• Title/Summary/Keyword: gestational age

Search Result 573, Processing Time 0.02 seconds

Listeria Sepsis and Pneumonia in a Premature Neonate (산전 감염 후 발생한 폐혈증 및 폐렴을 동반한 미숙아 리스테리아증 1례)

  • Park, Joon-Woo;Yoon, Jeong-Min;Sung, Tae-Jung
    • Neonatal Medicine
    • /
    • v.16 no.1
    • /
    • pp.94-98
    • /
    • 2009
  • Listeria monocytogenes (L. monocytogenes) is a foodborne anaerobic gram-positive rod and the third most common pathogen for neonatal meningitis. Although the mortality and morbidity of L. monocytogenes infections are high, thus causing serious problems in Western populations, neonatal listeriosis is relatively rare in Eastern countries, including Korea. Possible routes for intrauterine infection or vertical transmission of L. monocytogenes include infected placentas and the reproductive tract. Intrauterine infections may cause chorioamnionitis, preterm labor, spontaneous abortion, stillbirth, or neonatal infection. A high index of suspicion and early empirical antibiotic treatment are critical to achieve a favorable prognosis for neonatal listeriosis. We managed a case of L. monocytogenes sepsis and pneumonia in a premature neonate born at 26 weeks of gestational age from an asymptomatic mother with culture-proven placental infection. The neonate was successively treated with ampicillin and gentamicin.

Evaluation and Management of Antenatal Hydronephrosis

  • Hong, Young Kwon;Lee, Jun Ho
    • Childhood Kidney Diseases
    • /
    • v.19 no.1
    • /
    • pp.8-13
    • /
    • 2015
  • Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

A Case of Congenital Malaria (신생아에서 발생한 선천성 말라리아 1례)

  • Lee, Eun Jin;Chang, Hyen Ho;Lee, Chong Guk;Cho, Chong Rae
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.8
    • /
    • pp.821-825
    • /
    • 2003
  • Malaria is known to have been eradicated for a few decades through the persistent efforts of the national health program in South Korea. However, malaria caused by Plasmodium vivax has started to reappear incidiously among military personnel near to the De-militarized Zone since 1993. From that time on the number of malarial cases have increased abruptly year by year. However, congenital malaria in a neonate is extreamly rare in Korea. We experienced one case of malaria in a neonate who was born from a mother affected by malaria. This neonate was born at $33^{+3}$ weeks of gestational age. Here we present this case with a brief review of the literature.

Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies

  • Choi, Young Youn
    • Clinical and Experimental Pediatrics
    • /
    • v.57 no.12
    • /
    • pp.505-513
    • /
    • 2014
  • While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity. NEC is more prevalent in lower gestational age and lower birth weight groups. It is characterized by various degrees of mucosal or transmural necrosis of the intestine. Its exact pathogenesis remains unclear, but prematurity, enteral feeding, bacterial products, and intestinal ischemia have all been shown to cause activation of the inflammatory cascade, which is known as the final common pathway of intestinal injury. Awareness of the risk factors for NEC; practices to reduce the risk, including early trophic feeding with breast milk and following the established feeding guidelines; and administration of probiotics have been shown to reduce the incidence of NEC. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. Therefore, new potential techniques to detect early biomarkers or factors specific to intestinal inflammation, as well as further strategies to prevent the activation of the inflammatory cascade, which is important for disease progression, should be investigated.

Salt Preference and Sodium Intake among Pregnant Women (임부의 염분 기호도와 식이섭취, 소디움 섭취 실태)

