[Impact of the multiple births on the postnatal iron indices in premature infants].

PURPOSE: To investigate the impact of the multiple births on the iron metabolism indices in premature infants. MATERIAL AND METHODS: 102 premature infants, born before 33rd gestational week (GW), are investigated, divided in two groups: control group 1 - singletons (n 69), and case group 2 - twins (n 33). The serum levels of ferritin (Ferr), transferrin (Tf), soluble transferrin receptors (sTfR), iron (Fe), total iron binding capacity (TIBC) and transferrin saturation (SatTf) are examined from the birth to the term. RESULTS: The singletons are complicated more frequently by nosocomial infections also they require more often early haemotransfusions. Their initial levels of Ferr are higher; but sTfR - lower, especially in 36th week corrected age (WCA). Levels of Tf of the twins are elevated sharply after 33rd WCA, but to term are above upper limit of norm. The sTfR levels are higher and above normal value through whole observational period. Fe-curve is upward, but TIBC is on the lower limit through that period. Calculating SatTf, we established that twins are iron deprived at birth, but 1/3 of singletons are iron overloaded. Despite neonatal complications, 80% from singletons are with normal SatTf at term, but iron overload in twins are twice higher (42 vs. 20%). CONCLUSION: The multiple births are a risk factor concerning iron homeostasis in the infants, born before 33rd GW.

[Impact of the multiple births on the postnatal blood count indices in premature infants].

PURPOSE: To investigate the impact of the multiple births on the blood count indices in premature infants. MATERIAL AND METHODS: 299 premature infants, born before 33rd gesta-tional week (GW), are investigated, divided in 2 groups according to the ges-tational age at birth (< or = 29 GW and 30-33 GW). These groups are divided addi-tionally in 2 subgroups: 1- singletons, and 2- twins. Hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular Hgb concentration (MCHC), peripheral reticulocytes (Ret) are examined at birth and in 27th, 30th, 33rd, 36th and 39th week corrected age (WCA). RESULTS: The congenital infections are more often in group 1 of the newborns 5 29 GW. The twins 30th-33rd GW are with lower average weight and higher frequency of late blood transfusions. Comparing to singletons less mature twins are with initial higher levels of Hgb, Hct, MCV and lower levels of MCHC in 33rd and 36th WCA. They also show high-variable bone marrow answer with high levels of Ret in 30th, 33rd and 36th WCA. Initial values of Hgb, Hct are higher in more mature twins, MCHC also, but in 33rd and 39th WCA. Ret decrease permanently after elevation in 33rd WCA. The MCV levels are under the lower limit of normal in the both age groups. CONCLUSIONS: The multiple births are risk factor for hematological condition in premature infants but the risk is proportional to the duration of the intrauterine stay.

[Therapeutic effects of music on preterm infants in neonatal intensive care units]. / Terapevtichen efekt na muzikata vurkhu nedonoseni detsa v otdelenie za intenzivna terapiia na novorodenite.

The hospital care of premature and low-birth infants requires expensive technology and experienced care. Many studies have looked at the institution of developmental care in the NICU. Significant increases in oxygen saturation as well as decreased levels of agitation and heart rate were found with the use of music. Other studies have shown a doubled daily weight gain when premature babies in the NICU were exposed to music therapy.

A case of prune belly syndrome.

The prune belly syndrome was first described in 1839 by Frolich. Till now about 300 cases have been reported in literature. The complete form of the syndrome is presented by a classic triad that is seen only in boys and is incompatible with life. The etiology of the syndrome is uncertain. Genetic factors, intrauterine infections, adverse mechanical factors have been implicated. The prenatal diagnosis relies on the ultrasonographic findings of oligohydramnion, renal anomalies, and non-immune fetal hydropsy. The present case concerns a newborn of male sex suffering from the most severe and rare form of the syndrome. The child died 5 minutes after his birth. The pathological examination found the patient devoid of striated muscles anterior abdominal wall, urethral atresia, hyperthrophy of the urinary bladder, bilateral hydroureter and hydronephrosis and coinciding cryptorchidism. The case indicates the PBS as one of the possible reasons for non-immune fetal hydropsy.

