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Biomedical subjects

V Y Yu

Publications and source records attributed to V Y Yu.

At least 91 records · Page 5Linked to original sources
PubMed1984

Outcome of very low birthweight infants who required prolonged hospitalization.

Over a 4 year study period, 294 infants with a birthweight less than or equal to 1500 g survived their initial hospitalization; 103 (35%) were discharged after a gestational age of 40 weeks. The postdischarge infant mortality was significantly higher in those with prolonged initial hospitalization compared with the remaining survivors (6% vs 1%). During the first 2 years, significant infections were found in 66% and rehospitalization in 54% of the children who had prolonged initial hospitalization. At 2 years, 34% were below the 10th centile for weight as were 39% for height; head circumferences were normal. Major disability (27% vs 15%) and developmental delay (13% vs 4%) were significantly more common in survivors with prolonged initial hospitalization compared with the remaining survivors. The study demonstrated the continuing toll of perinatal morbidity among very low birthweight infants who required prolonged hospitalization and emphasized the need for comprehensive medical and social support, not only during their initial hospitalization, but also after discharge.

Australia↗
PubMed1984

Effect of mode of delivery on outcome of very-low-birthweight infants.

The hospital survival rate was 47% in 111 inborn infants who weighed 501-1000 g and 90% in 211 who weighed 1001-1500 g. The survival rate after caesarean birth was significantly higher than that after vaginal delivery in the 1001-1500 g group but not in the 501-1000 g group. At 2 years of age, 73% of survivors born at 501-1000 g and 85% of those born at 1001-1500 g had no neurological or developmental disability; no significant difference was found between caesarean and vaginal births. The mode of delivery did not significantly affect survival or late outcome of the 192 singleton infants with cephalic presentation. Although the survival rate was not significantly different between infants with breech and cephalic presentations, the former had a significantly higher disability rate. Within the group of 72 singleton infants with breech presentation, the survival rate after caesarean birth was significantly higher than after vaginal delivery in the 1001-1500 g group but not in the 501-1000 g group. No significant difference in late outcome was found between caesarean and vaginal births in this subgroup.

Breech Presentation↗
PubMed1984

Survival and 2-year outcome of extremely preterm infants.

The survival of 163 infants born within the hospital at 24-28 weeks gestation during a 4 1/2-year period and the morbidity in survivors at 2 years of age were reported. Hospital survival rates from 24-28 weeks at each week of gestation, excluding six infants with birth defects, were 36%, 32%, 57%, 70% and 74% respectively. The late outcome of children born at 24-26 weeks was compared with those born at 27-28 weeks. Of the 81 infants in the former group 46 (57%) died, nine (11%) survived with significant functional handicap and 26 (32%) were developing within the normal range. Of the 82 infants in the latter group, 28 (34%) died, eight (10%) survived with significant functional handicap and 46 (56%) were developing within the normal range. Although the mortality rate was significantly higher in the 24-26-weeks group, the physical disability and functional handicap rates in survivors were not statistically different between the two groups. Neither was developmental progress, as determined by psychological assessment, different.

Child Development↗
PubMed1984

Antecedents of periventricular haemorrhage in infants weighing 1250 g or less at birth.

Fifty infants who weighed 1250 g or less at birth were studied with serial real time cerebral ultrasound to evaluate the temporal relation of various perinatal factors to the onset and progression of periventricular haemorrhage (PVH). The significant antecedents of PVH were severe bruising at birth, low birthweight, short gestation, ratio of arterial oxygen pressure (PaO2) to fractional inspired oxygen (FiO2), and haematocrit on admission, hyaline membrane disease, assisted ventilation, pneumothorax, administration of tubocurarine, hypercapnia, hypoxaemia, and hypotension. Case control studies, in which infants with PVH at 26 weeks' and 28 weeks' gestation were compared with matched infants without PVH, confirmed that the antecedents identified were independent of gestational influences. A multivariate discriminant analysis for the antecedents of PVH showed that hyaline membrane disease, hypercapnia, and short gestation correctly classified presence or absence of PVH in 78% of the study group. A similar analysis comparing infants with germinal layer haemorrhage or intraventricular haemorrhage with those who developed intracerebral extension of haemorrhage showed that three factors found on admission (hypothermia, a low PaO2:FiO2 ratio, and severe bruising) combined to classify correctly 90% of the haemorrhages. Our data suggest that prevention of perinatal trauma and asphyxia as well as respiratory illness, especially hyaline membrane disease, and stabilisation of blood gas tensions, blood pressure, and haematocrit within the physiological range, are likely to be the most effective ways of preventing PVH in extremely preterm infants.

