Perinatal risk indicators for long-term neurological morbidity among preterm neonates

Teune, Margreet J.; Wassenaer, Aleid G. van; Dommelen, Paula van; Mol, Ben Willem J.; Opmeer, Brent C.

doi:10.1016/j.ajog.2011.02.055

Cited by 23 publications

(13 citation statements)

References 21 publications

(22 reference statements)

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“…Low birth weight survivors have rarely been followed up until school age, which is partially because of time‐consuming and high study cost (Teune et al . ). Studies correlating perinatal brain injury and school performance have varied in their outcomes.…”

mentioning

confidence: 97%

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Zhang

Mahoney

Pinto‐Martin

2012

Journal of Clinical Nursing

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mentioning

confidence: 97%

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Zhang

Mahoney

Pinto‐Martin

2012

Journal of Clinical Nursing

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“…First, compartment-based surgery appears to exert excellent locoregional control in cervical cancer combined with a low complication rate as shown for open surgery [10,13]. Second, the translation to a minimally invasive method by robotic assistance adds the advantages of minimally invasive surgery regarding blood loss, mobilization, length of hospitalization and short-term complications as it has previously been shown for robotic surgery [16,17]. With respect to the port-site recurrence in our report, we stress that exposure of the tumor to the surgical field must strictly be avoided.…”

Section: Discussionmentioning

confidence: 99%

Definition of compartment-based radical surgery in uterine cancer: radical hysterectomy in cervical cancer as ‘total mesometrial resection (TMMR)’ by M Höckel translated to robotic surgery (rTMMR)

et al. 2013

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BackgroundRadical hysterectomy has been developed as a standard treatment in Stage I and II cervical cancers with and without adjuvant therapy. However, there have been several attempts to standardize the technique of radical hysterectomy required for different tumor extension with variable success. Total mesometrial resection as ontogenetic compartment-based oncologic surgery - developed by open surgery - can be standardized identically for all patients with locally defined tumors. It appears to be promising for patients in terms of radicalness as well as complication rates. Robotic surgery may additionally reduce morbidity compared to open surgery. We describe robotically assisted total mesometrial resection (rTMMR) step by step in cervical cancer and present feasibility data from 26 patients.MethodsPatients (n = 26) with the diagnosis of cervical cancer were included. Patients were treated by robotic total mesometrial resection (rTMMR) and pelvic or pelvic/periaortic robotic therapeutic lymphadenectomy (rtLNE) for FIGO stage IA-IIB cervical cancer.ResultsNo transition to open surgery was necessary. No intraoperative complications were noted. The postoperative complication rate was 23%. Within follow-up time (mean: 18 months) we noted one distant but no locoregional recurrence of cervical cancer. There were no deaths from cervical cancer during the observation period.ConclusionsWe conclude that rTMMR and rtLNE is a feasible and safe technique for the treatment of compartment-defined cervical cancer.

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“…1 Preterm infants that survive are at risk for significant long-term morbidity including visual and hearing impairment, 2–4 lung disease, 5 and neurodevelopmental abnormalities. 6–9 Although preterm birth is a multifactorial disorder, 10,11 a dysfunctional cervix is prominent in many cases of spontaneous preterm birth. A short cervix measured in the midtrimester is associated with increased risk of subsequent preterm birth, with the shortest cervix conferring the highest risk.…”

Section: Introductionmentioning

confidence: 99%

Injectable silk-based biomaterials for cervical tissue augmentation: an in vitro study

Brown

Partlow

Berman

et al. 2016

American Journal of Obstetrics and Gynecology

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Background Cerclage therapy is an important treatment option for preterm birth prevention. Several patient populations benefit from cerclage therapy including patients with a classic history of cervical insufficiency; patients who present with advanced cervical dilation prior to viability; and patients with a history of prior preterm birth and cervical shortening. Although cerclage is an effective treatment option in some patients, it can be associated with limited efficacy and procedure complications. Development of an alternative to cerclage therapy would be an important clinical development. Here we report on an injectable, silk protein-based biomaterial for cervical tissue augmentation. The rationale for the development of an injectable biomaterial is to restore the native properties of cervical tissue. While cerclage provides support to the tissue, it does not address excessive tissue softening, which is a central feature of the pathogenesis of cervical insufficiency. Silk protein-based hydrogels, which are biocompatible and naturally degrade in vivo, are suggested as a platform for restoring the native properties of cervical tissue and improving cervical function. Objective We sought to study the properties of an injectable, silk-based biomaterial for potential use as an alternative treatment for cervical insufficiency. These biomaterials were evaluated for mechanical tunability, biocompatibility, facile injection and in vitro degradation. Study Design Silk protein solutions were crosslinked by an enzyme catalyzed reaction to form elastic biomaterials. Biomaterials were formulated to match the native physical properties of cervical tissue during pregnancy. The cell compatibility of the materials was assessed in vitro using cervical fibroblasts, and biodegradation was evaluated using concentrated protease solution. Tissue augmentation or bulking was demonstrated using human cervical tissue from non-pregnant hysterectomy specimens. Mechanical compression tests measured the tissue stiffness as a function of the volume of injected biomaterial. Results Silk protein concentration, molecular weight and concentration of crosslinking agent were varied to generate biomaterials that functioned from hard gels to viscous fluids. Biomaterials which matched the mechanical features of cervical tissues were chosen for further study. Cervical fibroblasts cultured on these biomaterials were proliferative and metabolically active over 6 days. Biomaterials were degraded in protease solution, with rate of mass loss dependent on silk protein molecular weight. Injection of cervical tissue samples with 100 μL of the biomaterial resulted in a significant volume increase (22.6% ± 8.8%, p<0.001) with no significant change in tissue stiffness. Conclusion Cytocompatible, enzyme-crosslinked silk protein biomaterials show promise as a tissue bulking agent. The biomaterials were formulated to match the native mechanical properties of human cervical tissue. These biomaterials should be explored further as a possible alternative to...

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Perinatal risk indicators for long-term neurological morbidity among preterm neonates

Abstract: In this cohort, male sex, intracranial hemorrhage, and seizures seem to be important risk indicators for long-term neurologic morbidity.

Cited by 23 publications

References 21 publications

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Perinatal brain injury, visual motor function and poor school outcome of regional low birth weight survivors at age nine

Definition of compartment-based radical surgery in uterine cancer: radical hysterectomy in cervical cancer as ‘total mesometrial resection (TMMR)’ by M Höckel translated to robotic surgery (rTMMR)

Injectable silk-based biomaterials for cervical tissue augmentation: an in vitro study

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