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Background: Respiratory distress is the major cause of neonatal intensive care unit (NICU) admission of full-term neonates for which they require different levels of mode of ventilation. Aims and Objectives: The objective of this study was to determine the demographic profile, clinical spectrum, and outcome of term neonates, requiring continuous positive airway pressure (CPAP) in tertiary care teaching hospitals. Materials and Methods: The study was a prospective observational study conducted from December 2020 to November 2022 in the neonatal section of the department of pediatrics. Results: A total of 261 neonates were included in the study. The male-to-female ratio was 1.7:1, the range of birth weight was between 2.1 kg and 3 kg (60.91%), the gestation age was 38 weeks (59.2%), and 73.6% were lower-segment cesarean section born. The age of starting CPAP in most of the newborns was at admission to NICU (in 69.73% of cases). The success rate of CPAP therapy was high (60.9%) and the rest 39.08% of patients did not settle with CPAP and required higher modes of respiratory support such as nasal intermittent positive pressure ventilation (IPPV) (5.89%) and IPPV (94.11%). Conclusion: In the resource-limiting settings, due to the non-availability of higher levels of ventilatory gadgets, the early use of CPAP as a mode of ventilation in full-term babies with transient tachypnea of newborns is well-documented and it can be safely used in other common neonatal conditions which can cause respiratory distress in full-term neonates. The low-middle-income countries are facing challenges to improve comprehensive neonatal care; there is a dire need for simple and cost-effective methods of respiratory support. Bubble CPAP is one such promising ventilatory support intervention, which may reduce the need for costly mechanical ventilators. [ABSTRACT FROM AUTHOR]

Early-term neonates (with a gestational age (GA) of 37 and 0/7 weeks to 38 and 6/7 weeks) face higher morbidities, including respiratory and neurodevelopmental issues, than full-term (39 and 0/7 weeks to 40 and 6/7 weeks) infants. This study explores whether hyperbilirubinemia necessitating phototherapy also differs between these groups. A retrospective study was conducted on neonates born from January 2021–June 2022, excluding those with specific conditions. Evaluated factors included GA, birth weight, bilirubin levels, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and feeding type, with phototherapy given as per AAP guidelines. Of 1085 neonates, 356 met the criteria. When stratifying the neonates based on the need for phototherapy, a higher proportion of early-term neonates required phototherapy compared to full-term (p < 0.05). After factoring in various risks (GA; birth weight; gender; feeding type; G6PD deficiency; transcutaneous bilirubin levels at 24 h and 24–48 h postpartum; maternal diabetes; and the presence of caput succedaneum or cephalohematoma), early-term neonates were more likely to need phototherapy than full-term babies (OR: 2.15, 95% CI: 1.21 to 3.80). The optimal cut-off for transcutaneous bilirubin levels 24–48 h postpartum that were used to predict phototherapy need was 9.85 mg/dl. In conclusion, early-term neonates are at a greater risk for developing jaundice and requiring phototherapy than full-term neonates. Monitoring bilirubin 24–48 h postpartum enhances early prediction and intervention. [ABSTRACT FROM AUTHOR]

Purpose: The cerebroplacental ratio (CPR) is associated with adverse perinatal outcome (APO) in low-risk pregnancies near term. A Doppler parameter, which also includes information from the uterine vessels could potentially improve detection of subclinical placental dysfunction. The aim of this study is to investigate the performance of cerebro-placental-uterine ratio (CPUR) related to APO prediction in low-risk term pregnancies in > 40 + 0 weeks. Methods: This is a retrospective cohort study. All low-risk pregnancies in which feto-maternal Doppler was examined from 40 + 0 weeks and an appropriate for gestational age fetus was present were included. ROC (receiver operating characteristic curves) analyses were performed to assess the predictive value of CPUR. The presence of at least one of the following outcome parameters was defined as composite APO (CAPO): operative delivery (OD) due to intrapartum fetal compromise (IFC), admission to the neonatal intensive care unit, umbilical cord arterial pH ≤ 7.15, 5 min APGAR ≤ 7. Results: A total of n = 114 cases were included. Mean gestational age at examination and delivery were 40 + 3 weeks and 40 + 6 weeks, respectively. Overall, CAPO occurred in 38 of 114 cases (33.3%). ROC analyses showed a significant association of CPUR (AUC = 0.67, p = 0.004) and CPR (AUC = 0.68, p = 0.002) with CAPO. Additionally, CPUR (AUC = 0.64, p = 0.040) showed a predictive value for OD due to IFC. Conclusion: The CPUR in > 40 + 0 weeks showed a predictive value for CAPO and OD due to IFC in low-risk pregnancies. However, the extent to which CPUR can be used to optimize delivery management warrants further investigations in prospective interventional studies. [ABSTRACT FROM AUTHOR]

