Ophthalmologic Findings in a Premature Infant leading to a Zika Diagnosis during the COVID-19 Pandemic: A Case Report.

We report on the first case of congenital Zika syndrome to be identified during the COVID-19 pandemic in Puerto Rico. The Zika virus (ZIKV) infection was first seen in Puerto Rico in December 2015. It is a flavivirus with vertical transmission, spreading from infected mothers to their fetuses and having a broad spectrum of clinical manifestations, of which microcephaly is the most worrisome. In Puerto Rico, routine ZIKV screening during pregnancy was implemented in October 2016. However, this practice has become less frequent over time. Nevertheless, the transmission of ZIKV continues, so it is important to ensure routine ZIKV screening in endemic regions, such as Puerto Rico.

Neutropenia and thrombocytopenia in very low birth weight infants of women with preeclampsia.

OBJECTIVE: Determine the incidence of neutropenia and thrombocytopenia during the first week of life in very low birth weight (VLBW) infants born to mothers with preeclampsia. METHODS: Medical records of infants born to mothers with preeclampsia admitted to NICU from 2005-2007 were reviewed. RESULTS: A total of 93 infants were included with a mean birth weight of 988 g and gestational age of 29 weeks. Neutropenia was present in 49% of the infants and thrombocytopenia in 56%. Infants with neutropenia had lower birth weights (p<0.01) and were born at lower gestational ages (p<0.01). Neutropenia was associated to a higher prevalence of positive blood cultures during the first week of life especially coagulase negative organisms. CONCLUSIONS: In this group of VLBW infants born to mothers with preeclampsia, neutropenia was common and it was associated to increase risk of bacterial infections during the first week of life.

Closure of patent ductus arteriosus in low-birth weight infants based on three management strategies.

UNLABELLED: There is controversy on the most advantageous management for infants with patent ductus arteriosus (PDA) and whether to favor actively closing the PDA or to conservatively observe. We aimed to describe the outcome of infants with PDA based on three management strategies used for its closure (conservative, indomethacin, ligation). METHODS: Retrospective medical record review of data from LBW infants (< 2000 with PDA admitted to NICU-SJCH. RESULTS: The prevalence of PDA was 16%. Based on management strategies: 31% did not require treatment. 19% resolved with conservative measures, 38% resolved with omethacin treatment, and 12% required ligation. There was no difference in birth weight, gestational, clinical criteria, morbidities and mortality in patients managed with the strategies evaluated. CONCLUSION: Results are consistent with previous reports. Development of PDA management guidelines will help standardize the definition of PDA and management criteria instead of treating on a case-by-case basis.

Loss of parental role as a cause of stress in the neonatal intensive care unit.

UNLABELLED: Having a baby in the Neonatal Intensive Care Unit (NICU) is a major source of stress for parents. The barriers to parenting and reactions to the environment may negatively influence the parent-infant relationship. OBJECTIVE: To identify NICU-related parental stress and associated factors. METHODS: Parents (N = 156) of newborns admitted to NICU completed the Parental Stressor Scale. RESULTS: Most of the parents (46%) rated the experience to be extremely stressful. The principal cause of stress was the alteration in parental role and being separated from their baby. Stress was not associated to education, marital status, infants' birth weight, gestational age, congenital anomalies or if the parents expected the baby to be in the NICU. CONCLUSION: Identification of areas associated to higher levels of stress in parents may help the NICU staff to establish strategies to help parents cope with the stress caused by being unable to start their parenting role immediately after their babies' birth.