Search

Objective: Hemodynamically significant patent ductus arteriosus(hsPDA) is resulting in severe mortality and morbidity in infants with extremely low birth weight(ELBW). In our study, we aimed to evaluate the necessity of performing routine echocardiography(ECHO) in the first 72hours in ELBW infants.Study Design:This study was planned retrospectively and observationally.Between June2016 and December2018,36 patients diagnosed with hemodynamically significant PDA(hsPDA) who were hospitalized in the neonatal intensive care unit(NICU),with ≤28Gw or ≤1000g were included in this study.These babies were routinely performed ECHO for PDA between 24-72hours,although they were asymptomatic in the period from June2016 to December2017(n:23).Between January2018 and December2018, patients without PDA symptoms were expected to complete 72hours for routine PDA screening (n:13).The patients were divided into 2 groups as early ECHO group(EEG)(n=23) and late ECHO group (LEG)(n=13).In the presence of at least one of the clinical signs of systemic hypoperfusion and/or pulmonary hyperperfusion, symptomatic PDA was accepted and closure treatment was applied with ibuprofen(n: 23) or paracetamol(n: 5).While the two groups were compared in terms of demographic features,ECHO findings,and the state of taking closure therapy,patients receiving closure therapy were compared in terms of mortality and premature morbidity.Results:The average birth weight of 36 patients was 855.9(± 241.5)g, and the average week of birth was 26.4(± 2.1)Gw.It was observed that the two groups were similar in terms of demographic characteristics.Although the findings of ECHO and treatment rates were similar between the two groups,it was observed that the EEG had earlier closure treatment(p = 0.03). In patients receiving closure treatment, performing early(n:17)and late(n:11) echocardiography showed no statistical difference in the long-term results.Conclusion:Performing early ECHO without symptoms in infants with ELBW may provoke the clinician to give PDA closure treatment earlier. In infants with ELBW,unnecessary closure treatment can be prevented by closely monitoring the symptoms of PDA and performing ECHO when necessary.

Introduction:Pediatric palliative care is the highest level of care aiming to improve the quality of life of all children and families with life-limiting and threatening diseases. The knowledge and awareness of pediatricians about pediatric palliative care in our country is not known. The aim of this study was to evaluate the knowledge and awareness level of pediatricians in the field of pediatric palliative care.Methods:The study was planned as a prospective study following the approval of Local Ethics Committee of Dr. Behçet Uz Children’s Hospital. Totally 217 pediatricians answered the questionnaire completely. The data obtained from the survey questions were uploaded to the SPSS program and statistical analysis was performed.Results:Of the 217 pediatricians who participated in the study, 67.3% were women and 59.4% were specialist physicians. 68.7% of the physicians were employed in education and research hospitals and 7.4% in private institutions. It was found that pediatricians heard about pediatric palliative care (p=0.002), but they thought it was less necessary when its effect on quality of life, analgesia and sedation use was questioned.Conclusion:Pediatric palliative care is a new field in our country. It was found that most of the participants heard about pediatric palliative care because they worked in education and research hospital but they did not know the content. In the coming years, we believe that increasing the number of centers and training will increase the knowledge level of pediatricians.

Objective: Hypoxic-ischemic encephalopathy (HIE) is an acute and progressive encephalopathy resulting from perinatal asphyxia. Approximately 15% infants with neonatal HIE die, whereas 25% exhibit subsequent neurological disabilities. In this study, it was intended to compare effects of total body cooling treatment administered for hypoxic-ischemic encephalopathy on neurological and developmental findings obtained at 18-36 months. Material and Methods: Patients who have been hospitalized between 2013 and 2014 in Neonatal Intensive Care Unit with a diagnosis of hypoxic-ischemic encephalopathy and treated total body cooling were included. After discharge, neurological examinations of the patients were evaluated by developmental assessments with “Bayley Scales of Infant Development II” at 18-36 months. Results: Mean MDI score of 17 patients was 90.2±16.3, and mean PDI score was 93.8±17.3. MDI scores were < 70 in 11.8% (n = 2) of all cases, and PDI scores were < 70 in 5.9% (n=1) of all cases. In 5.9% (n=1) of all cases, deafness and cerebral palsy were detected. Developmental disorder were found in 17.6% (n=3) of all cases. Conclusion: The therapeutic hypothermia in newborns decreased mortality in moderate and severe HIE and improved neurodevelopmental outcomes at 18th month. In our study, early neurological and developmental problem rates after therapeutic hypothermia were found similar with the literature. However, long period follow-up is necessary to determine minor disorders in these patients.

