Retinopathy of prematurity and bilirubin.
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Bilirubin↗
Biomedical subjects
A Ohlsson
Publications and source records attributed to A Ohlsson.
Treatments of preterm premature rupture of the membranes: a meta-analysis.
The objective of this overview was to critically evaluate published randomized controlled trials on treatments in preterm premature rupture of the membranes. The Oxford data base on perinatal trials, MEDLINE, Excerpta Medica, and Index Medicus were searched. Through primary and secondary review with preset inclusion criteria, two independent judges identified 27 randomized controlled trials, of which 13 met inclusion criteria. The quality of these randomized controlled trials was scored. Five randomized controlled trials regarding antenatal use of corticosteroids to prevent respiratory distress syndrome could be combined meta-analytically and showed a reduction in respiratory distress syndrome in the treatment group (p = 0.001). However, no significant reduction in respiratory distress syndrome (p = 0.286) was found after one study, with the lowest quality score, was excluded. A significant increase in endometritis and a trend toward an increase in neonatal infections and cesarean section rates were noted with treatment. Tocolysis, prophylactic antibiotics, and other interventions studied were not found to be of proved benefit and therefore should not be used outside of a randomized controlled trial.
Anti-Bacterial Agents↗
Dexamethasone-induced bradycardia.
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Bradycardia↗
Prenatal sonographic diagnosis of Pena-Shokeir syndrome type I, or fetal akinesia deformation sequence.
We report on a familial case of Pena-Shokeir syndrome type I (fetal akinesia deformation sequence) born to healthy parents. The antenatal ultrasound diagnosis was based on hydramnios, restricted limb movements, decreased fetal chest movements, small chest, arthrogryposis, clubfoot, fixed extension of knees, fixed flexion of elbows, camptodactyly, kyphosis of thoracic spine, cryptorchidism, and small muscle bulk. Thymic hyperplasia was noted at autopsy.
Abnormalities, Multiple↗
Fetal thoracic circumference: a prospective cross-sectional study with real-time ultrasound.
We report a prospective cross-sectional study of ultrasound fetal chest growth during normal pregnancy. The fetal chest circumference was measured in 100 normal pregnancies from 13 to 41 weeks' gestation. Nomograms of chest circumference versus gestational age and femur length were constructed. Data from 18 cases at risk for pulmonary hypoplasia indicated that the fetal chest circumference measurement may be useful in the antenatal prediction of lethal or clinically severe pulmonary hypoplasia.
Anthropometry↗
Serial measurements of cerebral blood flow velocity in preterm infants during the first 72 hours of life.
Serial measurements of cerebral blood flow velocity (CBFV) were made in 29 preterm infants, using continuous wave Doppler ultrasound. CBFV was measured in both anterior cerebral arteries and quantitative measurements of CBFV were determined using the area under the velocity curve. In all ventilated infants, CBFV increased significantly during the first 6 hours of life and continued to increase until 16 hours of age. Thereafter, CBFV remained relatively constant. This increase in CBFV was primarily the result of increased diastolic flow. Three infants who had evidence of intraventricular haemorrhage on cranial ultrasound, had similar CBFV compared with the infants with no evidence of haemorrhage. Two infants died and both demonstrated areas of periventricular leukomalacia at autopsy. These infants had a prolonged period of low CBFV. These measurements provide normal data for ventilated, preterm infants. As previously suggested in term infants, the initial rise in CBFV may be secondary to closure of the ductus although a generalized decrease in peripheral vascular resistance could also be a contributing factor. Fluctuations in CBFV rather than individual readings are probably more important in the genesis of IVH. An episode of significantly reduced CBFV is a poor prognostic sign.
Blood Flow Velocity↗
Perinatal mortality in a Saudi maternity hospital.
Perinatal mortality was analyzed in infants to mothers who delivered at the main Maternity hospital in Riyadh and who represented a large proportion of the obstetric population in the city. The crude perinatal mortality rate was 39.8 per 1000 births. The birth weight-specific mortality rates were compared with the corresponding Swedish rates. The ratio between the birth weight-specific mortality rates in Riyadh and Sweden increased from the lightest to the heaviest birth weight category. Thus the perinatal mortality rate was 2.3 times higher in infants less than 1500 g, and 8.8 times higher in infants with birth weights of 3500 g and more. Similarly, the ratio between the gestational age-specific mortality rates in Riyadh and Sweden increased with advancing gestational age. The perinatal mortality rate of infants less than 28 weeks was 1.6 times higher, and that of term infants 4.8 times higher than in Sweden. The findings indicated shortcomings in the obstetric services. The perinatal mortality rate of teenage mothers, who comprised 17 percent of the material, was 9.1 times the Swedish rate. Other risk groups were para 0 mothers and mothers with a previous infant loss.
