Premature birth is a serious medical, social and economic problem. Its consequences are multiple health complications leading to high neonatal mortality worldwide. Respiratory insufficiency and surfactant deficiency significantly increase the risk of developing Hyaline Membrane Disease (HMD) and other forms of Respiratory Distress (RDS). These are the most common causes of death in premature babies. In prenatal and neonatal medicine, new and adaptive prophylaxis is being implemented to reduce the risk of death of premature babies and reduce the development of health complications. The goal of effective corticosteroid prophylaxis is to reduce mortality, reduce complications in prenatal new-borns, and shorten their stay in neonatal and intensive units respectively. A retrospective study of 167 preterm infants was conducted, of which 89 (53.3%) had prophylaxis with dexamethasone. In 25 (15%) of preterm infants, there was a Hyaline Membrane Disease (HMD) and 101 (60.5%) developed other forms of Respiratory Distress Syndrome (RDS). The results obtained show that the incidence of HMD in preterm infants is mediated by the early gestational age and advanced age of the mother, and decreased by corticosteroid therapy.
Recent studies show that hospitalized COVID-19 patients have an increased incidence of arrhythmia, especially atrial fibrillation (AF). This single-center study included 383 hospitalized patients with positive polymerase chain reaction tests for COVID-19 from March 2020 to April 2021. Patient characteristics were documented, and data were analyzed for episodes of AF on admission or during the hospital stay, intrahospital mortality, need for intensive care and/or invasive ventilation, inflammatory parameters (hs-CRP, IL-6, and procalcitonin), and differential blood count. We demonstrated that in the setting of hospitalized cases of COVID-19 infection, there is an incidence of 9.8% (n = 36) for the occurrence of new-onset AF. Furthermore, it was shown that a total of 21% (n = 77) had a history of episodes of paroxysmal/persistent AF. However, only about one-third of patients with pre-existing AF had relevant documented tachycardic episodes during the hospital stay. Patients with new-onset AF had a significantly increased intrahospital mortality compared to the control and the pre-existing AF without rapid ventricular rate (RVR) group. Patients with new-onset AF required intensive care and invasive ventilation more frequently. Further analysis examined patients with episodes of RVR and demonstrated that they had significantly elevated CRP (p < 0.05) and PCT (p < 0.05) levels on the day of hospital admission compared to patients without RVR.
Poland Syndrome is a rare condition evident at birth that includes a wide range of malformations of chest and arm. The exact cause of the syndrome is unknown, but genetic involvement and a vascular abnormality of the subclavian artery are suspected. We report two cases of right-sided Poland Syndrome with true dextrocardia, diagnosed in neonatal period. Our report is focused on illustrating the importance of physical diagnosis and confirming that the associated features vary greatly among the individuals.
Premature birth is a significant medical, social and economic problem worldwide. In the 21st Century in developed countries, this problem accounts for over two thirds of neonatal deaths. In Bulgaria, statistics show that 10-12% of all pregnancies end with premature birth. Despite the number of studies in this field and the efforts made by obstetricians and gynecologists, the tendency to increase the number of preterm births has continued in the last decade. Its consequences are multiple complications who lead to a high neonatal mortality in the national and global world. Preterm birth is characterized by complex and vague etiology. A specific cause of premature birth can not be defined, but a set of risk factors is considered, divided into three main groups of etiological factors: socio-economic, medical-biological, and behavioral. Associated with preterm birth socio-economic and behavioral risk factors include poverty, unemployment, low education, poor prenatal care, harmful habits such as smoking, alcohol, drugs and other harmful substances, unhealthy family environment, severe and prolonged stress, excessive physical exercise (lifting weights), trauma (hits or violence), new pregnancies less than 6 months after previous birth, unhealthy diet and low mother BMI, etc. Essential for the preterm birth is also the medico - biological etiological factors. One of these is uterine enlargement, as the main reason for this may be the presence of: multiple pregnancies that occurred naturally or after using assisted reproductive technologies or polyhydramnios (increased amount of amniotic fluid). Other risk factors include: placenta previa, incorrect position of the fetus, myoma, uterine cervix malformations (including cerebrovascular insufficiency), preeclampsia, uterine contractions, acute infections during pregnancy (vaginal - chlamydia, trichomonas, mycoplasma , toxoplasmosis, bacterial vaginosis, viral rubella, cytomegalovirus, herpes, influenza, adenovirus infection, chronic diseases (hypertension, cardiovascular diseases, diseases of the lungs, liver or kidney anemia and etc.), genetic factors, previous premature birth, etc. These risk indicators are subject to detailed analysis in the work of a number of authors. To limit preterm births, a number of studies have been conducted to identify and identify the risk factors that are relevant to it. Identifying and recognizing their effects and impact leading to premature birth will significantly reduce the severe health, economic and social consequences as well as reduce the risk of neonatal death. In order to reduce the frequency of preterm births, adequate and specialized prenatal care is essential. They must be individually tailored for each particular case of pregnancy and take into account the complex of risk predispositions.
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