PubMed · 14106600
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V M CROSSE. 1963-12-21. CURRENT PROBLEMS ASSOCIATED WITH PREMATURITY.. https://pubmed.ncbi.nlm.nih.gov/14106600/
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BACKGROUND: Perinatal asphyxia constitutes a significant problem influencing neonatal mortality and morbidity. OBJECTIVES: The aim of the present work was to provide evidence of the usefulness of cardiac troponin T (cTnT) and echocardiographic investigations in the diagnosis of heart damage in full-term infants after intrauterine hypoxia. MATERIAL AND METHODS: The subjects were 39 asphyxiated and 44 term infants without fetal anoxia. Quantitative determinations of cTnT were performed between 12 and 24 h of life. Two-dimensional Doppler and color Doppler studies were performed at the bedside. We evaluated fractional shortening (FS), cardiac output (CO), cardiac index (CI), tricuspid (TI) and mitral (MI) insufficiency. RESULTS: Asphyxiated infants presented increased cTnT (mean 0.141+/-0.226 vs. 0.087+/-0.111 ng/ml; p<0.01) and TI (38.5 vs. 11.4% of population; p<0.05) compared to healthy infants. CO, CI and FS remained in the same range. CONCLUSIONS: We found cTnT to be the most useful among accessible diagnostic tools used in post-hypoxic heart damage in neonates. The data from our relatively small population study suggest a cTnT value of >0.1 ng/ml as a reliable marker of myocardial injury in neonates. Further study should be performed to generate a receiver-operator characteristic curve to discover what the cut-off level should be.
BACKGROUND: The aim of this study is to determine carnitine levels in hypoxic-ischemiac neonates. METHODS: Total and free carnitine levels were measured in 20 normal term neonates and 20 term neonates who were diagnosed as hypoxia-ischemia. RESULTS: Both total carnitine levels (43.7 +/- 10.0 microg/dl vice 27.8 +/- 11.8 microg/dl, p<0.0001) and free carnitine levels (28.0 +/- 8.8 vice 13.2 +/- 6.8 microg/dl, p<0.0001) were lower in the hypoxic-ischemic group). Additionally acyl/total carnitine ratio was higher in the asphyxic group (0.33 +/- 0.20 vice 0.56 +/- 0.24, p<0.0001). CONCLUSIONS: The findings of this study show that neonates with hypoxia-ischemia suffer carnitine deficiency.
OBJECTIVE: The purpose of this analysis was to study the relationship between an increasing cesarean delivery rate and term neonatal seizures and peripartum deaths. STUDY DESIGN: This was a retrospective analysis of annually collated institutional data on cesarean delivery and perinatal outcome. RESULTS: Of 77,350 women who delivered at 37 weeks' gestation or more through 12 years (1989 to 2000), the cesarean rate increased from 6.9% to 15.1%; perinatal mortality at term, average 3.1/1000, was unchanged. The cesarean rate for nulliparas doubled from 8.3% to 17.5%. The overall neonatal term seizure rate (overall 1.3/1000; and for nulliparas 2.5/1000) did not change. The overall peripartum death rate (0.8/1000) was unchanged, although the rate for nulliparas (1.5/1000) showed a significant decline. Overall seizure rate in nulliparas was 5-fold higher than in multiparas; presumed intrapartum asphyxia was associated with 84% of both seizures and neonatal deaths in nulliparas. Among 2547 prelabor cesarean deliveries, there were no peripartum deaths and one neonatal seizure, an incidence comparable with that in multiparas who labored. CONCLUSION: Despite a greater than 2-fold rise in cesarean section rate, the seizure rate and overall peripartum death rate at term did not alter significantly. Neonatal seizures occurred 5 times more often following first deliveries.