[The use of prostaglandins in prolonged pregnancy and their effect on the newborn infant]. / Prilozhenie na prostaglandini pri prenosena bremennost i efekt vurkhu novorodenoto.

OBJECTIVE: The purpose of this study was to evaluate the neonatal outcome in newborns from mothers with post-term pregnancy and vaginal prostaglandin (Prostin E2) for cervical ripening and labor induction. STUDY DESIGN: This prospective study included 82 newborns, w.g. 41-42, divided into three groups according to the management of post-term pregnancy: group I--preinduction with Prostin E2 before induction of labor with oxytocin; group II--induction with oxytocin only; group III--with expectant management. In each newborn group weight, size, head circumference, Apgar score and neonatal morbidity characteristics were noted. RESULTS: The cesarean delivery rate was 14.2% in group I, 12.9% in the group II and 3.3% in the III-d group. There were no significant differences between groups in the frequency of meconial amniotic fluid, neonatal meconium aspiration. The incidences of severe asphyxia, neonatal injury and pathologic neonatal icter were higher in the group I. CONCLUSIONS: Prostin E2, used for the cervical ripening and labor induction with oxytocin increased the rate of surgical interventions at delivery and neonatal morbidity.

[The anthropometric indices, morbidity and mortality of newborn infants with diabetic fetopathy]. / Antropometrichni pokazateli, zabolevaemost i smurtnost na novorodeni s fetopatiia diabetika.

UNLABELLED: A study was carried out to examine the anthropometric characteristics, neonatal morbidity and mortality in newborn infants with diabetic fetopathy. MATERIAL AND METHODS: Infant anthropometric measurements were obtained, neonatal morbidity and early neonatal mortality were determined in 15 neonates with diabetic fetopathy over 6 years. RESULTS: Among the study population, 33.3% of children had macrosomia. The incidence of aspiration syndrome and meconium aspiration syndrome was 40%, transient tachypnea was 33% and the observed incidence of hyaline membrane disease was 26%. The cardiologic pathology was result of patent ductus arteriosus, myocardial hypertrophy and persistent pulmonary hypertension. The most frequent biochemical changes were transient neonatal hypoglycemia and hyperbilirubinemia. The perinatal mortality rate was 26.7%, with cases of hemorrhagic disease of newborn and the incidence of neonatal thromboembolism. CONCLUSION: Despite the current improvements of diabetes care in pregnancy, newborn infants with diabetic fetopathy have a high level of morbidity and early neonatal mortality.

Neonatal muscle hypotonia--an early manifestation of cerebral palsy.

UNLABELLED: Cerebral palsy causes a number of diagnostic, therapeutic, organisational, and social problems. A timely diagnosis reduces the unfavourable effects of the disease and the resulting disability of the children. AIM: The aim of the present study was to evaluate the role of the neonatal muscle hypotonia as an early indicative symptom of cerebral palsy (CP). MATERIAL AND METHODS: Forty-two children with clinical and anamnestic data of muscle hypotonia (from the neonatal period to the age of 3) were enrolled in the study. An active and dynamic follow-up including specialized neurologic examinations was realised. RESULTS: The etiologic factors of utmost importance for CP were prematurity (40.5%) and perinatal asphyxia (26.2%). On the background of differently expressed muscle hypotonia, persisting from the neonatal period, the abnormalities in the psychoneurologic development during the first year after birth were characterized mainly by psychoemotional retardation. Motor deficit was marked from the 1st through 2nd year, and speech disorders appeared after the age of 2. CONCLUSIONS: The presence of partial or generalized muscle hypotonia in the neonatal age and its persisting in the subsequent stages of the child's life is an early indicative symptom of CP. The diagnosis is possible within the first two years of life, especially in children with perinatal pathology, by dynamic neurologic follow-up and prompt evaluation of the abnormalities in the psychoneurologic development.

[Neonatal birth trauma in relation to the means of delivery]. / Rodov travmatizum na novorodenoto v zavisimost ot nachina na rodorazreshenie.

