Search PubMed⌕ Search

Biomedical subjects

H R Gamsu

Publications and source records attributed to H R Gamsu.

At least 55 records · Page 3Linked to original sources
PubMed1991

Effects of intrauterine growth retardation on postnatal visceral and cerebral blood flow velocity.

Blood flow velocity and pulsatility index were measured with Doppler ultrasound in the superior mesenteric artery, coeliac axis, and anterior cerebral artery in 18 very low birth weight, small for gestational age infants, and compared with findings from 18 weight matched, and 18 gestation matched, appropriate for gestational age controls. Mean velocity in the superior mesenteric artery was lower in the small for gestational age infants (15 cm/s) than in the gestation matched control group (20.4 cm/s). In those small for gestational age infants who had evidence of fetal hypoxia the mean velocity in the superior mesenteric artery was even lower (11.5 cm/s). There were no differences in velocity in the cerebral artery among the groups. Infants who were small for gestational age still had significantly lower superior mesenteric artery velocity than gestation matched controls at 1 week of age. The results suggest a specific reduction in visceral perfusion in infants who are small for gestational age and who have experienced fetal hypoxia, and this could predispose these infants to necrotising enterocolitis.

Aging↗
PubMed1989

Screening for retinopathy of prematurity in a regional neonatal intensive care unit.

Retinopathy of prematurity (ROP) is attracting renewed interest from ophthalmologists and neonatologists because of the improved survival of very low birthweight premature infants, some of whom develop blinding disease. Ophthalmologists may find increasing pressure from paediatric colleagues to provide a screening service for babies at risk. The results of the last twenty-two months of a continuing programme at this hospital demonstrate the benefits of active screening, but indicate some of the potential problems for ophthalmologists who are likely to become involved in this work now and in the future.

Blindness↗
PubMed1989

Antenatal administration of betamethasone to prevent respiratory distress syndrome in preterm infants: report of a UK multicentre trial.

In a prospective, randomized, double-blind, multicentre trial the effect of antenatal treatment with betamethasone phosphate was compared with placebo in the prevention of the respiratory distress syndrome (RDS) in preterm infants. The dose of betamethasone was 4 mg every 8 h for six doses, unless delivery occurred. The 251 women who were enrolled gave birth to 262 liveborn infants, 130 in the beta-methasone and 132 in the placebo group; the two groups were evenly matched in most respects. The diagnosis of RDS in the newborn was confirmed by two independent assessors. Seven of the 130 infants in the betamethasone group and 16 of the 132 in the placebo group developed RDS. In infants whose mothers had received at least three injections, RDS was also less frequent in the steroid group than in the placebo group (3/104 and 10/104 respectively; P less than 0.05). There was a significant reduction of RDS in those born between 24 h and 6 days after entry into the trial (0/30 and 8/45 respectively; P less than 0.05). The largest difference in frequency of RDS occurred in the subgroup of infants born before 34 weeks gestation, within 8 days of trial entry, and whose mothers had received at least three injections (0/27 steroid group and 7/32 placebo group; P = 0.03), and there were also significantly fewer neonatal deaths (2/27 and 13/32, respectively; P less than 0.01) in this subgroup. Betamethasone did not provoke earlier delivery. Premature rupture of the membranes and maternal hypertension did not seem to contraindicate the use of steroids: there was no increase in maternal or neonatal sepsis nor in stillbirth in hypertensive pregnancies in the steroid group. Neonatal jaundice was significantly less frequent in the steroid (55/129) than in the placebo group (81/127; P less than 0.01) but not in the subgroups born before 34 completed weeks gestation.

Betamethasone↗
PubMed1989

Investigation of the effects of paralysis by pancuronium on heart rate variability, blood pressure and fluid balance.

The effects of pancuronium bromide on the cardiovascular system and fluid balance in preterm ventilated neonates was investigated. Infants were selectively paralysed if actively expiring. Their results were compared to a control group of similar gestational age, ventilated during the same study period, but who received no paralysing agent. There was no significant difference in the blood pressure of the two groups. Treatment with pancuronium was not associated with differences in blood pressure variability. All paralysed infants showed a significant reduction in heart rate variability which persisted during treatment. This was not present in the control infants. Paralysed infants, despite fluid restriction, had evidence of fluid retention, being significantly heavier than the control babies from day 3 onwards and above their birthweight by day 7. No paralysed or control infant developed a pneumothorax or renal failure. We conclude that selective treatment with pancuronium is without adverse effects on blood pressure but strict attention to fluid balance is essential.

Blood Pressure↗
PubMed1989

Multiple idiopathic emboli in a full term neonate.

We report a case of multiple idiopathic emboli leading to cerebral infarction and to limb ischaemia in a full term neonate. The increased frequency of diagnosis of cerebral infarction is highlighted. Treatment of cerebral and limb emboli is discussed and the need for further research into the causes and treatment of cerebral infarction is stressed.

Arm↗
PubMed1989

Outcome of neonatal necrotising enterocolitis: results of the BAPM/CDSC surveillance study, 1981-84.

Neonatologists in 100 special care baby units in the United Kingdom and Ireland collaborated in a four year surveillance study of neonatal necrotising enterocolitis. The average overall annual reporting rate of necrotising enterocolitis for infants in England and Wales was 0.3/1000 live births, but ranged from 9.5/1000 live births in infants weighing less than 1000 g at birth to 0.2/1000 live births in infants weighing 2500 g or more. There were more deaths among girls, infants who weighed less than 1500 g at birth, those whose bleeding was abnormal or who had low peripheral platelet counts, infants with Gram negative bacteraemia, and very low birthweight infants who developed it during the first few days of life. In both boys and girls, and in all birthweight groups, operation was associated with increased mortality.

