American journal of perinatology
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Resuscitation guidelines give no preference over use of self-inflating bags (SIBs) or T-piece resuscitators (TPR) for manual neonatal ventilation. We speculated that devices would differ significantly regarding time required to adjust to changed ventilation settings. ⋯ PIP adjustment takes longer with TPRs, compared with SIB/SIBM. TPRs and SIBM allow satisfactory adherence to ventilation parameters. SIBs should only be used with manometer attached.
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Randomized Controlled Trial Multicenter Study Comparative Study
Effect of hydration on spontaneous labor outcomes in nulliparous pregnant women: a multicenter randomized controlled trial comparing three methods.
To evaluate the effect of mode and amount of fluid hydration during labor. ⋯ Although apparently safe, neither increased intravenous hydration nor oral hydration during labor improves labor performance.
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Randomized Controlled Trial
Probiotic supplementation in mothers of very low birth weight infants.
Oral probiotic supplementation reduces the risk of necrotizing enterocolitis (NEC) in preterm infants. Concerns about safety and purity of probiotic preparations have limited their use in preterm infants. The authors administered probiotic bacteria to mothers of preterm infants, thereby avoiding the risks of direct exposure of infants to probiotic bacteria. ⋯ Postpartum maternal supplementation with probiotic bacteria may decrease the incidence of NEC in breastfed infants.
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The purpose of this study was to examine the attitudes of Romanian physicians toward withholding and withdrawing intensive care for infants whose prognosis is very poor. ⋯ Romanian physicians are uniformly reluctant to withhold or withdraw intensive care for infants, even those with very poor prognosis. In addition, physicians are very uncomfortable talking with parents about limiting or stopping support and talking about the death of an infant. Educational programs targeting the communication of difficult topics with parents have the potential to decrease the discomfort experienced by physicians in conversing with parents about their child's poor prognosis or death.
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Delivery room management of extremely premature infants is not subjected to professional regulations. In the United States, legal definitions of human viability and statutes regulating elective abortions vary by state, placing providers in an often difficult position regarding whether to attempt resuscitation when faced with the delivery of an infant of 22 to 25 weeks gestation. The objective of this study was to delineate variations in delivery room resuscitation practices of periviable infants in the United States in 2012. ⋯ Regional practice variation exists independent of specific state laws. Parental request is the most important factor to providers resuscitating 22 to 25-week infants. Providers' personal belief systems influence infant management infrequently.