[Prevention of early-onset neonatal group B streptococcal infection: neonatal outcome after introduction of national screening guideline]. / Prevence casné formy onemocnení novorozencu streptokoky skupiny B: neonatální outcome po zavedení doporuceného postupu.

OBJECTIVE: To evaluate the effectiveness of introduction of national guideline to prevent early-onset group B streptococcal (EOGBS) disease, number of screened women and incidence of GBS colonization. DESIGN: Retrospective cohort study. SETTING: Department of Obstetrics and Gynaecology, Department of Neonatology, University Hospital Ostrava. SUBJECT AND METHOD: We reviewed 8484 consecutive term pregnancies of women who delivered in our hospital, between years 1999-2001 before the introduction of guideline and years 2003-2005 following the guideline. RESULTS: In group 1999-2001 there were 12/3581 (3.35 per thousand) neonates with EOGBS infection in which 7/3581 (1.96 per thousand) had invasive disease. In group 2003-2005 there were 14/4903 (2.86 per thousand) neonates with EOGBS infection (p=68,33%), in which 6/4903 (1,22 per thousand) had invasive disease (p=39,52%). Number of screened women in years 2003-2005 increased from 40% to 65%, and 69% respectively. There were 577/3019 (19%) of GBS colonized women. CONCLUSION: There was 15% decrease of EOGBS disease following the introduction of guideline. Number of screened women increased by 29% in three-year period. GBS colonization in pregnant women is 19%.

[Changes in the developmental outcome of very low and extremely low birth weight infants at 24 months' corrected age born in 1997-2007]. / Zmeny incidence postizení vývoje u detí s velmi nízkou a extrémne nízkou porodní hmotností ve 24 mesících sicich korigovaného veku, narozených v letech 1997-2007.

OBJECTIVE: To describe the incidence of developmental impairments (DI) among very low birth weight (VLBW) infants at 24 months' corrected age, born in perinatal centers in 1997-2007, and evaluate their changing prognosis of intact development. DESIGN: Prospective epidemiological study. SETTING: Follow-up clinics of neonatal centers level III. METHODS: Live birth rate, in-hospital mortality, neonatal morbidity, DI and quality of survival were assessed. Neonatal morbidity was analyzed in periods 2000/2, 2003/5, and 2006/7 by the data of Institute of Health Informatics and Statistics. DI and quality of survival were evaluated in cohorts of VLBW infants born in 1997/9 (period I), 2000/2 (period II), 2003/5 (period III) and 2006/7 (period IV). RESULTS: Live birth rate of VLBW newborns in 1997-2007 increased in total of 39.5%, in-hospital mortality decreased, significantly in 1997-9 (fall of 10%). Neonatal morbidity, except infections, also declined. Significant decrease in DI-CP and visual impairment, was observed after period II, in category 1000-1499 g of 7/1.5%, in infants <1000 g of 8/7% resp. After period II, the prevalence of impaired children 1000-1499 g decreased of 5%, whereas in category < 1000 g only small decrease of 2% occurred in period III. Number of children without impairment increased gradually in both categories. CONCLUSIONS: The study showed significant increase in surviving VLBW infants, especially in category <1000 g. Increased survival rate at concurrent fall in severe neonatal morbidity (except infections) was not accompanied with worsened prognosis of an intact development.

[Spontaneous perforation of the stomach in neonates]. / Spontánní perforace zaludku u novorozencu.

The authors report on five neonates with perforation of the stomach manifested during the first two weeks of life. Four of the neonates had low birth weights. Asphyxia was proved in three neonates, in two histological examination revealed a congenital defect of the musculature of the gastric wall, in three a nasogastric tube was used. Causes which lead to gastric perforation in neonates are not uniform. Only by early diagnosis and surgical treatment the mortality can be reduced.