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1.
Am J Perinatol ; 2023 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-36848934

RESUMO

OBJECTIVE: This study aimed to evaluate the clinical characteristics of the neonates who fell in the maternity ward and identify the incidence of near miss events during the immediate postpartum period. STUDY DESIGN: The study consisted of two steps. The retrospective part included the evaluation of admissions due to the in-hospital newborn fall for 6 years. The prospective part included the assessment of the near miss events (any probability of falling of the newborn; either cosleeping or an incident with a possible consequence of falling of the newborn) in the postpartum clinic (<72 hours after delivery) for a period of 4 weeks. The details of the events and clinical outcomes were recorded. A questionnaire about fatigue was administered to mothers who experienced near miss event. RESULTS: Seventeen in-hospital newborn falls were recorded: 1.8 to 2.4/10,000 live births. The median age of the neonates when the fall occurred was 22 (16-34) postnatal hours. Fourteen events (82%) occurred between 10 p.m. and 6 a.m. All neonates who experienced a fall were discharged without any known adverse outcomes. Twelve mothers (71%) had experienced a near miss event before. In the prospective arm of the study, 67 out of 804 mothers (8.3%) were found to experience a near miss event (44/1,000 days of postpartum hospitalization). Thirty-two events (49%) occurred in the first postpartum day. Fifty-two events (78%) occurred between 10 p.m. and 6 a.m. Fifty-eight mothers (86%) had no companion. Sixty-three percent of the mothers expressed intense fatigue after delivery. CONCLUSION: In-hospital newborn fall may occur in the postpartum period, and near miss events should warn clinicians for a probable fall event. The nighttime shift requires more attention regarding the prevention of both the fall and the near miss events. Immediate postpartum mothers are needed to be observed carefully. KEY POINTS: · In-hospital newborn falls occurred mainly during the night shift.. · Nearly two-third of the mothers whose newborn was fallen experienced a previous near miss event.. · Any near miss event in the hospital was detected in 8.3% of mothers..

2.
J Pediatr Hematol Oncol ; 38(8): e319-e321, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27258032

RESUMO

Pulmonary artery thrombosis is rarely reported in preterm neonates. Although treatment of neonatal thrombosis remains controversial, thrombolytic agents must be considered when the thrombosis is life threatening. We herein present a case of a preterm newborn with pulmonary artery thrombosis accompanied by acute-onset respiratory failure and cyanotic congenital heart disease. The thrombosis was successfully treated using tissue plasminogen activator. In conclusion, the thrombolytic therapy should be considered in treatment of patients in whom the thrombosis completely occludes the pulmonary arteries.


Assuntos
Recém-Nascido Prematuro , Artéria Pulmonar/patologia , Terapia Trombolítica/métodos , Trombose/tratamento farmacológico , Cardiopatias/congênito , Humanos , Recém-Nascido , Insuficiência Respiratória , Ativador de Plasminogênio Tecidual/uso terapêutico
3.
J Pediatr Hematol Oncol ; 36(5): e310-2, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24072252

RESUMO

Leukemoid reaction, defined as a total leukocyte count of >50,000/mm, is most commonly related to antenatal administration of steroids, infections, and transient myeloproliferative disorder of Down syndrome in newborns. Atypical presentations of viral infections can be a diagnostic challenge in the newborn period. Cytomegalovirus (CMV) infection causes a multisystem disease, and symptomatic infants generally present with intrauterine growth restriction, hepatosplenomegaly, cholestasis, rash, thrombocytopenia, and microcephaly. We present a case of a preterm infant with severe myeloid leukemoid reaction (leukocyte count >100,000/mm) at birth who was diagnosed with congenital CMV infection on the basis of CMV polymerase chain reaction results after the appearance of cholestasis, blueberry muffin rash, and hepatosplenomegaly.


Assuntos
Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/diagnóstico , Reação Leucemoide/diagnóstico , DNA Viral/genética , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Contagem de Leucócitos , Masculino , Reação em Cadeia da Polimerase , Prognóstico
4.
Am J Perinatol ; 31(11): 983-6, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24792770

RESUMO

BACKGROUND: Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. AIM: The aim of this study is to determine the feasibility of remifentanil analgesia during laser treatment of ROP performed in the neonatal intensive care unit (NICU). PATIENTS AND METHODS: Remifentanil was infused continuously during the procedure starting with a dose of 0.2 µg/kg/min and increased gradually to 0.6 µg/kg/min to provide an adequate level of analgesia. RESULTS: We enrolled 64 infants. Remifentanil was infused continuously at a mean rate of 0.4 ± 0.1 µg/kg/min. No major adverse effects were observed except in two patients with reversible bradycardia and hypotension. Premature infant pain profile (PIPP) scores revealed no pain. Patients with bronchopulmonary dysplasia had similar remifentanil dosage, intubation duration, and extubation time. CONCLUSIONS: Remifentanil analgesia for ROP treatment performed in the NICU by pediatricians is a safe and effective modality. This modality offers a practical solution in hospitals without readily available pediatric anesthetists.


