RESUMO
OBJECTIVE: Do monochorionic (MC) and/or dichorionic (DC) twins show allometric scaling between placental and birth weight (PW, BW)? METHODS: We extracted BW, PW, gestational age (GA) and cord insertion type from 52 MC to 310 DC twins to calculate ß. DC twins were analyzed as summed and as individuals if placentas were separate. RESULTS: Mean ß for MC (0.78 ± 0.02), DC summed (0.78 ± 0.02), and DC with separate placentas (0.77 ± 0.03 and 0.76 ± 0.04) all non-significant. GA, summed BWs, total PW, BW discordance, and cord insertion sites did not differ between twin types or with ß. CONCLUSION: MC and DC twins show allometric scaling similar to singletons.
Assuntos
Peso ao Nascer/fisiologia , Metabolismo Energético/fisiologia , Desenvolvimento Fetal/fisiologia , Placenta/anatomia & histologia , Gravidez de Gêmeos/metabolismo , Feminino , Retardo do Crescimento Fetal/metabolismo , Retardo do Crescimento Fetal/patologia , Peso Fetal/fisiologia , Humanos , Recém-Nascido , Tamanho do Órgão , Placenta/metabolismo , Placenta/patologia , Gravidez , Gêmeos Dizigóticos , Gêmeos MonozigóticosRESUMO
Autoimmune hepatitis (AIH) in pregnancy can affect both fetal and maternal outcomes. Little is known regarding the fetal outcomes of AIH in pregnancy. The major risks include spontaneous abortions, fetal mortality, perinatal mortality and prematurity. Two common drugs used in the management of AIH, azathioprine and prednisone, may also be associated with adverse fetal outcomes. We present the case of perinatal focal intestinal perforation with a meconium pseudocyst in a preterm infant of a mother with autoimmune hepatitis on azathioprine and methylprednisone.
Assuntos
Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Hepatite Autoimune/complicações , Perfuração Intestinal/diagnóstico por imagem , Mecônio/diagnóstico por imagem , Peritonite/diagnóstico por imagem , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Ampicilina/uso terapêutico , Antibacterianos/uso terapêutico , Azatioprina/efeitos adversos , Enterococcus faecalis/isolamento & purificação , Feminino , Gentamicinas/uso terapêutico , Infecções por Bactérias Gram-Positivas/cirurgia , Hepatite Autoimune/tratamento farmacológico , Humanos , Ileostomia , Imunossupressores/efeitos adversos , Recém-Nascido , Recém-Nascido Prematuro , Perfuração Intestinal/microbiologia , Perfuração Intestinal/cirurgia , Laparotomia , Masculino , Mecônio/microbiologia , Peritonite/microbiologia , Peritonite/cirurgia , Gravidez , Resultado da Gravidez , Fatores de Risco , Resultado do Tratamento , UltrassonografiaRESUMO
OBJECTIVES: To compare targeted neonatal echocardiography (TnECHO) and antero-posterior (AP) chest radiographs in the localization of the umbilical venous catheter (UVC) tip and to determine the accuracy of UVC tip localization by TnECHO when performed by a trained cohort of pediatric housestaff physicians. STUDY DESIGN: Prospective, observational study of consecutive neonates requiring UVC insertion, in a tertiary care center, in an 18-month period. Chest radiographs reporting optimal position of the UVC tip were compared with the TnECHO results of the pediatric cardiologist. The latter was also compared with the results of TnECHO performed by the pediatric housestaff physicians. RESULT: Thirty neonates with birth weight ranging between 270 and 4490 g and gestational age ranging between 24 and 44 weeks were enrolled. Nine patients (27%) required UVC tip repositioning as the cardiologist performed TnECHO revealed sub-optimal tip position despite optimal position on chest radiography. Among them, four had the UVC tip in the right atrium and five in the left atrium. Compared with the cardiologist, the housestaff physicians had reported TnECHO with a high-accuracy rate (area under the receiver operating characteristic curve=0.81). CONCLUSION: TnECHO is superior to chest radiography for identifying malpositioned catheters. TnECHO performed by pediatric housestaff physicians with basic training, demonstrated high-accuracy rates.
