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1.
J Perinat Med ; 49(9): 1145-1153, 2021 Nov 25.
Article in English | MEDLINE | ID: mdl-34107572

ABSTRACT

OBJECTIVES: Multiple pregnancies sustain the high pace of extreme prematurity. Little evidence is available about triplet gestation given the evolution in their management during the last decades. The aim of the study was to compare the neonatal outcomes of triplets with those of matched singletons in a cohort study. METHODS: An observational retrospective cohort study of triplets and matched singletons born between 2004 and 2017 matched by gestational age was conducted. Additionally, the investigation performed in regard to data from the overall Greek population of interest. The primary outcome was mortality or severe neonatal morbidity based on pregnancy type. RESULTS: A total of 237 triplets of 24-36 weeks' gestation and 482 matched singletons were included. No differences in the primary outcome between triplets and singletons were found. Rates of severe neonatal morbidities did not differ significantly between triplets and singletons. A threshold of 1000 gr for birthweight and 28 weeks' gestation for gestational age determined survival on triplets [OR: 0.08 (95% CI: 0.02-0.40, p=0.0020) and OR: 0.13 (95% CI: 0.03-0.57, p=0.0020) for gestational age and birthweight respectively]. In Greece stillbirths in triplets was 8 times higher than that of singletons (OR: 8.5, 95% CI: 6.9-10.5). From 3,375 triplets, 94 were stillborn, whereas in singletons, 4,659 out of 1,388,273. In our center 5 times more triplets than the expected average in Greece were delivered with no significant difference in stillbirths' rates. CONCLUSIONS: No significant differences were identified in mortality or major neonatal morbidities between triplets and matched singletons highlighting the significance of prematurity and birthweight for these outcomes.


Subject(s)
Gestational Age , Infant, Newborn, Diseases , Pregnancy, Triplet/statistics & numerical data , Stillbirth/epidemiology , Triplets/statistics & numerical data , Birth Weight , Cohort Studies , Female , Greece/epidemiology , Humans , Infant , Infant Mortality/trends , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Infant, Newborn, Diseases/epidemiology , Intensive Care, Neonatal/statistics & numerical data , Male , Pregnancy , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology
2.
J Pediatr Hematol Oncol ; 41(3): e135-e140, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30601403

ABSTRACT

BACKGROUND: To date, clinical experience with prothrombin complex concentrate (PCC) in the neonatal population has been limited. AIM: The objective of this study was to describe our experience regarding the effectiveness and safety of PCC administration in newborns with severe bleeding or coagulopathy resistant to conventional therapy. METHODOLOGY: We retrospectively analyzed data from 37 neonates with intractable bleeding or severe coagulation disturbances. All patients received intravenous bolus administration of 20 or 30 u/kg of PCC per dose, as a rescue procedure. RESULTS: Hemostasis was achieved in the majority of neonates and we observed statistically significant improvement in prothrombin time, international normalized ratio, and activated partial thromboplastin time (P<0.001, P=0.044, P<0.001, respectively). Thirteen neonates survived, whereas 24 did not survive. In those who survived, PCC had been administered earlier (<24 h) in the disease process compared with those who died (P=0.043). Neither acute adverse events nor thromboembolic complications were observed in all neonates. CONCLUSIONS: In our study, PCC seemed to be a safe and effective intervention for hemostasis and early intervention was more effective as a rescue therapy, without any adverse event. Further prospective controlled trials are required to determine optimal dose and timing of PCC administration in neonates.


Subject(s)
Blood Coagulation Disorders/drug therapy , Blood Coagulation Factors/administration & dosage , Hemorrhage/drug therapy , Time-to-Treatment , Blood Coagulation Disorders/mortality , Blood Coagulation Factors/adverse effects , Blood Coagulation Tests , Female , Hemorrhage/mortality , Hemostasis/drug effects , Humans , Infant, Newborn , International Normalized Ratio , Male , Retrospective Studies
3.
Scand J Infect Dis ; 45(11): 872-7, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23902586

ABSTRACT

We describe the outbreak of a pan-susceptible Klebsiella pneumoniae strain in a neonatal intensive care unit. A total of 7 neonates developed bacteraemia (37% attack rate), of whom 3 died (43% case fatality rate). A birth weight < 1500 g was the only statistically significant risk factor. Despite an extensive environmental investigation, the source was not identified.


Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteremia/epidemiology , Cross Infection/epidemiology , Disease Outbreaks , Klebsiella Infections/epidemiology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/isolation & purification , Bacteremia/microbiology , Case-Control Studies , Cross Infection/microbiology , Female , Humans , Infant, Newborn , Intensive Care, Neonatal , Klebsiella Infections/microbiology , Male , Microbial Sensitivity Tests , Risk Factors , Survival Analysis
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