RESUMO
OBJECTIVES: To identify predictive criteria for a positive expectation in the context of rupture of membranes after 37 WG. METHODS: Single-center retrospective study including ROM≥37 WG. The primary outcome was labour onset within 24hours. We compared predictive factors for occurrence of spontaneous labour and described obstetrical and neonatal outcomes according to initial Bishop score<6 or ≥6. RESULTS: From January 2013 to December 2014, 520 patients were included. The predictive factors in case of unfavorable cervix were clinical leakage (P<0.001) and a cervical dilatation≥2cm (P<0.001) according to multivariate analysis. When the expectancy failed, there was a higher rate of cesarean section (24.3% vs. 9.6% P<0.001) but no more proven maternal-fetal infection. In case of Bishop≥6, we identified no predictive factor for labour onset but Apgar<7 at 5minutes (18.7% vs. 3.2% P=0.01) and admission to neonatal unit (18.8% vs. 3.2% P=0.04) were more frequent without majoration of maternal-fetal infection. CONCLUSION: The favorable expectation was the outcome for 70.8% of ROM at term. Clinical leakage and dilated cervix appeared as the main predictors in case of Bishop<6. Majoration of low Apgar score and admission to neonatal unit could be increased when no labour onset occurred despite Bishop≥6.
Assuntos
Ruptura Prematura de Membranas Fetais , Idade Gestacional , Início do Trabalho de Parto , Adulto , Índice de Apgar , Feminino , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Primeira Fase do Trabalho de Parto , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Fatores de TempoRESUMO
Cerebral abscess is considered as a rare lesion with severe prognosis in neonates. The present means of cerebral imaging allow for a better estimation of its frequency, a more precise diagnosis of the evolutive stage and the estimation of the efficacy of the treatments. Incision-drainage associated with antibiotic treatment was successful in children. Two cases of neonatal cerebral abscesses treated and cured according to this protocol are reported.
Assuntos
Antibacterianos/uso terapêutico , Abscesso Encefálico/terapia , Drenagem , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/cirurgia , Terapia Combinada , Ecoencefalografia , Feminino , Humanos , Recém-Nascido , Tomografia Computadorizada por Raios XRESUMO
Intrapericardial teratoma is a rare, and generally benign, tumor originating from the 3 germinal layers. It occurs in 60% of the cases in the first two years of life. Severe cardio-respiratory distress due to mediastinal compression and pericardial effusion are the main clinical symptoms. Echo-cardiography and cine-angiography confirm the diagnosis and early surgical removal brings immediate and durable improvement.
Assuntos
Pericárdio , Teratoma/diagnóstico por imagem , Ecocardiografia , Feminino , Humanos , Lactente , Pericárdio/patologia , Pericárdio/cirurgia , Radiografia , Teratoma/patologia , Teratoma/cirurgia , GêmeosRESUMO
A case of neonatal giant lobar emphysema secondary to a complex cardiac anomaly with pulmonary valvular agenesis is presented. Clinic and radiologic findings are sufficient to suggest diagnosis. Right heart catheterization is required to demonstrate the pulmonary valvular agenesis. Such an investigation should be recorded when observed a giant neonatal emphysema. Is failure occurs in the neonatal period the prognosis of this association is poor.