Effect of phototherapy on the ductus arteriosus diameter in extremely premature infants: A randomised controlled trial.

Patent ductus arteriosus (PDA) is a common complication among preterm infants (especially birth weight < 1000 g) and is closely associated with mortality and morbidity. Phototherapy (PT) is frequently used in the treatment of jaundice in premature infants in the first week of life. The relationship between PT and PDA has been investigated in a small number of studies but has not been fully elucidated because the studies had varying results. AIM: To examine the effect of PT on parameter (DA diameter, left atrial/aortic root ratio) in premature infants. METHODS: The study was planned as a prospective, randomised, double-blind study. A total of 83 infants <1000 g and < 30 weeks of gestation were included, and they were divided into two groups: the non-shielded and shielded groups. The babies included in the study were evaluated with a Doppler echocardiogram before and after PT. RESULTS: The hemodynamically significant PDA (hs-PDA) and left atrial/aortic root ratio significantly decreased in the shielded group, and the need for treatment due to PDA was significantly lower. The PT times of both groups were similar. CONCLUSION: Shielding application decreases the rate and severity of hs-PDA in extremely premature babies receiving PT.

Evaluation of the Effects of Delayed Cord Clamping in Infants of Diabetic Mothers.

OBJECTIVE: This study aimed to investigate the effect of delayed cord clamping (DCC) in infants of diabetic mothers. STUDY DESIGN: Women who had diabetes throughout their pregnancy and gave birth at 37 weeks of gestation or later were included in the study along with their babies. Early cord clamping was performed as soon as possible after birth, while DCC was performed by clamping 60 second after birth. The two groups were compared in terms of venous hematocrit (htc) levels and rates of hypoglycemia, jaundice requiring phototherapy, and respiratory distress. RESULTS: Venous htc levels at postnatal 6 and 24 hours were significantly higher in the DCC group (p = 0.0001). Polycythemia rates were higher in the DCC group at both 6 and 24 hours, but partial exchange transfusion (PET) was not needed in either group. There were no differences between the groups with regard to the rates of hypoglycemia or jaundice requiring phototherapy. Rate of admission to the neonatal intensive care unit (NICU) was lower in the DCC group. CONCLUSION: Although DCC increased the rate of polycythemia, it did not result in PET requirement. Moreover, DCC reduced the severity of respiratory distress and the rate of admission to NICU due to respiratory distress.