Aims:The aim of this prospective study was to evaluate the accuracy of transcutaneous bilirubinometry using the Minolta Air-Shields JM-103 device in preterm newborns of gestational age 32-34 weeks, and to identify the most appropriate measurement site.Methods: Transcutaneous bilirubin (TcB) measurements were performed over forehead, sternum and abdomen, if total serum bilirubin (TSB) had to be determined on clinical indication in neonates of selected gestational age. TSB levels were measured in a clinical laboratory using direct spectrophotometry. In order to assess transcutaneous bilirubinometry accuracy, diff erences between TSB and TcB, their CI95%, and correlation coeffi cients (r) between TcB and TSB were evaluated.Results: The study group consisted of 44 infants, including 6 very low birth weight (VLBW) neonates. The correlations between transcutaneous and laboratory values were found to be signifi cant and close. Minimal diff erences were observed when measured over sternum. The measurements over forehead had a tendency to underestimate TSB levels.Conclusions: Noninvasive measurement by Minolta JM-103 demonstrated signifi cant accuracy. The authors recommend measurements over sternum or abdomen in premature infants born within 32-34 gestational weeks as a reliable and accurate neonatal hyperbilirubinemia screening test. Transcutaneous bilirubinometry has the potential to reduce the number of blood samplings, thus reducing neonatal pain and discomfort, parental distress and medical care cost.
A b s t r a c t Hypotrophic newborn is a newborn with birth weight below the 5th percentile weight of corresponding gestational age. Hypotrophic infants have higher morbidity and mortality in comparison with eutrophic neonates. A higher incidence of hypoglycemia, polycythemia, hyperbilirubinemia, thrombocytopenia, perinatal asphyxia and caesarean section occurs typically in hypotrophic newborns. Both, intrauterine hemodynamic dysbalance and centralization of circulation due to hypotrophy cause decreased blood flow to the splanchnic circulation after the birth. There was observed a lower increase in blood flow through the coeliac artery and superior mesenteric artery in comparison with eutrophic newborns during the first postnatal week. These facts are likely to be associated with a higher frequency of abdominal problems and necrotizing enterocolitis.
Background: Early-onset group B Streptococcal disease (EOGBSD) is a serious but preventable neonatal infection. Maternal intrapartum antibiotic prophylaxis (IAP) does not prevent all cases of the disease. Management of asymptomatic neonates of GBS colonized mothers is problematic.Aims: The objective of this prospective study was to determine whether administration of intramuscular penicillin at birth to a strictly defi ned group of term newborns of GBS colonized mothers is an eff ective and safe method to prevent EOGBSD.Methods: A protocol for management of full-term infants born to GBS colonized mothers was created. Either an abnormality of blood count or presence of more than one obstetric risk factor were chosen as the indication criteria for administering postnatal antibiotic prophylaxis (PAP).Results: The study sample consists of 250 newborns (11.5 % of all term infants). PAP was administered in 39 cases. Indication criteria included leucocytosis in 37 cases, leucopenia in 1 case and obstetric risk factors in 1 case. There was no case of clinically manifest infection, and no case of sepsis either suspect or proven.Conclusions: The authors suggest that the strategy of selective PAP using penicillin, may be an eff ective and safe method in order to reduce morbidity and mortality from streptococcal infections. They recommend a combination of IAP and selective PAP.
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