Adult↗
Causes of perinatal death at a Saudi maternity hospital.
The time, cause and avoidability of perinatal deaths were analyzed in infants who were delivered in the main Maternity hospital in Riyadh and who represented a large proportion of all births in the city. The crude perinatal mortality rate was 39.8 per 1000 births. Of all deaths 53 percent occurred either intrapartum or within 24 hours of birth. The mortality rate in this time period was 9 times higher, and the intrapartum mortality rate 16 times higher than the corresponding Swedish rates. The causes of death were classified according to Wigglesworth. Of all deaths, 37 percent were due to asphyxial conditions in labor, 32 percent to conditions associated with preterm birth, and 17 percent to malformations. The perinatal mortality rates caused by asphyxia, preterm birth and malformations were 14.7, 12.6 and 6.7 per 1000 births, respectively. 75 percent of infants who died from asphyxia were born at term, and nearly half of the preterm deaths were associated with severe asphyxia at birth. Avoidable factors were found in 74 percent of the deaths. The high rate of asphyxia indicated deficiences in the obstetric management and a high priority should be given to the strengthening of the obstetric service.
Adult↗
Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period.
The follow-up records of 605 infants with birth weights of less than 1,500 g, with data available for 2 years after birth, were examined for evidence of abnormal pulmonary signs or symptoms. A total of 119 infants were identified and the neonatal oxygen requirements of these infants were compared with those of 486 infants who had normal pulmonary function. A requirement for oxygen at 28 days of life had a positive predictive value for abnormal pulmonary findings at the time of follow-up of only 38%, whereas 31% of those with normal pulmonary findings at the time of follow-up were still receiving oxygen at this age. The need for oxygen at 28 days was a good predictor of abnormal findings in infants of greater than or equal to 30 weeks' gestational age at birth but became increasingly less useful as gestational age decreased. It was found that, irrespective of gestational age at birth, the requirement for additional oxygen at 36 weeks' corrected postnatal gestational age was a better predictor of abnormal outcome, increasing the positive predictive value to 63%. The prediction of a normal outcome remained 90% for infants not receiving oxygen at this corrected gestational age.
Female↗
Single-dose kinetics of deuterium-labelled cannabinol in man after intravenous administration and smoking.
The single dose pharmacokinetics of deuterium-labelled cannabinol (2H2-CBN) were evaluated in six male cannabis users with different degree of abuse after smoking an average dose of 19 mg and after intravenous administration of 20 mg CBN. Plasma levels were measured for up to 72 h with selected ion monitoring by GC/MS using 2H7-CBN as internal standard. The systemic availability of smoked CBN was found to be 39 +/- 26% (min-max 6-65%). The mean plasma clearance was 19.1 +/- 2.6 ml min-1 kg-1 and the volume of distribution was determined to 50 +/- 23 l kg-1. The apparent terminal half lives for CBN were 32 +/- 17 h and 43 +/- 29 h after intravenous administration and smoking, respectively.
Adult↗
Complications following oral administration of exchange resins in extremely low-birth-weight infants.
Complications of the oral use of sodium polystyrene sulfonate and calcium polystyrene sulfonate are reported in five extremely low-birth-weight infants in which exchange resins were used to treat hyperkalemia. Radio opaque masses outlining the stomach were seen in all infants and could be palpated in the left upper quadrant of the abdomen. In two infants, at autopsy the palpable mass could be identified as a solid chalk-like concretion outlining the stomach. X-ray diffraction studies identified the material as Brushite. Administration of exchange resins by the gastric route should be avoided in the treatment of hyperkalemia in critically sick, extremely low-birth-weight infants.
Administration, Oral↗
Congenital and nosocomial sepsis in infants born in a regional perinatal unit: cause, outcome, and white blood cell response.
