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Abstract

Background: A low Apgar score at 5 minutes has been shown to be a risk factor for development of retinopathy of prematurity (ROP).

Aim: To examine the prognostic value of Apgar score at 5 minutes for development and progression of ROP.

Materials and methods: The study included 132 preterm infants who were screened from 4th week of life onward. Of these, 118 newborns were given Apgar score at 5 minutes. The prognostic significance of this index was studied as an absolute value and as a value ≤ 6. The patients were divided into two groups: group I had no evidence of ROP (n=82) and group II had some signs of ROP (n = 36). Group II was further divided into group IIA - spontaneously regressed cases (n=22), and group IIB with cases which progressed to treatment stages (n=14). We investigated 15 maternal and 20 newborn presumable risk factors for development and progression of ROP. Mann-Whitney U test, χ2 or Fisher’s exact test were used in the statistical analysis. Logistic regression was performed to find significant and independent risk factors for manifestation and progression of ROP.

Results: A low 5-minute Apgar score and an Apgar score of 6 or less at 5 minutes were not statistically significant risk factors of ROP (р=0.191, р=0.191, respectively), but were significant risk factors for the manifested ROP to progress to stages requiring treatment (p=0.046, р=0.036, respectively).

Conclusion: An Apgar score at 5 minutes of 6 or less was a significant and independent risk factor for progression of ROP to stages requiring treatment.

Abstract

Early amniotomy is one of the main interventions to enhance the labor progress and prevent dystocia in pregnant women. However, the efficacy of amniotomy has not been approved via labor-related indices and outcomes and has remained a subject for debate and future research. The present study was conducted to evaluate the effect of early amniotomy on labor indices and outcomes in nulliparous women. This randomized clinical trial was performed on 151 singleton pregnant women who were referred to Besat Hospital in Sanandaj, Iran, from March 2016 to March 2018. Participants were randomly divided into an early amniotomy (EA) group and a control group. Duration of the first and second phases of labor, corioamionit, dystocia rate, Apgar score at the first and fifth minutes, prolonged labor and post-partum haemorrhage were evaluated and compared between the two groups. Data were recorded in a checklist and analysed using SPSS Version 23. The p value <0.05 was considered significant. Results showed that labor indices such as duration of the first and second phases, Apgar score one and five minutes after delivery and frequency of prolonged labor, foetal distress and postpartum haemorrhage were significantly improved in patients of the early amniotomy group, compared with the control group (p≤0.05). Early amniotomy significantly decreased the total labor duration without significant increase in the rate of maternal and neonatal complications.

: 626-33. 5. Clark SL, Vines VL, Belfort MA. Fetal injury associated with routine vacuum use during cesarean delivery. Am J Obstet Gynecol. 2008; e4. 6. Miksovsky P,Watson WJ. Obstetricvacuum extraction: state of the art in the new millennium. Obstet Gynecol Survey. 2001; 56:736-51. 7. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953; 32: 260-7. 8. Kim TY, Ryu DH. The effect of fundal pressure at Caesarean section on maternal haemodynamics. Anaesthesia. 2006; 61:434-8. 9. Wylie B. Traction in forceps deliveries. Am

defined as the birth weight of a live born neonate <2500 g. Birth asphyxia was defined as an Apgar score of <7 at 1 min. In-hospital mortality was defined as an infant that died at any time during the entire course of hospitalization. For prolonged second stage of labor, the 95 th percentile for second-stage duration was defined as complete dilatation of the cervix to delivery of the neonate >2 h in nulliparous women and >1 h in multiparous women. Anemia (hematocrit less than 45% in the first day of life) and jaundice were diagnosed from the physician’s record. The

1 Introduction Data on pregnancy complications, labour, delivery, and perinatal outcomes are being extensively collected in all developed countries. However, due to logistic difficulties of a long-term follow-up, only the short-term outcomes, such as Apgar scores, neonatal respiratory morbidity, admission to neonatal intensive care units (NICU), etc., are mostly analysed ( 1 ). Of all perinatal factors, prematurity has been the most studied in terms of its long-term consequences. Preterm birth has been shown in observational studies to be associated with

Abstract

This retrospective study aims to analyze the relationship between biochemical changes occurring in newborns with sepsis proven by positive blood culture (BC) and possible correlations with 1 min Apgar score, 5 min Apgar score, gestational age (GA), and birth weight (BW). We included in the study all infants ≤7 days of life with positive BC that were admitted to the Neonatal Intensive Care Unit (NICU) and Neonatology Department (ND) of the County Emergency Clinical Hospital of Târgu Mureş, a tertiary level hospital, between 2014-2018. The analyzed parameters are: day of life for blood sampling (0-7 days of life), gender, Apgar score (1 and 5 minute), GA, BW, urea, creatinine, total bilirubin, direct bilirubin, aspartate aminotransferase (AST/GOT), alanine aminotransferase (ALT/GPT), c-reactive protein (CPR), bacteria involved, empiric antibiotics administered before blood sampling, temperature of the newborn on the day of BC. We found there is a statistically significant negative correlation between 1 and 5 min Apgar score and creatinine, between GA and urea and also between BW, GA and Direct Bilirubin. We found a statistically significant positive correlation between BW, GA and GPT.

