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Biomedical subjects

W Baerts

Publications and source records attributed to W Baerts.

At least 19 recordsLinked to original sources
PubMed1992

Visual field and grating acuity development in low-risk preterm infants during the first 2 1/2 years after term.

The effect of early visual experience on visual field size and grating acuity development was studied longitudinally in 36 appropriate for gestational age (AGA) and 26 small for gestational age (SGA) low-risk preterm infants. These were selected out of 194 very low birth weight (VLBW) infants (birthweight less than 1500 g) born in 1985 and 1986. Criteria for inclusion as low-risk were the absence of neurological, respiratory, circulatory and alimentary problems in the neonatal period; no retinopathy of prematurity and no evidence of abnormality on the neonatal cranial ultrasound scans. Binocular field sizes were assessed using kinetic arc perimetry. Binocular grating acuity was tested by means of the prototype version of the acuity card procedure. Results were compared with norms obtained in control fullterms in earlier studies. Infants were tested at 6 weeks, 6, 6, 9 and 12 months of age from the expected term date. Twenty-two of these infants were retested at 2 1/2 years of corrected age. Visual field size and visual acuity estimates of (both AGA and SGA) low-risk, VLBW preterms and control fullterms overlapped at all test ages, except for a slight but significantly faster development of the upper and the lower visual field at 6 weeks corrected age in the preterm group. These results indicate that for clinical purposes visual experience before the expected term date has not only no measurable effect on the normal development of behavioural acuity, but also no accelerating effect on the development of peripheral vision.

Child, Preschool↗
PubMed1992

Ophthalmic and cerebral blood flow velocities in preterm infants: influence of ambient lighting conditions.

Doppler ultrasound was used to study ophthalmic and middle cerebral artery flow velocities at different ambient lighting conditions in 28 preterm infants in the first week of life. We found significant increases of ophthalmic and middle cerebral artery blood flow velocities when ambient light was increased from moderate to intense. Flow velocities in the ophthalmic artery increased significantly more than in the middle cerebral artery. Doppler ultrasound studies of ophthalmic blood flow velocity may assist in answering the intriguing question whether light-induced changes of ocular perfusion play a role in the development of retinopathy of prematurity.

Arteries↗
PubMed1992

Streptococcal pharyngitis and epiglottitis in a newborn infant.

We describe a newborn infant with Streptococcus sanguis septicaemia and concomitant upper airway obstruction due to epiglottitis and pharyngitis. This rare infection of the supraglottic region was treated with endotracheal intubation and antibiotics. Full recovery occurred within 4 days.

Ampicillin↗
PubMed1992

Iatrogenic perforation of the lamina cribrosa by nasogastric tube in an infant.

A case of iatrogenic perforation of the lamina cribrosa, followed by intracranial placement of a nasogastric tube in a preterm neonate is described. By routine ultrasound examination of the brain an echogenic structure was seen, which was radiographically diagnosed as a nasogastric tube. The tube was manually removed under antibiotic prophylaxis. No complications were observed. The false route disappeared and long-term follow-up showed no neurological side effects.

Ethmoid Bone↗
PubMed1992

Neonatal cerebral ultrasound, neonatal neurology and perinatal conditions as predictors of neurodevelopmental outcome in very low birthweight infants.

To determine the assessments before discharge from the intensive care unit, that will predict outcome most accurately, a prospective longitudinal study in a cohort of 79 high risk VLBW children was conducted from birth to 3.6 years of age. Birthweight, gestational age, obstetrical and neonatal optimality, neonatal neurological examinations and neonatal cerebral ultrasound were studied in relation to outcome. The best predictor for outcome was a simple cerebral ultrasound classification according to the presence or absence of ventriculomegaly and intraparenchymal damage of any cause. Infants with normal neonatal cerebral scans or abnormal scans without ventriculomegaly almost invariably had a normal neurological outcome. In infants with cerebral lesions with ventriculomegaly the incidence of normal neurological outcome decreased to less than 50%. Intraparenchymal damage was associated with cerebral palsy as well as other (mental and sensori) handicaps in over 85% of the cases. Neonatal neurological examinations at preterm age had additional value in predicting neurological outcome especially in the group with ventriculomegaly. Neither birthweight, nor gestational age, obstetrical or neonatal optimality were independent variables in the prediction of outcome in high risk VLBW children at 3.6 years of age.

Brain↗
PubMed1992

Visual acuity and visual field development after cryocoagulation in infants with retinopathy of prematurity.

Visual development was studied in 10 very-low-birth-weight infants (less than 1500 g) with retinopathy of prematurity (ROP) stage 3+ who had been treated with cryocoagulation in both eyes. Binocular visual acuity (acuity cards method) and binocular visual fields (kinetic perimetry) were assessed repeatedly in the first year of life. At 12 months corrected age, visual acuity was normal in seven and impaired in three infants, who appeared to be severely myopic. Normal visual fields were found in eight infants at this age. The results indicate that cryotherapy in cases of ROP stage 3+ does not interfere with visual acuity development. The effect on visual field development needs further investigation.

