A prospective study of neonatal status with a follow-up of 4 to 7 years, was performed in 74 full-term newborns with acute fetal distress (AFD). They were born between 0.1.12.1971 ad 31.12.1975. Mental retardation (M.R.) occurred in 4,8% of the control children (born in 1972 without problem) and in 20,2% (15 children) of the children who suffered from AFD; in 12 of these 15 cases, IQ is between 65 and 90, in 3 between 50 and 65. The prognosis is worse only after unexpected neonatal distress, not after AFD with a known etiology, or after use of a forceps. The prognosis is better when FD secondary to a cord anomaly lead to an obstetrical operation. It is also better after cesarean section (1 MR among 17) or when the mother chose a private obstetrician (0 MR among 25. Apgar score has no prognostic value. Some neonatal clinical and EEG symptoms have a poor significance : persistence of anomalies at one week, seizures lasting more than 2 days. Severe retardation is always associated with cerebral palsy (C.P.). Among 12 children with moderate retardation, only one has a C.P., the 11 others have a poor--intellectual, social and/or affective--environment.

Acute Disease↗

PubMedDate not supplied

[Patent ductus arteriosus in premature newborns. Treatment with indomethacin (author's transl)].

The pharmacokinetic and pharmacodynamic effects of indomethacin were studied in 18 prematures with patent ductus arteriosus, treated either enterally (group I, n = 7), or intravenously (group II, n = 11). A definitive closure assessed by echocardiography was observed in 13 cases (72%), and it was only transient in 4 cases (21%). Assisted ventilation was discontinued between 1 and 6 days following therapy in 14 cases. In most cases, indomethacin induced a significant reduction of diuresis but the plasma creatinine level increased above 15 mg/l in 3 cases only. The elimination half life of indomethacin (t 1/2 beta), of 40.3 +/- 12.2 hours in group I and 33.9 +/- 11.7 hours in group II, is increased as compared with adults. The difference of the surface under the curve (AUC O leads to 24 h, ng.ml-1.h-1) between the infants who presented complete or transient closure, suggests a relationship between the biodisponibility of the drug and the effect on patent ductus arteriosus. Treatment with indomethacin is an interesting alternative to surgical ligation in prematures with patent ductus arteriosus. Because of its side effects, especially on the kidneys, it is recommended to use this treatment only in intensive care units. The intravenous route seems to be better than the enteral route.

Administration, Oral↗