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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of neonatal septicaemia associated with prolonged rupture of foetal membranes, discoloured amniotic fluid and/or maternal fever was investigated. A total of 807 blood cultures were performed on 329 neonates, the placental end of 239 umbilical cords and on 239 mothers. The study showed that in 97% of the neonates with a complicated delivery there was no evidence of septicaemia. Septicaemia was verified in 3% of the infants, and was intimately associated with low birth weight (p equals 0.02), neonatal asphyxia (p less than 10(-4)), clinical evidence of septicaemia (p less than 10(-4) and maternal fever (p equals 0.002). The incidence was particularly high in premature infants with neonatal asphyxia (27%) and in neonates born to febrile mothers (20%). None of the mothers showed any evidence of septicaemia, and haematogenous, transplacental spread of infection to the child was not seen. Routine prophylactic antibiotic therapy in neonates with a complicated delivery should therefore be reserved, in our opinion, for those infants at high risk of infection.
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PMID:Septicaemia of the newborn, associated with ruptured foetal membranes, discoloured amniotic fluid or maternal fever. 79 90

The neonatal morbidity was studied in 7015 neonates born at the All India Institute of Medical Sciences Hospital, New Delhi. The incidence of low birth weight babies was 26.7 per cent; one seventh (13.5%) of the series were preterm (less than 37 wk), while 6.6 per cent were 'small-for-dates'. Birth asphyxia of varying severity developed in 5.9 per cent infants. Respiratory distress syndrome was diagnosed in 5.7 per 100 live-births; most being due to hyaline membrane disease (33.5%), which affected 14.1 per cent of preterm babies. Neonatal hyperbilirubinemia occurred in 5.9 per cent, most of whom were premature. In nearly one-fifth, the cause of jaundice could not be identified after detailed investigations. Minor bacterial infections (conjunctivitis, pyoderma, oral thrush, umbilical sepsis) were observed in 1.8 per cent while major infections (septicemia, meningitis, diarrhoea) in 3.0 per cent. The overall incidence of major malformations was 2.3 per cent. Reasons for low incidence of bacterial infections and common occurrence of hyaline membrane disease in premature infants, are highlighted.
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PMID:A four year study on neonatal morbidity in a New Delhi hospital. 193

Persistent pulmonary hypertension of the newborn (PPHN), initially described by Gersony et al as persistent foetal circulation (PFC syndrome), results from a flawed transition from foetal to extrauterine pulmonary circulation. It is characterised by the maintenance of a high pulmonary vascular resistance and right-to-left shunting through the ductus arteriosus and foramen ovale. Infants with a wide variety of underlying clinical conditions develop PPHN. According to Rudolph three main anatomic types of PPHN can be identified: normal pulmonary vascular development increased pulmonary vascular smooth muscle development decreased cross-sectional area of pulmonary vascular bed. It is important to realize that several pathophysiologic mechanisms may coexist and interact. Besides metabolic and respiratory acidosis, hypercapnia and hypoxaemia some other factors induce pulmonary vasoconstriction. Thromboxane, leukotrienes and prostaglandins play a decisive role. Since PPHN can be associated with a broad spectrum of clinical conditions, a specific clinical picture is lacking. The baby is usually term or post-term, cyanotic immediately after birth or some hours later. Birth asphyxia, hyperviscosity, sepsis and aspiration of meconium have been recognized as predisposing factors. The diagnosis can be confirmed by echocardiography. Contrast echo will indicate right-to-left shunting with normal anatomy. Currently hyperventilation, tolazolin, chlorpromazin and dopamine/dobutamine have been advocated as central foci for clinical therapy. Recently prostacyclin was introduced as a specific pulmonary vasodilatator.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Persistent pulmonary hypertension of newborn. The PFC syndrome]. 229 36

The differential leukocyte count was studied within the first 24 hours of life in 115 infants of diabetic mothers (IDMs) appropriate for gestational age (AGA), 16 IDMs large for gestational age (LGA), 104 infants of non-diabetic mothers (INM's) AGA, and 22 INMs-LGA. A significant "shift to the left" was found in IDM's-LGA only. The usual cause of "shift to the left" such as maternal hypertension or fever, respiratory distress syndrome, meconium aspiration, neonatal asphyxia, sepsis, convulsions, or hypoglycemia could not explain this finding. It is hypothesized that increased glucocorticoid secretion may possibly play a role.
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PMID:Differential leukocyte count in infants of diabetic mothers. Increased band count associated with macrosomia. 373 70

