A Study on Patent Ductus Arteriosus in premature Infants

A Prospective study was done about incidence and treatment of hemodynamically significant' patent ductus arteriosus in premature infants admitted to neonatal intensive care unit of Ewha University Hospital from Feb. 1984 for one year. The results were as follows; 1) Among 46 infants with birth weight less than 2,000gm and gestational period 36 wks, 15(32.6%) developed a hemodynamically significant PDA. 2) The incidence of respiratory distress syndrome was six times higher in PDA group than that of non-PDA group(73.3% vs 12.9%). 3) The need for ventilatory assistance was five times higher in PDA group than that of non-PDA group(80% vs 16.1%). 4) The mortality rate was 40% in PDA group, 15% in non-PDA group. 5) The ratio of left atrium to aorta(LA/AO) in M-mode echocardiography was significantly higher in PDA group than that of non-PDA group(1.21+/-0.18 vs 0.93+/-0.23). 6) Indomethacin treated with usual medical therapy resulted in ductal closure in 80%, 20% with usual medical therapy only. 7) The mean LA/AO ratio was significantly decreased after indomethacin treatment(1.15+/-0.13 vs 1.21+/-0.18). 8) The change of the value of plasma sodium and potassium was not significant during indomethacin therapy, whereas BUN, creatinine value was increased during treatment, but that was reversible.

Early Neonatal Mortality Rate(II) : Obstetric Factors

The purpose of this study is to estimate early neonatal mortality rate in relation to obstetric factors. The early neonatal mortality rate was estimated on live births with a gestational period more than 28 weeks who died during the first 7 days of life in Ewha Womans University Hospital fro-m Jan. 1974 to Dec. 1978. During this period, there were 8218 single births and 127 early neonatal deaths. 1. We had 127 deaths out of 8218 single births, and early neonatal mortality rate came to 15.5 per 1000 live births. 2. The early neonatal mortality rate was increased in cases of maternal age over 40, higher in multipara, who had delivered more than 4 times, who had frequent abortions (more than 5 times) and it was also higher in para-one than para-two. 3. The early neonatal mortality rate was 7.9 times higher in abnormal presentation of fetus than normal one. 4. There was no significant difference in early neonatal mortality rate between spontaneous vaginal delivery and Caesarian section delivery, but significant high mortality rate was noted in breech delivery. 5. In cases of anemic mother (Hemoglobin less than 10 gm%, Hematocrit less than 32%), the early neonatal mortality rate was 2.8 times higher than non-anemic group. 6. The early neonatal mortality rate of babies from mothers without antenatal care was 3 ti-mes higher than that of mothers who had. 7. Hypertensive disorders in pregnancy was present in 15.8% of all live births and early neo-natal mortality rate was 10.8. The mortality rate was 6.5 times higher in chronic hypertensive vascular disorder with toxe-mia than in preeclampsia and 3.7 times higher in eclampsia than in precclampsis. 8. The obstetric complication which increased early neonatal mortality rate were polyhydra-mnios, amnionitis, abruptio placentae etc.

The Evaluation of AO Bilirubinometer for Neonatal Hyperbilirubinemia

AO bilirubinometer is a direct reading spectrophotometer specifically designed to measure total bilirubin using sera from newborn infantsl A study was performed to compare the bilirubin values obtained using the AO bilirubibometer and modified Diazo method(Rappaport method). The results were as follows : 1. The average percentage of recovery of AO bilirubinometer was 98.7%, while modified Diazo method was represented as 95.3%. 2. In comparison of two bilirubin techniques, the regression is linear, expressed by Y=1.16X-2.42, where values obtained as the bilirubinometer was on X axis and those from the modified Diazo mt\ethod on Y axis. The correlation coefficient was 0.95. 3. The variability of bilirubin values by cuvette was negligible, average percentage of variation coefficient being 0.1%. 4. The variability of bilirubin values by examiner was also negligible, the evarage percentage of bilirubin variation coefficient being 0.67%.