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The Take Care technique is feasible for the treatment of respiratory distress syndrome in infants with very low birth weight. It significantly reduces both the need and duration of MV, and thus the bronchopulmonary dysplasia rate in preterm infants.

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NCT01531179.

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Background: Treatment options for the closure of a hemodynamically significant patent ductus arteriosus (hsPDA) include medical therapy such as ibuprofen and indomethacin and surgical ligation. Objective: To evaluate the efficacy of intravenous paracetamol in preterm infants with hsPDA whose feeding was contraindicated or had feeding intolerance. Methods: Preterm infants with hsPDA were started on intravenous paracetamol treatment with parental consent. Paracetamol was administered at a dose of 60 mg/kg/day, in four divided doses, for a period of 3 days. In the absence of closure of hsPDA, treatment was extended up to 6 days, after which echocardiographic examination was performed. Results: A total of 10 preterm infants were included in the study with a median gestational age of 27^4/7 weeks (minimum–maximum: 24–29) and a median birth weight of 775 g (590–990). The first dose of intravenous paracetamol was given after a median of 6 days (2–15). On echocardiographic examination, median internal ductal diameter was 2 mm (1.5–3), with a median left atrium-to-aortic root ratio of 1.95 (1.6–2.2). Intravenous paracetamol resulted in successful closure of hsPDA in all patients. Conclusions: This study is the first case series in the literature which used intravenous paracetamol treatment for hsPDA. We believe that intravenous paracetamol could be used as an alternative drug for infants. Further prospective randomized-controlled trials are needed to evaluate the efficacy of intravenous paracetamol for the closure of hsPDA.

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Objective:To document the practice of labour in water, to assess the effects of water immersion during labor and/or birth (labour stages 1, 2 and 3) on maternal, fetal and neonatal wellbeing and to compare the outcomes and safety with conventional vaginal deliveries and deliveries with epidural analgesia. Material and Methods:Two-hundred and seven women electing for waterbirth (n=207) were compared with women having conventional vaginal deliveries (n=204) and vaginal deliveries with epidural analgesia (n=191). Demographic data, length of 1 st , 2 nd and 3 rd stage of labor, induction and episiotomy requirements, perineal trauma, apgar scores, NICU requirements and VAS scores were noted. Results:The 1 st stage of labor was shorter in waterbirths compared with vaginal delivery with epidural analgesia but the 2 nd and 3 rd stage of labor were shortest in patients having waterbirth compared with conventional vaginal delivery and vaginal delivery with epidural analgesia. Patients having waterbirth had less requirement for induction and episiotomy but had more perineal laceration. All women having waterbirths had reduced analgesia requirements and had lower scores on VAS. There was no difference in terms of NICU admission between the groups. Apgar scores were comparable in both groups. There were no neonatal deaths or neonatal infections during the study. Conclusion:The study demonstrates the advantages of labor in water in terms of reduction in 2 nd and 3 rd stage of labor, reduction in pain and obstetric intervention such as induction or amniotomy. (J Turkish-German Gynecol Assoc 2012; 13: 45-9) Key words: Water birth, analgesia, neonatal outcome Received: 15 September, 2011 Accepted: 22 November, 2011 Amaç: Suda doğum pratiğinin dökümentasyonu ve doğum travayı ve/veya doğum eylemi (doğumun birinci, ikinci ve üçüncü evresi) sırasında maternal, fetal ve yenidoğan iyilik hali üzerine etkilerini değerlendirerek, sonuçları ve güvenirlilik açısından epidural analjezi ile vajinal doğum ve konvansiyonel vajinal doğum sonuçları ile kıyas-lanması. Gereç ve Yöntemler:Suda doğum yapan ikiyüzyedi (n=207) kadın, konvansiyonel vajinal doğum yapan (n=204) ve epidural analjezi ile vajinal doğum yapan (n=191) kadınlarla kıyaslandı. Hastaların demografik verileri, doğum eyleminin 1., 2. ve 3. evresinin uzunluğu, indüksiyon ve epizyotomi ihtiyacı, perine travması, yenidoğanın apgar skorlaması, yoğun bakım ihtiyacı ve VAS skorları değerlendirildi. Bulgular:Konvansiyonel vajinal doğum ve epidural analjezi ile vajinal doğum yapanlarla kıyaslandığında suda doğuranlarda, doğumun 1. evresi kısalmakla birlikte özellikle 2. ve 3. evrelerin çok kısalmış olduğu görüldü. Suda doğum yapan hastalarda oksitosin ihtiyacı belirgin olarak daha azdı, epizyotomi oranı da daha düşüktü fakat daha fazla perineal laserasyon saptandı. Suda doğum yapan kadınların hepsinde analjezi ihtiyacı azalmıştı ve VAS skorları düşüktü. Gruplar arasında yenidoğan yoğun bakım ihtiyacı açısından fark yoktu. Apgar skorları benzerdi. Çalışma dönemi boyunca hiç yenidoğ...