ABSTRACT
PURPOSE: To assess the features of Retinopathy of Prematurity (ROP) in a Neonatal Intensive Care Unit during 8 years, analyzing the usefulness of the criteria in the screening protocol and the risk factors relating to the disease. METHODS: A retrospective study of the infants included in the screening program for ROP. The sensitivity of the criteria of birth weight (BW) < 1,500 g, post-conceptional age (PCA) < 32 weeks and subjective pediatric criteria (SPC) in the screening program were evaluated and compared with the incidence of ROP, and the need for treatment in these patient groups. Statistical analysis for ROP and no-ROP was then applied to the risk factors BW, PCA, oxygen therapy, and intercurrent diseases. RESULTS: Forty of 303 infants studied had ROP (13.2%). In ROP cases, 31 (77.5%) had spontaneous regression and 9 (22.5%) needed treatment. The screening program included 144 children with BW < 1,500 g and 159 children with BW > 1,500 g. The incidence of ROP was 26.4% in the first group and 1.3% in the second group (p < 0.001). Two cases were detected with a BW > 1,500 g but with a PCA < 32 weeks, and neither required treatment. There were 84 cases included because of SPC (27.7%); no cases of ROP were detected in these. The only independent risk factor found in a multivariant analysis was birth weight. CONCLUSIONS: None of the children included with a BW > 1500 g required treatment for ROP, but several cases of ROP could be missed by using this criteria only. SPC must be restricted in the screening program.
Subject(s)
Birth Weight , Gestational Age , Infant, Premature , Retinopathy of Prematurity/diagnosis , Humans , Infant, Newborn , Retrospective Studies , Risk FactorsABSTRACT
Objetivo: Registrar las características de la Retinopatíade la Prematuridad (RP) en una unidad neonatala lo largo de 8 años, analizando los criterios delprotocolo de despistaje y los factores de riesgo asociados.Métodos: Estudio retrospectivo de los prematurosincluidos en el protocolo de despistaje. Evaluaciónde la sensibilidad de los criterios Peso al nacer (PN) 1.500 gr fue 1,3% (p 1500 gr y EG 1.500 gr requirió tratamiento,pero usando sólo este criterio pueden no detectarsealgunos casos de RP. La inclusión de niños por CSPdebe restringirse
Purpose: To assess the features of Retinopathy ofPrematurity (ROP) in a Neonatal Intensive CareUnit during 8 years, analyzing the usefulness of thecriteria in the screening protocol and the risk factorsrelating to the disease.Methods: A retrospective study of the infants includedin the screening program for ROP. The sensitivityof the criteria of birth weight (BW) 1,500 g. Theincidence of ROP was 26.4% in the first group and1.3% in the second group (p 1,500 g but with a PCA 1500g required treatment for ROP, but severalcases of ROP could be missed by using this criteriaonly. SPC must be restricted in the screening program
Subject(s)
Male , Female , Infant, Newborn , Humans , Mass Screening , Retinopathy of Prematurity/epidemiology , Intensive Care Units, Neonatal/statistics & numerical data , Retrospective Studies , Risk Factors , Infant, Premature, Diseases/epidemiology , Birth Weight , Gestational AgeABSTRACT
BACKGROUND: To determine the usefulness of amnioinfusion as a function of meconium concentration and amniotic fluid index. METHODS: This was a prospective study of 206 pregnant women in whom amniotic fluid was moderately or heavily stained with meconium, according to subjective evaluation. The women were assigned randomly to receive amnioinfusion (n=103) or no amnioinfusion (control group, n=103). The results were compared in women with =/<15 % or >15 % meconium in the amniotic fluid (measured by centrifugation), and in women in whom the amniotic fluid index calculated 60 min after insertion of the amnioinfusion catheter was <10 or =/>10. RESULTS: In women with >15% meconium, amnioinfusion decreased the rate of cesarian sections motivated by fetal distress (2.5% vs 22.2%), and in women with =/<15% meconium, amnioinfusion decreased the presence of meconium below the vocal cords (6.4% vs 25.9%). Greater benefits after amnioinfusion were seen in women with an amniotic fluid index =/>10: the rate of cesarian sections was lower (1.3% vs 13.3%), as was the frequency of meconium below the vocal cords (10.1% vs 33.3%). CONCLUSIONS: Beneficial effects of amnioinfusion were seen in women with high and low concentrations of meconium, and with high and low amniotic fluid indexes. These criteria should therefore not be used to decide whether amnioinfusion is indicated when the amniotic fluid is moderately or heavily stained with meconium.
