Search

Congenital hydrops fetalis describes an abnormal accumulation of fluid in two or more compartments in a fetus. The disease is categorized based on the aetiology: immune- and non-immune hydrops fetalis. Today, the non-immune form is the most common. Once born, the child is initially handled symptomatically and will often need intensive care and treatment. Even though approximately one in five cases is still idiopathic, genetic diagnostic tools have become increasingly important in the diagnostic process. The prognosis depends on the aetiology and the gestational age when diagnosed and at birth, as argued in this review.

Neonatal herpes simplex disease (HSV) is a rare but life-threatening infection associated with high rates of morbidity and mortality. Recent studies indicate that the incidence rate has continued to rise over the past decades, while the mortality remains unchanged. Early clinical suspicion of HSV and parenteral antiviral treatment of acute disease is essential for the prognosis. The subsequent use of suppressive therapy with oral acyclovir has further enhanced the long-term prognosis. This review presents evidence of risk factors, clinical presentation, prevention, and management of HSV in newborns.

This review summarises the treatment of preterm infants in Denmark, which is dependent on the collaboration between several medical specialities. The problems of the preterm infants are related to the degree of prematurity, and the treatment should counter these issues, reduce complications related to prematurity and ensure growth and development. Developmental problems are the most common sequelae. There seems to be a dose-effect association between the whole spectrum of gestational age and developmental problems with the highest risk among the extremely preterm children. However, even in this group, most of the children will develop normally.

Approximately 60% of term newborn infants are jaundiced during the first week of life, which is caused by unconjugated bilirubin. Bilirubin encephalopathy is seen with severe hyperbilirubinaemia, when unbound bilirubin crosses the blood-brain barrier. The chronic form is called kernicterus spectrum disorder. To avoid this devastating condition, the treatment of choice for neonatal hyperbilirubinaemia is phototherapy, which is most efficient with LED light of 478-nm wavelength. In this review, we argue, that a systematic approach to hyperbilirubinaemic infants as well as surveillance of extreme neonatal hyperbilirubinaemia is highly important.

Seizures in the neonatal period are practically always a symptom of an underlying illness. Quick diagnosis and treatment can be crucial to the outcome. A few aetiological factors account for most of the seizures. However, a significant number is caused by rare conditions such as metabolic or genetic disorders, and arriving at the right diagnosis can be challenging. Previous studies indicate, that a standardized algorithm clearly improves the diagnostic success. This article presents an overview of aetiological factors and an algorithm for a standardized work-up.

The passage of foetal blood into maternal circulation is termed a foetomaternal haemorrhage (FMH). Most cases are clinically insignificant. However, in some cases a large FMH causes serious anaemia in the newborn child. Flow cytometry is a precise and fast method to analyse maternal blood for FMH and can be used both antenatally and postnatally. The clinician should consider using the analysis in cases of unexplained anaemia. We describe a case with severe FMH.

Introduction: Randomised studies have demonstrated the efficacy of hypothermia for the treatment of perinatal hypoxic-ischaemic encephalopathy (HIE) in term or late preterm infants. In August 2006, the Neonatology Department at Rigshospitalet, Copenhagen, introduced total body cooling for infants born at term with HIE., Material and Methods: This retrospective study comprises data from medical records of newborn children born with HIE during a period of 32 months. Relevant data for cooling were recorded. Structured neurological examinations were carried out on survivors when they were ten and or 18 months old., Results: A total of 32 infants fulfilled the criteria for cooling, the incidence being 0.4/1000 births. Twenty infants were cooled for 72 hours. Eleven infants had cooling discontinued before 72 hours because of their grave prognosis. One infant had cooling discontinued because of pulmonary hypertension. Most infants were cooled before six hours of age (median four hours). The mortality rate was 41%. A total of 45% were cooled without being placed in a ventilator. The side effects were of no major concern. Eight children had a neurological follow-up. One child had developed cerebral palsy and two children suffered delayed development., Conclusion: Total body cooling was carried out before six hours of age in the vast majority of infants born with HIE. Side effects were of less concern. Respiratory support with a ventilator could be avoided in 45% of the infants cooled for 72 hours. The mortality rate was 41%.

Case report on severe hypernatraemic dehydration in a non-recognised collodion baby who also suffered from hydrops fetalis caused by supraventricular tachycardia. Excessive transcutaneous fluid loss caused s-Na+ reaching 182 mmol/l within 36 hours of birth. The infant was cautiously rehydrated during the following three days. No sign of neurologic impairment was observed. It is emphasized that early observation of the collodion baby must take place in a humidified incubator. Major weight changes in the newborn should always result in analysis of serum sodium.

Introduction: Advances in perinatal care have increased the survival rate of extremely preterm (ETP) infants during the last decades. A key factor has been the ability to provide respiratory support with mechanical ventilation. Mechanical ventilation, however, is associated with pulmonary disease, such as bronchopulmonary dysplasia (BPD). A national prospective study of all EPT infants born in 1994-95 in Denmark found a low incidence of chronic lung disease (CLD), defined as oxygen dependence at 36 weeks postnatal age. In the cohort of surviving infants (n = 195), the incidence of CLD was 15% (95% CI: 11-19). Only 46% of the surviving children had been mechanically ventilated during the neonatal period, and this factor was proposed as an explanation of the low percentage of infants with CLD., Material and Methods: The present study evaluated CLD in a cohort of EPT infants born in 1998-2001 at Rigshospitalet, the university hospital in Copenhagen. The incidence of CLD was compared to that found in the cohort born in 1994-1995 and the data from the two cohorts were analysed together to investigate changes in CLD., Results: Although only 39% had been treated with mechanical ventilation in the neonatal period, as many as 37% (95% CI: 31-43) of the surviving children in the study (n = 220) had CLD. Analysing the data from the cohort born in 1994-95 and the cohort born in 1998-2001 together, the increase in CLD could be explained by an improved survival rate and a lower gestational age and birth weight in the 1998-2001 cohort., Discussion: Our results support the theory that CLD in EPT infants results from insults other than mechanical ventilation.