Neonatal Care Unit (neonatal + care_unit)

Distribution by Scientific Domains

Selected Abstracts

Continuous Subcutaneous Glucose Monitoring System in diabetic mothers during labour and postnatal glucose adaptation of their infants

E. Stenninger
Abstract Aims To assess a new technique for continuous monitoring of glucose concentration during labour in diabetic mothers. A second objective was to study maternal glucose levels in relation to postnatal glucose adaptation and the need for intravenous (IV) glucose treatment in the newborn infant. Methods Fifteen pregnant women with insulin-treated diabetes mellitus participated in this prospective pilot study. To measure their glucose control during labour we used the Continuous Subcutaneous Glucose Monitoring System (CGMS; Medtronic, Minneapolis, MN, USA) to calculate the mean glucose concentration and the area under the curve (AUC) in the last 120 min before delivery. All infants of these women were transferred to the neonatal care unit for early oral feeding and blood glucose measurements up to 14 h after delivery. Infants received IV glucose if blood glucose values were repeatedly < 2.2 mmol/l. Results All women coped well with the CGMS monitoring. AUC 0,120 min before delivery, mean glucose concentration 0,120 min before delivery and cord plasma insulin level were all significantly associated with the need for IV glucose in the newborn children. Conclusions In this study we found an association between maternal glucose concentrations during labour and postnatal glucose adaptation and need for IV glucose treatment in the infants. Online monitoring of glucose levels during delivery might help us to achieve maternal normoglycaemia and further reduce the risk of postnatal hypoglycaemia in the offspring. [source]

The influence of infant irritability on maternal sensitivity in a sample of very premature infants

Petra Meier
Abstract The relationship between maternal sensitivity and infant irritability was investigated in a short-term longitudinal study of 29 very preterm infants. Infant irritability was assessed at term with the Brazelton NBAS, the Mother and Baby Scales (MABS) and the Crying Pattern Questionnaire (CPQ). Maternal sensitivity was assessed by nurses' ratings in the neonatal care unit and at three months during mother,infant interaction observation. Cross-lagged panel analysis indicated that neonatal irritability did not influence sensitivity at 3 months nor did maternal sensitivity in the newborn period lead to reduced irritability at 3 months. Both irritability and maternal sensitivity showed moderate stability over time (r = 0.55 and r = 0.60, respectively). It is concluded that in early infancy maternal sensitivity shows little influence on infant irritability in very preterm infants. Copyright 2003 John Wiley & Sons, Ltd. [source]

Tocolysis and delayed delivery versus emergency delivery in cases of non-reassuring fetal status during labor

Leonel Briozzo
Abstract Aim:, To determine whether fetal intrauterine resuscitation using tocolysis and delayed delivery is better for the fetus than emergency delivery when fetal hypoxia is suspected because of a non-reassuring fetal heart-rate (FHR) pattern using conventional heart rate monitoring. Methods:, This was a prospective and randomized study, conducted between 2001 and 2004 at Pereira Rossell Hospital, Montevideo, Uruguay. The population consisted of 390 fetuses, in which intrauterine distress was diagnosed using electronic FHR monitoring. Of these, 197 were randomly assigned to the emergency delivery group and 193 to the fetal intrauterine resuscitation group. The inclusion criteria were: term singleton pregnancy, in labor, cephalic presentation, and no placental accidents. Results:, The time between randomization and birth was 16.9 7.6 min (mean SD) for the emergency delivery group, and 34.5 11.7 min (mean SD) for the resuscitation group. The relative risk (RR) of acidosis in the umbilical artery (pH < 7.1) in the emergency delivery group was 1.47 (0.95,2.27). The RR of base deficit ,12 mEq/L in the emergency delivery group was higher than in the resuscitation group (RR = 1.48 [1.0,2.2], P = 0.04). When considering the need for admission to the neonatal care unit, the relative risk was higher in the emergency delivery group than in the resuscitation group (RR = 2.14 [1.233.74], P = 0.005). No maternal adverse effects were reported. Conclusion:, Tocolysis and delayed delivery renders better immediate neonatal results than emergency delivery when fetal distress is suspected because of a non-reassuring fetal heart pattern. In addition, it may decrease the need for emergency delivery without increasing maternal and fetal adverse side-effects. [source]

