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Biomedical subjects

V Y Yu

Publications and source records attributed to V Y Yu.

At least 109 records · Page 6Linked to original sources
PubMed1983

Provision of perinatal services and survival of extremely low birthweight infants in Victoria.

The transfer of at-risk mothers to one of the three Level III maternity hospitals in Victoria has been promoted since 1975; since 1978, the Newborn Emergency Transport Service has been available throughout the State for the transport of infants to the four Level III neonatal units. By means of data from multiple sources, we ascertained the one-year survival of infants with birthweights of between 500 g and 999 g born in Victoria between 1978 and 1981. Of 711 live-born infants, 227 (31.9%) survived 28 days and 210 (29.5%) lived to at least one year of age; of 490 infants born in the Level III maternity units, 156 (31.8%) lived. There were 54 (24.4%) survivors among the 221 infants born elsewhere; all these survivors were included in the group of 105 babies who had been transferred after birth to Level III neonatal units. Although only 25.5% of all births for the State occurred in the Level III maternity hospitals, 69% of all infants who weighed between 500 g and 999 g at birth were delivered in these hospitals. The transfer of the mother or the new born baby to a Level III unit was possible in an additional 48 cases. Although survival rates from Level III hospitals may possibly improve in the future, the shortage of ventilator beds remains a practical obstacle.

Australia↗
PubMed1983

Collaborative study of very-low-birth-weight infants. Correlation of handicap with risk factors.

Two large maternity services studied consecutive inborn infants (birth weight range, 500 to 1,500 g) born between 1977 and 1978. The multidisciplinary team members used identical assessment methods and documentation. Of 259 long-term survivors, 252 (97.3%) were seen at 2 years of age. Survival rates for hospitals 1 and 2 were 68.5% and 69.0%, respectively. Cerebral palsy rates for hospitals 1 and 2 were 11.8% and 11.2%, respectively. Major handicaps (cerebral palsy, mental developmental index [MDI] on the Bayley scales less than 69, epilepsy, deafness, or blindness) occurred in 30 (18.6%) and 17 (17.3%) of hospitals 1 and 2 survivors, respectively. Both cerebral palsy and developmental delay (MDI below 75 without severe or moderate cerebral palsy) were significantly correlated with a number of perinatal variables, but none were common to the two hospitals. Of the 30 children with cerebral palsy, 15 (50%) were not ventilated, and 28 (93%) had a five-minute Apgar score greater than 4; there was no indication that selective treatment to prevent cerebral palsy was possible.

Blindness↗
PubMed1983

Bronchopulmonary dysplasia in very low birthweight infants.

Twenty-four (6%) of 375 infants with birthweights less than or equal to 1500g developed bronchopulmonary dysplasia (BPD); 16 (15%) of 107 in those less than or equal to 100g and 8 (3%) of 268 in those greater than 1000g. The incidence was 10% in those who required assisted ventilation. Perinatal asphyxia, significant respiratory distress, pulmonary interstitial emphysema and patent ductus arteriosus were statistically more common in BPD infants compared with the remaining 351 very low birthweight infants. Hyaline membrane disease was the primary respiratory disease in 54% of BPD infants. The mean durations of oxygen and ventilatory therapy were 68 days and 37 days respectively. Twenty-nine percent did not require more than 60% oxygen for over 24 hours. Only 38% required a peak airway pressure of over 30 cmH2O. Early postnatal growth was satisfactory on parenteral nutrition support. No perinatal factor was found to be predictive of death from BPD. The prolonged duration of hospital treatment has obvious implications to the psychosocial and economic costs of BPD.

Bronchopulmonary Dysplasia↗
PubMed1983

Determinants of developmental performance of very low-birthweight survivors at one and two years of age.

The developmental outcome of 61 very low-birthweight infants was studied prospectively by means of the Bayley Scales of Infant Development at one and two years of age, corrected for prematurity. Preliminary analysis revealed that the mean scores for mental and psychomotor development were within the normal limits at both testing occasions. However, further analysis showed that there was a significant decrease in mental development scores from one to two years of age, due primarily to an increase in the numbers of low-scoring children with 'hyperactive' behaviour at two years. Separate subgroups of children with suboptimal mental and psychomotor development scores were characterised at both testing occasions by the presence of 'hyperactive' behaviour and disability, usually of a minor degree. The presence of hyperactivity, disability and lowered mental performance may help in the early identification of children at increased developmental risk.

