Journal of perinatal medicine
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Clinical Trial Controlled Clinical Trial
G-CSF, GM-CSF and IL-6 levels in cord blood: diminished increase of G-CSF and IL-6 in preterms with perinatal infection compared to term neonates.
The objectives of this study were 1) to clarify the physiologic regulation of cytokines such as IL-6, G-CSF and GM-CSF in preterm and term neonates and 2) to evaluate the influence of perinatal stress and infection on endogenous cytokine levels. ⋯ The response of G-CSF levels in preterms to infection is diminished. Body cell mass is more important than gestational age to provide high G-CSF levels during states of infection.
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Infants with congenital cyanotic heart disease are at increased risk of developing necrotising enterocolitis (NEC). We examined a cohort of infants with congenital cyanotic heart disease in order to assess the role of cardiac catheterisation in the pathogenesis of NEC. ⋯ Infants with congenital cyanotic heart disease appear to be at a greater risk of gastrointestinal complications including necrotising enterocolitis in the days following cardiac catheterisation. We suggest a more cautious approach to feeding is required during this period.
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The administration of non-steroidal antiinflammatory drugs (NSAID) has occasionally been related to fetal and neonatal cardiopulmonary, gastrointestinal, cerebral and renal complications. This report describes a term newborn with severe persistent pulmonary hypertension due to premature closure of the ductus arteriosus following a 5 day maternal treatment with diclofenac two weeks before delivery. ⋯ The child recovered, but tricuspid regurgitation persisted, presumably because of irreversible ischemic damage of one papillary muscle. This is the first reported case of persistent pulmonary hypertension of the newborn (PPHN) in association with maternal diclofenac treatment and represents a most severe form of PPHN induced by NSAID.
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Oxytocin is involved in the regulation of preterm and term labor but the exact effect mechanisms are not fully understood. A regulatory action by vasopressin may also exist. The concentrations of oxytocin and vasopressin V1a receptors in myometrium from pregnant women are high before and in the beginning of labor both preterm and at term. ⋯ The same authors also reported successful tocolysis with the drug in actual preterm labor. Atosiban is currently in phase III of clinical development and seems to have the same effectiveness but fewer side-effects compared to beta-mimetics. These properties suggests that Atosiban may offer advantages over existing therapies in acute treatment of preterm labor.
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The aim of this study was to assess women's level of satisfaction with management during labour and to ascertain their preference for mode of delivery. The basis for the findings was the cross-sectional anonymous questionnaire survey of 520 women at a Dublin obstetric hospital. Visual analogue scales were used to assess degree of satisfaction. ⋯ Factors significantly associated with high levels of satisfaction were good analgesia during labour (particularly epidural), vaginal delivery, adequate preparation for labour and if personal wishes were listened to by staff. Almost all women have a preference for vaginal delivery. Satisfaction with care in labour is significantly influenced by vaginal delivery, empathetic communication by staff and good analgesia in labour.