Neonatal transport scoring systems can assess severity before and after transport, improve transport efficiency, and predict the occurrence of critical illness. The aim of this study was to compare four neonatal transport scoring methods to predict mortality risk and clinical utility within the first week after transportation. This was a single-center retrospective cohort study. All patients were full-term, out-born neonates. Each patient was assessed by the Transport Risk Index of Physiologic Stability (TRIPS), Mortality Index for Neonatal Transportation (MINT), Transport-Related Mortality Score (TREMS), and Neonatal Critical Illness Score (NCIS) scoring methods. Receiver operating characteristic (ROC) curves and decision curve analysis (DCA) for each method were compared for their utility in predicting mortality risk within the 1st week after admission. In total, 368 full-term infants were included (368/770, 47.8% of all transported infants). Within the 1st week after admission, five infants (1.36%, 5/368) died while receiving advanced life support and full treatment, and 24 infants (6.52%, 24/368) died soon after they were discharged against medical advice. The areas under the curve (AUCs) for the MINT, TRIPS, TREMS, and NCIS for the prediction of mortality were 0.822, 0.827, 0.643, and 0.731, respectively (all p < 0.05). However, the clinical net benefits for the MINT and TRIPS were far superior than those for the NCIS and TREMS. Conclusion: It was concluded that the TRIPS and MINT might be more suitable for the prediction of mortality in full-term, out-born neonates in the neonatal intensive care unit (NICU) within the 1st week after transportation. What is Known: • Neonatal transport scores can assess not only the mortality risk during transportation but also the mortality risk of critically ill newborns after admission to the NICU. • The effectiveness of neonatal transport scores in predicting mortality risk is different. What is New: • Our data indicate that the diagnostic efficacy of the MINT, TRIPS, and NCIS in the prediction of full-term infant mortality was high. • The TRIPS and MINT scores had better clinical utility and could be used to predict mortality within the 1st week after transportation in full-term out-born neonates. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a case study related to Apgar scores at 1 and 5 min after birth were 9 and 10, respectively and he was referred to the neonatal intensive care unit (NICU) with abdominal distention since birth and bilious nasogastric aspirates beginning on postnatal day 1. Topics include the patient failed to pass any meconium within the first 24 h of life, and the plain abdominal radiograph revealed multiple has dilated bowel loops without air fluid levels.

Objective: To measure the size of the anterior fontanelle (AF) in healthy late-preterm and term newborns and correlate it with birth weight, gestational age, gender, occipito-frontal circumference, small for gestational age status and birth weight z-score.Methods: This was an observational study carried out from October 2013 through April 2015 at a tertiary care hospital. Newborns ≥ 34 wk gestation were enrolled. Fontanelle edge was palpated with index finger and size calculated by adding anterior-posterior and transverse diameters and dividing by two.Results: A total of 1010 neonates were enrolled. The mean AF size was 2.23 ± 0.52 cm (mean ± SD). There was a significant decrease in the size of the AF with advancing gestational maturity on one-way ANOVA (F = 31.30) (P < 0.001) and also by increasing birth weight (F = 20.34) (P < 0.001). There was no significant difference in the mean AF size between males; 2.21 ± 0.54 cm and females; 2.25 ± 0.55 cm (mean ± SD) (P = 0.575). There was a strong correlation between AF size with increasing birth weight; correlation (r) = 0.985. In small for gestational age neonates the AF was larger, 2.27 ± 0.55 (mean ± SD) and a strong correlation between birth weight z-score and AF size was noted (r = 1.012).Conclusions: The mean AF size in late-preterm and term Indian newborns in a mixed community hospital was 2.23 ± 0.52. A strong correlation was found between AF size with increasing birth weight and with birth weight z-score in small for gestational age babies. [ABSTRACT FROM AUTHOR]