This paper reports the creation of India's national neonatal-perinatal database. The database has a continuous reporting format, uniform in its definitions, and is checked and compiled at a nodal center, which is a necessity for planning and monitoring health care. Data were compiled from intramural births of 16 centers, which included neonatal morbidity and mortality data for the year 1995. Furthermore, the database comprised data on 38,592 births, 37,082 of which were live-born and 1510 stillborn. Statistics show that the incidence of low birth weight (LBW) was 32.8% and that of preterms 12.3%, while two-thirds of the LBW infants were term babies. Among institutional births, the incidence of birth asphyxia would approximate 5%, while septicemia was observed in 3.9% of intramural live births. Birth asphyxia, septicemia, and causes related to immaturity account for almost three-fourths of the neonatal deaths, a majority of which could be prevented.
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PMID:Neonatal morbidity and mortality: report of the National Neonatal-Perinatal Database. 956 38

Morbidity and mortality in the first 7 days of life were investigated in a prospective study of the 7972 viable live births at the Eden Hospital Nursery in Calcutta, India, in a 22-month period in 1995-96. The early neonatal mortality rate was 32.86/1000 and the morbidity rate was 66.85/1000. 48.8% of these deaths occurred in the first 24 hours of life and 80% within 72 hours. In 67.7% of deaths, there had been no antenatal care. Overall, 28.34% of infants were low birth weight; however, these infants comprised 77.8% of early neonatal deaths. The highest neonatal mortality rates were recorded in babies of primiparas (43.03), grand multiparas (103.89), mothers under 20 years of age (44.15) or over 30 years of age (46.04), and those with nonsingleton births (142.85) and breech deliveries (114.28). Birth asphyxia was the most common cause of neonatal mortality (65.26%); another 10.30% of deaths involved septicemia. Klebsiella was the most commonly isolated organism (55.27%) in septicemic neonates. Reductions in the incidence of low-birth-weight deliveries through measures such as community-level educational outreach could have a significant impact on the prevention of early neonatal mortality and morbidity in India.
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PMID:Early neonatal morbidity and mortality in a city based medical college nursery. 1038 99

One hundred and fifty nine neonates were ventilated over a period of one year of whom 74 (46.54%) survived. This study aims to analyse the indications, complications and outcome of babies requiring mechanical ventilation. The early outcome measures were (i) survival rate with respect to birth weight, gestation and indication of ventilation, and (ii) Complications of assisted ventilation. One hundred and forty seven babies received IPPV and 34 received CPAP. Twenty two out of these 34 required IPPV later. Survival was cent percent on exclusive CPAP mode. HMD was the commonest indication for ventilation followed by Birth asphyxia, Apnea of prematurity, Meconium Aspiration Syndrome and Persistent Pulmonary Hypertension of the New born. Survival rates increased with increasing birth weight and gestational age, changing from 25% for < 1000 gm and 20% for < 28 wks to 53% for > 2500 gms and 50.2% for > 37 wks. Prolonged ventilatory support was needed for HMD (mean 114 hrs) and PPHN (mean 156 hrs). Commonest complication was Sepsis (26%) followed by Pulmonary hemorrhage, Pneumothorax and IVH. Lower success rates in ventilation is due to the poor survival of babies weighing < 1000 gms and those with a gestation of < 28 wks with nosocomial infections as a major complication of assisted ventilation being an additional factor.
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PMID:Neonatal mechanical ventilation--experience at a level II care centre. 1077 75