Cryosurgery↗
PubMed1992

The effect of heparin in arterial catheters on the coagulation in preterm infants.

The coagulation of 16 healthy preterm infants (control infants) was compared with 15 ventilated preterm infants (study infants) receiving 0.5 ml/hr of a solution containing 5 IU/ml heparin intra-arterially in order to keep a radial artery catheter patent. A venous sample was obtained in both groups, in the study group a sample from the arterial catheter was also taken. Both the heparin dependent (APTT, thrombin time) and the heparin independent coagulation factors (AT-III, Clotting Factors I, II, V and VII) were not different between the venous samples of both groups. The arterial samples showed a significantly elevated APTT and thrombin time compared with venous samples, especially when the heparin level in the sample was higher than 0.1 IU/ml. These elevations are due to heparin in the sample from the arterial line as the venous sample in the same patient did not show any heparin effect. The heparin non-dependent factors were not different between venous and arterial samples. We conclude that a solution containing 5 IU/ml heparin given at a rate of 0.5 ml/hr does not influence coagulation in preterm infants. Determination of heparin independent coagulation factors can be done in both venous samples and samples taken from the arterial catheter, in these arterial samples the heparin dependent factors can be influenced by the heparin present in the catheters.

Blood Coagulation↗
PubMed1991

Relationship between fetal cardiac and extra-cardiac Doppler flow velocity waveforms and neonatal outcome in intrauterine growth retardation.

In a total of 42 consecutive pregnancies with intrauterine growth retardation (IUGR), Doppler velocimetry was related to neonatal outcome as determined by Apgar score at 1 min, umbilical artery acid-base status and PO2, number of nucleated red blood cells (NRBC), duration of ventilatory support, and sonographic appearance of cerebral leukomalacia. Doppler flow velocity waveforms were obtained from the ascending aorta (AO), pulmonary artery (PA), internal carotid artery (ICA) and umbilical artery (UA) at 2-3 day intervals until delivery. At cardiac level the peak systolic velocity (PSV) and time-averaged velocity (AV), and at peripheral level the pulsatility index (PI) was determined. As all Doppler parameters were significantly related to gestational age at birth, gestational age was taken into account in the analysis. There was no relationship between Apgar score, acid-base status and Doppler parameters. Low AVAO was related to a low umbilical artery PO2. Significant correlations were established between PSVPA, AVPA and PIUA, and the duration of neonatal ventilatory support. Infants who died within 22 days after admission to the neonatal intensive care unit (n = 7) displayed a significantly higher PIUA than those who remained alive. The PIUA was also related to the absolute and relative number of NRBCs. No relationship existed between the Doppler parameters and degree of leukomalacia. The present study demonstrates that from all Doppler parameters, the PIUA is most clearly related to neonatal outcome in IUGR.

Acid-Base Equilibrium↗
PubMed1990

[A study of the sequelae of perinatal hypoxia and convulsions in full-term newborn infants].

Perinatal hypoxia may result in neuromotor handicaps. The occurrence of convulsions after perinatal hypoxia is regarded as a bad prognostic sign. Thirty-two full-term babies with perinatal hypoxia were studied retrospectively. Post-hypoxic convulsions were seen in 20 newborns. In 26 out of 29 survivors follow-up assessments were made between 2 months and 2 years of age. Severe neuromotor abnormalities were demonstrated in 10 out of 19 patients with post-hypoxic convulsions, whereas no abnormalities were found in 7 patients without convulsions (p = 0.016, Fisher exact test). Although post-hypoxic convulsions are a bad prognostic sign, a number of infants with convulsions appear to develop normally. Further research on prognostic factors concerning neurodevelopment after perinatal hypoxia and convulsions appears indicated.

Child Development↗
PubMed1990

Cerebral lesions in preterm infants after tocolytic indomethacin.

The incidence and type of cerebral lesions in 159 infants born before 30 weeks gestation were studied, using ultrasound. Indomethacin was given as part of tocolytic management to mothers with a high incidence of early rupture of membranes and preterm labour; and 76 fetuses were exposed to the drug as a result. For the remaining 83 pregnancies, in which there was a high incidence of chronic fetal distress and in utero hypoxia, tocolysis was either not started or limited to fenoterol. The neonatal course was similar for both groups of infants, except that patent ductus arteriosus was less commonly diagnosed in the 76 infants exposed to indomethacin. However, the incidence of periventricular leukomalacia was increased among infants exposed to any tocolytic agent; and cystic lesions occurred more commonly in those exposed to indomethacin.

Administration, Rectal↗
PubMed1989

Effects of very low birth weight (VLBW) on visual development during the first year after term.