Child Development↗
PubMed1983

Growth and development of very low birthweight infants recovering from bronchopulmonary dysplasia.

Twenty four infants with birthweights less than or equal to 1500 g had bronchopulmonary dysplasia (BPD). Four died in the neonatal period and four in the postneonatal period-one had been discharged and was aged one year. Sixteen (67%) survived long term and were followed up until they were two years old. Common medical conditions included respiratory illnesses in 14 (88%) children and otitis media in 8 (50%). Eleven (69%) required hospital admission for an average of 5 times; total days in hospital averaged 27 days. The most common reasons for admission were bronchiolitis and bronchopneumonia. At two years 37% were below the 10th centile for weight, as were 25% for height: head circumferences were normal. Two children had cerebral palsy, two had developmental delay, two had multiple disabilities, and one had sensorineural deafness. Of the 24 BPD infants, 8 (33%) died, 7 (29%) survived with a disability (severe in one), and 9 (38%) had a normal neurodevelopmental outcome. From the available perinatal data it was not possible to predict late disabilities in BPD survivors.

Blindness↗
PubMed1983

Computerised nutritional data management in neonatal intensive care.

We report a minicomputer based recording, reporting, and research system for patient data management in the neonatal intensive care unit (NICU). It is moderately priced, transportable, and independent of a central computer. It requires only a desk top and standard power supply, and successfully meets the medical documentation, communication, and research needs of the NICU. The first phase of programme development has enabled us to process growth and nutritional data from infants on complex parenteral and enteral nutrition. The system is well suited to medical users and provides a practical interactive data management system with many potential applications in the NICU.

Australia↗
PubMed1982

Collaborative study of very-low-birthweight infants: Techniques of perinatal care and mortality.

The neonatal units in two large maternity hospitals collaborated in a study of 440 liveborn infants weighting 500-1500 g born in 1977 and 1978: 377 (85.7%) were born in hospital. The overall survival rate was 70.5%, with a range of 67.5% to 71.5% for the inborn and outborn categories of infants in each hospital. In hospital A the survival rate of infants weighing greater than or equal to 1100 g was higher than that in hospital b, whereas the survival rate of infants weighing less than 800 g was higher in hospital B. Obstetric risk factors and obstetric management differed little between the hospitals, but there were several important differences in paediatric management; in particular, hospital B (with a better survival rate of infants weighing under 800 g) used ventilatory support and parenteral feeding much more frequently.

Australia↗
PubMed1982

Clinical features of eight pregnancies resulting from in vitro fertilization and embryo transfer.

In vitro fertilization (IVF) and embryo transfer (ET) have resulted in the birth of nine babies, including twins. One of the twins had a congenital cardiac malformation and seven of the nine babies were girls. Labor occurred preterm in two pregnancies; and in six delivery was by cesarean section. Plasma human chorionic gonadotropin (hCG), progesterone (P), and estriol (E3) measurements and ultrasonic scans showed no obvious differences from pregnancies resulting from natural conception. Cytogenetic studies from cord blood and histologic examination of the placentas were unremarkable. The theoretic risks of pregnancy following IVF and ET are discussed. Definite conclusions cannot be drawn until a large number of babies are delivered and a long-term follow-up is completed. Initial results from the current small sample are encouraging.

Adult↗
PubMed1982

Infants born before 29 weeks gestation: survival and morbidity at 2 years of age.

In a collaborative study involving two hospitals with large maternity services, 166 liveborn infants of gestational age from 24 to 28 weeks were born in the calendar years 1977 and 1978. Of these infants, 75 (45.2%) died either in hospital or after discharge home. At the age of 2 years, 16 (9.6%) of the cohort had a major handicap [cerebral palsy, Mental Developmental Index (MDI) under 69, deafness or blindness]. An additional 20 children (12.0%) had significant developmental delay (MDI 69 to 84, -2 to -1 SD below mean) and 53 (31.9%) were considered to be free of these handicaps. Psychological assessments were not performed on two survivors (1.2%) but reliable reports indicated that they were free of major handicaps. Long-term survival increased in a stepwise fashion from 9.1% at 24 weeks to 68.5% at 28 weeks gestation, and there was a trend for major handicap and significant developmental delay to decrease in incidence with increasing maturity. Of the 58 children who had presented by the vertex 42 (72.4%) were free of significant handicap; however, of the 31 children in whom there had been either a breech presentation or a transverse lie, only 11 (35.5%) were free of significant handicap (chi 2 = 9.69, P less than 0.01). The mode of delivery (vaginal or caesarean section) did not significantly affect the handicap rate in the survivors.