Age Factors↗
PubMed1988

Immediate effects of albumin infusion in ill premature neonates.

Ten normotensive premature infants with idiopathic respiratory distress syndrome, and albumin concentrations of less than 30 g/l were given 5 ml/kg of 20% salt poor albumin by infusion. Concentrations measured six hours after infusion had increased significantly and these were associated with significant reduction in weight and improvement in urine output.

Albumins↗
PubMed1987

Pleuro-amniotic shunting for fetal chylothorax.

The immediate neonatal course of two babies with gross hydrops fetalis, associated with chylothorax, is compared. One fetus managed by antenatal insertion of a pleuro-amniotic shunt had no evidence of pleural effusion at birth and required less resuscitation.

Amnion↗
PubMed1987

Birthweight-specific risk factors for necrotising enterocolitis.

In a multicentre case-control study of necrotising enterocolitis risk factors were found to vary with birthweight of cases. In very low birthweight cases the risk factors identified were those associated with prolonged or recurrent hypoxia (recurrent apnoea, respiratory distress, assisted ventilation, and umbilical artery catheterisation). In heavier birthweight infants the risk factors were, in contrast, related to hypoxia at birth (low 1 minute Apgar score and endotracheal intubation at birth) and umbilical vessel catheterisation used in exchange transfusions. Contradictory findings in published case-control studies carried out in the USA may be due to differences in patient populations and management policies. Hypoxia and umbilical vessel catheterisation should still be considered as risk factors for necrotising enterocolitis.

Apgar Score↗
PubMed1984

The management of severe rhesus isoimmunization by fetoscopic intravascular transfusions.

Twenty-five severely rhesus-isoimmunized fetuses, including 15 with hydrops fetalis, underwent a total of 77 intrauterine transfusions between 19 and 32 weeks' gestation. Fifty-eight of the procedures were fetoscopically directed intravascular transfusions, nine were ultrasound-guided intraperitoneal transfusions, and 10 were a combination of intravascular transfusion, fetal paracentesis, and intraperitoneal transfusion. The average number of antenatal procedures per patient was three (range, one to five). The survival rate for the 19 fetuses that received their initial intrauterine transfusion at or before 25 weeks' gestation was 84%; 11 of the 13 hydropic fetuses and five of the six fetuses without antenatal evidence of hydrops survived. In six cases hydrops fetalis was reversed in utero. The outcome in patients referred after 25 weeks' gestation was poor; neither of the two hydropic fetuses and only two of the four nonhydropic ones survived, which suggests the importance of early referral to a team experienced in the management of this problem. However, most of these fetal losses occurred early in the series. Seven of the 20 neonates were hydropic, and nine had severe thrombocytopenia (platelet count, less than 50,000 X 10(6)/L). The mean cord blood hematocrit and bilirubin of the neonates were 25.1% and 82 mumol/L, respectively. The babies required a total of 69 exchange transfusions (range, 0 to 9) and 68 simple transfusions (range, 0 to 25). One newborn infant who had had ultrasound evidence of hydrops fetalis at 22 weeks' gestation did not require any exchange transfusions. Nine patients required intermittent positive pressure ventilation (eight had respiratory distress syndrome and one had apnea) for a range of 1 to 86 days. The neonatal survival rate was 90% (18/20).

Blood Transfusion, Intrauterine↗
PubMed1983

Pulmonary interstitial emphysema in very low birthweight infants.

Forty six of 142 infants weighing less than 1500 g at birth, who had chest radiographs in the first 5 days of life, developed pulmonary interstitial emphysema (PIE) and in 19 this occurred in the first 24 hours. PIE was seen more frequently in infants weighing less than 1000 g at birth (24 of 57) than in those weighing 1000-1500 g (22 of 85). Ventilation for hyaline membrane disease was strongly associated with PIE, and only babies who were resuscitated, or ventilated, or had hyaline membrane disease developed the disorder. Most pneumothoraces were preceded by x-ray appearances of PIE (17 of 21). Mortality was increased in ventilated infants who developed PIE and was high in those with severe x-ray changes.

Humans↗
PubMed1983

Neonatal paracetamol poisoning: treatment by exchange transfusion.

The metabolism and excretion of paracetamol was studied in an infant of 29 weeks' gestation who was exposed to the drug when his mother ingested 32.5 g 16 hours before delivery. We have confirmed that sulphation is the major pathway and that the mixed function oxidase system is sufficiently active at this gestational age to produce hepatotoxic metabolic products. As most of the recognised drug treatments for paracetamol poisoning seemed unsuitable in this case, the infant was treated with exchange transfusions.

Acetaminophen↗
PubMed1982

Features predictive of brachial plexus injury during labour.

The labours of 8 patients which resulted in the birth of babies with brachial plexus injury were studied. Four of the mothers were Black, 1 was Asian and 3 were White. Seven had instrumental deliveries. All babies were above average birth weight. Shoulder dystocia occurred in 7, with 5 of these showing abnormal partographic patterns. The abnormal active phase on the partogram should serve as a first stage warning of the possibility of shoulder dystocia. Methods of management of this second stage complication are reviewed.

Adult↗