  • Im, Mi Jeung;Cho, Dong Sook
    • Women's Health Nursing
    • /
    • v.22 no.4
    • /
    • pp.297-307
    • /
    • 2016
  • Purpose: This study was to estimate salt preference and sodium intake of pregnant women, and identify the relationship between salt preference and sodium intake. Methods: Research design was a cross sectional correlational survey with 197 pregnant women who visited outpatient clinics for antenatal care. The sodium intake levels were estimated by the amounts of sodium intake using the 24-hour recall method and sodium concentration in spot urine. The data were analyzed using descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: Sodium intake using 24-hour recall method was $3,504{\pm}1,359mg$. Sodium intake levels had statistically significant differences depending on income. The average amount of sodium in spot urine was $2,882{\pm}878mg/day$. Sodium excretion levels had statistically significant differences depending on whether participants had preexisting hypertension in their family history and Body Mass Index (BMI) pre-conception. Salt preference was $62.61{\pm}20.96$ out of 180 points. Salt preference had significant differences depending on income, parity, gestational age, BMI pre-conception and showed negative correlation with sodium quantity in spot urine. Conclusion: Sodium intake in pregnant women recommended by World Health Organization recommended is 175%. Salt preference was not significantly different between sodium intake levels, however it was negatively correlated with sodium quantity in spot urine among pregnant women.

Yakson vs. GHT Therapy Effects on Growth and Physical Response of Preterm Infants and on Maternal Attachment (약손요법이 미숙아의 성장 및 생리적 반응과 미숙아 어머니의 애착에 미치는 효과 - GHT[Gentle Human Touch]요법과 비교하여 -)

  • Im, Hye-Sang
    • Journal of Korean Academy of Nursing
    • /
    • v.36 no.2
    • /
    • pp.255-264
    • /
    • 2006
  • Purpose: This study is aimed to confirm the effects of Yakson therapy on the growth and physical response of preform infants, and maternal attachment to them compared with GHT therapy. Method: The design of this study is nonequivalent control group with repeated measuring by quasi experimental study. The subjects are preterm infants in 26 - 34 gestational age hospitalized in the NICU of 4 university hospitals with an experimental group of 15 and a control group of 14. Yakson therapy consists of three phases: laying a hand, caressing by hand, and laying a hand again taking 5 minutes for each phase. Result: As a result of administering Yakson therapy to preform infants; the average weight gain of the Yakson group was higher than that of the GHT group, but there is no significant difference between groups. The oxygen saturation and maternal attachment difference between the Yakson and the GHT group were not significant. Significant differences in the average daily increase of oral intake and apical pulse rate were observed between the Yakson group and GHT group. Conclusion: These data suggested that Yakson therapy may be an effective nursing intervention which can facilitate growth and physical response of preform infants.

Generalized Meconium Peritonitis Diagnosed with Antenatal Ultrasonography (산전 초음파검사로 진단된 범발성 태변성 복막염 2예보고)

  • Kim, Soong-Chul;Hwang, Shin;Yoo, Shi-Joon;Kim, In-Koo
    • Advances in pediatric surgery
    • /
    • v.1 no.1
    • /
    • pp.59-62
    • /
    • 1995
  • Meconium peritonitis is defined as an aseptic, chemical or foreign-body peritonitis caused by spill of meconium in the abdominal cavity related to the prenatal perforation of the intestine. Perforation is usually caused by obstruction from meconium ileus, intestinal atresia, stenosis, volvulus, internal hernia, congenital peritoneal bands, intussusception, or gastroschisis. Less commonly, no evidence of distal obstruction exists. Here, we present two cases of generalized meconium peritonitis of antenatal diagnosis. The first case, detected at 8 months of gestational age, had a perforation of the proximal blind pouch of jejunal atresia, associated with respiratory distress due to severe abdominal distension. This case was successfully treated with resection and anastomosis and brief period of postoperative ventilatory support. The second case had a distal ileal perforation with thick meconium in the terminal ileum. In this case, there was no dilatation of ileum proximal to the perforation site. Resection and anastomosis was performed and postoperative course was uneventful.