The frequency of birth trauma has fallen considerably in recent years. This decline reflects in particular a greater tendency to perform a caesarean section when difficulties of delivery would appear. Birth trauma often causes not only early, but late and continuous illness in neonates. For this reason it is an important problem in neonatal practice. 1791 newborn have been investigated: 1515 (84.5%) by vaginal delivery, 177 (9.8%) by caesarean section, 38 (2.1%) by forceps, 18 (1.01%) by vacuum extraction and 43 (2.4%) by pelvic presentation. The results show the frequency of birth trauma (5.5%) and asphyxia (5.9%) by vaginal delivery and by operative methods (19.8%--S.C., 60.5%--F., 88.8%--V.E.) and their dependence on some factors: induction or stimulation of labor, meconium stained amniotic fluid, prolonged or extremely rapid labor.

[The biochemical changes in overweight pregnant women during the pregnancy]. / Biokhimichni promeni pri bremenni s nadnormeno teglo po vreme na bremennostta.

The degree of weight gain during pregnancy as a risk factor for a mother and her newborn is a disputable problem. Most of the studies have shown, that maternal overweight gain has a bad effect on labor delivery outcome. The present study included 108 pregnant women, subdivided into three groups, according to weight gain during pregnancy: Group I(32) - < 12 kg, Group II(42) - 12 < - < 20 kg. Group III(34) - > 20 kg. The patients were estimated according to their age, parity, pregnancy induced hypertension and mode of delivery. The authors investigated biochemical indicators of protein, lipid and electrolyte balance. The results illustrate the influence of prenatal overweight gain on the pregnancy complication, mode of delivery and some biochemical changes.

[The immune changes at the beginning of pregnancy]. / Imunni promeni v nachaloto na bremennostta.

The authors investigated cellular and humoral immunity as well as the amount of circulating immune complexes (CIC) in 84 women, 52 of whom were healthy nonpregnant and 32 with normal pregnancy during the first trimester. Considerable changes were established in the immune status-depression of cellular immunity in pregnant women, an increase of the amount of CIC in the same women, humoral immunity did not show synonymous changes a reduction of IgG content in pregnant women and an increase of IgA in the same group. The level of IgM was not altered. The possible causes for the discovered changes are discussed.

[Circulating immune complexes in women with prolonged pregnancy]. / Tsirkulirashti imunni kompleksi pri zheni s prenosena bremennost.

The authors examined 90 pregnant women, divided into three groups: pregnant women at 39-40 weeks gestation, parturients and women with prolonged pregnancy. Circulating immune complexes were determined. Differences in the three groups were statistically significant. The lowest level of circulating immune complexes was found in women with prolonged pregnancy, but the highest--in parturients. Inferences are made for the significance of circulating immune complexes for the onset of delivery and development of postmaturity.

[Autoradiographic study of the action of yohimbine on rat spermatogenesis]. / Avtoradiografichno prouchvane deistvieto na iokhimbina vurkhu spermatogenezata na plukh.

The authors found an increase in the number of labelled spermatogonia and spermatocytes with 35 to 40% in the experimental animals as a result of performed quantitative studies on mature male rats after chronic treatment with jochimbin and simultaneous application of 3H-thymidine. This statistically significant difference in comparison with the control animals showed that jochimbin stimulated the mitotic activity of spermatogonia as a result of which the number of spermatozoa was increased and the whole process of spermatogenesis was affected. The biologic action of jochimbin on the spermatogenesis of a rat was similar to that of the preparation TB-68, examined by us.

[Effect of preparation TB-68 on spermatopoiesis in rats (autoradiographic study)]. / Vliianie na preparata TB-68 vurkhu spermatopoeazata na plukh (avtoradiografichni izsledvaniia

Male mature rats were treated per of with TB-68 and intraperitonealy with 3H-thymidine during 7 and 12 days. By means of statistical count of labelled cells in semi niferous tubules a considerable increase of DNA replicating cells in experimental animals was established. The higher percentage of labelled calls reveales an stimulating effect of TB-68 concerning the spermatogonial proliferation, some acceleration of the meiosis and positive influence of the spermatopoiesis as a whole.