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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four hundred ninety-eight acetylcholinesterase-stained suction rectal biopsies from 456 children were examined to assess the occurrence of "isolated" or "primary" intestinal neuronal dysplasia at Children's Hospital of Pittsburgh. Cases of proven Hirschsprung's disease were excluded. In 38 biopsies from 38 patients, we found a mild to moderate increase in mucosal acetylcholinesterase staining and abundant submucosal ganglion cells (large, irregular ganglia or at least five ganglia per HPF). This group was clinically heterogeneous with a frequent history of prematurity and small left colon/meconium plug syndrome, protein/formula intolerance, or obstructive anatomic gastrointestinal abnormalities. We feel that isolated "intestinal neuronal dysplasia," as diagnosed by suction rectal biopsy and the above criteria, is a descriptive biopsy appearance. Rather than characterizing a unique disease entity, it is encountered in a variety of clinical situations. Based on our observations and review of the literature, we therefore conclude that "intestinal neuronal dysplasia" not associated with Hirschsprung's disease, neurofibromatosis, or multiple endocrine neoplasia syndrome has yet to be well defined in clinical and histopathologic terms. The histologic diagnosis, at this time, should be reserved for those rare, florid cases of parasympathetic hyperganglionosis that are documented by adequate tissue sampling.
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PMID:Intestinal neuronal dysplasia. 205 Dec 70

From a retrospective study on induced abortions carried out in East Germany the effects of abortion on subsequent fertility are summarized as follows: 1) the 1st pregnancy following abortion often ends in miscarriage or premature birth; 2) the technic of abortion determines the outcome of subsequent pregnancy; careful dilatation and the most physiologic method are recommended to prevent miscarriage and/or cervix insufficiency; 3) there is a 10.17% risk of prematurity following abortion as against a 5.49% overall risk; and 4) about 70% of pregnancies following abortion result in labor starting in 37th-39th week. Most abortion complications occur in the initial 3 days. Especially hazardous are forced dilatation of the cervix and wide dilatation of the cervix in primigravidas and multigravidas with scar tissue formation. Curettage with the abortion forceps is more hazardous than suction curettage, 50% less risk in the latter method. A 2nd abortion with long induction time and high microbial ascending contamination has a 11.4% complication rate. Hysterotomy in advanced pregnancy has more complications. Recommendations for risk reduction are: 1) use of a flexible or rigid suction catheter (Karman size 8) up to the 8th week of pregnancy; follow-up with curettage for placenta residuals; 2) with normal dilatation risk use Hegar dilatation with vacuum extraction and control curettage; lumen width to be determined by pregnancy week and not to exceed Hegar 12 (12 mm); 3) with increased dilatation risk in the 1st trimester priming with prostaglandin; laminaria are also useful; and 4) with a 2nd pregnancy reserved for 2nd trimester; induction with prostaglandins. Broad-spectrum antibiotics should be used to minimize risk of infection. The author has constructed a model in the form of a disk useful in assessing abortion risks. It is based on extensive statistics and gives particulars about use of abortion results, diagnosis and indications for methods to be used.
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PMID:[Recommendations for abortion technics]. 728 70

The prevalence of hyperthyroidism in pregnancy is about 0.2%. The most common cause is Graves' disease. Maternal, fetal, and neonatal morbidity and mortality may be reduced to a minimum with careful attention to the clinical symptoms and interpretation of thyroid tests. Ideally, hyperthyroid women should be rendered euthyroid before considering conception. The incidence of maternal and neonatal morbidity is significantly higher in those patients whose hyperthyroidism is not medically controlled. Even the incidence of thyroid storm is high in women who are under poor medical supervision in the presence of a medical or obstetric complication. Maternal morbidity includes a higher incidence of toxemia, premature delivery, placenta abruptio, congestive heart failure, and thyroid crisis. In some series, anemia and infections were also reported. Neonatal morbidity includes SGA neonates, intrauterine growth retardation, LBW infants, and prematurity. Fetal goiter and transient neonatal hypothyroidism is occasionally reported in infants of mothers who have been overtreated with ATD. Propylthiouracil and MMI are equally effective in controlling the disease. In most patients, symptoms improved and thyroid tests returned to normal in 3-8 weeks after initiation of therapy. Resistance to ATD is extremely rare, most cases are caused by patient poor compliance. Surgery for the treatment of hyperthyroidism is reserved for the unusual patient who is allergic to both ATD; to those who have large goiters; to those who require large doses of ATD; or to those patients who poorly comply. Fetal and neonatal hyperthyroidism can be predicted in the majority of cases by the previous maternal medical and obstetric history and by the proper interpretation of thyroid tests. Finally, hyperthyroidism may recur in the postpartum period.
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PMID:Hyperthyroidism in pregnancy. 910 49

Platelets contribute to primary haemostatic events and are closely linked to plasmatic coagulation. Their function is highly dependent not only on their number but also on their integral physiology. In comparison with adults or children, the haemostasis of newborn infants, although physiological, is characterized by a reduced functional reserve capacity leading to the rapid occurrence of bleeding disorders especially in the presence of additional risk factors such as prematurity, asphyxia, or infection. Morphological and biochemical differences reflect an immature cellular stage which results in platelet hyporeactivity and contributes to the reduced capacity of the neonatal haemostatic system. Additionally acquired and inherited platelet disorders markedly affect platelet function. Hence assessment of neonatal platelet physiology may supply important information, however, no adequate screening tests are currently available, and technical difficulties of blood sampling limit the value of laboratory testing. Evaluation of the neonatal platelet function is highly dependent on individual laboratory results and it is advisable to perform complex diagnostic procedures with the collaboration of specialists experienced in neonatal haematology. With the advent of new technology such as platelet flow cytometry more adequate tools are available, although still reserved for specialized laboratories, thus awaiting their clinical significance. The role of maternal influences on neonatal platelet function must be always considered. Thus, neonatal platelet physiology and pathophysiology is complex and require more studies and experience.
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PMID:Neonatal platelet physiology and pathophysiology. 950 79

