American journal of perinatology
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Observational Study
Head Position Change Is Not Associated with Acute Changes in Bilateral Cerebral Oxygenation in Stable Preterm Infants during the First 3 Days of Life.
Several recent intraventricular hemorrhage prevention bundles include midline head positioning to prevent potential disturbances in cerebral hemodynamics. We aimed to study the impact of head position change on regional cerebral saturations (SctO2) in preterm infants (< 30 weeks gestational age) during the first 3 days of life. ⋯ Stable preterm infants tolerated brief changes in head position from midline without significant alternation in bilateral SctO2; the impact on critically ill infants needs further evaluation.
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The diagnosis of coagulopathy cannot always be performed at point of care. Thromboelastography (TEG) and the platelet-function analyzer (PFA-100), have emerged as reliable means for coagulation analysis. However, their reliable utility in pregnancy remains to be determined. We sought to establish reference values with concomitant determination of other known coagulation measures in nonlaboring gravidae in an effort to report the mean and variance of multiple testing modalities. ⋯ Our data suggest that TEG values are significantly different in term, nonlaboring, healthy gravidae compared with nonpregnant reference values. Pooled means and standard deviations shown here may be considered for reference.
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Postpartum hemorrhage (PPH) is a major cause of maternal mortality, with almost 300,000 cases and ~72,000 PPH deaths annually in sub-Saharan Africa. Novel prevention methods practical in community settings are required. Tranexamic acid, a drug to reduce bleeding during surgical cases including postpartum bleeding, is potentially suitable for community settings. Thus, we sought to determine the impact of tranexamic acid on PPH-related maternal mortality in sub-Saharan Africa. ⋯ These analyses point to the importance of preventive and treatment interventions compatible with home and clinic use, especially for sub-Saharan Africa, where the majority of births occur at home or community health clinics. Given its feasibility to be given in the home, tranexamic acid has potential to save many lives.
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This study aims to assess the risk of morbidity associated with maternal lactic acid concentration in women with possible sepsis in pregnancy. ⋯ Elevated lactic acid in pregnancy is associated with adverse maternal outcomes from presumed sepsis. In this cohort, lactic acid measurement was a marker of more severe infection.
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Multicenter Study
Pilot study of a new mathematical algorithm for early detection of late-onset sepsis in very low-birth-weight infants.
Diagnosis of late onset sepsis (LOS) in very low birth weight (VLBW) preterm infants relies mainly on clinical suspicion, whereas prognosis depends on early initiation of antibiotic treatment. RALIS is a mathematical algorithm for early detection of LOS incorporating six vital signs measured every 2 hours. ⋯ RALIS has a promising potential as an easy to implement noninvasive early indicator of LOS, especially for ruling out LOS in VLBW high-risk infants.