Introduction: Perinatal asphyxia is one of the most common causes of neonatal morbidity and mortality in most countries of the world. The objective of my study was to assess the correlation of clinical findings of perinatal asphyxia with cranial sonography in full term babies. Study Design: Retrospective study. Setting: Neonatal Intensive Care Unit of Children's Hospital Multan. Period: January 2016 to October 2016. Material and Methods: 100 full term babies having history of delayed cry were scanned within three days of birth in Neonatal Intensive Care Unit of Children's Hospital Multan. Clinically findings including full term babies, birth weight, grunting, cyanosis history of mode delivery, resuscitation history, delayed cry and hypoxic ischemic encephalopathy (HIE) grades were taken from baby's hospital file record and standard images including coronal and sagittal plans were taken by Ultrasound machine probe of frequency 3-5 MHz. Findings were recorded on data collection sheets and spread on EXEL sheets. Correlation was found by using SPSS software. Result: Out of 100 neonates 63 were male and 37 were female with birth weight (2.4-3.6) having mean ± SD 3.08 ± 0.53. HIE grades (mild, moderate and severe) were found in 12, 83, 5 babies respectively and ultrasound grades 0 (normal/ mild echogenic), grade 1 (moderate echogenic) and grade 2 (severe/generalized echogenic) were found in 32, 52, 16 neonates respectively with r= 0.37 and P-value < 0.05 showing moderate positive correlation. Conclusion: Cranial ultrasound is a good screening tool to evaluate asphyxiated neonatal brain. It has a moderate positive correlation with clinical findings. [ABSTRACT FROM AUTHOR]

Copyright of Boletin Clinico Hospital Infantil del Estado de Sonora is the property of Asociacion Medica del Hospital Infantil del Estado de Sonora A.C. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Boletin Clinico Hospital Infantil del Estado de Sonora is the property of Asociacion Medica del Hospital Infantil del Estado de Sonora A.C. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Czecho-Slovak Pediatrics / Česko-Slovenská Pediatrie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The early clinical manifestations of congenital syphilis (CS) vary from asymptomatic to florid lesions, involving multisystem damage. But little is known about the differences of early clinical features between preterm and term neonates with CS. Objectives: To compare the clinical characteristics between preterm and term neonates with CS and analyze the possible underlying reasons for the differences. Methods: Consecutive medical charts of infants at risk for CS from January 1999 to December 2009 were retrospectively reviewed. Neonates with positive 19S-IgM in serum were included in the study. Results: Among the 1,670 cases at risk for CS, 130 neonatal cases with positive 19S-IgM in serum were included in the analysis, including 58 preterm ones and 72 full-term ones. Compared with term neonates with CS, preterm ones were more likely to have characteristic skin rash (36.2 vs. 9.7%, p < 0.001), hepatomegaly (51.7 vs. 25%, p = 0.02), splenomegaly (32.8 vs. 15.4%, p = 0.02), PRP titer ≥1:8 (96.6 vs. 70.8%, p < 0.001), thrombocytopenia (43.1 vs. 23.6%, p = 0.018), elevated CRP (65.5 vs. 36.5%, p = 0.002), and abnormal long bone X-ray results (94.6 vs. 68.1%, p < 0.001). Fewer mothers of preterm neonates with CS received treatment for syphilis (15.5 vs. 40.3%, p = 0.003). The rate of withdrawal of care was higher in preterm neonates with CS (31 vs.12.5%, p = 0.036). Conclusions: Preterm neonates with CS had more clinical evidences and suffered more than term ones. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Evaluation of two-stage single-volume exchange transfusion (TSSV-ET) in decreasing the post-exchange rebound increase in serum bilirubin level, with subsequent reduction of the need for repeated exchange transfusions. Methods: The study included 104 neonates with hyperbilirubinemia needing exchange transfusion. They were randomly enrolled into two equal groups, each group comprised 52 neonates. TSSV-ET was performed for the 52 neonates and the traditional single-stage double-volume exchange transfusion (SSDV-ET) was performed to 52 neonates. Results: TSSV-ET significantly lowered rebound serum bilirubin level (12.7 ± 1.1 mg/dL), compared to SSDV-ET (17.3 ± 1.7 mg/dL), p < 0.001. Need for repeated exchange transfusions was significantly lower in TSSV-ET group (13.5%), compared to 32.7% in SSDV-ET group, p < 0.05. No significant difference was found between the two groups as regards the morbidity (11.5% and 9.6%, respectively) and the mortality (1.9% for both groups). Conclusion: Two-stage single-volume exchange transfusion proved to be more effective in reducing rebound serum bilirubin level post-exchange and in decreasing the need for repeated exchange transfusions. [ABSTRACT FROM AUTHOR]

