The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Jan 2009
Reliability of procalcitonin in neonatology. Experience in 59 preterm newborns.
Procalcitonin (PCT) has been proposed as an interesting marker in the diagnosis, prognosis, and response to treatment of patient with neonatal sepsis. Fifty-nine neonates (34 males and 25 females) with a mean gestational age of approximately 31 weeks and a mean weight of about 1750 g admitted in the Neonatal Intensive Care Unit of Cagliari (Italy) were evaluated in controls and in infected neonates, before and after 48 h of life. From our experience it emerges that PCT is a marker of early and late neonatal sepsis which is reliable in preterm neonates. A cut-off of 0.5 ng/ml starting from the third day of life appears to be capable of ensuring good test sensitivity and specificity.
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J. Matern. Fetal. Neonatal. Med. · Jan 2009
Randomized Controlled Trial Multicenter StudySide effects of oral misoprostol for the prevention of postpartum hemorrhage: results of a community-based randomised controlled trial in rural India.
To investigate the side effects of 600 microg oral misoprostol given for the mother and the newborn to prevent postpartum hemorrhage (PPH). ⋯ Misoprostol is associated with a significant increase in postpartum maternal shivering and fever with no side effects for the newborn. Given its proven efficacy for the prevention of PPH, the benefits of misoprostol are greater than the associated risks.
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J. Matern. Fetal. Neonatal. Med. · Sep 2008
Periviable babies: Italian suggestions for the ethical debate.
With the advancement of medical technology, the outcomes for high-risk infants have greatly improved. However, hand and hand with the more positive result of saving neonates, modern neonatal intensive care has also brought to light several issues regarding the ethical grounds in infant care. One of the greatest problems concerns newborns at the threshold of viability. ⋯ In order to provide helpful suggestions during the initial management of the threatened birth of an infant with a gestational age of 25 completed weeks or less, we conducted a study for reviewing international studies on survival and morbidity rates, international guidelines and practice recommendations. This gave rise to the creation of a consensus document subsequently submitted to the Italian Scientific Societies for approval. The 'Carta di Firenze' does not attempt to deal with the problems related to pediatric euthanasia or eugenetics: its aim is to protect the infant and the mother from undue suffering although addressing recommendations for the work of clinicians.
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J. Matern. Fetal. Neonatal. Med. · Aug 2008
Case ReportsManagement of a massive pulmonary embolism in a pregnant patient with mechanical fragmentation followed by delayed catheter-directed thrombolysis in the early postpartum period.
There are limited data available on the management of massive pulmonary embolism in pregnancy. The use of systemic thrombolysis has been reported, but there are few documented cases on the use of mechanical fragmentation or catheter-directed thrombolysis. Systemic thrombolysis in pregnancy increases the risk of major hemorrhage and there are reports of massive subchorionic hematomas following its use. We describe the use of mechanical fragmentation and optional retrievable inferior vena cava (IVC) filter insertion in a 38-week pregnant woman followed by delayed pharmacological catheter-directed thrombolysis during the early postpartum period to successfully treat a massive pulmonary embolism.
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J. Matern. Fetal. Neonatal. Med. · Aug 2008
Comparative StudyThe effect of epidural analgesia on labor progress and outcome in nulliparous women.
The present study was designed to investigate the influence of epidural analgesia on labor progress and outcome in nulliparous women. ⋯ Epidural analgesia in nulliparous parturients increases the risk for labor dystocia and accordingly is an independent risk factor for vacuum extraction. Nevertheless, it does not pose an independent risk for cesarean delivery.