PubMed HealthSearch

Biomedical subjects

V Y Yu

Publications and source records attributed to V Y Yu.

At least 109 records · Page 6Linked to original sources

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

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

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

Infants born before 29 weeks gestation: survival and morbidity at 2 years of age.

In a collaborative study involving two hospitals with large maternity services, 166 liveborn infants of gestational age from 24 to 28 weeks were born in the calendar years 1977 and 1978. Of these infants, 75 (45.2%) died either in hospital or after discharge home. At the age of 2 years, 16 (9.6%) of the cohort had a major handicap [cerebral palsy, Mental Developmental Index (MDI) under 69, deafness or blindness]. An additional 20 children (12.0%) had significant developmental delay (MDI 69 to 84, -2 to -1 SD below mean) and 53 (31.9%) were considered to be free of these handicaps. Psychological assessments were not performed on two survivors (1.2%) but reliable reports indicated that they were free of major handicaps. Long-term survival increased in a stepwise fashion from 9.1% at 24 weeks to 68.5% at 28 weeks gestation, and there was a trend for major handicap and significant developmental delay to decrease in incidence with increasing maturity. Of the 58 children who had presented by the vertex 42 (72.4%) were free of significant handicap; however, of the 31 children in whom there had been either a breech presentation or a transverse lie, only 11 (35.5%) were free of significant handicap (chi 2 = 9.69, P less than 0.01). The mode of delivery (vaginal or caesarean section) did not significantly affect the handicap rate in the survivors.

Australia

Early development of infants 1000 g or less at birth.

In a 4-year period the neonatal survival rate for 26 infants weighing 501-750 g was 42% and for 81 infants weighing 751-1000 g it was 61%. All 59 surviving infants have been assessed at follow-up; 39 were at least 2 years old (corrected for prematurity) and data from the remaining 20 were derived from assessment at 1 year corrected age. Five children had cerebral palsy, 4 had multiple handicaps, 4 each had a sensory handicap, 2 had developmental delay, and 1 had a dilated right ventricle without clinical hydrocephalus. Twelve of the 16 children with defined handicaps were considered to have significant functional handicaps. Therefore, of the 107 infants in this series, 48 (45%) died, 12 (11%) survived with significant functional handicaps, and 47 (44%) were considered to be developing within the normal range. No significant differences in the incidence of handicap were observed between inborn and outborn children, boys or girls, those who were small or appropriate for gestation, those who weighed less than or equal to 750 g or greater than 750 g at birth, and those who required or did not require prolonged oxygen or ventilation.

Child Development

Determinants of stress for staff in a neonatal intensive care unit.

Components of stress for 22 paediatric consultants and 29 nursing sisters working in neonatal intensive care units were studied. Ten situations were rated for their intensity of stress and their frequency of occurrence. For intensity of stress, significantly more paediatric consultants rated the competing demands of personal life versus work as highly stressful, than did nursing sisters. For frequency of stress, significantly more paediatric consultants rated 4 situations as frequently occurring than did nursing sisters (priorities of care, understaffing/overwork, personal life versus work, condition of outborn infants). However, significantly more nursing sisters found problems in working with their peers a frequently occurring stress than paediatric consultants. Total scores calculated for intensity and frequency of stress showed that although the overall intensity of stress experienced was similar, paediatric consultants had a significantly higher mean score for frequency of stress than nursing sisters in the neonatal intensive care unit.

Australia

Retrolental fibroplasia--controlled study of 4 years' experience in a neonatal intensive care unit.

During the 4 years 1977-80, 14 infants developed retrolental fibroplasia (RLF) in the neonatal unit at this medical centre. All were very low birthweight (VLBW) infants who weighed 1500 g or less at birth. The incidence of RLF was 3.5% for all VLBW infants admitted for neonatal intensive care and 4.7% for VLBW survivors. The mean birthweight of the affected infants was 970 (range 730-1310) g and mean gestational age 26 (range 24-29) weeks. Seven of the affected infants (2.4% of VLBW survivors) had significant scarring with temporal dragging of the optic disc and retinal detachment. Each of the 14 infants was matched with 2 control infants in order to see whether any factors predisposing to the development of RLF, including those related to oxygen therapy and monitoring, could be identified. The only factor associated with RLF was a higher volume of blood given with replacement transfusions. The occurrence of RLF was unrelated to an increase in requirement for or duration of oxygen therapy, arterial oxygen tensions as determined by intermittent sampling, or the availability of transcutaneous oxygen monitoring. The care taken in oxygen therapy may have been responsible for failure to show a quantitative association between hyperoxaemia and RLF. Although the problem of oxygen therapy in preterm infants is far from being resolved, current neonatal intensive care methods have limited the occurrence of RLF to VLBW infants. This study demonstrated a lower incidence of RLF in VLBW infants despite an improved survival rate compared with that previously reported.

Humans

Nonimmunologic hydrops fetalis: a review of 61 cases.

Sixty-one cases of nonimmunologic hydrops fetalis were studied. The incidence of nonimmunologic hydrops fetalis, 1 in 3748 births, was unchanged in 2 decades. The mortality from nonimmunologic hydrops fetalis remained high (98%). Polyhydramnios (75%), anemia (45%), and preeclampsia (29%) were the commonest prenatal maternal complications, whereas postpartum hemorrhage or difficulty with placental delivery, or both, occurred in 64%. Ultrasound examination always was successful in detecting the hydropic state. Many presumed etiologic factors were noted, although in 38% no possible cause was found. A major congenital anomaly was present in 41%. The obstetric and neonatal care of nonimmunologic hydrops fetalis must be improved. If nonimmunologic hydrops fetalis is diagnosed during the investigation of polyhydramnios, consideration should be given to early delivery in the interest of the fetus.

Edema

Hospital referrals of home births in the intrapartum and postpartum periods.

Twenty home birth patients referred for hospital management were reviewed. Eleven mothers were referred in labour and nine infants in the first week after birth. The clinical presentation and neonatal outcome are described. The majority had antenatal factors suggesting increased perinatal risk. Careful patient selection, prompt detection and early referral of complications, and adequate facilities for infant resuscitation should minimise the risks of home birth. More research is required on the population requesting home birth and its outcome.

Adolescent

Parents' reactions to unrestricted parental contact with infants in the intensive care nursery.

In order to determine parental attitudes and reactions to a policy in which the quality and quantity of parental contact with their preterm or critically-ill infants in the intensive care nursery were determined by the parents, 20 parental pairs were studied regarding their pattern of involvement with their infants, the emotional stress which they experienced, and their responses to the nursery environment during the first fortnight after their infants' birth. This study demonstrated that early and extended parent-infant contact was possible for infants admitted to the intensive care nursery. Both parents chose to maintain a high level of involvement with their infants despite the associated anxiety and anticipatory grief experienced during this period. All felt more reassured with repeated visits, and most believed their infants also felt more loved and secure with the increased contact. The majority would have been opposed to restricted visiting hours and restricted contact with their infants. An open visiting policy and an organized parental-care programme is an important component of neonatal intensive care, since every preterm or critically-ill infant has a family whose psychosocial needs must be recognized and supported.

Attitude