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Resuscitation of the Newborn
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
If the heart rate fails to improve beyond 60 bpm after 30 seconds of performing cardiac compressions, then the administration of medication should be considered (Table 30.2). Up to three doses of adrenaline should be administered, with one dose of sodium bicarbonate given before the third dose, depending on the response. Insertion of an umbilical venous catheter (UVC) is the quickest method to gain access to the circulatory system in a collapsed newborn. Insertion of a UVC to a depth of 4–5 cm in a sterile manner is required for the successful administration of drugs.
Test Paper 1
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
A neonate has an umbilical venous catheter inserted. On an abdominal X-ray, it has advanced up to the level of T10 at the midline. In which structure is the tip of the catheter? Left portal veinRight portal veinDuctus venosusSuperior mesenteric veinSplenic vein
Neonatology
Published in Timothy G Barrett, Anthony D Lander, Vin Diwakar, A Paediatric Vade-Mecum, 2002
Timothy G Barrett, Anthony D Lander, Vin Diwakar
If the HR does not improve, continue the above measures and insert an umbilical venous catheter. If the infant is acidotic, give 2–4 ml/kg of 4.2% sodium bicarbonate slowly via the umbilical vein while maintaining adequate ventilation. IV adrenaline, 0.1 ml/kg, is recommended by most authorities. However, it should be remembered that the need for adrenaline at resuscitation is associated with a poor outcome. Intratracheal adrenaline is probably ineffective.
Congenital ichthyosis (icthyosis lamellaris non bullosa) – therapy
Published in Journal of Obstetrics and Gynaecology, 2021
Miljana Z. Jovandaric, Svetlana J. Milenkovic
A female, premature newborn from a first, controlled pregnancy, was delivered naturally, in 35 GW (gestation week), BW (body weight) 2520 g (grams), BL (body length) 47 cm, HC (head circumference) 33 cm, with an Apgar score of 8. At birth there was a lamellar scaling on the trunk, in addition to an apparent eversion of the eyelids (ectropion). The skin first began to scale in the upper chest, expanding towards the face and other parts of the body. The newborn was placed in the incubator humidified to 70%. The skin was treated with 3% dilution of cholesterol in Vaseline. The umbilical venous catheter was inserted, antibiotic therapy and intravenous rehydration initiated and, due to the increase of C-reactive protein (CRP) infection parameters, 55 mg/l of Cephtriaxon was introduced on the sixth day. Escherichiacoli, sensitive to Cephtriaxion, was isolated from the skin smear. The blood culture remained sterile. The electrolytes, blood test results, and CRP were all within the normal reference values. There was no bleeding or inflammatory change on the scaled skin and the dermal part of the skin remained visible. Echocardiographic examination of the brain, heart and abdomen of the newborn did not reveal pathological changes. Skin regeneration was fully achieved within 14 days (Figure 1). There were no dermatological, chronic and autoimmune diseases recorded in the family medical history.
Operative treatment for tricuspid valve endocarditis in a premature neonate
Published in Baylor University Medical Center Proceedings, 2021
Gitanjali Indramohan, Sheba John, Christopher E. Greenleaf, Balaguru Duraisamy
A preterm male, at 30 weeks’ gestation and with a birth weight of 1010 g, was transferred from another hospital at 18 days of life (DOL) for management of IE. Initially, he was treated for respiratory distress syndrome related to prematurity. He had an umbilical venous catheter with its tip at the tricuspid valve on DOL 1 to 3. Echocardiogram on DOL 2 showed a patent ductus arteriosus and normal tricuspid valve (Figure 1a). He developed fever and thrombocytopenia on DOL 10. He was started on antibiotic therapy with vancomycin and gentamicin. Echocardiogram revealed a mass on the tricuspid valve measuring 6 mm in diameter, without evidence of stenosis or regurgitation (Figure 1b). There was a small patent foramen ovale with left to right shunt. Blood culture was positive for methicillin-sensitive Staphylococcus aureus. He developed an abscess in the right wrist which was drained on DOL 16. Abdominal ultrasonogram was suspicious for splenic infarct. Eye exam was negative for Roth’s spots. Cerebrospinal fluid culture was negative. Ultrasound of the head was normal on DOL 20.
Cardiac Tamponade – a Cause of Sudden Death in a Premature Newborn
Published in Fetal and Pediatric Pathology, 2022
M. Inês Nunes Marques, António Bento Guerra, Sónia Antunes, Laura Martins, Lucília Carvalho
We report the case of a male newborn, with supervised prenatal care, delivered at 30 weeks’ gestation age due to spontaneous preterm labor. Betamethasone 12 mg was administered one hour before birth. APGAR scores were 5/8/9 with a good response to immediate resuscitation maneuvers. Upon admission to the Neonatal Intensive Care Unit (NICU), he developed respiratory distress syndrome, and was placed a nasal continuous positive airway pressure (nCPAP). The umbilical venous catheter (UVC) tip’s correct position was confirmed by thoracic and abdominal X-ray (Figure 1) at the supradiaphragmatic inferior vena cava. Antibiotics and total PN were started. On the 3rd day, sudden onset of hemodynamic instability led to cardiorespiratory arrest with unsuccessful resuscitation.