Australia↗
PubMed1982

Early development of infants 1000 g or less at birth.

In a 4-year period the neonatal survival rate for 26 infants weighing 501-750 g was 42% and for 81 infants weighing 751-1000 g it was 61%. All 59 surviving infants have been assessed at follow-up; 39 were at least 2 years old (corrected for prematurity) and data from the remaining 20 were derived from assessment at 1 year corrected age. Five children had cerebral palsy, 4 had multiple handicaps, 4 each had a sensory handicap, 2 had developmental delay, and 1 had a dilated right ventricle without clinical hydrocephalus. Twelve of the 16 children with defined handicaps were considered to have significant functional handicaps. Therefore, of the 107 infants in this series, 48 (45%) died, 12 (11%) survived with significant functional handicaps, and 47 (44%) were considered to be developing within the normal range. No significant differences in the incidence of handicap were observed between inborn and outborn children, boys or girls, those who were small or appropriate for gestation, those who weighed less than or equal to 750 g or greater than 750 g at birth, and those who required or did not require prolonged oxygen or ventilation.

Child Development↗
PubMed1982

Determinants of stress for staff in a neonatal intensive care unit.

Components of stress for 22 paediatric consultants and 29 nursing sisters working in neonatal intensive care units were studied. Ten situations were rated for their intensity of stress and their frequency of occurrence. For intensity of stress, significantly more paediatric consultants rated the competing demands of personal life versus work as highly stressful, than did nursing sisters. For frequency of stress, significantly more paediatric consultants rated 4 situations as frequently occurring than did nursing sisters (priorities of care, understaffing/overwork, personal life versus work, condition of outborn infants). However, significantly more nursing sisters found problems in working with their peers a frequently occurring stress than paediatric consultants. Total scores calculated for intensity and frequency of stress showed that although the overall intensity of stress experienced was similar, paediatric consultants had a significantly higher mean score for frequency of stress than nursing sisters in the neonatal intensive care unit.

Australia↗
PubMed1982

Retrolental fibroplasia--controlled study of 4 years' experience in a neonatal intensive care unit.

During the 4 years 1977-80, 14 infants developed retrolental fibroplasia (RLF) in the neonatal unit at this medical centre. All were very low birthweight (VLBW) infants who weighed 1500 g or less at birth. The incidence of RLF was 3.5% for all VLBW infants admitted for neonatal intensive care and 4.7% for VLBW survivors. The mean birthweight of the affected infants was 970 (range 730-1310) g and mean gestational age 26 (range 24-29) weeks. Seven of the affected infants (2.4% of VLBW survivors) had significant scarring with temporal dragging of the optic disc and retinal detachment. Each of the 14 infants was matched with 2 control infants in order to see whether any factors predisposing to the development of RLF, including those related to oxygen therapy and monitoring, could be identified. The only factor associated with RLF was a higher volume of blood given with replacement transfusions. The occurrence of RLF was unrelated to an increase in requirement for or duration of oxygen therapy, arterial oxygen tensions as determined by intermittent sampling, or the availability of transcutaneous oxygen monitoring. The care taken in oxygen therapy may have been responsible for failure to show a quantitative association between hyperoxaemia and RLF. Although the problem of oxygen therapy in preterm infants is far from being resolved, current neonatal intensive care methods have limited the occurrence of RLF to VLBW infants. This study demonstrated a lower incidence of RLF in VLBW infants despite an improved survival rate compared with that previously reported.

Humans↗
PubMed1982

Nonimmunologic hydrops fetalis: a review of 61 cases.

Sixty-one cases of nonimmunologic hydrops fetalis were studied. The incidence of nonimmunologic hydrops fetalis, 1 in 3748 births, was unchanged in 2 decades. The mortality from nonimmunologic hydrops fetalis remained high (98%). Polyhydramnios (75%), anemia (45%), and preeclampsia (29%) were the commonest prenatal maternal complications, whereas postpartum hemorrhage or difficulty with placental delivery, or both, occurred in 64%. Ultrasound examination always was successful in detecting the hydropic state. Many presumed etiologic factors were noted, although in 38% no possible cause was found. A major congenital anomaly was present in 41%. The obstetric and neonatal care of nonimmunologic hydrops fetalis must be improved. If nonimmunologic hydrops fetalis is diagnosed during the investigation of polyhydramnios, consideration should be given to early delivery in the interest of the fetus.

Edema↗