Biomedical subjects

R Deddish

Publications and source records attributed to R Deddish.

3 recordsLinked to original sources

PubMed1993

Neonatal morbidity after preterm delivery in the presence of documented lung maturity.

OBJECTIVE: Our purpose was to determine the incidence of significant neonatal morbidity in fetuses with documented pulmonary maturity delivered before 37 weeks' gestation. STUDY DESIGN: A retrospective review of 213 pregnancies with documented fetal lung maturity (lecithin/sphingomyelin ratio > or = 2.0 or phosphatidylglycerol present) and delivery before 37 weeks was performed. The incidence of neonatal respiratory distress syndrome, bronchopulmonary dysplasia, grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, infectious morbidity, hyperbilirubinemia, and admission to the special care nursery was determined for those pregnancies with intact membranes and preterm premature rupture of membranes. RESULTS: Serious neonatal morbidity declined with advancing gestational age and was less common after 32 completed weeks of pregnancy. Although the frequencies of respiratory distress syndrome, grade 3 or 4 intraventricular hemorrhage, and necrotizing enterocolitis were 19.4% (12/62), 8.1% (5/62), and 4.8% (3/62), respectively, at < or = 33 weeks' gestation, one case of respiratory distress syndrome, one case of grade 3 intraventricular hemorrhage, and one case of necrotizing enterocolitis occurred in the 151 neonates born at > or = 34 weeks' gestation. CONCLUSIONS: In spite of fetal lung maturity major neonatal morbidity was observed in our patient population. These data relating neonatal morbidity to gestational age are useful in the critical decision regarding timing of delivery.

Adult↗

PubMed1990

Severe acidosis and subsequent neurologic status.

To examine the relationship between severe acidosis at birth and evidence of subsequent neurologic dysfunction, a 4-year review was performed encompassing 15,528 neonates. One hundred forty-two (0.91%) of these neonates had an umbilical cord arterial pH less than or equal to 7.05 with a base deficit greater than or equal to mEq/L. Neurologic assessments found 101 of 110 term neonates (91.8%) and 17 of 32 preterm neonates (53.1%) with severe acidosis to be free of neurologic deficits at the time of hospital discharge. Follow-up developmental evaluation data were available for 7 of 9 term neonates and 8 of 15 preterm neonates with abnormal examinations. Although 5 term and 6 preterm infants demonstrated mild developmental delays or mild tone abnormalities in the first year of life, none exhibited a major motor or cognitive abnormality at 12 to 24 months of age. Consequently, acidosis in umbilical cord blood, even when severe, is a poor predictor of subsequent neurologic dysfunction.

Acid-Base Equilibrium↗

PubMed1988

Caution in antenatal intervention.

We assessed 18 fetuses who harbored a urinary tract malformation that was diagnosed by antenatal sonography. The antenatal diagnosis corresponded to the postnatal diagnosis in 66 per cent of the cases. We review the course of 6 fetuses who had catheters placed percutaneously to drain dilated urinary tracts that were believed to be caused by posterior urethral valves (5) or an obstructed megaureter (1). Only 2 of these fetuses exhibited valves postnatally. No fetus had any recognized benefit from the antenatal intervention. We found that sonography may not readily differentiate fetuses with hydronephrosis with obstruction from those without obstruction. From this experience we conclude that intervention in pregnancies suspected of harboring a fetus with a malformed urinary tract should be done cautiously. Antenatal sonography is useful to identify the fetus with a dilated urinary tract. This identification permits perinatal specialists to be alerted so that preparations for reconstructive surgery in such cases can be made early postpartum.

Female↗