Pediatric palliative care is a top-level care system that focuses on improving the quality of life of the child and family. Quality of life is an expression of individual well-being based on an individual's assessment of their own life. It includes satisfaction in all areas of life, including physical and mental health, environment, and social areas.The study was conducted with the primary caregiver parents of children admitted to the pediatric palliative care service of the Health Science University İzmir Dr. Behçet Uz Child Disease and Surgery Training and Research Hospital. The Turkish version of the World Health Organization Quality of Life WHOQOL-Bref (TR) questionnaire was applied with a personal information form containing demographic data.Eighty-four patients were hospitalized in the specified period, and 67 primary caregiver parents agreed to participate in the study. Total scores evaluated by WHOQOL-Bref (TR); the physical domain was 19.95 ± 3.30, the mental domain was 19.95 ± 3.18, the social domain was 10.11 ± 2.40, and surrounding area was 16.38 ± 2.82. The physical and psychological subgroups' scores were statistically significantly higher in primary caregiver parents with good social support (P.005).It has been determined that in order to increase the quality of life and care of children with life-limiting and/or threatening diseases, the quality of life of primary caregiver parents should be increased, and "social support" procurement, which has the most important effect on the quality of life, is an important need.

Objective New viruses have emerged, causing global damage and mass deaths that can spread to international borders, the latest of which is the new coronavirus (COVID-19). After the Second International Congress on Artificial Intelligence in Health, themed "Artificial Intelligence in Health During COVID-19 Pandemic Process" organized online by İzmir Bakırçay University and İzmir Provincial Health Directorate with the contributions of the International Association of Artificial Intelligence in Health, a questionnaire was conducted to evaluate the knowledge of the participants about artificial intelligence applications. Materials and Methods: This study aimed to evaluate the interest of the congress participants in this field with the questions which form the questionnaire such as the duration of the interest of the participants in the field of artificial intelligence in health, their publication status, the development of studies on artificial intelligence with the COVID-19 pandemic, demographic structures such as age and gender, and educational level. 130 participants answered the questionnaire consisting of 23 questions. Questionnaire responses were analyzed in a statistical setting. Results: We found that 130 people filled out the questionnaire and the majority of the participants were female, with participation from many organizations, but university staff showed more interest. We have seen that the 30-39 age group is more interested in artificial intelligence than the other age groups, but the majority of the participants do not have academic studies in this field. We found that the technical terms related to artificial intelligence were not well known by the participants, and that the number of participants who tended to this field, especially in the recent year, was high. Another important point was that people working in this field stated that they would definitely follow up if scientific activities continued. Conclusion: We know how important congresses, symposiums, courses and other meetings are, especially for scientist candidates, which will be held to raise awareness about the usage areas of artificial intelligence-based health technologies, to develop new communication and work networks by bringing together different disciplines, to create an agenda and to lay the groundwork for new studies, and we think that there is a need for many repetitive activities in this field and that these activities should be continued.

