RESUMEN
BACKGROUND: This study aimed to describe the perinatal outcome and central nervous system (CNS) anomalies in fetuses undergoing red blood cell (RBC) intrauterine transfusion (IUT). METHODS AND MATERIALS: This was an observational single-cohort study carried out at Vall d'Hebron University Hospital in Barcelona, Spain, between 2002 and 2018 in women undergoing RBC IUT for suspected fetal anemia. Primary outcomes were adverse perinatal outcome (intrauterine or neonatal death and termination of pregnancy [TOP]), prenatal or postnatal CNS anomalies, and significant neurological impairment. RESULTS: A total of 145 RBC transfusions were performed in 68 pregnancies of 60 women. The median gestational age for the first transfusion was 26 weeks (range, 18-32). Twenty-two (32%) fetuses were hydropic at the first transfusion. Fifty-eight pregnancies (85.3%) resulted in live births and 10 (14.7%) in adverse perinatal outcomes. Adverse perinatal outcomes were associated with hydrops (odds ratio [OR], 6.69; 95% confidence interval [CI], 1.53-29.23; P = .012) and gestational age at first transfusion (OR, 0.69; 95% CI, 0.54-0.89; P = .04). Four (5.9%) cases of cerebellar hemorrhage were diagnosed prenatally. In 14 (35%) of the 41 neonates undergoing brain ultrasound and/or magnetic resonance imaging (MRI) abnormalities were reported. The median follow-up was 6.5 years (range, 3 months to 19 years). Significant neurological impairment was reported in two cases (4.2%). CONCLUSION: In fetuses undergoing intrauterine RBC transfusion, the survival rate is high, particularly in the absence of hydrops and if the gestational age at first transfusion is above 22 weeks. Significant neurological impairment is uncommon, despite the fact that postnatal CNS anomalies at ultrasound or MRI are frequent.
Asunto(s)
Anemia , Transfusión de Sangre Intrauterina/efectos adversos , Transfusión de Eritrocitos/efectos adversos , Enfermedades Fetales , Malformaciones del Sistema Nervioso , Reacción a la Transfusión/mortalidad , Adolescente , Adulto , Anemia/mortalidad , Anemia/terapia , Femenino , Enfermedades Fetales/mortalidad , Enfermedades Fetales/terapia , Edad Gestacional , Humanos , Malformaciones del Sistema Nervioso/etiología , Malformaciones del Sistema Nervioso/mortalidad , Embarazo , Estudios Retrospectivos , Centros de Atención TerciariaRESUMEN
A complete, objective and systematic documentation of delivery room resuscitation is important for research, for quality improvement, for teaching and as a reference for postresuscitation care. However, documentation during neonatal resuscitation is usually paper-based, retrospective, inaccurate and unreliable. In this narrative review, we discuss the strengths and pitfalls of current documentation methods in neonatal resuscitation, as well as the challenges of introducing new or emerging technologies in this field. In particular, we discuss innovations in electronic and automated medical records, video recording and Smartphones and Tablet Apps. Given the lack of a consensus standard, we finally propose a list of items that should be part of any neonatal resuscitation documentation method.
Asunto(s)
Registros Médicos , Resucitación , Estudios Retrospectivos , Mejoramiento de la Calidad , DocumentaciónRESUMEN
After the publication of the recommendations, agreed by all the scientific societies through the ILCOR, at the end of 2020, the GRN-SENeo began a process of analysis and review of the main changes since the last guidelines, to which a specific consensus positioning on controversial issues, trying to avoid ambiguities and trying to adapt the evidence to our environment. This text summarizes the main conclusions of this work and reflects the positioning of that group.
Asunto(s)
Resucitación , ConsensoRESUMEN
After the publication of the recommendations, agreed by all the scientific societies through the ILCOR, at the end of 2020, the GRN-SENeo began a process of analysis and review of the main changes since the last guidelines, to which a specific consensus positioning on controversial issues, trying to avoid ambiguities and trying to adapt the evidence to our environment. This text summarizes the main conclusions of this work and reflects the positioning of that group.
Asunto(s)
Salas de Parto , Resucitación , Recién Nacido , Embarazo , Humanos , Niño , Femenino , Resucitación/métodos , Encuestas y Cuestionarios , AlgoritmosRESUMEN
The care of the umbilical cord until its detachment still remains controversial. The latest updated recommendations by the World Health Organisation advocate dry cord care in those countries with adequate obstetric care and low neonatal mortality rate. In recent years, new studies and reviews attribute some benefit to applying chlorhexidine on the umbilical stump. An analysis is presented here of the available evidence and results in the advisability of still recommending the dry cord care in the newborns in our setting.
Asunto(s)
Cuidado del Lactante/normas , Cordón Umbilical , Humanos , Recién Nacido , Guías de Práctica Clínica como AsuntoRESUMEN
Due to its severity, as well as the consequences of a late diagnosis, critical congenital heart defects (CCHD) represent a challenging situation, making an early diagnosis necessary and ideally before symptoms appear when circulatory collapse or death of the newborn can occur. Due to this, a prenatal and very early postnatal diagnosis is very important. Prenatal ultrasound screening and physical examination of the newborn can miss a considerable number of CCHD cases. Pulse oximetry screening has been demonstrated to be an effective, non-invasive, inexpensive, and well accepted tool in the early diagnosis of CCHD. The Spanish National Society of Neonatology, through its Standards Committee, and based on the current evidence, recommend the implementation of pulse oximetry screening of CCHD in Spain, and then to offer the best therapy possible to these newborn infants.