The incidence, cause, and outcome of sepsis and the white blood cell response were studied in 6315 infants born in a regional perinatal unit. The incidence of neonatal sepsis was 6.5 per 1000 live births. Congenital sepsis (12 cases) was overwhelming, with associated maternal infection (92%), neutropenia (75%), and high rate of mortality (50%). The most common organism was Escherichia coli (58%). Gestational age and birth weight were similar in survivors and nonsurvivors. There was a strong correlation between total white blood cell count and both mature and immature neutrophil counts in survivors but this correlation decreased substantially in neonates that died. Analysis of variance indicated that the means for polymorphonuclear leukocyte and immature neutrophil counts were significantly higher in survivors. Nosocomial sepsis (38 cases) occurred in premature low birth weight infants receiving invasive, intensive care. The most common organism was Staphylococcus epidermidis (76%). Total white blood cell, polymorphonuclear leukocyte, and immature neutrophil counts rose significantly in response to sepsis. None died. Prevention of congenital sepsis requires methods to detect early maternal-fetal infection. Providing granulocytes to neutropenic neonates with congenital sepsis might improve outcome.
Bacterial Infections↗
Review of causes of perinatal mortality in a regional perinatal center, 1980 to 1984.
During 1980 to 1984, 279 deaths occurred among 15,306 births in a regional perinatal unit. Survival to discharge corrected for lethal malformations was 81% or better in infants with a birth weight above 749 gm. Congenital malformations (23.2%), infections (21.3%), asphyxia (19.8%), and hyaline membrane disease (11%) caused most perinatal deaths.
Asphyxia Neonatorum↗
Risk factors for perinatal mortality in Canada.
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Birth Weight↗
Campomelia, cervical lymphocele, polycystic dysplasia, short gut, polysplenia.
An aborted fetus, the offspring of consanguineous parents, had the unusual combination of campomelia, cervical lymphocele, polycystic kidneys, pancreas, and liver, short gut, and polysplenia. Births of earlier similarly affected fetuses suggest an autosomal recessive inheritance. Skeletal, lymphatic, and renal lesions were seen at 26 weeks' gestation by ultrasonography, but not at 16 weeks.
Abnormalities, Multiple↗
Single-dose kinetics of deuterium-labelled cannabidiol in man after smoking and intravenous administration.
The disposition of deuterium-labelled cannabidiol, 2H2-CBD, was studied in five young men who were marihuana smokers. The pattern of use ranged from infrequent to frequent use of the drug. Plasma concentrations, determined by mass fragmentography, were followed for 72 h after both intravenous administration of 20 mg 2H2-CBD and smoking of an estimated amount of 18.8-19.4 mg 2H2-CBD. Systemic availability after smoking was determined by comparing the areas under the plasma concentration versus time curves for the two treatments and was found to be 31 +/- 13%. A four-fold difference in the availability of the compound was noted for the five subjects. Based on the area under the curve and the dose after intravenous administration, a plasma clearance of 960-1560 ml min-1 was calculated. A terminal elimination phase was not reached at 72 h, but the kinetic parameters were estimated from the 72 h beta-elimination. A half-life of 31 +/- 4 h after smoking and 24 +/- 6 h after injection was estimated as well as a distribution volume of 2520 +/- 470 l (32.7 +/- 8.61 kg-1).
Adult↗
Candidiasis in very low birthweight infants. Ultrasonography in the diagnosis of renal involvement.
Systemic candidiasis is a serious infection in very low birthweight infants. Its diagnosis is difficult to make and is often missed. Renal involvement may be diagnostic, consisting of mechanical obstruction by fungus masses in the renal pelvis. A case is presented which demonstrates the importance of carrying out multiple ultrasonographic examinations of patients at risk.
Candidiasis↗
Changing etiology and outcome of neonatal septicemia in Riyadh, Saudi Arabia.
To study the etiology of neonatal septicemia and factors associated with outcome, all charts of neonates with bacteremia and clinical sepsis admitted to a neonatal unit in Saudi Arabia, from 1 November 1980 to 31 October 1984 were reviewed. The results were compared to a previous study period in the unit (1 November 1976-31 October 1980). Septicemia was diagnosed on 50 occasions in 49 neonates. The incidence of neonatal sepsis among patients born in the hospital was 2.5/1,000 live births. Mortality from sepsis was 33% and was associated with neutropenia in 63%. The most commonly isolated bacteria were E. coli, Klebsiella and Staphylococcus aureus. Salmonella enteritidis serotypes were isolated in 4% of the cases. Group B streptococci (GBS) were isolated, for the first time, from blood of 3 neonates. Salmonella species were less frequently and GBS more often isolated than previously. GBS have now appeared as etiologic organisms in neonatal sepsis also in Saudi Arabia. Salmonella septicemia remains more common in Saudi Arabia than in the West.
Escherichia coli Infections↗