Birth Injuries↗
PubMed1984

Timing and evolution of periventricular haemorrhage in infants weighing 1250 g or less at birth.

The brains of 50 consecutively admitted infants who weighed 1250 g or less at birth were examined with real time ultrasound. Of 30 (60%) who had periventricular haemorrhage (PVH), 19 (63%) bled on the first day and 17 (57%) showed extension of the initial haemorrhage on serial scans. The median age was 16 hours when PVH was first detected and 48 hours when PVH reached its maximum extent. Ventricular size at birth correlated with gestation. Progressive ventricular growth was seen after birth in infants both with and without PVH. Charts of normal ranges of ventricular size and head circumference were drawn up from birth to 10 weeks of age. All infants with PVH showed a transient increase in ventricular size at 2 weeks of age but most returned to normal by 6 weeks of age. Ventricular dilatation after PVH that was greater than the 95th centile for this population developed in 5 (31%) of 16 survivors, four of whom subsequently developed hydrocephalus, although none required ventriculo peritoneal shunting. The optimal timing for diagnosis with ultrasound is at the end of the first week for PVH and the second to third week for ventricular dilatation.

Age Factors↗
PubMed1984

Neonatal and postneonatal mortality in very low birthweight infants.

We reviewed 388 very low birthweight infants admitted to this neonatal intensive care unit over a four year period to determine the pattern of neonatal and postneonatal deaths up to age 2 years. Neonatal mortality is no longer an adequate indicator of outcome because deaths arising from perinatal events occur after the first month of life.

Australia↗
PubMed1984

Perinatal risk factors for necrotizing enterocolitis.

The perinatal histories of 50 very low birthweight infants weighing 1500 g, or less, with necrotizing enterocolitis were compared with those of the remaining 325 very low birthweight infants who were admitted to this hospital during a four year study period. Many factors previously reported to be associated with necrotizing enterocolitis were found with equal frequency in both groups of babies. The only adverse factor which was more frequently present in patients with necrotizing enterocolitis was hypothermia on admission to hospital. Those infants who developed severe necrotizing enterocolitis also had a higher incidence of polycythaemia. A further controlled study which examined feeding practices showed that the timing, type, and volume of milk feeding were not different in infants with necrotizing enterocolitis and matched controls. Prematurity is clearly the greatest risk factor which predisposes to the development of necrotizing enterocolitis and most of the factors previously implicated in the aetiology may simply represent the descriptive characteristics of a population of sick, very low birthweight infants.

Animals↗
PubMed1984

Ultrasound and necropsy study of periventricular haemorrhage in preterm infants.

The diagnostic accuracy of cerebral ultrasound for periventricular haemorrhage was determined by comparing this with necropsy findings in 30 preterm neonates of 30 weeks' gestation or less and birthweight under 1500 g. Ultrasound gave an accurate diagnosis of 85% in infants with germinal layer haemorrhage, 92% in intraventricular haemorrhage, and 97% in intracerebral haemorrhage. False positive errors were caused by vascular congestion; false negative errors occurred when the maximum dimension of haemorrhage was less than 3 mm. Cerebral ultrasound gave a diagnostic accuracy of 63% for periventricular leucomalacia. False negative errors occurred when periventricular leucomalacia was microscopic or when it was out of range of the scanner. The maximum width of the germinal layer was measured in 77 neonates of gestational age 23 to 36 weeks who died and had no periventricular haemorrhage at necropsy. The progressive involution of the germinal layer with increasing gestational age paralleled the steady decrease in incidence of periventricular haemorrhage diagnosed over the same gestational age range. Neonates of the youngest gestational age who had the most extensive germinal layers also had the highest risk for periventricular haemorrhage.