Asunto(s)
Cardiopatías Congénitas/diagnóstico , Tamizaje Neonatal/normas , Oximetría/normas , Algoritmos , Enfermedad Crítica , Humanos , Recién NacidoRESUMEN
Tras la publicación de las recomendaciones, consensuadas por todas las sociedades científicas a través del ILCOR, a finales del año 2020, el GRN-SENeo inició un proceso de análisis y revisión de los principales cambios desde las últimas guías, a los que se añadió un posicionamiento específico de consenso en temas controvertidos, tratando de evitar ambigüedades, y procurando adaptar la evidencia a nuestro medio. El presente texto, resume las principales conclusiones de este trabajo y refleja el posicionamiento de dicho grupo. (AU)
After the publication of the recommendations, agreed by all the scientific societies through the ILCOR, at the end of 2020, the GRN-SENeo began a process of analysis and review of the main changes since the last guidelines, to which a specific consensus positioning on controversial issues, trying to avoid ambiguities and trying to adapt the evidence to our environment. This text summarizes the main conclusions of this work and reflects the positioning of that group. (AU)
Asunto(s)
Humanos , Recién Nacido , Salud Infantil , Reanimación Cardiopulmonar , Recién Nacido , Consenso , NeonatologíaRESUMEN
Criteria for newborn hospital discharge have to include physiological stability and family competence to provide newborn care at home. In this document, the Committee of Standards of the Spanish Society of Neonatology reviews the minimum criteria to be met before hospital discharge of a term newborn infant. We include a review of hospital discharge criteria for the late preterm infants, as these infants are often not hospitalised and remain with their mother after birth. A shortened hospital stay (less than 48h after delivery) for healthy term newborns can be considered, but it is not appropriate for every mother and newborn. Newborn infants discharged before 48h of age, should be examined within 3-4 days of life.
Asunto(s)
Parto Obstétrico , Alta del Paciente/normas , Humanos , Recién NacidoRESUMEN
Hospital discharge criteria for the pre-term newborn are mainly based on physiological competences (thermoregulation, respiratory stability, and feeding skills), although family support and ability to care for the baby, as well as a well-planned discharge are also cornerstones to ensure a successful discharge. In this article, the Committee of Standards of the Spanish Society of Neonatology reviews the current hospital discharge criteria in order for it to be useful as a clinical guide in Spanish neonatal units.
Asunto(s)
Cuidado Intensivo Neonatal/normas , Alta del Paciente/normas , Humanos , Recién Nacido , Recién Nacido de muy Bajo PesoRESUMEN
Newborn identification is a legal right recognised by international and national laws. Moreover, improving the accuracy of correct patient identification is an important goal of patient safety solutions programs. In this article, the Standards Committee of the Spanish Society of Neonatology establishes recommendations to ensure correct identification of the newborn whilst in hospital. Currently, the most reliable method of identification of the newborn is the combination of identification cord clamp and bracelets (mother bracelet, newborn bracelet and cord clamp with the same number and identical and exclusive barcode system for each newborn) and the collection of maternal and umbilical cord blood samples (for DNA testing only for identification purposes).
Asunto(s)
Dermatoglifia del ADN , Sistemas de Identificación de Pacientes/métodos , Sistemas de Identificación de Pacientes/normas , Humanos , Recién NacidoRESUMEN
Hyperbilirubinaemia is one of the most frequent causes of hospital readmission during the first week of life. Its detection is still a big challenge, mainly due to the early discharge from the hospital that can be associated with a delay of the diagnosis. The identification of those newborns at risk of developing significant hyperbilirubinaemia is one of the main priorities in the public health care system. An approach to the management of newborn jaundice is presented in this article, following the recommendations based on the medical evidence and on the opinion of the Standards Committee of the Spanish Society of Neonatology.
