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An outbreak of rotavirus-associated neonatal necrotizing enterocolitis.

An outbreak of necrotizing enterocolitis and hemorrhagic gastroenteritis occurred in two nurseries during 25 days in August 1982. Eleven of the 40 patients in these nurseries during that time developed disease (attack rate 27.5%). In seven of the 10 patients with gastrointestinal disease, stool samples tested for human rotavirus were positive by ELISA, whereas in 20 unaffected infants, no stools tested demonstrated HRV (P = 0.0001). Eleven staff members had serologic evidence of recent HRV infection. Comparison of risk factors traditionally associated with the development of NEC between the affected and unaffected infants revealed no significant differences. Rotavirus infection was the only finding that was highly correlated with this epidemic.

Cross Infection↗

Real time ultrasound diagnosis of hemorrhagic pathological conditions in the posterior fossa of preterm infants.

Real time echoencephalography (RTE) was used to diagnose and serially follow intracranial pathological conditions in the posterior fossa of infants with a gestational age of less than 34 weeks. The posterior fossa was studied in four planes (coronal, modified coronal, sagittal, and parasagittal) with a sector scanner equipped with a high frequency transducer that was placed on the fontanelles and the sutures. Hemorrhagic complications were easily differentiated from normal anatomy. RTE diagnosis was confirmed with computed tomographic scans (5 patients) and postmortem examination of the brain (18 infants). RTE is a precise and noninvasive technique to visualize hemorrhagic and other forms of abnormalities in the infratentorial compartment.

Cerebral Hemorrhage↗

Prenatal adrenal hemorrhage confirmed by postnatal surgery.

A case is reported of massive adrenal hemorrhage in a newborn with evidence of bleeding in utero. A large cystic mass noted on prenatal ultrasonography at 20 weeks of gestation was followed by serial examinations until birth at 38 weeks of gestation. Postnatal evaluation included abdominal sonography, diethylenetriaminepentaacetic acid renal scan, voiding cystourethrography and abdominal plain film. Surgical exploration confirmed massive adrenal hemorrhage.

Adrenal Gland Diseases↗

Intestinal obstruction in a neonate with adrenal hemorrhage and renal vein thrombosis.

Adrenal hemorrhage and renal vein thrombosis are two distinct vascular entities encountered in the newborn period. Occasionally, both entities may co-exist in the same patient. A premature infant of a diabetic mother presented with intestinal obstruction secondary to extrinsic compression by the mass effect of the enlarged hemorrhagic adrenal and thrombosed kidney on the left hemicolon, a phenomenon which to our knowledge has not previously been described.

Adrenal Gland Diseases↗

Neonatal retinal hemorrhages and influence of perinatal factors.

We studied fundus oculi in 234 newborns, divided into two groups of mothers and neonates with or without disease. The overall frequency or retinal hemorrhages was 30.3% (71 neonates). In each group, we studied the association between retinal hemorrhage and several variables of labor and the newborn infant. Statistically significant differences were found in the incidence of hemorrhage in one (2.6%) neonate born by cesarean section, as compared with 61 (38%) spontaneous or 9 (25%) forceps delivery.

Birth Injuries↗

Haemorrhagic infarction of the myocardium in a newborn with haemoglobin H disease and erythroblastosis.

Extensive haemorrhagic myocardial infarction developed in a newborn, apparently as a result of anoxia due to erythroblastosis fetalis, associated with haemoglobin H disease. Acute massive myocardial infarction in the neonatal period is rare and usually is associated with congenital malformation of the heart or its blood supply. Neonatal myocardial infarction in the anatomically normal heart with normal coronary vessels, has been described in only 8 patients (1). The communication describes a newborn with acute haemorrhagic myocardial infarction due to anoxia believed to be caused by the combined effect of erythroblastosis fetalis and haemoglobin H disease.

Erythroblastosis, Fetal↗

[Winckel's disease].

Explore the source record for details and available documents.

Amniotic Fluid↗

The maternal and neonatal outcome of triplet gestations.

OBJECTIVE: Our purpose was to determine the contemporary maternal and neonatal outcome of triplet gestations. STUDY DESIGN: A retrospective review of 57 triplet deliveries between April 1, 1989, and July 31, 1994, was performed. RESULTS: The mean gestational age at delivery was 33.0 +/- 2.7 weeks, and the mean birth weight was 1820 +/- 513 gm. The most common maternal complications were preterm labor (86.0%), anemia (58.1%), preeclampsia (33.3%), preterm premature rupture of the membranes (17.5%), postpartum hemorrhage (12.3%), and HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome (10.5%). Neonatal complications included hyaline membrane disease (29.6%), transient tachypnea of the newborn (20.1%), intraventricular hemorrhage (7.7%), and major congenital anomalies (7.1%). The perinatal mortality was 41 per 1000. Birth order had no significant effect on the incidence of neonatal complications. CONCLUSION: Perinatal mortality rates have improved in recent years but remain higher than for singleton gestations. Despite increasing experience with triplets, the rate of maternal complications is high.

Female↗

The influence of route of delivery and hyaline membranes on the risk of neonatal intracranial hemorrhages.

The relationship of route of delivery and hyaline membranes to eight sites of intracranial hemorrhage was evaluated in 513 autopsied newborn infants. Those delivered by cesarian section appeared to be at less risk for most hemorrhages compared with newborns delivered vaginally. However, the reductions in risk were small and did not achieve nominal levels of statistical significance. Thus, "birth trauma" probably contributes little to the risk of most neonatal intracranial hemorrhages. Newborns who developed hyaline membranes appeared to be at greater risk for most hemorrhages than those who did not, particularly if the infant had been delivered by cesarian section. This was especially marked for subarachnoid and germinal matrix hemorrhage.

Cerebral Hemorrhage↗