Assuntos
Analgésicos Opioides/uso terapêutico , Piperidinas/uso terapêutico , Retinopatia da Prematuridade/cirurgia , Analgésicos Opioides/administração & dosagem , Estudos de Viabilidade , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Fotocoagulação a Laser , Masculino , Medição da Dor , Piperidinas/administração & dosagem , Remifentanil
5.
Arch Argent Pediatr ; 115(6): e424-e427, 2017 Dec 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29087127

RESUMO

Neonatal abstinence syndrome (NAS) due to prenatally exposure to citalopram can develop during the first days of life even with low dose of drug exposure. Supportive management is the first choice but phenobarbital can be used in treatment of this syndrome. Breastfeeding should not be interrupted. These neonates should be followed both for NAS and neurodevelopmental outcome. In this article, we reported a newborn with NAS due to citalopram exposure with a lower dose than previously reported in the literature, during the last six months of pregnancy. Phenobarbital was used because of non-pharmacological treatment failure.


El síndrome de abstinencia neonatal (SAN) debido a la exposición prenatal al citalopram se desarrolla durante los primeros días de vida, incluso con una exposición al fármaco en dosis bajas. El tratamiento de apoyo es la primera opción, aunque puede usarse el fenobarbital en el tratamiento de este síndrome. No debe interrumpirse la lactancia. Debe hacerse un seguimiento de estos recién nacidos para establecer el desenlace del SAN y las consecuencias en el desarrollo neurológico. En este artículo presentamos el caso de un recién nacido con SAN debido a exposición al citalopram en una dosis más baja que lo informado previamente en la bibliografía durante los últimos seis meses del embarazo. Se utilizó el fenobarbital debido al fracaso del tratamiento no farmacológico.


Assuntos
Antidepressivos de Segunda Geração/efeitos adversos , Citalopram/efeitos adversos , Síndrome de Abstinência Neonatal/etiologia , Anticonvulsivantes/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Humanos , Recém-Nascido , Masculino , Síndrome de Abstinência Neonatal/tratamento farmacológico , Fenobarbital/uso terapêutico , Gravidez , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal
7.
Arch. argent. pediatr ; 115(6): 424-427, dic. 2017.
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-887406

RESUMO

El síndrome de abstinencia neonatal (SAN) debido a la exposición prenatal al citalopram se desarrolla durante los primeros días de vida, incluso con una exposición al fármaco en dosis bajas. El tratamiento de apoyo es la primera opción, aunque puede usarse el fenobarbital en el tratamiento de este síndrome. No debe interrumpirse la lactancia. Debe hacerse un seguimiento de estos recién nacidos para establecer el desenlace del SAN y las consecuencias en el desarrollo neurológico. En este artículo presentamos el caso de un recién nacido con SAN debido a exposición al citalopram en una dosis más baja que lo informado previamente en la bibliografía durante los últimos seis meses del embarazo. Se utilizó el fenobarbital debido al fracaso del tratamiento no farmacológico.


Neonatal abstinence syndrome (NAS) due to prenatally exposure to citalopram can develop during the first days of life even with low dose of drug exposure. Supportive management is the first choice but phenobarbital can be used in treatment of this syndrome. Breastfeeding should not be interrupted. These neonates should be followed both for NAS and neurodevelopmental outcome. In this article, we reported a newborn with NAS due to citalopram exposure with a lower dose than previously reported in the literature, during the last six months of pregnancy. Phenobarbital was used because of non-pharmacological treatment failure.


Assuntos
Humanos , Masculino , Gravidez , Recém-Nascido , Síndrome de Abstinência Neonatal/etiologia , Citalopram/efeitos adversos , Antidepressivos de Segunda Geração/efeitos adversos , Fenobarbital/uso terapêutico , Complicações na Gravidez/psicologia , Complicações na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal , Síndrome de Abstinência Neonatal/tratamento farmacológico , Transtorno Depressivo Maior/tratamento farmacológico , Anticonvulsivantes/uso terapêutico
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