Objective In this study, we aimed to compare the clinical, laboratory, and radiological findings of noncoronavirus disease 2019 (COVID-19) viral agents in newborn infants hospitalized for lower respiratory tract infection during the COVID-19 pandemic. Methods This prospective cross-sectional study conducted between 11 March 2020 and 31 July 2021 included neonates with lower respiratory tract infections admitted to the neonatal intensive care unit of the Dr. Behcet Uz Children's Hospital. Nasopharyngeal swab samples were taken from all hospitalized patients for multiplex respiratory polymerase chain reaction (PCR) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR. The detection of respiratory viral pathogens was performed by multiplex real-time PCR assay (Bosphore Respiratory Pathogens Panel Kit V4, Anatolia Geneworks, Turkey). Infants with SARS-CoV-2 PCR positivity were excluded from the study. Patients' data were obtained from the electronic medical registry system. The non-COVID-19 viruses of the cases were analyzed according to seasonal variation (in/off-season). The pulmonary findings of the cases were classified as normal, infiltration, air bronchogram, and reticulogranular appearance at the time of admission. Results A total of 80 infants were included during the study period. A multiplex PCR test was performed to identify viral agents affecting the lower respiratory tract of infants; it was determined that 31% (25 out of 80) were respiratory syncytial virus (RSV), 41% (33 out of 80) were rhinovirus (Rhino), and the remaining portion (28%, 22 out of 80) were other viral agents (enterovirus, bocavirus, adenovirus, influenza, and parainfluenza). Compared with Rhino and other viral agents, RSV was detected most frequently in seasonal hospitalizations (p Conclusion During the pandemic period, RSV affected the prognosis in intensive care unit admissions due to lower respiratory tract infection in newborns.

Aim: The purpose of this study is to compare the clinical criteria of preterm infants on their third day of life with their echocardiographic findings for the correct diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA). Material And Methods:The infants with a gestational age of

OBJECTIVE: We aimed to investigate the role of incomplete of antenatal steroid therapy by comparing with no and complete steroid exposure on mortality and morbidity in preterm infants.STUDY DESIGN: This is a prospective, an observational study which includes preterm infants of 32 weeks of gestation and/or ≤1500 grams who were referred to Izmir Dr. Behcet Uz Children's Hospital NICU during the one year period. Infants were divided into three groups according to the administration of antenatal steroid as those who received incomplete-dose antenatal steroid, complete dose steroid therapy and those with no steroid exposure. Intubation at the delivery room, surfactant requirement, the inotropic requirement in the first 72 hours and morbidities associated with prematurity were determined as the primary results. Mortality and bronchopulmonary dysplasia at discharge and stage ≥2 retinopathy were analyzed as secondary outcomes.RESULTS: We found that 54 infants were born with an incomplete dose, 55 infants with complete dose and 38 infants with no steroid therapy. Surfactant requirement, inotropic requirement, and hemodynamically significant patent ductus arteriosus were lower in the steroid exposure group leading to a statistical difference (p

Objective This study aimed to evaluate the efficacy of Pycnogenol (PYC) and its antioxidant and antiapoptotic effect in an experimental hypoxic-ischemic (HI) rat model. Study design A total of 24 Wistar albino rats who were on the seventh postnatal day were divided into three groups with developed HI brain injury model under the sevoflurane anesthesia: 40 mg/kg PYC was given to Group A, saline was given to Group B, and the sham group was Group C. Neuronal apoptosis was investigated by terminal deoxynucleotidyl transferase dUTP nick end labeling and immunohistochemically stained manually with primer antibodies of tumor necrosis factor-α and interleukin-1β. Results The neuronal cell injury was statistically lower in the PYC treatment group. Conclusion This is the first study that investigates the role of PYC in the HI brain injury model. PYC reduces apoptosis and neuronal injury in the cerebral tissue of the rats. PYC may be a protective agent against hypoxic-ischemic encephalopathy. Key points · This is the first study that investigates the role of PYC in the HI brain injury model.. · PYC may be a protective agent against hypoxic-ischemic encephalopathy.. · Sevoflurane should not be preferred in rat studies where neuronal apoptosis will be investigated..