Behavioural visual functions were assessed in 155 very low birth weight (VLBW) infants during the first 12 months after expected term. Visual development was examined (mainly cross-sectionally) at 6 weeks, 3, 6, 9, and 12 months of corrected age by assessment of visual acuity, visual fields, optokinetic nystagmus and visual threat response. Many VLBW infants showed visual impairments (54.2%). No single visual function appeared to be specifically susceptible to impairments, deficits were often apparent across a range of functions. Visual impairments were observed at all test ages, and could already be assessed at 6 weeks of corrected age. The highest incidence of visual impairments was scored at 6 months corrected age. Beyond 6 months, less deficits were observed, suggesting in many infants a delayed rather than a permanently impaired visual development. In some infants deficits became evident at a later stage, after an apparently normal initial development. The results suggest that VLBW infants are at risk for impaired visual development.

Humans↗
PubMed1989

Effects of perinatal hypoxia on visual development during the first year of (corrected) age.

Visual development was assessed in 124 infants (112 preterms and 12 fullterms) who had suffered from perinatal hypoxia and in 55 control preterm infants during the first year of corrected age. Using behavioural techniques, visual functions were tested during follow-up visits in the Sophia Children's Hospital. Corrected ages at testing ranged from 3 months to 1 year. During this period, infants with perinatal hypoxia showed more abnormalities in visual functions than preterm control infants. Gestational age at birth did not influence the outcome of visual development after perinatal hypoxia. Most visual impairments were demonstrated at 3 and 6 months of age. All infants with severe neuro-developmental handicaps showed visual deficits, although neuro-developmental abnormalities and visual deficits could be present as isolated phenomena. Ultrasound abnormalities related well with visual dysfunctions. Prospective studies of infants with visual deficits and a history of perinatal hypoxia are indicated.

Asphyxia Neonatorum↗
PubMed1989

[Videodensitometry in echoencephalography of premature infants].

In 22 premature children (12 normal prematures and 10 with brain pathology) echodensity was measured as average grey scale values. For performing the measurements, echoencephalograms were recorded on videotape and analysed by an IBM-AT computer and a high resolution framegrabber. An evident difference of echodensity was measured between normal parenchyma, skull, fresh cerebral haemorrhages and cerebral oedema.

Brain↗
PubMed1988

Outcome of periventricular-intraventricular hemorrhage at 2 years of age in 484 very preterm infants admitted to 6 neonatal intensive care units in The Netherlands.

Of 484 newborn infants with a gestational age of less than 32 weeks and admitted to 6 neonatal intensive care units in the Netherlands, 294 survived and were available for follow-up at the corrected age of two years. The total incidence of impaired neurodevelopmental outcome was 23.1%. Sixty-nine children had a periventricular-intraventricular hemorrhage (PIVH) in the neonatal period: 31 grade I, 21 grade II, 12 grade III, 5 grade IV. Children with grade I and II PIVH had significantly more handicaps than children without PIVH (36.5% vs 17.8%, p less than 0.01). This held even true after the data were adjusted for possible confounding factors (odds ratio [OR] 2.1, confidence interval [1.3, 3.3], p less than 0.01). Children with grade III and IV PIVH had also more handicaps than children without PIVH (52.9% vs 17.8%, p less than 0.001); after adjustment for confounding factors the OR was 3.0, confidence interval [1.6, 5.5], p less than 0.01. The difference between children with grade I and II PIVH and children with grade III and IV PIVH was not significant.

Cerebral Hemorrhage↗
PubMed1988

Brainstem electric response audiometry in preterm infants.

In the Sophia Children's Hospital in Rotterdam 108 preterm infants were examined with Auditory Brainstem Response (ABR). Ears were categorized as 1) normal sensitivity for post-conceptional age (PCA), 2) probably-mild loss of sensitivity, or 3) a moderate to severe loss of sensitivity. All infants showed ABR peaks, so no "deaf" individuals were found. A bilaterally normal sensitivity was found in 61. A probably-mild loss was found in 22 infants and a moderate to severe loss in 21 infants. The type of loss was conductive in 31 and cochlear in 12. A moderate to severe bilateral cochlear loss was found in 2. This is in line with the literature. Of the 43 infants with a (probable) loss 18 were examined again at 3 months corrected age. Only half of the conductive losses had disappeared, the other half was exacerbated. About 2 out of 3 initially moderate to severe losses were confirmed at follow-up. The moderate to severe losses of the cochlear type were all confirmed.

Audiometry, Evoked Response↗
PubMed1987

Reliability of sonography in non-hemorrhagic periventricular leucomalacia.

Sonographic pictures of the brain of 19 newborn infants who died at a mean age of 4.2 days after birth (range 1-23 days) were examined independently by five experienced sonographers. In all infants information on postmortem brain pathology was available. Diagnoses made by the sonographers based on the sonographic pictures were compared with the gross postmortem findings. The results of the study show that except for one infant with a subarachnoid hemorrhage all cerebral hemorrhages were diagnosed accurately by all sonographers. Non-hemorrhagic periventricular leucomalacia (PVL), however, was missed on sonography in 2 of the 3 cases. Surprisingly, PVL was diagnosed on sonography in 1 (8%) to 6 (50%) of 12 infants in which postmortem examination of the brain revealed no PVL. It is concluded that non-hemorrhagic PVL cannot be diagnosed accurately using sonography in the first days of life, if a 5 MHz transducer is used.

Diagnostic Errors↗