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| 2. |
- Hellström-Westas, Lena, et al.
(författare)
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Long-distance transports of newborn infants with congenital heart disease
- 2001
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Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 22:5, s. 380-384
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Tidskriftsartikel (refereegranskat)abstract
- Little has been published about specific problems that may occur during long-distance transports of newborn cardiac patients. During a 4-year period after centralization of pediatric heart surgery in Sweden, 286 transports were prospectively investigated. A majority (77.3%) of the transports were carried out by nonspecialized teams. Ten severe adverse events, including the death of 1 infant, occurred during the 286 transports (3.5%). Another infant died later of cerebral complications from hypoxia, rendering a transport-related mortality of 0.7%. Twenty-two infants (7.7%) were severely hypoxic (oxygen saturation < or =65%) at arrival, and 12 of these infants suffered from transposition of the great arteries. During the second 2-year period increased use of intravenous prostaglandin E1 and transportation from tertiary-level units was associated with better transport outcome. During the same time period, overall 30-day postoperative mortality for pediatric cardiac surgery decreased from 4.0% to 1.2% in our hospital. When highly specialized treatment is centralized for quality reasons it is also important that risks associated with transport are considered and that the quality of transport is high. For some cardiac malformations antenatal diagnosis and referral of the mother for delivery to a center with pediatric cardiac surgery would probably further increase the chance of healthy survival in some infants.
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| 3. |
- Jörgensen, Connie, et al.
(författare)
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Ultrasound measurement of the fetal cerebral ventricles: a prospective, consecutive study
- 1986
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Ingår i: Journal of Clinical Ultrasound. - : Wiley. - 0091-2751 .- 1097-0096. ; 14:3, s. 185-190
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Tidskriftsartikel (refereegranskat)abstract
- Real-time ultrasound was used in 654 consecutive pregnancies to obtain standard growth parameters for the fetal brain. Measurement of the width of the lateral ventricle (LVW) and hemisphere and their relationships to menstrual age, biparietal diameter, and birth weight were determined. The growth of the LVW was to a great extent independent of birth weight but dependent on menstrual age. Thirteen fetuses with a single ventricular width measurements exceeding +2 SD from the mean were separately evaluated, and all but one case were found to be normal.
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| 4. |
- Sivén, Maria, et al.
(författare)
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Agenesis of the ductus venosus and its correlation to hydrops fetalis and the fetal hepatic circulation: case reports and review of the literature.
- 1995
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Ingår i: Fetal and Pediatric Pathology. - : Informa UK Limited. - 1551-3823. ; 15:1, s. 39-50
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Tidskriftsartikel (refereegranskat)abstract
- Under normal conditions about 50% of the placental venous return bypasses the liver through the ductus venosus. This blood flow is preferentially directed toward the foramen ovale and provides optimum oxygenation to the fetal heart and brain. Absence of the ductus venosus is a rare vascular anomaly, the significance of which has been disputed. We distinguish the pattern in which the liver is entirely bypassed, a manifestation of a fundamental malformation in the umbilical venous system, from the pattern in which the ductus venosus is absent despite a normal course of the umbilical vein. We review the literature regarding the latter and report eight new cases. Three of the four previously reported cases showed associated malformations and two of them suffered from portal congestion and hydrops. Among our eight cases three showed severe malformations in the cardiovascular system. Three cases presented themselves with hydrops fetalis and disturbance in the portal circulation, and two case
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| 5. |
- Thorngren-Jerneck, Kristina, et al.
(författare)
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Cerebral glucose metabolism measured by positron emission tomography in term newborn infants with hypoxic ischemic encephalopathy
- 2001
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Ingår i: Pediatric Research. - 1530-0447. ; 49:4, s. 495-501
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Tidskriftsartikel (refereegranskat)abstract
- Total and regional cerebral glucose metabolism (CMRgl) was measured by positron emission tomography with 2-(F-18) fluoro-2-deoxy-D-glucose ((18)FDG) in 20 term infants with hypoxic ischemic encephalopathy (HIE) after perinatal asphyxia. All infants had signs of perinatal distress, and 15 were severely acidotic at birth. Six infants developed mild HIE, twelve moderate HIE, and two severe HIE during their first days of life. The positron emission tomographic scans were performed at 4-24 d of age (median, 11 d). One hour before scanning, 2-3.7 MBq/kg (54-100 µCi/kg) (18)FDG was injected i.v. No sedation was used. Quantification of CMRgl was based on a new method employing the glucose metabolism of the erythrocytes, requiring only one blood sample. In all infants, the most metabolically active brain areas were the deep subcortical parts, thalamus, basal ganglia, and sensorimotor cortex. Frontal, temporal, and parietal cortex were less metabolically active in all infants. Total CMRgl was inversely correlated with the severity of HIE (p < 0.01). Six infants with mild HIE had a mean (range) CMRgL of 55.5 (37.7-100.8) mol.min(-1).100 g(-1), 11 with moderate HIE had 26.6 (13.0-65.1) µmol.min(-1).100 g(-1), and two with severe HIE had 10.4 and 15.0 µmol.min(-1).100 g(-1), respectively. Five of six infants who developed cerebral palsy had a mean (range) CMRgl of 18.1 (10.2-31.4) µmol.min(-1).100 g(-1) compared with 41.5 (13.0-100.8) µmol.min(-1).100 g(-1) in the infants with no neurologic sequela at 2 y. We conclude that CMRgl measured during the subacute period after perinatal asphyxia in term infants is highly correlated with the severity of HIE and short-term outcome.
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| 6. |
- Tolockiene, Egle, et al.
(författare)
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Intrauterine infection may be a major cause of stillbirth in Sweden
- 2001
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 80:6, s. 511-518
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Tidskriftsartikel (refereegranskat)abstract
- Aim of the study. To investigate intrauterine infection as a cause for unexplained stillbirth. Methods. Chorioamnionitis was studied in a material of stillbirths (117 subjects from the years 1985-1994) from a region in the south Sweden. Control material (126 alive and healthy newborns and with healthy mothers) was gathered from the same region. Results. Chorioamnionitis was a common diagnosis both with stillbirths and 'healthy' deliveries (82 and 68%, respectively). Extension of the inflammation to decidua basalis was seven times more common among stillbirths than among controls (odds ratio 7.2, confidence interval 2.8-21.9). The most common bacteria found at cultures were Escherichia coli , Coagulase negative staphylococcus, Enterococcus faecalis and group B Streptococcus. The risk for stillbirth was doubled if both inflammation and bacteria were present (odds ratio 2.3, confidence interval 0.92-5.8). Meconium discharge was more common among stillbirths than controls (odds ratio=4.7, confidence interval 1.7-14). There were no differences in any respect regarding macerated and non-macerated stillbirths. Our findings are similar to the results from studies in developing countries except for the higher incidence of stillbirths in such countries. Conclusions. Thus, a large part of otherwise unexplained stillbirths might be due to ascending infections.
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