Objective Sepsis is a complex clinical condition caused by a dysregulated immune response to an infection resulting in a fatal outcome. This study aimed to investigate the value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for diagnosing culture-proven sepsis in preterm infants. Methods Preterm neonates were evaluated for late-onset sepsis (LOS). Laboratory investigations were performed. Urine sTREM-1 samples and blood cultures were synchronously collected. Using blood culture results, preterm neonates were divided into the culture-proven group and suspected sepsis group. Results A total of preterm 62 infants were included in the study; 31 had culture-proven sepsis and 31 were suspected as having sepsis. There were no significant differences in gestational age, sex, birth weight, and delivery mode between the groups. Neonates in the culture-proven group had significantly higher urine sTREM-1 levels than did those in the suspected sepsis group. Using a cut-off point for a urine sTREM-1 level of 78.5 pg/mL, the sensitivity was 0.90, specificity was 0.78, positive predictive value was 0.68, and negative predictive value was 0.94. Conclusions The present study highlights the role of urine sTREM-1 levels in LOS. Urine sTREM-1 may be a reliable and sensitive marker in detecting sepsis in preterm infants.

Objective: In this study, it was aimed to compare the sleep quality of healthy children with the actigraphic evaluation and quality of life of monosymptomatic enuresis children of similar age groups. Materials and Methods: This prospective study was conducted in Celal Bayar University Faculty of Medicine and has been submitted to the Department of Pediatric Nephrology. Patients included in the study were suffering from urinary incontinence for two years and only from monosymptomatic enuresis nocturna. The study group consisted of healthy children with monosymptomatic enuresis nocturna who volunteered to participate and those who did not have any systemic disease of similar age and sex. The demographic data, quality of life and activity of all the cases that were taken into the study were tried to be evaluated with sleep quality. Results: Forty children with 40 monosymptomatic enuresis nocturna diagnoses matching the study criteria were included. The control group consisted of 20 healthy children. There were no difference in demographic characteristics between the groups (p>0.05). The Kid-KINDL total score was 59.6±12.9 in children with monosymptomatic enuresis nocturna and 74.8±6.3 in healthy children (p=0.001). The effective sleep duration was statistically lower in children with monosymptomatic enuresis nocturna, and the effective duration of wakefulness, number of naps and fragmentation index were found to be higher in children with monosymptomatic enuresis nocturna (p=0.001). Conclusion: This is the first study in the literature to compare actigraphic analysis and quality of life of healthy children with enuretic children. We think that children with monosymptomatic enuresis nocturna have a significant deterioration in their quality of life compared to healthy children in sleep quality and this leads to an effect on the quality of life.

INTRODUCTION: The aim of this study is showing the satisfaction levels of patient’s relatives using pediatric palliative care service, aiming to eliminate the problems of pediatric patients at the end-of-life stage and their relatives thereafter improving quality of life. METHODS: The population of the study consists of 87 relatives of patients who were hospitalized between May and November 2017 in the palliative care unit of İzmir Dr. Behçet Uz Children’s Hospital. In the study, FS-ICU 24 scale which was prepared by Dodek et al. and which was translated into Turkish and tested for validity and reliability by Erdal et al. was used to find out the satisfaction levels of 87 patients relatives. RESULTS: While scores of care and treatment of patients, interest and giving information to the patient’s relatives, perception, affect to emotion situation of patient’s relatives, decision-making process and waiting of environment and logistic support sub-dimensions were favorable. DISCUSSION AND CONCLUSION: Today, the safety and quality of health care services are important as being accessible and widespread. How to evaluate this stuation is merely carried out by the satisfaction of the patient’s relatives. Satisfaction levels of both patients and their relatives deliver us information about the quality and safety of given health care. This study provides us the importance and necessity of the palliative health care units. We believe that more studies in advance will contribute to the quality of services.