No epidemiological surveys have examined risk factors related to the death of very low birth weight infants (VLBWIs) in Japan. The objectives of this study were to examine the death rate and fatalities related to complications among VLBWIs, and to analyze factors possibly determining the death of VLBWIs. The subjects of this study were 811 VLBWIs admitted to the Neonatal Care Center of Niigata City General Hospital between April 1987 and March 2003. We obtained information on gender, birth weight, gestational age, Apgar scores, single/multiple pregnancy, postnatal transfer, mode of delivery, complications and outcome (alive or deceased) at the time of discharge from medical records. Of the 811 infants, 98 died prior to discharge (12.1%). Logistic regression analysis showed that independent risk factors for death of VLBWIs were male gender (relative risk [RR]: 2.0), low birth weight (RR: 0.56), necrotizing enterocolitis (RR: 58.0), pulmonary hypoplasia (RR: 37.8), chromosomal abnormalities (RR: 36.3), congenital heart diseases (RR: 9.8), persistent fetal circulation (RR: 9.6), neonatal asphyxia (RR: 6.3) and sepsis (RR: 4.4). The risk for death rises 1.8-fold if birth weight decreases by 100 g. A very high risk of perinatal death is associated with necrotizing enterocolitis, pulmonary hypoplasia or chromosomal abnormalities. The risk of death due to congenital heart diseases or neonatal asphyxia is relatively lower, but the incidences of these two disorders are high (8% and 6%, respectively). From the viewpoint of prophylactic treatment aimed at reducing the death rate of VLBWIs, measures to increase birth weight are of primary importance. Furthermore, early treatment and improved perinatal management of congenital heart diseases and neonatal asphyxia are anticipated to reduce the overall death rate of VLBWIs.
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PMID:Factors affecting short-term mortality in very low birth weight infants in Japan. 1567 72

Acute phase proteins are sensitive markers of tissue necrosis and inflammatory process. These markers may be especially useful in the neonatal period, in which mortality and morbidity rates are high, because fetus and baby are subjected to numerous metabolic, genetic, physiologic and environmental injuries such as neonatal asphyxia and septicemia. The purpose of the present study was to establish normal cord blood levels of some acute phase proteins in healthy term neonates. Umbilical cord blood was obtained at the time of vaginal delivery in 60 newborn infants (30 girls, 30 boys). Specific protein concentrations were measured by nephelometric assay. Transferrin, ceruloplasmin, alpha-1 antitrypsin, prealbumin, and alpha-2 macroglobulin concentrations [arithmetic mean (+/- SD)] were found to be 199.7 (+/- 34.6) mg/dl, 14.6 (+/- 4.0) mg/dl, 160.2 (+/- 23.6) mg/dl, 11.9 (+/- 2.2) mg/dl, and 284.6 (+/- 44.4) mg/dl, respectively. Prealbumin levels for girls [12.9 (+/- 2.2)] were found to be significantly higher than those of boys [10.9 (+/- 1.8)] (p < 0.001), while there were no significant differences between the other proteins. We conclude that these results may be used as reference values for the diagnosis of pathological conditions in newborns.
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PMID:Reference values of cord blood transferrin, ceruloplasmin, alpha-1 antitrypsin, prealbumin, and alpha-2 macroglobulin concentrations in healthy term newborns. 1747 44

A retrospective multicenter study of 38 cases of acute renal failure (ARF) in newborns was carried out from April 1992 to September 1995 in the pediatric department so f a group hospitals of he Royal Medical Services in Jordan, to evaluate the etiology and the mortality rate in the first month of life. ARF was diagnosed according to the urine out put, serum level of creatinine and blood urea nitrogen. Neonatal asphyxia, the most common cause in this study, accounted for 42% (N=16) of renal failure and was associated with the highest mortality rate 70% (N=11). Drugs (aminoglycosides or vancomycin), the second most common cause of renal failure, accounted for 14% (N=7), but no patient sided. Septicemia accounted for 15.7% (N=6) of renal failure; one patients died. Three cases were due to genitorreal anomalies, one died with real agenesis. The other six cases were of different causes, four of them died. None of the newborns was treated by dialysis. We conclude that neonatal asphyxia is the most common cause of ARF in our series, and it carries poor prognosis. However, drug induced ARF has relatively good prognosis. The overall prognosis of ARF in the newborn was rather poor, the cumulative mortality, without dialysis, being of ARF in the newborn was rather poor, the cumulative mortality, without dialysis, being 45% in this study.
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PMID:Acute renal failure in newborn: etiology and mortality rate in jordan patients. 1840 77


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