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Biomedical subjects

G von Muralt

Publications and source records attributed to G von Muralt.

At least 19 recordsLinked to original sources
PubMed1988

[Hepatitis B screening in late pregnancy and results of immunization in newborn infants].

Screening for hepatitis Bs antigen in late pregnancy was introduced in mid-1983 at the University Women's Hospital, Berne. 4118 pregnant women had been investigated by the end of 1986, of whom 26 (0.63%) turned out to be HBsAg positive. The prevalence of HBsAg carriers was 0.12% in Swiss women, 0.65% in other European women, 12.5% in women from the Far East and 5.6% and 4.9% in women from the Near East and Africa respectively. Newborns of HBsAg positive mothers simultaneously received hepatitis B immunoglobulin (400 IU anti-HBs) and a first injection of hepatitis B vaccine (Hevac B 5 mg) in the first hours of life, followed by vaccinations after two, three and twelve months. Of 18 children investigated after the first year of life none was HBsAg positive. 14 children (78%) were shown to have HBs antibodies. Two of the four anti-HBs-negative unfortunately received only the first vaccine injection after birth. Taking this fact into account, the "success rate" of the immunoprophylaxis is 88%.

Female↗
PubMed1988

Prenatal and postnatal prophylaxis of infections in preterm neonates.

Administration of gamma-globulin for intravenous administration (IVIG) to preterm neonates (0.3 g/day in neonates below 1000 g; 0.5 g/day in neonates over 1000 g for 6 consecutive days) led to a significant rise in circulating serum IgG levels. After 6 days of IVIG administration, the IgG serum levels reached an average of 11 to 12 g/liter, values usually seen in normal term infants. The mortality rate of the preterm infants with septicemia decreased from 44% in the infants receiving only antibiotics to 8% in the infants treated by IVIG together with the same antibiotic. The IVIG preparation was well-tolerated by all newborns. Blood gas analysis, clinical examination, monitoring of respiration, pulse and body temperature revealed no untoward reactions attributable to IVIG. Follow-up at an average age of 2.5 years showed no evidence of harmful effects of IVIG treatment in the neonatal period. In a recently concluded study no differences in the levels of various liver enzymes in infants treated with IVIG and in untreated infants was found 6 weeks after administration of IVIG. In another group of preterm infants with perinatal infections who received IVIG after birth, the serum IgG levels were determined at 3 to 4 and 6 to 8 weeks of age. At 3 to 4 weeks no difference was found in the serum IgG levels in infants with or without recurrent infections. At 6 to 8 weeks the serum IgG levels were slightly decreased in infants with recurrent as compared to those without recurrent infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1988

Qualitative changes of white blood cells and perinatal diagnosis of infection in high-risk preterm infants.

A total of 60 preterm infants, aged less than 37 weeks of gestation were studied. Morphological changes of polymorphonuclear neutrophils (PMN) were evaluated in two groups of patients. PMN vacuolization was frequently noted at birth in preterm neonates with culture-proven infection (sensitivity 86%, specificity 90%). Toxic granulations were a less reliable indicator of bacterial infection. A relatively good correlation with other parameters in use for "sepsis screen" we found with band cell/total neutrophil ratio (X2 = 1.66, P greater than 0.1). Examination of peripheral blood smears for vacuolization of WBCs appears to provide adjunct in the early detection of bacterial infection in preterm babies.

Cytoplasmic Granules↗
PubMed1987

Relationship between peri-intraventricular hemorrhage and neonatal hyperbilirubinemia in very low-birthweight infants.

The incidence of hyperbilirubinemia (serum bilirubin values greater than 205 mumol/l) in two groups of preterm infants (birthweight less than 1500 gm) with and without peri-intraventricular hemorrhage (PIVH) was studied. In the first 10 days of life, 16 (39%) of the 41 infants with PIVH vs. 22 (46.8%) of those without PIVH (n = 47) had high bilirubin levels. No difference in peak serum bilirubin concentrations nor a need for phototherapy was noted between the two groups (P greater than 0.07). Forty-one infants had PIVH: 30 had PIVH grade I or II and 11 had grade III or IV. No statistically significant correlation was found between degree of PIVH and hyperbilirubinemia. Moreover, at 12 months corrected age, major and minor handicaps were equally distributed between the two groups. The neurologic outcome appeared to relate, in largest part, to the severity of the PIVH, and to not be influenced by the hyperbilirubinemia. We conclude that there is no positive relationship between incidence and extension of PIVH, plasma bilirubin levels, and outcome in very low-birth weight infants.

Brain Damage, Chronic↗
PubMed1987

Fetal sex and distribution of peri-intraventricular hemorrhage in preterm infants.

