[Care of premature infants and nursing--lessons from premature infant care: based on records of clinical training in premature infant care for midwifery students].
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Humans↗
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The mechanical properties of prematurely and non--prematurely ruptured membranes. Methods and preliminary results.
The mechanical properties of the chorioamniotic membranes have been studied by several investigators over the past 100 years. No relationship between membrane strength, as measured by rupture tension, and premature or non-premature rupture of the membranes has been demonstrable. In the present study, several measures of the mechanical properties of the chorioamniotic membranes were examined. These included thickness, rupture tension, work to rupture, strain to rupture, and moduli of elasticity (Young). Prematurely and non-prematurely ruptured membranes differed with respect to thickness near the rupture site and Young's modulus near the placenta. Differences between the groups for the other parameters were not significant. This study suggests that there may be inherent differences between membranes which rupture prematurely and those which do not.
Biomechanical Phenomena↗
[Clinical problems of premature labor. 1. Diagnosis of threatening premature labor and the screening procedure].
At first the allround etiology of premature birth is explained in the paper. There are to distinguish three groups: 1. Causes with known etiologic mechanism. 2. Causes with partly known etiologic mechanism. 3. Dispositions for premature birth. These are concluded from statistically investigations. In the last group are collected the patients from which are established some known scores for diagnosis of the risk of premature birth. All the scores but have a detriment. If they want to detect about 90% from premature births one must carry out examination and observation about 40% from all pregnant women. For this the scores are not suitable for selection of patients to observe in a special consultation. The organised care for pregnant women must be in such a way that all the criterias of imminent prematurity will be detected. This way has been successfull in our hospital.
Adolescent↗
[Premature rupture of fetal membranes and premature labor].
The portion of early rupture of the membranes among 521 premature births from 1962 to 1971 was 43.4%. The statistically sure effects of the early rupture of the fetal membranes to some irregularities in pregnancy and delivery on 214 premature births are reported, compared with 202 premature births without early rupture of the membranes. Twins are not considered. The therapeutic management of that time in the hospital consisted of staying in bed without tokolytics or antibiotics. After premature rupture of fetal membranes occured very often: irregular obstetrical presentation, hemorrhage and fever during labour, cesarean section and forceps delivery; the perinatal morbidity was increased. From that aspects for prophylaxis and therapy were deduced.
Amniocentesis↗
[Clinical studies on imipenem/cilastatin sodium in the early therapy of preterm premature rupture of the membrane or threatened abortion and premature delivery].
The efficacy and safety of early therapy with imipenem/cilastatin sodium (IPM/CS) were studied in patients who had chorioamnionitis with preterm PROM or threatened abortion and premature delivery. The following results were obtained. 1. The clinical efficacy of IPM/CS administered by intravenous drip infusion at daily dosages of 1 to 2 g as concurrent treatment with antiuteronics (ritodrine hydrochloride or terbutaline sulfate) was studied in patients with threatened abortion and premature delivery in the 11th to 34th week of pregnancy (n = 9), or premature PROM in the 23rd to 36th week (n = 9). 2. Response to IPM/CS were good in all of the patients with threatened abortion and premature delivery. Latent periods were prolonged for more than 7 days in 44.4% (4/9) of the patients with preterm PROM. 3. Changes in elastase appeared to be significant as those in CRP for inflammatory markers. 4. These findings combined with our previous results indicate that treatment of preterm PROM before the 32nd of pregnancy prolongs the latent period.
Abortion, Threatened↗
Haemophilus influenzae amnionitis associated with prematurity and premature membrane rupture.
Prematurity and premature rupture of the membranes present major obstetric problems. When associated with amnionitis, the result may be disastrous. A case of Haemophilus influenzae aminionitis in association with premature rupture of the membranes is presented. The rarity of this organism as a causative agent in amnionitis and its possible causative role in premature membrane rupture are considered in review of the scant relevant literature.
Adult↗
Erythropoietic progenitor cells from premature neonates studied using a validated serum-deprived medium. Evidence that peripheral blood BFU-E from premature neonates are increased in number and are highly dependent upon burst promoting activity for in vitro growth.
We have examined a serum-deprived culture system in order to verify that it is suitable for the study of burst forming unit erythroid (BFU-E) progenitor cells from premature neonates. Optimum growth of BFU-E from premature neonates was observed with each media constituent using the same concentration as that previously described for adult subjects. Growth of immature BFU-E from premature neonates were highly dependent upon a source of Burst Promoting Activity and mature BFU-E derived colonies emerged at day 12 compared to day 14 in adults. Our preliminary results with the validated medium suggest that premature infants have increased peripheral blood concentrations of BFU-E compared to healthy adult controls.
Adult↗
[Investigations on the utilization of parenterally administered amino acids by premature and small-for-dates neonates. I. Free amino acids in the blood of premature and small-for dates neonates (author's transl)].