Effects of bathing immediately after birth on early neonatal adaptation and morbidity: A prospective randomized comparative study

Yasushi Nako
Abstract Objective: Because the risks and benefits of early bathing of newborn infants are not well established, we investigated the effects of bathing immediately after birth on rectal temperature, respiratory rate, heart rate, blood pressure, percutaneous arterial blood oxygen saturation (SpO2) and early neonatal morbidity. Methods: The study was designed as a randomized prospective comparative study in the neonatal care unit of a university hospital. A total of 187 healthy term and near-term newborn infants, who were delivered vaginally without asphyxia, between January and December 1997 were the study subjects. We compared findings in newborns who were bathed 2,5 min after birth (n=95) with those of a control group (n=92) who received dry care instead. Groups were comparable with respect to gestational age, birthweight, male : female ratio, Apgar score and umbilical blood pH. Rectal temperature was measured with an electronic thermometer immediately before the intervention bathing or dry care and at 30 min and 1, 2, 3, 8 and 12 h after birth. Heart rate, respiratory rate, systolic and diastolic blood pressure and SpO2 were measured at 1, 2, 8 and 12 h after birth. The incidence of early neonatal morbidity, including hyperbilirubinemia and gastrointestinal and respiratory problems, was also compared. Results: Rectal temperature changed over time postnatally in both groups (P<0.0001, ANOVA) and there was a significant difference in rectal temperature between groups (P<0.0001, ANOVA). Mean ( SEM) rectal temperature at 30 min after birth (i.e. approximately within 20 min after intervention) was significantly higher in the bathed group than in the control (dry care) group (37.30~0.06 vs 37.00~0.05C, respectively; P=0.000022). Respiratory rate, heart rate, blood pressure and the ratio of the number of infants with SpO2 90,94% and 95,100% did not differ significantly between the two groups. The incidence of early neonatal morbidity, including vomiting, acute gastric mucosal lesion, polycythemia, need for tube feeding, phototherapy and oxygen therapy, also did not differ between the two groups. Conclusions: Early bathing, minutes after birth, did not appear to adversely affect the adaptation of healthy full-term and near-term newborn infants. [source]

Interleukin-10 and transforming growth factor-,1 in cord blood: relationship with paternal allergy and cesarean section

V Balossini
Abstract Aim: To measure Interleukin-10 (IL-10) and transforming growth factor-,1 (TGF-,1) in cord blood and assess their relationship with parental allergy and perinatal characteristics. Methods: In a neonatal care unit 212 consecutive full-term and appropriate for gestational age newborns were recruited. IL-10 and TGF-,1 levels were determined in cord blood by high sensitivity ELISA. Perinatal characteristics, mode of delivery and presence of allergy in parents were recorded. Results: Out of 212 newborns, 136 were of non-allergic parents and 76 (35.8%) of one or both allergic parents. In newborns of allergic fathers median IL-10 levels tended to be lower (0.67 vs. 1.06 pg/mL, p = 0.07) and TGF-,1 levels were significantly lower (40.9 vs. 45.3 ng/mL, p = 0.008) than in newborns of non-allergic parents. Multiple general regression analysis showed that presence of paternal allergy (,=,0.19, p = 0.003) to be born by cesarean section (,=,0.21, p = 0.03) and younger gestational age (,= 0.14, p = 0.04) independently contributed to decrease TGF-,1 levels (multiple R = 0.38, p < 0.0001). Conclusion: Paternal allergy and cesarean section are associated to decreased TGF-,1, which might be the mediator of the increased risk of atopy development. Cord blood IL-10 and TGF-,1 levels of our newborn series could be used as reference values for further studies on these relationships. [source]