Medicine and Health Sciences Commons^™

Improved Growth And Development In Premature Infants Managed With Nasal Continuous Positive Airway Pressure, Susan L. Flesher M.D., Renee S. Domanico M.D.

Susan L Flesher, MD

Objective: Our goal was to assess the association between the use of nasal continuous positive airway pressure (NCPAP) vs. conventional ventilation (CV) in premature infants and its effects on: 1) growth in the NICU and at follow up visits 2) neurodevelopmental outcomes measured by Bayley Infant Neurodevelopmental Screener (BINS) 3) the incidence of retinopathy of prematurity (ROP) and chronic lung disease (CLD).

Methods: A retrospective chart review of two groups of NICU patients was conducted. The first group was from 1/1999 – 12/2000 (n=140) and was managed by CV. The second group (n=168) was from 1/2003 – 12/2004 and was …

Emergence Of Candida Parapsilosis As The Predominant Species Causing Candidemia In Children., I Levy, L G Rubin, Sanjeev Vasishtha, V Tucci, S K Sood

Sanjeev Vasishtha MD

An increase in the rate of isolation of Candida parapsilosis, relative to other Candida species, in our children's hospital led us to analyze the clinical and epidemiological variables associated with candidemia. We sought to determine if these variables are different for patients infected with C. parapsilosis. All episodes of candidemia occurring over a 7-year period were analyzed retrospectively. Of 81 episodes in 80 patients, 35 (43%) were in neonates, and 46 (57%) were in nonneonates. C. parapsilosis was isolated in 40 episodes (49%). C. parapsilosis was significantly more likely than non-C. parapsilosis species to be associated with prematurity (P = …

Treatment Of Premature Labor With Indomethacin., D. Blake, Jennifer Niebyl, R. White, K. Kumor, N. Dubin, J. Robinson, P. Egner

Jennifer R Niebyl

No abstract provided.

Candida Albicans Chorioamnionitis Associated With Preterm Labor And Sudden Intrauterine Demise Of One Twin. A Case Report, U. Friebe-Hoffmann, David Bender, C. Sims, P. Rauk

David P Bender

BACKGROUND: Although cervicovaginal Candida infections occur in 20-25% of pregnancies, the incidence of ascending infection in these cases is only 0.8%, and such infection rarely causes chorioamnionitis. CASE: Sudden intrauterine fetal demise (IUFD) of twin A occurred in a diabetic primigravida presenting with a twin pregnancy and preterm labor at 33 weeks of gestation. Placental pathology and autopsy of the stillborn twin revealed extensive chorioamnionitis and fetal sepsis in the presence of Candida albicans. Twin B was unaffected. CONCLUSION: In this case, C albicans chorioamnionitis seemed to be associated with sudden IUFD.

Fundal Height As A Predictor Of Preterm Twin Delivery., D. Rouse, Gregory Skopec, F. Zlatnik

Gregory S Skopec

OBJECTIVE: To determine whether fundal height might predict early delivery in twin pregnancies; that is, whether larger fundal heights predispose to earlier delivery. METHODS: From the charts of 336 well-dated twin pregnancies, we generated a series of fundal height curves. RESULTS: Within our population of twin pregnancies, the mean fundal height at any given gestational age did not differ between pregnancies delivered before 34 weeks and those delivered at or after 34 weeks. A single fundal height measurement above the 90th percentile before 34 weeks yielded a sensitivity of 23% and a specificity of 79% for delivery before 34 weeks, …

The Plasma Renin-Angiotensin System In Preeclampsia: Effects Of Magnesium Sulfate., S. Sipes, C. Weiner, Thomas Gellhaus, J. Goodspeed

Thomas M Gellhaus

Two groups of women were studied in a prospective longitudinal fashion to determine the effects of a 2.5-hour infusion of magnesium sulfate upon the renin-angiotensin system. Serum magnesium concentration, angiotensin-converting enzyme concentration, and plasma renin activity were measured at uniform intervals in women with either preeclampsia or preterm labor. Plasma renin activity was significantly lower (3.9 +/- 2.2 versus 6.1 +/- 1.8 ng/mL/minute; P = .004) and angiotensin-converting enzyme significantly higher (47.1 +/- 14 versus 34.0 +/- 10 U/mL; P = .008) in women with preeclampsia than in those with preterm labor. Magnesium infusion was associated with a sustained decline …

Histologic Chorioamnionitis, Microbial Infection, And Prematurity., F. Zlatnik, Thomas Gellhaus, J. Benda, F. Koontz, L. Burmeister

Thomas M Gellhaus

The purpose of this study was to relate histologic chorioamnionitis to the isolation of microorganisms from the freshly separated chorioamnion in women who had early preterm delivery (before 35 weeks' gestation) following spontaneous labor. Histologic chorioamnionitis was identified in 51 of 95 study subjects. It was more common in the second trimester (72%) than from 27-34 weeks' gestation (33%) (P less than .001). Culture specimens were obtained for aerobic and anaerobic bacteria, yeasts, mycoplasmas, and Chlamydia. Microorganisms were recovered from 38 subjects; all culture reports were negative in 36. A statistically significant association was demonstrated between histologic chorioamnionitis and positive …

Ambulatory Surgery. The Selection And Administration Of Perioperative Intravenous Fluids For The Pediatric Patient, J. Aker, Cormac O'Sullivan

Cormac T. O'Sullivan

No abstract provided.

Early- And Late-Onset Group B Streptococcal Infections: Overview And Case Studies, Rebecca Siewert, D. Holida

Rebecca Siewert

Infants that are admitted and cared for in the neonatal intensive care unit are at risk for sepsis. Group B Streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis. Group B Streptococcus is classified into early- and late-onset sepsis. With early onset, infants develop symptoms within 7 days of birth. With late onset, they develop symptoms between 7 days and 3 months of life. Prompt identification and treatment of suspected septic infants are crucial. Infants who develop early- or late-onset GBS sepsis are at risk for sequelae ranging from normal physiologic outcome to devastating long-term conditions and …

Breastfeeding Success With Preterm Quadruplets, L. Mead, Rebecca Chuffo, P. Lawlor-Klean, P. Meier

Rebecca Siewert

Although the incidence of triplet and quadruplet birth has increased in the United States, few research-based guidelines are available for assisting mothers of these multiple births with breastfeeding. The purpose of this case study is to report a successful breastfeeding experience of a mother with preterm quadruplets. The quadruplets were born by cesarean delivery at 34 weeks' gestation and weighed from 1,820 g to 2,240 g. In-hospital breastfeeding experiences were managed by the authors, according to research-based guidelines for breastfeeding preterm neonates and infants. During the first month after discharge of the four newborns, the mother breastfed 12-34 times daily. …