(1) Haemorrhagic disease of the newborn is due to vitamin K deficiency. Although rare, it is life-threatening and can have neurological sequelae. Prevention is based on routine vitamin K1 administration at birth. (2) The oral route is suitable for healthy term neonates, but dosing must be repeated if the infant is mainly breastfed. (3) The intramuscular route is reserved for neonates at risk (prematurity, neonatal disease, maternal treatment with antiepileptics or antibiotics), because of a possible risk of carcinogenicity.
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PMID:Prevention of haemorrhagic disease of the newborn. Routine vitamin K1 administration is justified. 1034 52

RSV is the most important respiratory pathogen in infants and young children. About 1% of primary RSV infections result in hospitalization. The virus is spread by large droplets of secretions or contact with contaminated secretions. Infants infected with RSV may demonstrate poor feeding, rhinorrhea, apnea, lethargy, wheezing, and respiratory distress. Diagnosis may be made by clinical signs and symptoms (especially those observed during epidemics), by chest radiographs showing hyperinflation, or by rapid antigen detection with immunofluorescence of nasopharyngeal aspirates. Risk factors for severe disease accompanied by complications include chronic heart disease, chronic lung disease, immunodeficiency, HIV, and prematurity. Immunity is incomplete and of short duration, and reinfection is common. Treatment remains supportive and consists of oxygen administration, hydration, and diligent monitoring. Use of corticosteroids, bronchodilators, antibiotics, and ribavirin is controversial and is dependent largely on physician preference. Use of ribavirin should be reserved for patients who have severe underlying conditions associated with increased mortality rates. Intravenous RSV Ig has been replaced by palivizumab, which is generally recommended for infants at high risk for severe RSV, including those with a history of prematurity and those with chronic lung disease.
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PMID:RSV infection in infants and young children. What's new in diagnosis, treatment, and prevention? 1060 68

Many preterm infants are given multiple red blood cell transfusions during the early weeks of life. Because firm standards for neonatal transfusions do not exist, it is important to consider the pathophysiology of the anemia of prematurity, the goals of transfusion therapy and blood banking practices that best provide safe and effective neonatal transfusions. There is increasing agreement that efforts continue to minimize phlebotomy blood losses, to transfuse per conservative indications and to limit donor exposure by transfusing stored red blood cells from a single unit reserved for an infant--rather than insisting on fresh blood.
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PMID:Blood banking issues pertaining to neonatal red blood cell transfusions. 1072 86

The adolescent's pregnancy is not rare. In the clinical view the maternal prognosis is better than the foetal which is reserved. In fact the rate of prematurity, intra uterin under development, genetous malformation and perinatality death is increased. In the psychosocial view, these pregnancies occurs problems specially the relationship between mother and child and real social break of these adolescents.
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PMID:[Pregnancy in adolescence: maternal-fetal prognosis]. 1118 79

Apnea, defined as cessation of breathing resulting in pathological changes in heart rate and oxygen saturation, is a common occurrence in sick neonates. Apnea is a common manifestation of various etiologies in sick neonates. In preterm children it may be related to the immaturity of the central nervous system. Secondary causes of apnea should be excluded before a diagnosis of apnea of prematurity is made. Methylaxanthines and Continuous Positive Airway Pressure form the mainstay of treatment of apnea in neonates. Mechanical ventilation is reserved for apnea resistant to above therapy. An approach to the management of apnea in neonates has been described.
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PMID:Apnea in the newborn. 1175 33

NSAIDs or cyclooxygenase inhibitors (COX inhibitors), including aspirin, are widely used to treat pain, fever and the articular symptoms of chronic rheumatic diseases. Manifestations of connective tissue or autoimmune diseases are commonly treated with glucocorticosteroids. The effect and side effects of NSAIDs depend on the isoforms of cyclooxygenases that they preferentially or selectively inhibit. The use of COX inhibitors has recently been associated with infertility and miscarriage. The classical nonselective COX inhibitors, including aspirin, do not increase the risk of congenital malformations in humans but administered in the latter part of gestation, they can affect pregnancy and the fetus. The ability of nonselective and selective COX inhibitors to prolong gestation has been used by obstetricians to inhibit premature delivery. The vascular effects of prostaglandin inhibitors can cause constriction of the fetal ductus arteriosus and reduce renal blood flow. These complications have been described for most nonselective COX inhibitors but are increasingly reported also for the selective COX-2 inhibitors. Aspirin, which causes irreversible inhibition of cyclooxygenases, differs from other NSAIDs with regard to indication, effects and side effects. Prematurity, which is increased in pregnancies of women with connective tissue diseases, is an additional risk factor for adverse effects of antenatal exposure to NSAIDs. Therefore, treatment with COX inhibitors should be discontinued at week 32 of gestation. The ability of NSAIDs to compromise reproductive function by inhibition of ovulation and as causative agents for miscarriage is still under debate. Glucocorticosteroids given in early pregnancy are a risk factor for the development of oral clefts. Therefore, the daily dose should be kept to <or= 15 mg during the first trimester. High doses of glucocorticosteroids in the second and third trimester are reserved for flares of autoimmune diseases. Intrauterine fetal growth restriction and premature delivery are possible side effects of high doses.
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PMID:Anti-inflammatory pharmacotherapy during pregnancy. 1501 26


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