Objective: To study maternal risk factors associated with full term low birth weight (LBW) neonates. Design: Matched pair case control study. Setting: Multicenter study including 2 medical colleges and 1 civil hospital, between July 2009 to December 2009. Patients: Of 2382 neonates screened, 274 full term LBW babies (of 638) and 274 pair matched controls (of 1744) were included in the study. 364 LBW babies were excluded because of premature delivery/gestational age not known (314), unavailability of suitable matched controls (18), and insufficient data (32). Methods: Maternal factors including birth spacing, height, pre-delivery weight and pregnancy weight gain, age, parity, educational and economic status, type of family, antenatal care (ANC), maternal exposure to tobacco, hypertension and anemia were studied. Results: Birth spacing <36 months, maternal height ≤145 cm, pre-delivery weight ≤55 kg, pregnancy weight gain ≤6 kg, exposure to tobacco, inadequate antenatal care, maternal hypertension, low socio-economic status, maternal anemia and less maternal education were associated with delivery of a low birth weight infants. Conditional logistic regression analysis showed that significant risk factors associated with low birth weight were inadequate ANC (OR-4.98, 95% CI-2.64 to 9.39), maternal weight before delivery ≤55 kg (OR-4.81, 95% CI-2.53 to 9.15) and height ≤145 cm (OR-4.13, 95% CI-2.04 to 8.37). Conclusion: Maternal malnutrition, inadequate antenatal care and poor weight gain during pregnancy are significant predictors for delivery of a low birth weight neonate. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is frequently associated with multiple hematologic abnormalities, including depletion of protein C. The status of protein C is not known in infants who clinically present with a sepsis-like picture without a culture-proven sepsis. The objectives of this study were to determine whether sepsis-like illness is associated with a reduction in protein C. Methods: In this case-control, cross-sectional study, 49 full-term neonates admitted to the neonatal intensive care unit (NICU) with the clinical manifestation of sepsis that was not proven by cultures. Fifty healthy full-term newborns were also randomly selected as a control group. Protein C concentrations were compared between both groups. Results: There was no difference between the case and control groups regarding sex and gestational age. Protein C concentration did not differ between groups (p > 0.05); mean protein C concentration was 29.4% of the normal adult level in cases with clinical sepsis and 32% in the control group. Conclusion: Protein C deficiency was not related to clinical manifestations in sepsis-like illness. Further studies examining other predictors of sepsis-like illness are recommended. [ABSTRACT FROM AUTHOR]