SummaryBackground Mechanical ventilation is an essential therapy in the treatment of respiratory failure in preterm infants. However, optimal ventilation strategy continues to be difficult to define. Objective To compare the effects of volume guarantee (VG) combined with intermittent mandatory ventilation (SIMV) and VG combined with pressure support ventilation (PSV) on the pulmonary mechanics and short term prognosis in preterm infants with respiratory distress syndrome. Methods Infants of

Cutis marmorata telangiectatica congenita is a rare, benign, sporadic and cutaneous vascular disease. A newborn female baby whose mother was aged 29 years and used propylthiouracil during pregnancy was hospitalized because of varicose lesions on the skin of the lower extremity and on the back, which were present at birth. It was observed that the lesions did not disappear, although appropriate room temperature was provided. The patient was diagnosed as having cutis marmorata telangiectatica congenita and screened for additional anomalies. She had no additional anomalies, and she was discharged and monitored. At the postnatal sixth month, the cutaneous vascular lesions disappeared spontaneously. Cutis marmorata telangiectatica congenita, which is a rare condition, should be kept in mind in the differential diagnosis of physiologic cutis marmoratus, which occurs frequently in the neonatal period.

Kyphosis is the most severe spinal deformity associated with meningomyelocele (MMC) and is seen in approximately 15% of neonates. Our purpose is to present our clinical experience, to discuss the technique and deformity correction in kyphectomy in neonates with MMC, and to assess its long-term outcomes. In this prospective study, the authors reviewed eight cases submitted to surgery between 2013 and 2015. We evaluated clinical characteristics that were analyzed, as were the operative technique employed, and angle range of the kyphosis deformity postcorrection follow-up. Neonatal kyphectomy was performed of six females and two males. The mean birth weight was 2780 g, and the mean age at the time of surgery was 5.6 days. There were S-shaped type deformity in lumbar region in all neonates. In the correction of the kyphotic deformity, a total vertebrae were removed from four patient, whereas a partial vertebrectomy was done in four. The mean operative time was 116 min. No patients did not require the blood transfusion. There were no serious complications, and wound closure was successful in all patients. The mean follow-up period was 4 years and 3 months (range 36–61 months), except one patient who died 1 week after discharge. The mean preoperative kyphosis of 75.6° (range, 50°-90°) improved at last follow-up to 35° (range 15°–55°). All patients had surgical procedures for hydrocephalus. Three patients had surgery for Chiari type II malformation. The mean hospital stay was 27.7 days. Kyphectomy performed at the time of dural sac closure in the neonate is a safe procedure with excellent correction.

Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormalities such as holoprosencephaly, nasal cavity anomalies, cleft palate-lip, hypotelorism, microcephaly, and panhypopituitarism. Congenital nasal pyriform aperture stenosis is a lethal cause of neonatal respiratory distress due to narrowing of the pyriform aperture anteriorly and it can be confused with choanal atresia. In this report, we present a newborn infant with solitary median maxillary central incisor syndrome accompanied by other abnormalities including holoprosencephaly, nasal pyriform aperture stenosis, microcephaly and panhypopituitarism. Chromosomal analysis showed heterozygous SIX3 gene deletion at 2p21 region resulting in a more severe form of holoprosencephaly.El síndrome del incisivo central único de la línea media del maxilar es un trastorno raro que implica anomalías de la línea media, como holoprosencefalia, anomalías de las fosas nasales, fisura palatina, labio leporino, hipotelorismo, microcefalia y panhipopituitarismo. La estenosis congénita del orificio nasal anterior es una causa mortal de dificultad respiratoria neonatal debido al estrechamiento del orificio nasal anterior, y podría confundirse con la atresia de coanas. En este informe, presentamos el caso de un recién nacido con síndrome del incisivo central único de la línea media del maxilar acompañado de otras anomalías, tales como holoprosencefalia, estenosis del orificio nasal anterior, microcefalia y panhipopituitarismo. El cariotipado mostró una deleción heterocigota en el gen SIX3 en la región 2p21, que produjo una forma más grave de holoprosencefalia.