Asunto(s)
Hiperbilirrubinemia/diagnóstico , Hiperbilirrubinemia/terapia , Edad Gestacional , Humanos , Hiperbilirrubinemia/prevención & control , Recién NacidoAsunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Reanimación Cardiopulmonar , Neonatología , Intubación , Preceptoría , Encuestas y Cuestionarios , Pediatría , EspañaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Hemocromatosis/terapia , Diagnóstico Precoz , Hemocromatosis/diagnóstico , Hemocromatosis/fisiopatología , Estudios Retrospectivos , InmunohistoquímicaRESUMEN
El cuidado del cordón umbilical hasta su desprendimiento continúa siendo motivo de controversia en la actualidad. La Organización Mundial de la Salud recomienda en su última revisión realizar la cura en seco en países con cuidados obstétricos adecuados y una tasa baja de mortalidad neonatal. Por otro lado, en los últimos años han surgido nuevos estudios y revisiones que atribuyen un beneficio a aplicar clorhexidina tópica en el muñón. El presente documento analiza la evidencia disponible y concluye en la conveniencia de continuar recomendando la cura en seco en los nacimientos de nuestro entorno
The care of the umbilical cord until its detachment still remains controversial. The latest updated recommendations by the World Health Organisation advocate dry cord care in those countries with adequate obstetric care and low neonatal mortality rate. In recent years, new studies and reviews attribute some benefit to applying chlorhexidine on the umbilical stump. An analysis is presented here of the available evidence and results in the advisability of still recommending the dry cord care in the newborns in our setting
Asunto(s)
Humanos , Recién Nacido , Cordón Umbilical , Cuidado del Lactante/normas , Guías de Práctica Clínica como AsuntoRESUMEN
No disponible
Asunto(s)
Humanos , Lactante , Consenso , Palivizumab/uso terapéutico , Profilaxis Antibiótica/normas , Virus Sincitiales Respiratorios/efectos de los fármacos , Sociedades Médicas/normas , Virus Sincitial Respiratorio Humano , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico , Grupos de Riesgo , Hospitalización , Factores de RiesgoAsunto(s)
Antivirales/uso terapéutico , Enfermedades del Prematuro/prevención & control , Palivizumab/uso terapéutico , Guías de Práctica Clínica como Asunto , Infecciones por Virus Sincitial Respiratorio/prevención & control , Esquema de Medicación , Humanos , Recién Nacido , Recien Nacido Prematuro , Neonatología , Riesgo , Sociedades Médicas , EspañaRESUMEN
El documento partede una reflexión sobre la política de restricción de visitas de los padres en las unidades neonatales y del acompañamientoen las plantas de maternidad que se aplicó en los hospitales en las primeras fases de la pandemia. Casi un año tras suinicio, un grupo de neonatólogos con espíritu autocrítico trabajamos de forma conjunta, en el marco del Grup dEstudisNeonatals, con la voluntad de analizar los posibles efectos adversos de las medidas sobre aspectos fundamentales comoson el neurodesarrollo del recién nacido, la lactancia materna y la salud psicológica de los progenitores. Y, finalmente,desde el conocimiento y recursos que teníamos en ese momento, elaborar nuevas recomendaciones.(AU)
The document is based on a reflection on the policy ofrestricting parental visits in neonatal units and the accompanying in maternity wards that was applied in hospitals inthe early phases of the pandemic. Almost a year after its beginning, a group of neonatologists with a self-critical spiritworked together, within the framework of the Grup dEstudis Neonatals, with the aim of analyzing the possible adverseeffects of the measures on fundamental aspects such as the neurodevelopment of the newborn, breastfeeding andthe psychological health of the parents. And, finally, from the knowledge and resources we had at that time, to developnew recommendations.(AU)
El document parteix duna reflexiósobre la política de restricció de visites dels pares a les unitats neonatals i de lacompanyament a les plantes dematernitat que es va aplicar als hospitals a les primeres fases de la pandèmia. Gairebé un any després del seu inici,un grup de neonatòlegs amb esperit autocrític treballem conjuntament, en el marc del Grup dEstudis Neonatals,amb la voluntat danalitzar els possibles efectes adversos de les mesures sobre aspectes fonamentals com sónel neurodesenvolupament del nounat, la lactància materna i la salut psicològica dels progenitors. I, finalment, desdel coneixement i recursos que teníem en aquell moment, elaborar noves recomanacions.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Pandemias , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Infecciones por Coronavirus/epidemiología , Unidades de Cuidado Intensivo Neonatal , Servicio de Acompañamiento de Pacientes , Visitas a Pacientes , Salud Mental , Mujeres Embarazadas/psicología , Embarazo/psicologíaRESUMEN
La identificación del recién nacido es un derecho reconocido, tanto a nivel internacional como nacional, y la correcta identificación del paciente constituye una prioridad dentro de las políticas de mejora de la seguridad de la asistencia sanitaria. En este documento el Comité de Estándares de la Sociedad Española de Neonatología recoge las recomendaciones para garantizar la identificación inequívoca del recién nacido durante su estancia hospitalaria. La combinación del codificador neonatal (pulsera de la madre y pulsera del recién nacido y pinza de cordón con un mismo número y con un código de barras idéntico y exclusivo para cada recién nacido), junto con la recogida de una muestra de sangre materna y otra de sangre del cordón umbilical (para análisis de ADN en caso exclusivamente de duda de identidad) es actualmente el método más fiable de identificación del recién nacido (AU)
Newborn identification is a legal right recognised by international and national laws. Moreover, improving the accuracy of correct patient identification is an important goal of patient safety solutions programs. In this article, the Standards Committee of the Spanish Society of Neonatology establishes recommendations to ensure correct identification of the newborn whilst in hospital. Currently, the most reliable method of identification of the newborn is the combination of identification cord clamp and bracelets (mother bracelet, newborn bracelet and cord clamp with the same number and identical and exclusive barcode system for each newborn) and the collection of maternal and umbilical cord blood samples (for DNA testing only for identification purposes) (AU)