Objective: To assess the value of transvaginal cervical length (CL) measurement and funneling of the internal cervical os to predict the onset of spontaneous labor within one week. Design: Observational prospective study. Population: A total of 234 women who delivered after spontaneous onset of labor. Methods: CL was measured and the presence of funneling of the internal cervical os was recorded by transvaginal ultrasound examination. Main Outcome Measures: CL changes from 37 to 40 weeks of gestation as a one-point measurement, as well as the long-term (16-21 weeks to term or 37-40 weeks) and short-term (weekly from 37 to 40 weeks) differences in CL. Results: The one-point measurement of CL, with an optimum cut-off point of 25 mm [odds ratio (OR) 3.19; 95% confidence interval (CI) 2.01-5.05] and a decreased long-term CL (cervical shortening of 55% as an optimum cut-off point (OR 3.75; 95% CI 1.76-8.00) may predict the onset of spontaneous labor within one week. The likelihood of spontaneous labor within one week is high when funneling of the internal cervical os is present (OR 2.68; 95% CI 1.71-4.19). Conclusions: Transvaginal CL measurement and observation of funneling of the internal cervical os are useful predictors of the onset of spontaneous labor. [ABSTRACT FROM AUTHOR]

Objective: Testing the validity of C-reactive protein (CRP) in extremely low birth weight (ELBW) infants. Methods: During a five-year period, 483 infants with probable (36%) and definite sepsis (64%) were enrolled in the study. Results: ELBW infants with definitive sepsis had CRP levels comparable with full-terms ( p = 0.992). However, the highest (hs) values were observed in infants >2500 g, 24 h after the septic work up whereas in those with birth weight (BW) <1000 g after 48 h. Highest CRP levels of infants with early sepsis were similar to those of the late onset ones ( p = 0.825). The causative microorganism had a strong influence on CRP values, as Gram negative germs produced significantly higher CRP levels in comparison to infants with Gram positive sepsis. Conclusions: Highest CRP values in <1000 g infants increase in levels comparable to full terms, but with a 24-h delay. [ABSTRACT FROM AUTHOR]

Visual acuity was measured in both preterm and full-term infants by means of forced-choice preferential looking. The ages of infants tested ranged from one month to 12 months. The results of both groups were considered and compared in terms of natal and conceptional age. The data suggested that preterm infants show visual responses equivalent to their full-term counterparts by nine months of age. Trends indicate that visual acuity development in healthy preterm infants appears to be accelerated when compared with full-term infants of the same post-conceptional age. [ABSTRACT FROM AUTHOR]

With the aid of the scanning electron microscope the possible sites of materno-foetal oxygen transfer were investigated. Fresh small tissue pieces were obtained and processed from at least six regions of central and peripheral parts of the maternal surface of human full-term placentas. The surface ultrastructural features of the syncytiotrophoblast lining the stem and floating villi were surveyed. The microvilli projecting from the apical portion of the syncytiotrophoblast appeared to be highly pleomorphic and showed regional variation in their distribution. On the other hand, our results confirmed the occurrence of non-microvillous areas on the apices of some floating villi. When present, these areas were always free from contact with maternal red blood cells. Maternal red blood cells, however, were seen in close contact only with areas covered with microvilli. Occasionally, impressions ('footmarks') were apparent on some surfaces and detached microvilli were seen adherent to the surface of other maternal red cells which had separated from the villous surface. Our results indicate, therefore, that the microvillous areas of the chorionic villi are the most likely sites for oxygen transfer and that one of the functions of the microvilli is gas transfer across the placenta. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Pediatrics is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pertussis, or whooping cough, is a severe infection when affecting young children. Infants in the neonatal period are especially vulnerable, since they have not received vaccination, and have an immature immune system. We report a case of a neonate who was diagnosed with pertussis complicated by multiple episodes of apneas, bradycardia and desaturation events. The infant was critically ill and was admitted to the Neonatal Intensive Care Unit, but subsequently improved while receiving only conventional respiratory support and was discharged home with an overall good outcome. [ABSTRACT FROM AUTHOR]