Peri-intraventricular hemorrhage (PIVH) is an important complication of the brain in immature newborn infants. In a real-time ultrasound study with frequent scanning of 78 preterm infants (50 with birth-weight less than 1,500 g and 28 weighing more than 1,500 g), we examined the influence of sex on the occurrence of PIVH. A significant difference between sexes was only found in the group with birth-weight below 1,500 g. PIVH occurred in 72% of male infants and in 28% of females (p less than 0.001). This effect is probably due to a difference in the timing of cerebral vascular maturation in males leading to a difference in the risk of developing PIVH between the sexes before 34 weeks of gestation.

Cerebral Hemorrhage↗
PubMed1987

Incidence of peri-intraventricular hemorrhage in premature neonates weighing more than 1500 g.

With the advent of modern methods of neonatal care, intracranial hemorrhage probably has become the most common neurological complication in premature infants weighing less than 1500 g at birth. This paper is a prospective study of 75 preterm infants of 34 weeks gestation or more and birth weight above 1500 g (range 1500 g to 2500 g). All neonates were screened by cranial ultra-sonography for evidence of peri-intraventricular hemorrhage (PIVH). Perinatal risk factors, incidence of PIVH and neurological outcome were studied. Sonographic abnormalities were detected in 16 (21.3%) of our patients. Intracranial hemorrhage was frequently associated with a low Apgar score, need of resuscitation and/or assisted ventilation immediately after birth (P less than 0.005). This study suggests, that ultrasound screening should be reserved to those large premature infants (greater than 1500 g) with high risk of hypoxic-ischemic injury.

Birth Weight↗
PubMed1986

Transplacental passage of intravenous immunoglobulin in the last trimester of pregnancy.

Immunoglobulin G was given intravenously (IVIgG) to pregnant women (27 to 36 weeks gestation) with signs of chorioamnionitis who were at risk for preterm delivery. Twenty-four patients received antibiotics alone (control group). Twenty-seven patients received the same antibiotics in combination with IVIgG, either 12 gm in 12 hours (low IVIgG dosage) or 24 gm on each of 5 consecutive days (high IVIgG dosage). Transplacental passage of IVIgG was shown to be a function of gestational age and of dose. Up to the thirty-second week of gestation, IgG infusions had no effect on IgG concentrations in cord sera. After that time, cord serum IgG levels were significantly higher in the high-dose group compared with the low-dose and control groups. All four subclasses of IgG, and two different antibodies present in the IVIgG preparation passed from the mother to the fetus. Thus the infused IgG mimicked the transplacental passage of endogenous IgG.

Chorioamnionitis↗
PubMed1986

Correlation of raised cord-blood CK-BB and the development of peri-intraventricular hemorrhage in preterm infants.

This study concerns the prognostic value of total cord-blood CK-BB activity measured with a new method in preterm infants at risk of PIVH. Twenty-six patients with gestational age less than 36 weeks were studied. The presence of PIVH was proved by either ultrasound scans or autopsy. Total CK-BB values in cord-blood of infants who developed PIVH were significantly higher than those of patients without cerebral bleeding (P less than 0.001).

Cerebral Hemorrhage↗
PubMed1986

Incidence of retinopathy of prematurity in low birth weight infants with peri-intraventricular hemorrhage.

Data from 80 high-risk low birth infants were analysed to determine whether there is a clinical association between Retinopathy of Prematurity (ROP) and Peri-Intraventricular Hemorrhages (PIVH) in preterm newborns. Diagnosis of retinopathy was made by retinal examination at approximately four weeks of age. All infants were routinely and repeatedly scanned by real-time ultrasound to diagnose the presence of Peri-Intraventricular Hemorrhages. PIVH was clearly present in 41 (51.2%) of them, whereas 39 (48.7%) infants had no evidence of intracerebral bleeding. We found no statistically significant association between cicatricial retinopathy and PIVH (P = 0.1). We suppose therefore, that the sensitivity of retinal vasculature and cerebral vasculature to the various factors considered to be important in the development of PIVH is different.

Cerebral Hemorrhage↗
PubMed1986

Experience with intravenous immunoglobulin treatment in neonates and pregnant women.

Results of 2 methods to treat infection in the neonate are reported. One study demonstrates a decrease in mortality and recurrent infection when neonates with septicemia were given intravenous immunoglobulin (IVIG). In another study, IVIG was administered to pregnant women with symptoms of infection and at risk for preterm delivery. IVIG infused at high doses after 32 weeks of gestation significantly decreased infection in newborns without affecting term.

Dose-Response Relationship, Drug↗
PubMed1986

Neurological prognosis of high-risk preterm infants with peri-intraventricular hemorrhage and ventricular dilatation.