Background: Given the severity and high mortality of multidrug-resistant Gram-negative bacilli (MDR-GNB) infections, the use of colistin will increase in patients with MDR-GNB infection. Objective: This study aims to assess the efficacy and safety of intravenous colistin in very low birth weight (VLBW; birth weight < 1500 g) preterm infants. Methods: We retrospectively analyzed the medical records of patients who received colistin between June 2016 and December 2017. The patients were assigned to two groups: the VLBW group and the non-VLBW group. Both groups were evaluated for response to treatment and adverse effects. Results: In total, 66 infants who received colistin therapy were included; of these, 28 infants were VLBW. All of our patients received standard colistin treatment of 5 mg/kg per day in three doses and the median duration of colistin treatment was 14 days. No significant differences were observed between the groups with respect to the efficacy of colistin (defined as showing microbiological clearance in control cultures and the absence of mortality during treatment) (89.3 vs 86.8%, p > 0.99). Serum magnesium and potassium levels were significantly lower in the VLBW group than in the non-VLBW group during colistin therapy (magnesium, 1.30 vs 1.70 mg/dL, p

WOS: 000435746600016 PubMed ID: 29055117 Background: The neutrophil to lymphocyte ratio (NLR) is an easily accessible biomarker that has been reported to represent disease severity in adult trials. The aim of this study was to evaluate the relationship between culture positiveness and NLR in cases where the reason of sepsis was considered, and to foresight an idea about the active agents. Methods: Preterm infants with birth weights

Respiratory syncytial virus (RSV) lower respiratory tract infection is the most common viral infection in childhood. RSV-infected infants demonstrate various radiographic findings. The aim of the study is to evaluate whether assessment of radiological characteristics of lower tract infection due to RSV may be a predictor of clinical outcome in newborns.The study included 36 newborn infants hospitalized for lower tract infection. In order to detect RSV, RSV Respi-Strip (Coris Bioconcept Organization) test kits were used on admission. Chest X-rays and clinical characteristics of the study group were reviewed.Of 36 patients hospitalized for lower tract infection from October 2012 to April 2013, 18 (50%) newborns were infected with RSV. The study included 36 neonates. Patients with RSV-positive infants at admission had greater need for respiratory support, supplemental oxygen and prolonged stay in the NICU. Newborns with an atelectasis pattern on admission chest radiograph had greater at RSV-positive infants.Chest radiological patterns with lower respiratory tract infection in newborn infants due to RSV are a predictor of clinical outcome.

WOS: 000418201400011 Objective: Neonatal hyperbilirubinemia is a frequently seen clinical condition, and bilirubin encephlopathy is presetly an important health problem. In our study the patients who had undergone blood exchange transfusion were evaluated as for responsible etiologic factors, complications developed due to blood exchange transfusion and development of bilirubin encephalpathy. Methods: Between January 2012 and January 2015, infants who were admitted to Izmir Tepecik Training and Research Hospital due to hyperbilirubinemia and underwent exchange transfusion were retrospectively investigated. Demographic data, laboratory parameters, exchange complications and the frequency of development of bilirubin encephalopathy were investigated. Cases with bilirubin encephalopathy were compared with non-encephalopathic ones as for the presence of risk factors. Results: Twenty-seven infants were included into the study and 59.3% of the cases were male and 55.6% of them were born with caesarean section. The mean gestational age of the infants was 36.5 +/- 3.1 weeks and their mean birth weight was 2912.5 +/- 759 grams. The mean age at the time of admission was 34.2 +/- 54.2 hours and 81% of infants had exchange transfusion within the first 24 hours due to ABO incompatibility in 40.7% and Rh incompatibility in 33% of the infants. Total bilirubin and platelet counts decreased after exchange transfusion, leading to a statistical difference (p

WOS: 000397546800018 PubMed ID: 27317627 Neonatal subcapsular liver hematoma (SLH) occurs in ∼15% of neonates due to several risk factors, including trauma, prematurity, tracheal intubation, and umbilical venous catheterization. 1234 Previously, only one full-term infant has been reported with isolated scrotal wall hematoma as a result of SLH in the medical literature. 1 This is the first case report of an isolated scrotal hematoma in a preterm infant due to SLH.

