricular haemorrhage (IVH) and/or death within 1 month. SETTING: Single-centre level IV neonatal intensive care unit. PATIENTS: Neonates 24-29 weeks' gestation less than 12 hours old with invasive blood pressure monitoring...
November 1, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Carlotta Spagnoli, Raffaele Falsaperla, Michela Deolmi, Giovanni Corsello, Francesco Pisani
Neonatal seizures are the most common neurological event in newborns, showing higher prevalence in preterm than in full-term infants. In the majority of cases they represent acute symptomatic phenomena, the main etiologies being intraventricular haemorrhage, hypoxic-ischemic encephalopathy, central nervous system infections and transient metabolic derangements.Current definition of neonatal seizures requires detection of paroxysmal EEG-changes, and in preterm newborns the incidence of electrographic-only seizures seems to be particularly high, further stressing the crucial role of electroencephalogram monitoring in this population...
November 1, 2018: Italian Journal of Pediatrics
Jeanie L Y Cheong, Katherine J Lee, Rosemarie A Boland, Alicia J Spittle, Gillian F Opie, Alice C Burnett, Leah M Hickey, Gehan Roberts, Peter J Anderson, Lex W Doyle
BACKGROUND: Decisions regarding provision of intensive care and post-discharge follow-up for infants born extremely preterm (<28 weeks' gestation) are based on the risks of mortality and neurodevelopmental disability. We aimed to elucidate the changes in probability of three outcomes (death, survival with major disability, and survival without major disability) with postnatal age in extremely preterm infants offered intensive care, and the effect of postnatal events on the probability of survival without major disability...
December 2018: Lancet Child & Adolescent Health
Sasank Chilamkurthy, Rohit Ghosh, Swetha Tanamala, Mustafa Biviji, Norbert G Campeau, Vasantha Kumar Venugopal, Vidur Mahajan, Pooja Rao, Prashant Warier
BACKGROUND: Non-contrast head CT scan is the current standard for initial imaging of patients with head trauma or stroke symptoms. We aimed to develop and validate a set of deep learning algorithms for automated detection of the following key findings from these scans: intracranial haemorrhage and its types (ie, intraparenchymal, intraventricular, subdural, extradural, and subarachnoid); calvarial fractures; midline shift; and mass effect. METHODS: We retrospectively collected a dataset containing 313 318 head CT scans together with their clinical reports from around 20 centres in India between Jan 1, 2011, and June 1, 2017...
October 11, 2018: Lancet
David Churchill, Lelia Duley, Jim G Thornton, Mahmoud Moussa, Hind Sm Ali, Kate F Walker
BACKGROUND: Severe pre-eclampsia can cause significant mortality and morbidity for both mother and child, particularly when it occurs remote from term, between 24 and 34 weeks' gestation. The only known cure for this disease is delivery. Some obstetricians advocate early delivery to ensure that the development of serious maternal complications, such as eclampsia (fits) and kidney failure are prevented. Others prefer a more expectant approach, delaying delivery in an attempt to reduce the mortality and morbidity for the child that is associated with being born too early...
October 5, 2018: Cochrane Database of Systematic Reviews
K L Hon, S Liu, J Cy Chow, K Yc Tsang, H S Lam, K W So, Y Ky Cheng, A Kc Leung, W Wong
BACKGROUND: Extremely low birth weight (ELBW) infants exhibit high rates of mortality and morbidity. We retrospectively assessed factors associated with mortality and morbidity among ELBW infants. METHODS: Perinatal demographic data were reviewed for all ELBW infants born between 2010 and 2017 at a tertiary neonatal unit. RESULTS: For non-survivors (21% of ELBW infants) and survivors, the median gestational ages were 24.1 and 26.2 weeks, respectively, and median birth weights were 650 g and 780 g, respectively (all P<0...
October 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Georgios Tsivgoulis, Duncan Wilson, Aristeidis H Katsanos, João Sargento-Freitas, Cláudia Marques-Matos, Elsa Azevedo, Tomohide Adachi, Christian von der Brelie, Yoshifusa Aizawa, Hiroshi Abe, Hirofumi Tomita, Ken Okumura, Joji Hagii, David J Seiffge, Vasileios-Arsenios Lioutas, Christopher Traenka, Panayiotis Varelas, Ghazala Basir, Christos Krogias, Jan C Purrucker, Vijay K Sharma, Timolaos Rizos, Robert Mikulik, Oluwaseun A Sobowale, Kristian Barlinn, Hanne Sallinen, Nitin Goyal, Shin-Joe Yeh, Theodore Karapanayiotides, Teddy Y Wu, Konstantinos Vadikolias, Marc Ferrigno, Georgios Hadjigeorgiou, Rik Houben, Sotirios Giannopoulos, Floris H B M Schreuder, Jason J Chang, Luke A Perry, Maximilian Mehdorn, João-Pedro Marto, João Pinho, Jun Tanaka, Marion Boulanger, Rustam Al-Shahi Salman, Hans R Jäger, Clare Shakeshaft, Yusuke Yakushiji, Philip M C Choi, Julie Staals, Charlotte Cordonnier, Jiann-Shing Jeng, Roland Veltkamp, Dar Dowlatshahi, Stefan T Engelter, Adrian R Parry-Jones, Atte Meretoja, Panayiotis D Mitsias, Andrei V Alexandrov, Gareth Ambler, David J Werring
OBJECTIVE: Whether intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA-ICH) is uncertain. METHODS: We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality...
November 2018: Annals of Neurology
Victoria Yj Tay, Srinivas Bolisetty, Barbara Bajuk, Kei Lui, John Smyth
AIM: To evaluate trends in admission temperature and its effect on mortality and short-term morbidities in extremely preterm infants. METHODS: A regional cohort study of infants born at 23-28 weeks' gestation and admitted to the 10 neonatal intensive care units in New South Wales and the Australian Capital Territory between 1994 and 2012. Hypothermia was defined as skin temperature <36°C on admission to the neonatal intensive care unit. The primary outcome was hospital mortality...
September 15, 2018: Journal of Paediatrics and Child Health
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