The fasting levels of free amino acids were determined in the serum of 23 premature and 7 small-for-dates newborns during the first 4 weeks of life. This was done by ion-exchange chromatography after ultrafiltration of the serum, which allowed quantification. Differences were recognized in regards to age, and nutritional state: 1. Small-for-dates newborns at term showed significantly lower asparagine and glycine levels when compared to hypotrophic prematures. 2. Leucine was lower in male than in female prematures. 3. Leucine and phenylalanine were lower in hypotrophic than in eutrophic prematures. 4. Nearly all investigated fasting amino acid levels were highest in the 3rd week of life. A decrease was observed during the 4th week of life. Threonine, Proline, Alanine, Valine, Isoleucine, Lysine and Arginine were significantly higher in the 3rd compared to the 1st week.
Age Factors↗
Clinical use of the LH-RH in assessing gonadotropic reserve in children with idiopathic precocious puberty, premature thelarche and premature adrenarche.
Serum LH and FSH were assayed in 31 girls with normal pre puberty, precocious puberty, premature thelarche, and premature adrenarche, aged 2 to 9 years. The effect of synthetic luteinizing hormone-releasing hormone (LH-RH) on serum gonadotropins was evaluated in eleven of them. In all girls with precocious puberty, serum LH was increased up to high levels. The mean releasable LH in two girls with idiopathic precocious puberty was significantly greater than in normal prepubertal or pubertal children. Basal FSH in children with precocious puberty was within the limits of normal prepuberal children, and FSH secretion in response to LH-RH was not significantly greater than in the group of normal prepubertal and pubertal girls. In children with premature thelarche and premature adrenarche, basal levels of LH and FSH, as well as gonadotropin response to LH-RH were in the prepubertal range. These preliminary results show that the LH-RH test might be of clinical value in differenitating abnormal puberal development.
Age Factors↗
Ocular cosmesis in retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group.
We report the externally apparent outcome in the natural history cohort (n = 4099) that was followed up prospectively in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity. The overall incidence of an adverse cosmetic outcome in the survivors who were examined 12 months post term (n = 2759) was 15.1%. Adverse cosmetic outcomes included strabismus (12.8%), nystagmus (3.3%), total retrolental membrane (1%), epiphora (0.6%), corneal opacity (0.6%), cataract (0.3%), and episcleral hyperemia (0.3%). A comparable subgroup examined 24 months post term showed strabismus (14.4%), nystagmus (2.2%), epiphora (0.5%), corneal opacity (0.7%), cataract (0.5%), episcleral hyperemia (0.5%), lid fissure asymmetry (2.4%), and corneal diameter asymmetry (2.0%). The rate of adverse aesthetic outcome was greatest in eyes that had developed more severe acute retinopathy of prematurity and an unfavorable structural outcome. In patients with bilateral threshold retinopathy of prematurity who underwent no therapeutic ocular procedures, other than randomized assignment to undergo cryotherapy in one eye, more frequent adverse cosmetic outcomes were found in the untreated eyes.
Acute Disease↗
A randomized placebo-controlled trial of erythromycin for the treatment of Ureaplasma urealyticum to prevent premature delivery. The Vaginal Infections and Prematurity Study Group.
Ureaplasma urealyticum has been associated with low birth weight and histologic chorioamnionitis and it is a frequent isolate from the chorioamnion of patients who are delivered prematurely. In prior clinical trials using antibiotics active against U. urealyticum, antibiotic treatment was associated with reduced prematurity and increased mean birth weight. In this multicenter, randomized, double-blind clinical trial, pregnant women with U. urealyticum were treated with 333 mg of erythromycin base or placebo three times daily, starting between 26 and 30 weeks' gestation and continuing through 35 completed weeks of pregnancy. Women with urinary tract infection or Neisseria gonorrhoeae infection were excluded from the trial, and women with Chlamydia trachomatis or group B streptococci were excluded from these analyses. Erythromycin did not eliminate U. urealyticum from the lower genital tract. There were no significant differences between erythromycin- and placebo-treated women in infant birth weight or gestational age at delivery, in frequency of premature rupture of membranes, or in neonatal outcome.
Adult↗
[Premature rupture of the membranes and RDS incidence in prematures (author's transl)].
In the years 1974, 1975 and 1976 495 children were born alive with a birthweight less than 2500 g in the Ist Department of Gynecology and Obstetrics of the University of Vienna. We selected all cases with dystrophy or factors, which were a disposal for RDS, so we got a rest of 188 prematures with a weight from 1000 g to 2500 g. For these children we checked the influence of time of rupture of the membranes (ROM) before delivery to the incidence of RDS. We found a lower incidence of RDS of the newborns when duration of ROM exceeded the time of 12 hours. This fact was statistically significant in the class of premature newborns with a weight of 1500 g to 2000 g. The similar trend was found in 119 dystrophic newborns with a weight between 1000 g to 2500 g, although there was no statistical significance. No influence of duration of labor on the incidence of RDS neither in selected premature nor dystrophic newborns was found.