Amaç: Yenidoğan yoğun bakım ünitesine meningomyelosel tanısıyla yatırılan hastaların klinik sonuçları ile annenin sosyodemografik özelliklerini araştırmayı amaçladık. Gereç ve Yöntem: Ocak 2012 - Aralık 2014 tarihleri arasında meningomyelosel nedeni ile yatan tüm yenidoğanların perinatal bilgileri, annenin sosyodemografik özellikleri, prenatal tanısı, kesenin özellikleri, operasyon zamanı, hastanede yatış süresi, eşlik eden ek anomalileri, ventriküloperitoneal şant gerekliliği, şant enfeksiyonu, taburculuk sonrası poliklinik kontrolleri ile hastaneye yatış sıklığı ve yatış nedenleri prospektif-gözlemsel olarak kaydedildi. Denver Gelişimsel Tarama Testi-II ile postnatal 18. ayda psikomotor değerlendirme yapıldı ve çocuklar normal, sınırda gerilik ve ciddi gerilik şeklinde sınıflandı. Bulgular: İki yılda yatırılan 50 hastanın ortalama doğum ağırlığı 3012±485 g, gestasyon haftası 37.9±1.4 hafta idi. Hiçbir anne prekonsepsiyonel dönemde folik asid kullanmamıştı. Gebelikte %90'ında kullanım yoktu. Keselerin 25'i torakolomber, 24'ü lumbosakral ve 1'i servikotorasik yerleşimliydi. Alt ekstremite muayenesinde 27 yenidoğan paraplejik, 11'i minimal ve 12'si ise tam hareketliydi. Ortalama operasyon günü 4.9±3 gündü. Hidrosefali 35, hidronefroz 33, Chiari tip 2 malformasyonu 24, pes ekinovarus 22, kifoz 16 yenidoğanda mevcuttu. Denver Gelişimsel Tarama Testi-II ile 14 bebekte normal, 31 bebekte sınırda ve 5 bebekte ise ciddi gerilik saptandı. Sonuç: Gebelikte folik asid alınması, tüketilen gıdalardaki folik asid miktarının arttırılması ve kadınların eğitimi meningomyeloselin insidansının azaltılmasında önemlidir. Aim: We aimed to analyze the clinical outcomes and maternal sociodemographic features of the patients followed in the neonatal intensive care unit with meningomyelocele diagnosis. Materials and Methods: Babies with meningomyelocele followed in the unit between January 2012 and December 2014 were analyzed prospectively and observationally. Perinatal data, maternal sociodemographic features, prenatal diagnosis, features of the sac, operation time, hospitalization duration, associated abnormalities, need of ventriculoperitoneal shunt, shunt infection, controls of policlinic, rehospitalization frequency and causes for each baby were recorded. Eighteen months after birth, children were assessed by the Denver Development Screening Test-II for psychomotor delay and the children were classified as normal, borderline delay and significant delay. Results: Fifty neonates admitted to the unit were diagnosed as meningomyelocele during the study period. Mean birth weight and gestational age were 3012± 485 g and 37.9± 1.4 weeks, respectively. 90% of the mothers had never used folic acid during pregnancy. Twenty-five of sacs were located in the lumbosacral, 24 in the thoracolumbar, and 1 in the cervicothoracic regions. Paraplegia was determined in 27 neonates. Mean operation time was within 4.9 ± 3 days. Among all neonates, 35 were diagnosed as hydrocephaly, 33 as hydronephrosis, 24 as Chiari type 2 malformation, 22 as pes equinovarus, and 16 as kyphosis. Denver Development Screening Test-II were normal in 14 babies whereas borderline delay in 31 and significant delay in 5. Conclusion: Educating women, folic acid use during pregnancy and fortification of food seem to be the important for reducing incidence of meningomyelocele.

• Lateral position is considered to be safer than the supine position for endotracheal intubation during surgery, because the weight of the head is not transmitted to the sac; this eliminates the risk of compression-related preoperative rupture of the sac, or an inadvertent incresae in the intracranial pressure.