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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prolapse of the umbilical cord occurred 69 times in 30112 deliveries. The incidence was higher in abnormal presentations, particularly in compound presentation (11.1%), and in breech presentation (2.9%), especially when these occurred in association with prematurity. Twenty-five (36.2%) of the 69 infants died; 21 of these were dead at the time of diagnosis of cord prolapse, two died in the neonatal period of respiratory distress syndrome, and two died from complications of breech extraction. Reduction in perinatal mortality will be possible only if early diagnosis of cord prolapse can be made by means of vaginal examination or fetal heart monitoring, and the birth trauma associated with difficult vaginal delivery prevented.
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PMID:Prolapse of the umbilical cord: a study of 69 cases. 57 44

To ensure an optimum result in pregnancy it is essential that the physician be alert in the antenatal period to recognize those women and their babies who are at risk during labour. Premature labour, with its attendant risk of respiratory distress syndrome in the newborn, continues to be an important factor in perinatal morbidity and mortality. Early recognition of predisposing factors and the judicious use of myometrial inhibiting agents have helped to reduce the incidence of fetal prematurity in these cases. A long interval between rupture of the membranes and delivery continues to be a danger to both mother and fetus. Delivery is recommended when gestation is beyond 36 weeks or when there are signs of incipient infection, and once labour has begun antibiotics should be used prophylactically. Failure of labour to progress should be recognized and managed aggressively in its early stages. Amniotomy and oxytocin infusion have reduced considerably the incidence of prolonged labour and its risks to both mother and fetus. The role of intrapartum monitoring of the fetal heart rate, measurement of the pH in the fetus's scalp blood and assessment of amniotic fluid is discussed, as is the monitoring of maternal well-being.
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PMID:Labour: when to worry. 63 Apr 88

Between 1954 and 1973, 101 heroin-addicted mothers gave birth to 149 babies at Vancouver General Hospital. Thirty-seven percent of the infants had low birth weights and two thirds were born preterm. Average birth weight was 2,710 gm as compared with an overall average of 3,420 gm for this hospital. Tobacco and alcohol abuse, and poor maternal nutrition probably contributed to the growth retardation. Withdrawal symptoms were observed in 68% of the babies, and this may have been aggravated by multiple drug use, which was prevalent, including alcohol, barbiturates, and "soft drugs." Neonatal mortality rate of 6.7% and a stillbirth rate of 4% resulted in a perinatal mortality rate of 10.7%. Prematurity, respiratory distress syndrome, and other perinatal complications related to an unfavorable social background accounted for most neonatal deaths, but none was attributable directly to narcotic withdrawal.
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PMID:Narcotic addiction, pregnancy, and the newborn. 64 51

Nine infants with early-onset Haemophilus sepsis were seen between January 1973 and July 1977. Of the five isolated strains that were typed, only one was type B. All infants had respiratory distress, metabolic acidosis, and large alveolar-arterial oxygen tension difference gradients. Eight infants weighed less than 1,500 gm and died; one infant weighed 1,701 gm and survived. Roentgenograms in six of eight showed hyaline membrane disease. Pulmonary pathologic specimens in eight infants revealed hyaline membranes in six and polymorphonuclear leukocytes in the alveolar spaces in four. In two infants, small Gram-negative bacilli were noted within proteinaceous exudates in alveolar ducts. The route and time of infection in these infants with early-onset Haemophilus sepsis are unclear. However, the possibility that the infection occurs before birth and that these infants represent septically aborted prematures is suggested by the high incidence of prematurity in infants with early-onset Haemophilus sepsis and early detection of bacteremia in three infants.
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PMID:Early-onset Haemophilus sepsis in newborn infants: clinical, roentgenographic, and pathologic features. 70 99

A survey of neonatal deaths occurring over two years in Northern Ireland disclosed that many hospitals where babies could be born probably could not be staffed and equipped to deal effectively with major perinatal problems. The incidence of congenital malformations, especially neural tube defects, was high. A reduction in neonatal deaths from this cause might be expected if facilities for antenatal diagnosis and termination of pregnancy were made available, although this raises grave ethical problems. Many infants died of prematurity and the idiopathic respiratory distress syndrome. A considerable reduction in neonatal deaths might be expected with improved care at the place of delivery backed by a regional centre with facilities for transporting and treating severely ill infants needing intensive care.
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PMID:Neonatal death in Northern Ireland. 70 3

In a series of 1,000 newborn infants referred to a regional neonatal center, 32 iatrogenically preterm infants were identified. All had been delivered following elective termination of uncomplicated, apparently term pregnancies, without prior documentation of fetal lung maturity or ultrasonic determination of fetal biparietal diameter. Associated acute morbidity included asphyxia neonatorum in 10, respiratory distress syndrome in 24, and pneumothorax or pneumomediastinum in nine patients. One infant died. Hospital costs totaled $150,643, for a mean of $4,701 per patient. The unexpected premature births were associated with major parental grief reactions and alterations in their daily activities, Iatrogenic prematurity is a major regional health care problem which, when viewed on a national basis, may affect thousands of newborn infants and their families annually. Our data suggest the need for more accurate assessment of fetal maturity, before elective termination of pregnancy, by well-established techniques.
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PMID:Iatrogenic prematurity due to elective termination of the uncomplicated pregnancy: a major perinatal health care problem. 73 60