Birth Weight↗
Fetal lung maturity. I. Mode of onset of premature labor. Influence of premature rupture of the membranes.
In a prospective study of 133 spontaneous premature deliveries the relation between premature rupture of the membranes (PRM) and development of respiratory distress syndrome (RDS) in newborn infants is examined. PRM is associated with a significantly decreased incidence of RDS in newborn infants (P less than 0.002). This relation is valid at a gestational age of 28 weeks or more and a birthweight greater than 1000 g. Total respiratory morbidity in newborn infants (transient tachypnea + RDS) is also significantly decreased when labor is associated with PRM (P less than 0.005). Assessment of the influences of sex of the infant, fetal asphyxia, and delivery by cesarian section shows that PRM bears a stronger relation than each of these individual factors to a decreased incidence of RDS. Duration of the latent period has no influence on protection from RDS, and it is suggested that fetal lung maturity occurs before the membranes rupture.
Birth Weight↗
[Relationship between premature labor and maternal age, as well as between premature labor and parity].
Various publications of the last years and own studies, too demonstrate that birth rank and maternal age, as well, in each case independently influence the risk of prematurity. The rate of prematurity for primiparous and multiparous women is above the average; it is just the same for very young and comparatively old women. Basing on a review of literature eventual causes are briefly discussed.
Female↗
The correlation of visual function with posterior retinal structure in severe retinopathy of prematurity. Cryotherapy for Retinopathy of Prematurity Cooperative Group.
The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity previously reported reduced incidence of both poor structural and functional outcomes after cryotherapy. We compared the results in 304 eyes of patients in the randomized portion of the trial in whom both structural and functional assessments were performed 12 months after randomization. Two hundred fifty-five eyes (83.9%) had concordant outcomes: 153 eyes had favorable structural and functional outcomes and 102 eyes had unfavorable structural and functional outcomes. Twenty-nine eyes (9.5%) had discordant outcomes: 20 eyes had favorable structural and unfavorable functional outcomes and nine eyes had unfavorable structural and favorable functional outcomes. The small number of discordant outcomes could generally be accounted for by three factors: (1) retinal abnormalities beyond those considered in the photographic grading system (12 eyes), (2) nonretinal visual pathway disease (five eyes), or (3) false-positive and false-negative results in the measurement systems used to evaluate structure and function (five eyes). In 20 eyes (6.6%), photographs could not be graded or the visual acuity was untestable. We conclude that the appearance of the posterior pole of the eye correlates well with grating acuity in the 12-month-old infant with a history of severe retinopathy of prematurity.
Cryosurgery↗
Operational aspects of terminating randomization in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity. Cryotherapy for Retinopathy of Prematurity Cooperative Group.
The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) is a randomized clinical trial sponsored by the National Eye Institute (NEI) designed to test whether cryotherapy applied to eyes of premature infants with a specified extent of stage 3+ ROP significantly decreases the incidence of an unfavorable outcome. An unfavorable outcome is defined as either retinal detachment or a retinal fold and was determined at 3 months posttreatment by the use of a masked photographic system. Enrollment into the trial was terminated on recommendation of the Data and Safety Monitoring Committee 9 months before the scheduled closing date for enrollment because of demonstrated treatment benefit. The purpose of this article is to discuss the operations involved in the orderly termination of enrollment and dissemination of results from this trial. These activities included preparation of trial participants and staff, release of trial information, continuing patient care, data collection and coding, and publication of trial results.
Blindness↗
[Effect and correlation of various risk factors in the development of retinopathy of prematurity. A retrospective study of 338 premature infants].
The statistical significance of ophthalmological and pediatric findings in the development of retinopathy of prematurity (ROP) was evaluated in a retrospective study of 338 premature infants. Short gestation time, frequent hypoxia, and low birthweight were strongly correlated with advanced stages of ROP. The influence of Vitamin E treatment, duration of oxygen therapy, and need for transfusions was less significant. Neither multiple births nor the infant's sex had any influence on the development of ROP. Cryotherapy appears to reduce ROP, but the number of cases in the present study was too small to permit statistical analysis.
Birth Weight↗
In vitro effects of inosine-pyruvate-phosphate on P50 values and DPG contents of fresh and stored blood from healthy neonates, symptom-free premature infants and premature infants with respiratory distress syndrome.
A study was made of the effect of a 3-hour incubation with inosine-pyruvate-phosphate (IPP) on the P50 values and 2,3-DPG contents of fresh blood and blood which had stood for 96 h, from healthy adults, term neonates, 1-2-week-old symptom-free premature infants and RDS premature infants. It was found that the P50 value and the 2,3-DPG content could be increased considerably by IPP treatment in both the fresh and the stood blood in the various groups of neonates. The question remains open as to whether the effect of IPP, in significantly improving the O2 transport in neonates, is a consequence of the 2,3-DPG alone or of some other metabolite. In RDS the stimulating effect of the IPP mixture is appreciably lower.
Adult↗