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

Twenty-seven children of very low birthweight (less than or equal to 1,500 g) whose lung function had been measured on several occasions during the first year were studied at the age of about 9 years. Fifteen of the children had received neonatal intermittent positive pressure ventilation, mostly for respiratory distress syndrome. Ten of the ventilated children were still oxygen dependent at 30 days of age. Compared to the remainder of the group, mechanically ventilated children had reduced lung compliance in early infancy and increased thoracic gas volume in the middle of their first year. These changes correlated with the level of neonatal respiratory therapy as indicated by the oxygen score. Lung compliance in early infancy, but not thoracic gas volume, correlated with forced expiratory volume at 1 second recorded at 9 years. On the other hand, reduced airway conductance showed no significant correlation with the neonatal oxygen score, but there was a strong correlation between airway conductance late in infancy and lung function at 9 years. This relationship was independent of neonatal mechanical ventilation. We conclude that perinatal factors, which may be associated with disturbed lung mechanics early in infancy, are only weak and indirect predictors of childhood lung function. Airway conductance late in infancy, determined by constitutional factors, prematurity itself or other undetermined factors, is a good predictor of airway function at 9 years.
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PMID:Relationship between infant lung mechanics and childhood lung function in children of very low birthweight. 219 Dec 61

Acceleration of fetal maturation with intra-amniotic administration of thyroxine was employed in eight patients in whom preterm delivery was necessary because of malignant disease of the mother. Thyroxine (200 mcg to 500 mcg) was given at weekly intervals starting at the 27th to 32nd week of gestation until the L-S ratio exceeded 2.0. The fetuses were delivered between the 29.4 and 34.0 week. None of the newborns suffered from respiratory distress syndrome, and three newborns were cared for in the regular nursery. Thyroxine-induced acceleration of fetal maturation and pre-term delivery permits earlier initiation of antineoplastic and radiation therapy without exposing the fetus to the hazards of maternal therapy and those of prematurity.
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PMID:Acceleration of fetal maturation with intra-amniotic thyroxine in the presence of maternal malignancy. 222 Mar 44

We compared previously healthy prematurely born infants with full-term infants hospitalized with respiratory syncytial virus (RSV) infection to evaluate the role of prematurity on the clinical course of the illness. During a 5-yr period (1984 to 1989), 484 previously healthy patients were admitted to the hospital with RSV infection. No differences were found in the presenting symptoms of respiratory distress, cough, fever or shock, although the premature group was more likely to present with apnea (p less than .001). Chest roentgenograms revealed that premature infants had a higher incidence of atelectasis/infiltrate and hyperinflation (p less than .05). Premature infants had longer hospital stays as well as a higher Physiologic Stability Index and Therapeutic Intervention Score (p less than .001). They were also more likely to receive supplemental oxygen, ICU admission, mechanical ventilation, and nothing by mouth status (p less than .001). We conclude that premature birth increases the risk of more severe and prolonged RSV disease.
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PMID:Does prematurity alter the course of respiratory syncytial virus infection? 224 9

The authors analyse a series of 23 multiple pregnancies (19 triplet pregnancies, 3 quadruplets and 1 quintuplet). The first objective is to fight prematurity. Over and above all use of drugs as tocolytics (beta-mimetic drugs and progesterone) should routinely be advised and as soon as there is any threat of premature labour hospitalisation is needed. Twenty one of the 23 patients had prophylactic cerclage (Shirodkar's stitch). In 77% of the cases respiratory distress in the newborn was avoided by using cortico-therapy. Vaginal delivery can be carried out under certain conditions in triplet pregnancies. If certain precautions are taken there does not seem to be any immediate difference in the post delivery period of these children if they are born vaginally or by caesarean. Perinatal mortality is raised (at 5.6% for triplets and 58.3% for quadruplets). The psychological implications of these pregnancies are important. Problems appear as soon as the diagnosis is made and continue for years afterwards. On the social level, help given by the social services are usually inadequate. If the couples belong to the National Association for Mutual Aid of Parents of Children of Multiple Births, a system of mutual support is available. We recommend that these pregnancies should be looked after by several disciplines. These consist not only of obstetricians, paediatricians, anaesthetists, those who resuscitate together, but also psychologists, dietitians, social workers, community workers and physiotherapists.
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PMID:[Multiple pregnancies. III. Therapeutic, psychologic and social aspects]. 225 84

A communitywide prospective survey was conducted in the urban slums of Gorakhpur, to elicit information on factors contributing to India's high rate of neonatal mortality. Neonatal mortality accounts for more than 50% of total infant mortality in India. To successfully reduce infant mortality to 60/1000 live births, more information is needed on the contribution of prematurity, low birth weight, infections, respiratory distress, birth asphyxia, hyperbilirubinemia, birth injury, congenital malformation, and other determinant factors of neonatal morbidity and mortality, especially in urban slums. Compared with the standards of more developed countries, high levels of neonatal morbidity and mortality were found with the main causes being infections and respiratory distress. Neonatal mortality was found to bear an inverse relationship with birth weight and gestational age. Higher mortality rates were observed in institutional deliveries, despite the fact that the overall majority of mortality occurred in the home. Neonatal mortality was found to be significantly higher (p.001) in home deliveries conducted by untrained dais. Proper training of traditional dais and paramedical workers would minimize the extent of these deaths.
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PMID:Neonatal morbidity and mortality in ICDS urban slums. 227 77