Fifty-eight preterm neonates evaluated by real-time sonographic scanning of the head were prospectively studied. They were divided into three groups: 13 with peri-intraventricular hemorrhage (PIVH) alone, 19 with subsequent ventricular dilatation and 26 control infants without ultrasound evidence of PIVH. At 12 months of age detailed neurological follow-up assessment was carried out. Five (8.6%) patients had major handicaps, 34 minor neurological abnormalities. The severity of the PIVH correlated with the neurologic outcome (p less than 0.02). The incidence of major handicaps was significantly greater in the group with ventricular dilatation (p less than 0.03). Among the infants with PIVH, major handicaps were only present if associated with grade III and IV. Severe posthemorrhagic ventricular dilatation increased the risk for major handicaps. Adverse neurological sequelae at follow-up appeared to be attributable to the extent of PIVH and aggravated by severe ventricular enlargement.

Brain Diseases↗
PubMed1986

Persistent pulmonary hypertension in preterm-infants.

Persistent pulmonary hypertension of the newborn (PPHN) is a cyanotic syndrome that occurs primarily in full-term and postmature infants and causes right-to-left shunts at the atrial or ductal levels or both. Term babies with PPHN show structural changes in pulmonary vascular smooth muscle as a result of chronic prenatal distress. It is our opinion that in preterm babies the PPHN syndrome also exists. In this group of patients the potential pathways to the persistence of high pulmonary vascular resistence are only functional vascular changes precipitated by acute perinatal stress. The cyanosis of PPHN is rapidly regredient in preterm infants and clinical resolution occurs promptly if the diagnosis is correct and the treatment is started as early as possible in centers capable of extensive monitoring and neonatal supportive care to minimize the risks of Tolazoline therapy.

Carbon Dioxide↗
PubMed1986

Fetal ventriculomegaly, agenesis of the corpus callosum and chromosomal translocation--case report.

Real-time ultrasound was used to evaluate intracranial anatomy and ventricular size in a child with fetal ventriculomegaly. It was associated with agenesis of the corpus callosum and chromosomal translocation. Serial measurements of cerebral ventricular dilatation at various gestational age may improve perinatal management of the newborn with fetal ventricular enlargement.

Agenesis of Corpus Callosum↗
PubMed1986

Obstructive ventriculomegaly.

Intracranial Hemorrhage (ICH) occurs primarily in premature infants, and post-hemorrhagic ventricular dilatation is a well-known complication in this age-group. Blood clots within the ventricle are diagnostic of ICH but not usually seen. In our case Real-Time Ultrasonography has proved to be very helpful to identify intraventricular hematomas and to control obstructive ventriculomegaly without therapeutic intervention.

Cerebral Hemorrhage↗
PubMed1985

[Incidence of occipital ventriculomegaly in premature infants with peri-intraventricular hemorrhage].

Ventricular dilatation after periventricular/intraventricular hemorrhage (PIVH) is a more common complication than was assumed before the advent of ultrasound. In this prospective study based on 264 ultrasonic head scans, the true incidence of ventriculomegaly was investigated in two groups of preterm infants with PIVH. The major incidence of PIVH in babies with less than 34 weeks of gestation (p less than 0.05) was confirmed. Statistical analysis of the follow-up examinations showed that the degree of ventriculomegaly correlated well with the extent of the cerebral-intraventricular hemorrhage (X2 test, p less than 0.002).

Cerebral Hemorrhage↗
PubMed1985

Prognostic value of serum creatine kinase brain isoenzyme in term babies with perinatal hypoxic injuries.

Creatine kinase brain isoenzyme (CK-BB) may be released into the serum after brain injury. Its concentration was measured serially in a group of 80 term infants at risk of perinatal hypoxic damage. Their neurodevelopmental outcome was furthermore assessed at 12 months of age. Our results are consistent with the hypothesis that infants with high CK-BB concentration, measured in serum with a new and very sensitive method for enzyme analysis, have more frequently poor short-term outcome (p less than 0.02). These data suggest that early CK-BB measurement may be clinically useful to identify newborns at high risk for neurologic or developmental sequelae.

Brain↗
PubMed1985

Interruption of breast-feeding versus phototherapy as treatment of hyperbilirubinemia in full-term infants.

Since 1963 there are reports in the literature about the syndrome of breast milk jaundice. The factors that may contribute to this phenomenon are still unclear. In our study the effect of interruption of breast-feeding in 25 jaundiced full-term infants was compared to the effect of phototherapy in 25 jaundiced otherwise healthy full-term infants. The results show that this treatment has the same therapeutic effect as phototherapy (p greater than 0.05) without its stressful complications and can be recommended as alternative treatment of this type of hyperbilirubinemia.

Bilirubin↗