Hyaline membrane disease (HMD) is leading single cause of death of newborn, premature infants. The "hyaline membranes" consist chiefly of fibrin. The clinical manifestation of HMD is the respiratory distress syndrome (RDS). Infants with RDS were treated with urokinase-activated human plasmin in a previous clinical trial. Survival rate was increased in the plasmin treated group as compared to the placebo recipients. However, cost and difficulty in the preparation of the enzyme made this treatment impractical. We, as well as others, have shown the premature infants lack serum plasminogen; thus they are unable to develop effective fibrinolysis and are defenseless against pulmonary fibrin deposition. Therefore, plamsinogen was tested as a possible preventive agent in RDS due to HMD. In a double blind, randomized study, infants between 1 and 2.5 kg birth weight received plasminogen or placebo shortly after birth, and were then followed for development of RDS. After 100 infants were entered into the study, the code was broken and results were evaluated to assure safety of the procedure. Among the 100 infants, 51 received placebo, 49 received plasminogen. Among the infants who received placebo, seven developed mild, and ten developed severe respiratory distress; of these ten, five died with histopathologically documented HMD. Two infants died from causes other than HMD. Among the 49 infants treated with plasminogen, 13 developed mild and three developed severe respiratory distress. There was no death due to HMD. Two deaths were due to other causes. Factors placing the infant at risk from HMD (degree of prematurity, sex, cesarean section, bleeding episodes during pregnancy, maternal diabetes) were found to be evenly distributed between control and treated groups. Since completing the first phase of the study, data of an additional 277 infants has become available. Although the code was not broken in this series, a preliminary look at mortality data in comparison with mortality data of the first series of 100 (in which the code was broken) suggests that preventive activity of plasminogen has been maintained in the second phase of the study.
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PMID:Studies on the prevention of respiratory distress syndrome of infants due to hyaline membrane disease with plasminogen. 79 69

Oedema of the umbilical cord, defined as visible oedema in a cord wish a minimal cross sectional area of 1-3 cm-2, is found in 10 per cent of deliverieo. It is seen more frequently in cetain complications of pregnancy such as abrupti placentage, maternal diabetes, macerated intrauterine death and in conditions affectint the infant including prematurity, rhesus isoimmunization, respiratory distress syndrome (RDS) and transient respiratory distress (TRD). There is a higher incidence in infants delivered by Caesarean section. There is no significant association between cord oedema and either fetal distress or neonatal asphyxia nor is there any correlation with maternal hypertension or oedema. The mechanism of production of the odema is discussed; low oncotic pressure, raised hydrostatic pressure in the placenta and umbilical cord, and an increase in total water in the feto-placental unit are considered. The presence of oedema of the cord may reflect similar changes in the lungs which antenatally predispose aninfant whose pathway for production of surfactant is immature to develop RDS and the mature infant to develop TRD. The value of cord oedema as a warning sign is stressed.
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PMID:Oedema of the umbilical cord and respiratory distress in the newborn. 80 96

Seven children born prematurely who survived the respiratory distress syndrome, seven children born prematurely who had no neonatal lung disease, and seven normal children born at term were studied by comparison of flow volume curves obtained while breathing air to those obtained while breathing 80% helium and 20% oxygen. Expiratory flow rates in air both groups of prematurely born children were lower than flow rates of the children born at term, and the volumes of iso-flow were higher in the survivors of RDS than those of the children born at term. The differences in flow rates in air suggest an increase in large airway resistance in both groups of prematurely born children. It is speculated that this may be secondary to growth retardation related to prematurity. The elevated Viso V in the RDS group suggests an increase in small airway resistance secondary to the disease or to its therapy.
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PMID:Long-term pulmonary sequelae of premature birth with and without idiopathic respiratory distress syndrome. 83 78

Birth and perinatal records from all medical facilities serving the Rochester, Minn population from 1965 through 1974 were reviewed for cases of intracranial hemorrhage. Among a total of 10,850 live births, 12 documented cases of hemorrhage were found, yielding an average rate of occurrence of 1.1/1,000 live births. To investigate the role of some 30 potential risk factors, a case-control study was undertaken. Only prematurity and respiratory distress syndrome (RDS) were significantly associated with intracranial hemorrhage. This study demonstrates that neonatal intracranial hemorrhage is relatively common, associated with prematurity and RDS, difficult to recognize clinically, and characterized by poor prognosis.
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PMID:Perinatal intracranial hemorrhage. Incidence and clinical features. 88 1


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