To investigate the value of the auditory brainstem response as a reliable test for the neurologic prognosis of infants with neonatal indirect hyperbilirubinemia, auditory brainstem response studies were performed in 22 infants. The patients were followed up until 12 months of age. Two patients demonstrated pathologic auditory brainstem response consistent with auditory neuropathy but had no neurologic finding except a lack of speech at 12 months of age. Two other patients had neurologic sequelae, one showing severe dyskinetic cerebral palsy, the other mild hypotonia and motor retardation, but their auditory brainstem response results were normal. These results suggested that auditory brainstem response examination might not provide reliable information for the neurologic prognosis. Neurologic disturbances resulting from bilirubin neurotoxicity can be seen in patients with a normal auditory brainstem response, but patients with an abnormal auditory brainstem response may not have any neurologic dysfunction apart from speech retardation.
A prenatally diagnosed patient was referred to our hospital at 35 weeks of gestation. Antenatal ultrasonography demonstrated cardiomegaly and aneurysm of the vein of Galen. A 3,290 g male baby was delivered by elective cesarean section at 37 weeks of gestation. Physical examination was remarkable for tachypnea, hyperdynamic precordium with a continuous murmur, cranial bruit and bounding carotid pulses. Magnetic resonance angiography confirmed vein of Galen aneurysmal malformation and demonstrated the vessels feeding the aneurysm. Postnatal management included aggressive medical treatment of cardiac failure and transarterial embolization of the vessels feeding the aneurysm at 3 days of age. Posthemorrhagic hydrocephalus developed after embolization, and a ventriculo-peritoneal shunt was placed at 29 days of age. Presently, the patient is 4 years of age and has no neurological abnormality at follow-up. Vein of Galen aneurysmal malformations can cause severe morbidity and mortality in neonates. However, careful obstetric follow-up and early postnatal endovascular treatment of these malformations may lead to a favorable outcome.
The aim of this study was to document the magnetic resonance imaging (MRI) findings of cases with a history of severe neonatal indirect hyperbilirubinemia. Ten cases (eight cases with neurologic findings, two normal cases) with a history of severe neonatal indirect hyperbilirubinemia were studied. Neurologic findings and MRI results were described and correlated. Seven of eight cases with neurologic findings demonstrated symmetric and uniform increased T2 signal changes limited to globus pallidi. MRI scans of two cases without neurologic findings showed no abnormality. Severe neonatal indirect hyperbilirubinemia should be considered in the differential diagnosis of bilateral symmetric hyperintense signal changes in the globus pallidus on MRI. However, high levels of unconjugated bilirubin concentrations in the neonatal period may not always cause such lesions of globus pallidus on MRI despite the presence of neurologic findings.
Objectives: This study is aimed to evaluate the role of maternal mean platelet volume (MPV) levels for antenatal prediction marker of early onset neonatal sepsis in term infants born to mothers who have low infection risk.
Material and methods:A total of 62 pregnant women who gave birth in our hospital and whose neonates were admitted to a third level Neonatal Intensive Care Unit due to confirmed neonatal sepsis between January 2010 and May 2016 were selected as a study group. Within the same period, 68 women who gave birth to healthy neonates were enrolled as a control group. We compared maternal MPV values which were evaluated before delivery. The receiver operating characteristic (ROC) curves were drawn to evaluate the values maternal MPV in the diagnosis of neonatal sepsis.Results: MPV levels were detected statistically higher in the study group than the control group (8.27 ± 1.85 vs. 8.98 ± 1.16) (p = 0.001).
Conclusion:The maternal serum MPV level is a clinically useful, non-invasive and reliable marker in antenatal prediction of EOS.
Background: In hypoxic newborns, cardiac troponin T (cTnT) was shown to be an indicator of cardiac damage and increased levels of nonprotein-bound iron (NPBI), an indicator of increased free radical production and perinatal brain damage. Objective: The aim of this study was to determine cord blood cTnT and NPBI levels in neonates of mild pre-eclamptic mothers. Methods: The study included 50 babies of mild pre-eclamptic mothers and 50 babies of healthy mothers. cTnT and NPBI levels were measured in cord blood. Results: The mean gestational age in the pre-eclamptic and healthy groups were 36.1 ± 3.5 and 38.1 ± 1.9 weeks, mean birth weights were 2,456 ± 945 and 3,059 ± 493 g. Cord blood median cTnT level was significantly higher in the pre-eclamptic group (0.024 vs. 0.015 ng/ml). Serum cTnT in the 95th percentile was 0.047 ng/ml in the healthy group. cTnT levels of preterm babies in the pre-eclamptic group was found to be significantly higher compared to term babies in the control group (0.038 vs. 0.013 ng/ml). It could not be demonstrated whether there is a statistically significant relation between cTnT levels and respiratory distress, gestation, type of delivery, sex and birth weight. The median NPBI level was higher in the control group (3.26 vs. 1.86 µmol/l). Conclusions: Increased levels of cTnT may be a biochemical marker of cardiac involvement in babies of mild pre-eclamptic mothers. In this study, no correlation was found between cTnT levels and NPBI levels.
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