Abstract

The relationship between the type and size of placenta and the development of twin fetuses is still discussed in perinatology. The objective of this paper is to answer the question whether the final weight and size of placenta is a limiting factor for fetal growth in twin pregnancy. The study material consisted of 1,261 pairs of fetuses from monochorionic (MC) and dichorionic (DC) twin pregnancies, born by cesarean section between pregnancy weeks 22 and 41 at the Perinatology and Gynecology Department of the Poznan University of Medical Sciences between 2003 and 2009. Histological examination of secundines, placental weights, and birth weight of twins were evaluated, and the newborn condition was assessed by the Apgar score. Statistical evaluation by analysis of variance assessed placental growth related to gestational age and also the effect of placental-fetal weight ratio on neonate clinical condition. We observed an increase in placenta growth until 38 weeks of pregnancy in twins sharing one placenta and until 36 weeks of pregnancy in twins with separate placentas. Between 22 and 35 weeks of pregnancy, the placental-fetal weight ratio in twins sharing one placenta was higher and they were also smaller than twins with separate placentas The placental-fetal weight ratio was comparable in all twins at delivery and was associated with the clinical condition of newborns. Newborns who received an Apgar score of 8 or more 10 minutes post delivery had a lower ratio than neonates with Apgar score equal to or lower than 7 (p≤0.01). Although these latter twins had both smaller placentas and smaller birth weights, their placental-fetal weight ratios were significantly higher than those of twins born in good condition. Placental growth decreases before pregnancy term but does not limit fetal birth weight in twin pregnancy.

Abstract

OBJECTIVE: The aim of this study was to provide data about the course and outcome of pregnancy in the women with aortic stenosis (AS) with special attention to complications in pregnant with severe AS, which was asymptomatic prior to conception.

METHODS: Eleven pregnant women with different grades of AS were monitored in ambulatory and clinical conditions during pregnancy, childbirth and the post-partum period. The Apgar scores of the neonates born by mothers with AS were compared to those of neonates born by healthy mothers, using the variation statistical analysis.

RESULTS: In the group with severe AS, asymptomatic prior to conception, aggravation of the NYHA functional class (FC) with left ventricular heart failure was observed. Pregnancy, childbirth and post-partum period were normal in the group with moderate aortic stenosis and in those with ventricular defects, corrected prior to conception. The sums of the Apgar scores for the whole group did not differ from those for the neonates, born by healthy mothers.

CONCLUSION: The results suggest that there is a need of consensus for the complex of examinations, enabling diagnostic differentiation of pregnant women with severe AS requiring urgent defect correction and, the prognosis of pregnancy in women with asymptomatic severe AS.

Abstract

Spontaneous premature closure of the human fetal ductus arteriosus is an uncommon event that often results in significant morbidity and mortality. We present a case of a fetus with prenatal previously not detected bone defect that presented with idiopathic intrauterine closure of the ductus arteriosus. A 23-year-old mother at 39 weeks of gestation was admitted to the hospital because of an abnormal findings in four chamber screening view of the fetal heart on routine ultrasonography. The fetal echocardiography showed no detectable flow through the ductus arteriosus. Cesarean section was performed 1 hour later. A female newborn weighing 2640g with Apgar scores of 0, 2, 4 and 6 at 1, 3, 5, and 10 minutes, respectively, was delivered.

Abstract

This is a case report about very rare findings in 2nd half of pregnancy (after normal 1 trimester scan ) at 18th week of gestation fetal macrosomia was detected unrelated to maternal diabetes, and acceleration fetal growth later on with unusual cardiac abnormalities (fetal cardiomegaly, cardiomyopathy, partial abnormal venous connection ). Progressive features of congestive heart failure with polyhydramnios in a fetus with estimated 5500 g predicted a poor outcome and severe neonatal condition, which was presented and discussed with the parents to be. Casearean section was performed at 33rd weeks of gestation due to maternal dyscomfort, severe legs edema and her tachypnoe. Baby boy was delivered with birth weight of 5050g, Apgar 4 with mutiple tumors. Conservative care was introduced and neonated died on the 3rd day. Differential diagnosis was discussed with special attention to Costello syndrome however without proved by genetic make-up from neonatal blood.