Infants with esophageal atresia and a distal tracheoesophageal fistula are predisposed to respiratory failure on the basis of prematurity, respiratory distress syndrome, aspiration of saliva, and reflux of gastric contents into the tracheobronchial tree. Thoracotomy and primary repair may be delayed to allow time for complete evaluation of the infant and respiratory stabilization. Poorly compliant lungs and a large distal fistula can result in selective passage of ventilatory gases into the gastrointestinal tract with resultant hypercarbia. Fogarty balloon occlusion of the distal esophageal segment halts this air shunt and facilitates effective mechanical ventilation.
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PMID:Esophageal atresia, distal tracheoesophageal fistula, and an air shunt that compromised mechanical ventilation. 194 74

We have performed a statistical study of 1218 autopsies of neonates to extract the factors related to fatal neonatal intraventricular hemorrhage (IVH). Prematurity indicated by a short gestational period or a low birth weight was the most significant factor for IVH. Many other factors considered to be related to IVH were also related closely to prematurity. Therefore, we pose the following question throughout the study: Did the factors independently relate to IVH without any confounding effects of prematurity? To obtain the answer, we tried a statistical adjustment for gestational age to eliminate the confounding effects of prematurity. After the adjustment was made, we concluded that the following 10 items, in order, were the actual factors related to fatal IVH: prematurity, subependymal hemorrhage, subarachnoidal hemorrhage, respiratory distress syndrome, hyaline membrane disease, respiratory acidosis, intracerebral hemorrhage, cyanosis, respirator care, and low Apgar score. There were two distinctive categories in the factors that were eliminated by the adjustment. One was a group that has no significance whatsoever in any subdivided gestational groups, such as meconium aspiration syndrome, due to purely the result of the confounding effect. The other was a group that showed its statistical significance only in a certain period of gestation, such as breech presentation.
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PMID:A statistical study of autopsied cases of neonatal intraventricular hemorrhage. 239 12

Singapore's infant mortality has fallen drastically from a high of 131 per thousand births in 1931 to 56 in 1954 and a low of 7.4 in 1987. Postneonatal mortality used to account for many of the infant deaths but since the 1960s, neonatal mortality has become increasingly important. It now accounts for about three quarters of all infant deaths. This study of neonatal deaths in 1987 showed that sex, birth order, maternal age and social class in terms of possible contributory factors has not changed much over a thirteen year period. The important causes of neonatal deaths being congenital anomalies and perinatal conditions such as severe prematurity, severe birth asphyxia and respiratory distress syndrome.
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PMID:Neonatal deaths in 1987--maternal and child factors. 239 39

The main complication in multiple gestation with more than two fetuses is prematurity, with its concomitant increase in perinatal mortality and morbidity. Clearcut indications as to management of these pregnancies are lacking, and the efficiency of elective cerclage is controversial. Twelve triplets and three quadruplets out of 27 multiple pregnancies were electively sutured and compared to 10 triplets and two quadruplets without this procedure. Otherwise, both groups were managed uniformly regarding bed-rest, beta-mimetic drugs and dexamethasone for the enhancement of fetal lung maturity. Mean duration of pregnancy in patients with cerclage was 35 weeks, significantly longer than those who did not undergo this procedure (30.7 weeks) (p < 0.01). Furthermore, in the former group, the mean neonatal weight was significantly higher (p < 0.01), mean Apgar scores were better, significantly lower rates of respiratory distress syndrome occurred (p < 0.05), perinatal mortality rate was significantly reduced (p < 0.01) and the mean hospitalization period was shorter (p < 0.025). It seems that elective cervical suture is a definite contribution to the successful management of multiple pregnancies with more than two fetuses.
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PMID:Is elective cerclage justified in the management of triplet and quadruplet pregnancy? 256 15

The clinical spectra of 82 infants of diabetic mothers (IDMs) encountered in the past 15 years are presented. The perinatal mortality rate was 6.1%, The observed morbidities of the 78 live-born IDMs were: large for gestational age, 35.9%; prematurity, 12.8%; small for gestational age, 12.8%; respiratory distress, 17.9%; low Apgar score, 6.4%; nerve injury, 2.6%; hypoglycemia, 10.3%; hyperbilirubinemia, 28.2%; polycythemia, 12.8%; hypocalcemia, 5.1%; hypertrophic cardiomyopathy, 3.8%. Furthermore, 15.9% (13/82) of these infants suffered from congenital malformation, a rate nearly 10 times higher than that of the general neonatal population born in this hospital. In comparing sugar control during organogenesis, the mothers who had malformed infants had significantly higher fasting plasma glucose level than the mothers who had normal infants (P less than 0.05). Since tight control of maternal diabetes is mandatory to reduce the prevalence of mortality and malformation of the IDMs, we suggest that there is an urgent need to improve health education and supervision before and during pregnancy in all diabetic women.
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PMID:Clinical analysis of infants of diabetic mothers. 263 3


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