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La ventosa obstétrica es un instrumento moderno que puede ayudar al nacimiento por las vías naturales en caso de defecto de progresión del feto o de riesgo de pérdida del bienestar fetal. En la actualidad, la ventosa es el instrumento más utilizado en todo el mundo y desde 2016 también en Francia. Su principio mecánico se basa en la prensión-tracción, con una fijación del instrumento a la cabeza mediante el vacío (presión negativa). Es un instrumento de tracción, de flexión y de rotación inducida. Su curva de aprendizaje es mucho más simple que con los otros instrumentos. Una ventosa moderna debe cumplir unas especificaciones estrictas y algunas ventosas aún disponibles en la actualidad ya no deberían utilizarse. El parto instrumental es potencialmente peligroso para la madre y para el feto y requiere unas indicaciones claras y una evaluación del balance beneficio/riesgo. La ventosa parece ser menos perjudicial para el periné que los otros instrumentos.

Objectives: To compare the accuracy of ultrasonography (US) and magnetic resonance imaging (MRI) in diagnosing white matter abnormalities in preterm infants and to determine the specific indications for MRI. Design: [...]

Abstract Objective--To develop and validate a scale suitable for use in clinical practice as a tool for assessing prolonged pain in premature infants. Methods--Pain indicators identified by observation of preterm [...]

An environmental investigation and a cohort study were carried out to analyse an outbreak of infection caused by a serotype 010 Pseudomonas aeruginosa in a neonatal intensive care unit. Thirty [...]

This study reports an investigation of outbreaks of methicillin-resistant Staphylococcus aureus(MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source of transmission of MRSA to newborns.

ABSTRACTThe effect of optimized maternal therapy by bactericidal agents was evaluated in a reproducible rabbit model of Escherichia colimaternofetal infection simulating human pharmacokinetics. Intravenous antibiotic therapy was begun in the pregnant rabbit 12 h after bacterial intrauterine inoculation, using a computer-controlled pump to simulate human pharmacokinetics of ceftriaxone (1 g/day) associated or not with gentamicin (3 mg/kg of body weight/day). Data were compared for fetal survival, quantitative blood cultures, fetal histology in treated versus untreated groups, and maternal and fetal antibiotic concentrations in plasma in treated animals. Antibiotic therapy led to dramatic improvement in maternal outcome (100% survival versus 100% death in the untreated group in association with maternal septicemia). Fetal survival also improved, with the two-drug combination providing a more potent effect. After 3 days of treatment, 32% of fetuses survived with one-drug therapy and 62% with two-drug therapy (Yates corrected χ2, P< 0.05). In untreated animals, bacterial counts in blood cultures increased rapidly during the first 24 h up to 8.1 ± 0.5 log CFU/ml, but remained relatively constant at all times with antibiotic treatment: 4.5 ± 0.7 log CFU/ml at the start of treatment and 6.2 ± 0.4 and 5.2 ± 0.9 log CFU/ml after 72 h for one- and two-drug therapy, respectively (data are means ± standard deviations). The failure of animals to be cured after 3 days of treatment was not due to an inadequate concentration of ceftriaxone, as the residual level in fetal serum at sacrifice was more than 1,000 times the MIC of the microbe. Unexpectedly, inflammation in fetal lung decreased in the treated group after as little as 24 h of antibiotic therapy, despite persistent bacteremia. Although maternal outcome improved and drug concentrations were above the MIC, the treatment did not achieve sterilization of fetuses in utero for this rabbit E. colimaternofetal infection. However, fetal survival showed some improvement, and the histologic features of lung inflammation were reduced.

Oxygen consumption (v@?O2) was measured during controlled and spontaneous ventilation with continuous positive airway pressure in newborn infants in whom chronic lung disease later developed. The oxygen cost of breathing (the difference in v@?O"2 between spontaneous and controlled ventilation) was significantly higher in infants with chronic lung disease than in control infants (20.1% +/- 7.5% and 4.8% +/- 4.9% of v@?O"2 during spontaneous ventilation [p < 0.05], respectively). (J PEDIATR 1995;127:984-7)

(Am J Obstet Gynecol. 2017;216(5):518.e1–518.e12)Advances in care have resulted in large decreases in mortality and disability rates for preterm infants. While significant reductions in the rates of cerebral palsy have been seen, there has been no similar reduction in intraventricular hemorrhage (IVH), which is aggravated by weaknesses in the germinal matrix, changes in cerebral blood flow, and coagulation problems. Although the association of postnatal factors with IVH have been studied, the fact that the condition occurs within a few days of delivery implies that perinatal causes may be more important. In particular, the effect of pregnancy complications has not been studied. This study compared the incidence of IVH with the primary causes of preterm delivery.