Cerebral Hemorrhage↗
PubMed1983

Provision of perinatal services and survival of extremely low birthweight infants in Victoria.

The transfer of at-risk mothers to one of the three Level III maternity hospitals in Victoria has been promoted since 1975; since 1978, the Newborn Emergency Transport Service has been available throughout the State for the transport of infants to the four Level III neonatal units. By means of data from multiple sources, we ascertained the one-year survival of infants with birthweights of between 500 g and 999 g born in Victoria between 1978 and 1981. Of 711 live-born infants, 227 (31.9%) survived 28 days and 210 (29.5%) lived to at least one year of age; of 490 infants born in the Level III maternity units, 156 (31.8%) lived. There were 54 (24.4%) survivors among the 221 infants born elsewhere; all these survivors were included in the group of 105 babies who had been transferred after birth to Level III neonatal units. Although only 25.5% of all births for the State occurred in the Level III maternity hospitals, 69% of all infants who weighed between 500 g and 999 g at birth were delivered in these hospitals. The transfer of the mother or the new born baby to a Level III unit was possible in an additional 48 cases. Although survival rates from Level III hospitals may possibly improve in the future, the shortage of ventilator beds remains a practical obstacle.

Australia↗
PubMed1983

Collaborative study of very-low-birth-weight infants. Correlation of handicap with risk factors.

Two large maternity services studied consecutive inborn infants (birth weight range, 500 to 1,500 g) born between 1977 and 1978. The multidisciplinary team members used identical assessment methods and documentation. Of 259 long-term survivors, 252 (97.3%) were seen at 2 years of age. Survival rates for hospitals 1 and 2 were 68.5% and 69.0%, respectively. Cerebral palsy rates for hospitals 1 and 2 were 11.8% and 11.2%, respectively. Major handicaps (cerebral palsy, mental developmental index [MDI] on the Bayley scales less than 69, epilepsy, deafness, or blindness) occurred in 30 (18.6%) and 17 (17.3%) of hospitals 1 and 2 survivors, respectively. Both cerebral palsy and developmental delay (MDI below 75 without severe or moderate cerebral palsy) were significantly correlated with a number of perinatal variables, but none were common to the two hospitals. Of the 30 children with cerebral palsy, 15 (50%) were not ventilated, and 28 (93%) had a five-minute Apgar score greater than 4; there was no indication that selective treatment to prevent cerebral palsy was possible.

Blindness↗
PubMed1983

Bronchopulmonary dysplasia in very low birthweight infants.

Twenty-four (6%) of 375 infants with birthweights less than or equal to 1500g developed bronchopulmonary dysplasia (BPD); 16 (15%) of 107 in those less than or equal to 100g and 8 (3%) of 268 in those greater than 1000g. The incidence was 10% in those who required assisted ventilation. Perinatal asphyxia, significant respiratory distress, pulmonary interstitial emphysema and patent ductus arteriosus were statistically more common in BPD infants compared with the remaining 351 very low birthweight infants. Hyaline membrane disease was the primary respiratory disease in 54% of BPD infants. The mean durations of oxygen and ventilatory therapy were 68 days and 37 days respectively. Twenty-nine percent did not require more than 60% oxygen for over 24 hours. Only 38% required a peak airway pressure of over 30 cmH2O. Early postnatal growth was satisfactory on parenteral nutrition support. No perinatal factor was found to be predictive of death from BPD. The prolonged duration of hospital treatment has obvious implications to the psychosocial and economic costs of BPD.

Bronchopulmonary Dysplasia↗
PubMed1983

Determinants of developmental performance of very low-birthweight survivors at one and two years of age.

