Influence of Antenatal Magnesium Sulfate Exposure on Perinatal Outcomes in VLBW Infants with Maternal Preeclampsia

PURPOSE: Magnesium sulfate (MgSO4) is a commonly used drug for eclampsia prophylaxis and the first choice tocolytic agent for preterm labor. Recently it has been reported to have a fetal neuroprotective effect. This study was aimed to evaluate the influence of antenatal magnesium sulfate exposure on perinatal outcomes in very low birth weight infants (VLBWIs) with maternal preeclampsia. METHODS: We conducted a retrospective study of VLBWIs (n=81) with maternal preeclampsia (June 2005 through June 2012), who had been admitted to the NICU at Ewha Womans University Mok Dong Hospital. Clinical characteristics and neonatal complications were analyzed according to the antenatal exposure to MgSO4. Antenatal MgSO4 exposure was the only medication that had been administered up to the period of delivery. RESULTS: Among 81 neonates, 20 neonates were exposed to antenatal MgSO4. Mean gestational age was low in MgSO4 exposed group [29.5+/-2.8 vs. 31.6+/-2.3 weeks (P=0.02)]. The incidence of significant patent ductus arteriosus (S-PDA) was higher in MgSO4 exposed group after adjustment by gestational age (P=0.02). There were no differences between the two groups with regard to rates of respiratory distress syndrome, use of ventilator, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia and mortality. CONCLUSION: Antenatal MgSO4 exposure was associated with a higher risk of significant PDA in VLBWIs with maternal preeclampsia.

A girl with sternal malformation/vascular dysplasia association / 소아과

Sternal malformation/vascular dysplasia association is a rare congenital dysmorphology, which has not yet been reported in Korea. Its typical clinical features include a sternal cleft covered with atrophic skin, a median abdominal raphe extending from the sternal defect to the umbilicus, and cutaneous craniofacial hemangiomata. We report a case of a full-term newborn who presented with no anomalies at birth, except for a skin defect over the sternum and a supraumbilical raphe. Multiple hemangiomas appeared subsequently on her chin and upper chest wall, and respiratory distress due to subglottic hemangioma developed during the first 2 months of life. Her symptoms were controlled with oral prednisolone administration. No respiratory distress have recurred during the 3-year follow-up period.

Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009 / 소아과

PURPOSE: Hand-foot-mouth disease (HFMD) is a common viral illness in children, which is usually mild and self-limiting. However, in recent epidemics of HFMD in Asia, enterovirus 71 (EV71) has been recognized as a causative agent with severe neurological symptoms with or without cardiopulmonary involvement. HFMD was epidemic in Korea in the spring of 2009. Severe cases with complications including death have been reported. The clinical characteristics in children with neurologic manifestations of EV71 were studied in Ewha Womans University Mokdong Hospital. METHODS: Examinations for EV71 were performed from the stools, respiratory secretion or CSF of children who presented neurologic symptoms associated with HFMD by realtime PCR. Clinical and radiologic data of the patients were collected and analyzed. RESULTS: EV71 was isolated from the stool of 16 patients but not from respiratory secretion or CSF. Among the 16 patients, meningitis (n=10) was the most common manifestation, followed by Guillain-Barre syndrome (n=3), meningoencephalitis (n=2), poliomyelitis-like paralytic disease (n=1), and myoclonus (n=1). Gene analysis showed that most of them were caused by EV71 subgenotype C4a, which was prevalent in China in 2008. CONCLUSION: Because EV71 causes severe complications and death in children, a surveillance system to predict upcoming outbreaks should be established and maintained and adequate public health measures are needed to control disease.