  • PDF

Effects of Nonnutritive Sucking on Behavioral State in Preform Infants (비영양 흡철의 미숙아 행동상태에 대한 효과)

  • Shin Hee Sun
    • Child Health Nursing Research
    • /
    • v.4 no.2
    • /
    • pp.305-313
    • /
    • 1998
  • The purpose of study was to examine the effect of nonnutritive sucking(NNS) on behavioral state in preform infants. Fourteen infants (gestational age 28-35 weeks, M=31.86 ; birth weights 1095-2275g, M=1694g) admitted to NICU, serving as their controls were randomly administered 5 min of nonnutritive sucking and a control condition. Behavioral state was measured using the Anderson Behavioral State Scale(ABSS). Heart rates were obtained for each infant before and during NNS and bottle feeding. Data collecction was done by 3 experienced nurses in NICU 2 times a day for conseculive 4 days for each subject. Interrater reliability were .80-.90. The findings were as follows : 1. Preform infants averaged active restless states 58.93% in the prointervention phase and 27.32% in the NNS phase. Inactive awake states were 3.57% in the preintervention phase and 34.64% in the NNS phase. 2. There were significantly more positive changes to inactive awake states for the NNS intervention, Z=-2.35, p=.01. 3. There was no statistically significant difference in heart rate change between NNS intervention and control condition, z=-1.15, p=.24. 4. The rates of feeding success determined by finishing prescribed amount of milk by bottle feeding within 15 minutes were 83.94% in NNS intervention and 89.29% in control condition. The findings from this study confirmed that NNS is effective for behavioral state modulation and inducing optimal state for feeding in preform infant. The NNS intervention in nursing practice may help the transition of preform infants for nipple feeding.

  • PDF

Prevalence and Predictors of Exclusive Breastfeeding in Late Preterm Infants at 12 Weeks

  • Lee, Soo Yeon;Jang, Gun Ja
    • Child Health Nursing Research
    • /
    • v.22 no.2
    • /
    • pp.79-86
    • /
    • 2016
  • Purpose: The purpose of this study was to identify breastfeeding practice with late preterm infants (LPIs), and to determine predictors of exclusive breastfeeding at the 12th week after discharge. Methods: The participants were 106 mothers of LPIs hospitalized in neonatal intensive care units at two university hospitals. Data were collected between February and October, 2013. Questionnaires included characteristics of LPIs, their mothers, and feeding-related characteristics. Feeding methods were exclusive breastfeeding, mixed feeding, and formula feeding. Results: Exclusive breastfeeding steadily increased from 5.7% at the 1st week to 19.8% at the 12th week, as did formula feeding from 27.3% to 67.9%. Contrarily, mixed feeding decreased from 67.0% at the 1st week to 12.3% at the 12th week. The ratio of formula feeding was higher than that of exclusive breastfeeding over time. Predictors for exclusive breastfeeding were the following: type of delivery (OR=2.96, 95%CI=1.07-8.14), feeding intolerance (OR=3.03, 95%CI=1.26-7.25) and feeding method during hospitalization (OR=7.84, 95%CI=3.15-19.53). Conclusion: In order to increase breastfeeding opportunities for LPIs, educational programs for gestational age-appropriate breastfeeding should be developed. The focus of breastfeeding education needs to be on mothers who delivered their LPIs through Cesarean-section and LPIs who had feeding intolerance or were fed only formula during hospitalization.

Catheter-related bloodstream infections in neonatal intensive care units

  • Lee, Jung-Hyun
    • Clinical and Experimental Pediatrics
    • /
    • v.54 no.9
    • /
    • pp.363-367
    • /
    • 2011
  • Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters, peripherally inserted central catheters, and tunneled catheters. CRBSI is defined as a laboratory-confirmed bloodstream infection (BSI) with either a positive catheter tip culture or a positive blood culture drawn from the CVC. BSIs most frequently result from pathogens such as gram-positive cocci, coagulase-negative staphylococci, and sometimes gram-negative organisms. CRBSIs are usually associated with several risk factors, including prolonged catheter placement, femoral access, low birth weight, and young gestational age. Most NICUs have a strategy for catheter insertion and maintenance designed to decrease CRBSIs. Specific interventions slightly differ between NICUs, particularly with regard to the types of disinfectants used for hand hygiene and appropriate skin care for the infant. In conclusion, infection rates can be reduced by the application of strict protocols for the placement and maintenance of CVCs and the education of NICU physicians and nurses.