RESUMEN
BACKGROUND: Subdural haematomas are thought to be uncommon in babies born at term. This view is mainly based on findings in symptomatic neonates and babies in whom subdural haemorrhages are detected fortuitously. We aimed to establish the frequency of subdural haemorrhages in asymptomatic term neonates; to study the natural history of such subdural haematomas; and to ascertain which obstetric factors, if any, are associated with presence of subdural haematoma. METHODS: We did a prospective study in babies who were born in the Jessop wing of the Central Sheffield University Hospitals between March, 2001, and November, 2002. We scanned neonates with a 0.2 T magnetic resonance machine. FINDINGS: 111 babies underwent MRI in this study. 49 were born by normal vertex delivery without instrumentation, 25 by caesarean section, four with forceps, 13 ventouse, 18 failed ventouse leading to forceps, one failed ventouse leading to caesarean section, and one failed forceps leading to caesarean section. Nine babies had subdural haemorrhages: three were normal vaginal deliveries (risk 6.1%), five were delivered by forceps after an attempted ventouse delivery (27.8%), and one had a traumatic ventouse delivery (7.7%). All babies with subdural haemorrhage were assessed clinically but no intervention was needed. All were rescanned at 4 weeks and haematomas had completely resolved. INTERPRETATION: Presence of unilateral and bilateral subdural haemorrhage is not necessarily indicative of excessive birth trauma.
Asunto(s)
Hematoma Subdural/diagnóstico , Hematoma Subdural/epidemiología , Puntaje de Apgar , Traumatismos del Nacimiento/diagnóstico , Traumatismos del Nacimiento/epidemiología , Traumatismos del Nacimiento/etiología , Peso al Nacer , Cesárea , Parto Obstétrico/efectos adversos , Extracción Obstétrica , Femenino , Hematoma Subdural/etiología , Humanos , Recién Nacido , Presentación en Trabajo de Parto , Segundo Periodo del Trabajo de Parto , Imagen por Resonancia Magnética , Forceps Obstétrico , Embarazo , Estudios Prospectivos , Reino Unido/epidemiología , Extracción Obstétrica por AspiraciónRESUMEN
OBJECTIVE: To determine the neonatal outcome in the form of use of morphine and triclofos to treat the neonatal abstinence syndrome following maternal opiate use in late pregnancy. METHODS: Retrospective case study of 51 pregnancies associated with maternal opiate use between January 1992 and December 1997. RESULTS: There were 51 pregnancies which resulted in 51 live births. In the third trimester 22 women took methadone only, 19 women used heroin and 10 women stopped opiate use during pregnancy. Babies of methadone using mothers were less likely to be treated with morphine or triclofos than heroin using women. Morphine, triclofos use was more common in high dose methadone users compared with low users. CONCLUSIONS: Successful methadone substitution compared with continued heroin use results in reduced morphine and triclofos use in the babies exposed.
Asunto(s)
Resultado del Embarazo , Trastornos Relacionados con Sustancias , Analgésicos Opioides/uso terapéutico , Femenino , Heroína/efectos adversos , Humanos , Recién Nacido , Morfina/uso terapéutico , Síndrome de Abstinencia Neonatal/tratamiento farmacológico , Organofosfatos/uso terapéutico , Embarazo , Tercer Trimestre del Embarazo , Estudios RetrospectivosRESUMEN
PIP: Population policy in Africa is reviewed, and policymakers' growing awareness of the impact of population growth on economic development is examined. The focus is on Sub-Saharan Africa since the 1974 World Population Conference held in Bucharest, Romania.^ieng