American journal of perinatology
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We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patients underwent an elective cesarean section with prophylactic pelvic artery catheterization of internal iliac arteries through femoral or brachial approach. ⋯ There were no major catheterization-related complications. Three women had a subsequent pregnancy and uncomplicated delivery by cesarean section. Prophylactic pelvic artery catheterization and embolization in women with placenta accreta is safe and effective in prevention of hysterectomy and should be considered in woman wishing to preserve fertility.
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Comparative Study
Short-term outcomes of patent ductus arteriosus ligation in preterm neonates: reason for concern?
We evaluated outcomes of preterm infants following surgical ligation of patent ductus arteriosus (PDA). We performed a retrospective chart review. Our cohort (N = 82) had a median (range) gestational age of 25.5 (23 to 28) weeks and birth weight of 765 (484 to 1150) g. ⋯ A lower gestation was significantly associated with postoperative deterioration and BPD. Preterm infants undergoing PDA ligation often experience a postoperative deterioration and have an extremely high incidence of comorbidities. Whether the ductus itself or the "therapeutic" ligation is causally linked to these adverse outcomes remains to be determined.
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Randomized Controlled Trial
Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial.
Postoperative ileus is one of the common problems after abdominal surgeries. It contributes to delayed recovery and prolongs hospital stay. Sham feeding, such as gum chewing, may accelerate return of bowel function and reduce morbidity and length of hospital stay. ⋯ Gum chewing was easily tolerated without any complications. Gum chewing is an inexpensive, convenient, and physiological method in enhancing the recovery of bowel function. But this may not facilitate early hospital discharge, lactation, or defecation.
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We investigated pCO(2) patterns and the relationship between pCO(2) levels and neurodevelopmental outcome in term infants with hypoxic-ischemic encephalopathy. Blood gases during the first 72 hours of life were collected from 52 infants with hypoxic-ischemic encephalopathy. Moderate hypocapnia (pCO(2) <3.3 kPa), severe hypocapnia (pCO(2) <2.6 kPa), and hypercapnia (pCO(2) >6.6 kPa) were correlated to neurodevelopmental outcome at 24 months. ⋯ In conclusion, only one in nine newborns had normocapnia throughout the first 72 hours. Severe hypocapnia was rare and occurred only in ventilated babies. Hypercapnia and hypocapnia in infants with hypoxic-ischemic encephalopathy during the first 72 hours of life were not associated with adverse outcome.
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We sought to determine cytokine response in term and late preterm newborn infants on phototherapy. Twenty newborn infants with gestational age > or = 35 weeks and birth weight > or = 2000 g in the first week of life had serum interleukin (IL)-6, IL-8, IL-10, IL-1beta, and tumor necrosis factor (TNF)-alpha measured immediately prior to and after 24 hours on phototherapy. Exclusion criteria were newborns with severe congenital malformations, congenital infections, birth asphyxia, sepsis, hemolytic anemia that required blood transfusion, maternal-infant Rh incompatibility and those who required exchange transfusion or intravenous immunoglobulin treatment for hyperbilirubinemia. ⋯ There were no statistical differences in IL-8, IL-10, IL-1beta, and TNF-alpha concentrations before and after 24 hours on phototherapy. There was a statistically significant correlation between IL-6 decline and irradiance (r = 0.57, p = 0.009). The finding that serum IL-6 decreases in newborn under phototherapy suggests that phototherapy possibly has an anti-inflammatory effect, although the clinical implications of this study deserve further studies.