The developmental outcome of 61 very low-birthweight infants was studied prospectively by means of the Bayley Scales of Infant Development at one and two years of age, corrected for prematurity. Preliminary analysis revealed that the mean scores for mental and psychomotor development were within the normal limits at both testing occasions. However, further analysis showed that there was a significant decrease in mental development scores from one to two years of age, due primarily to an increase in the numbers of low-scoring children with 'hyperactive' behaviour at two years. Separate subgroups of children with suboptimal mental and psychomotor development scores were characterised at both testing occasions by the presence of 'hyperactive' behaviour and disability, usually of a minor degree. The presence of hyperactivity, disability and lowered mental performance may help in the early identification of children at increased developmental risk.

Child Development↗
PubMed1983

Growth and development of very low birthweight infants recovering from bronchopulmonary dysplasia.

Twenty four infants with birthweights less than or equal to 1500 g had bronchopulmonary dysplasia (BPD). Four died in the neonatal period and four in the postneonatal period-one had been discharged and was aged one year. Sixteen (67%) survived long term and were followed up until they were two years old. Common medical conditions included respiratory illnesses in 14 (88%) children and otitis media in 8 (50%). Eleven (69%) required hospital admission for an average of 5 times; total days in hospital averaged 27 days. The most common reasons for admission were bronchiolitis and bronchopneumonia. At two years 37% were below the 10th centile for weight, as were 25% for height: head circumferences were normal. Two children had cerebral palsy, two had developmental delay, two had multiple disabilities, and one had sensorineural deafness. Of the 24 BPD infants, 8 (33%) died, 7 (29%) survived with a disability (severe in one), and 9 (38%) had a normal neurodevelopmental outcome. From the available perinatal data it was not possible to predict late disabilities in BPD survivors.

Blindness↗
PubMed1983

Computerised nutritional data management in neonatal intensive care.

We report a minicomputer based recording, reporting, and research system for patient data management in the neonatal intensive care unit (NICU). It is moderately priced, transportable, and independent of a central computer. It requires only a desk top and standard power supply, and successfully meets the medical documentation, communication, and research needs of the NICU. The first phase of programme development has enabled us to process growth and nutritional data from infants on complex parenteral and enteral nutrition. The system is well suited to medical users and provides a practical interactive data management system with many potential applications in the NICU.

Australia↗
PubMed1982

Collaborative study of very-low-birthweight infants: Techniques of perinatal care and mortality.

The neonatal units in two large maternity hospitals collaborated in a study of 440 liveborn infants weighting 500-1500 g born in 1977 and 1978: 377 (85.7%) were born in hospital. The overall survival rate was 70.5%, with a range of 67.5% to 71.5% for the inborn and outborn categories of infants in each hospital. In hospital A the survival rate of infants weighing greater than or equal to 1100 g was higher than that in hospital b, whereas the survival rate of infants weighing less than 800 g was higher in hospital B. Obstetric risk factors and obstetric management differed little between the hospitals, but there were several important differences in paediatric management; in particular, hospital B (with a better survival rate of infants weighing under 800 g) used ventilatory support and parenteral feeding much more frequently.

Australia↗
PubMed1982

Clinical features of eight pregnancies resulting from in vitro fertilization and embryo transfer.

In vitro fertilization (IVF) and embryo transfer (ET) have resulted in the birth of nine babies, including twins. One of the twins had a congenital cardiac malformation and seven of the nine babies were girls. Labor occurred preterm in two pregnancies; and in six delivery was by cesarean section. Plasma human chorionic gonadotropin (hCG), progesterone (P), and estriol (E3) measurements and ultrasonic scans showed no obvious differences from pregnancies resulting from natural conception. Cytogenetic studies from cord blood and histologic examination of the placentas were unremarkable. The theoretic risks of pregnancy following IVF and ET are discussed. Definite conclusions cannot be drawn until a large number of babies are delivered and a long-term follow-up is completed. Initial results from the current small sample are encouraging.

Adult↗