Ten thousand nine hundred and sixty four consecutive live births weighing more than 500 g and more than 28 weeks of gestation were subjected to a thorough clinical examination within 24 h of birth. Those suspected of having congenital heart disease (CHD) were followed up every 4-6 weeks for a ...

BACKGROUND: Despite current medical and surgical therapy, infants with symptomatic congenital mitral stenosis (CMS) continue to have high rates of morbidity and mortality. Catheter balloon dilation has been successful in relieving symptoms in a few older children with CMS but has not been evaluated in infants. METHODS AND RESULTS: We ...

The aim of this randomized study was to compare the neonatal outcome in infants who have been exposed in utero to indomethacin with that in infants exposed to a beta-adrenergic agonist, nylidrin hydrochloride. Eighty pregnant women threatened with preterm labor between 24 and 34 weeks of gestation were enrolled in ...

During the past decade, an increasing incidence of staphylococcus organisms resistant to penicillinase-resistant penicillins has necessitated the use of vancomycin. This increased utilization has revitalized research concerning efficacious vancomycin dosing regimens for premature neonates, infants, and children. Vancomycin dosing in neonates is variable because this patient population has decreased renal ...

Contractions to serotonin (5-HT) and endothelin-1 (ET-1) in infant (0-2 yr) and adult (38-71 yr) vertebral arteries were examined in the presence of either the cyclooxygenase inhibitor indomethacin or NG-monomethyl-L-arginine (L-NMMA), an inhibitor of nitric oxide production. In addition, endothelium-dependent relaxations to acetylcholine were characterized in arteries contracted with agonist. ...

Antenatal closure of the ductus arteriosus has been considered as a potential risk factor for the development of hydrops fetalis and persistent fetal circulation of the newborn. We present an infant with antenatal ductal closure who had not received prenatal prostaglandin synthetase inhibitors. The pulmonary vascular morphological findings are described ...

Twenty preterm infants were studied serially with Doppler echocardiography to document changes in pulmonary artery pressure, myocardial thickness, and patent ductus arteriosus associated with dexamethasone treatment for chronic lung disease. Pulmonary artery pressure was assessed with Doppler, by its inverse correlation with the ratio of the pulmonary artery time to ...

In a consecutive study of 14 boys and 17 girls with non-B-cell ALL who were > or = 1 year of age at diagnosis, the degree of myelosuppression during the last year of MTX/6MP maintenance therapy was analyzed in relation to the erythrocyte concentration of MTX polyglutamates and 6-thioguanine nucleotides ...

Chloro-aluminum sulfonated phthalocyanine (CASPc) is a photo-chemically active dye employed in photodynamic therapy (PDT). CASPc is a potent generator of singlet oxygen when irradiated with 675 nm light and is also capable of fluorescence, allowing visualization of the dye in tissues. We devised an angiography system using CASPc fluorescence to ...

Patent ductus arteriosus is a frequent indication for surgical intervention in preterm infants. Commonly this operation is performed through a dorsolateral thoracotomy. In an animal trial (piglets smaller than 1,400 g) instruments and technique for thoracoscopic clipping of patent ductus arteriosus were developed. Since January 1993, 3 premature infants have ...

BACKGROUND: The use of indomethacin as a tocolytic agent in pregnant women appears to be accompanied by a low incidence of neonatal complications. However, the neonatal effects of indomethacin have been studied primarily in infants born after 32 weeks' gestation. This study was designed to examine the incidence of neonatal ...

From 1989 through 1992 we followed more than 200 fetuses and newborn infants referred for heart transplantation, of whom more than 140 were ultimately registered to receive a transplant. During this time, the interval before these infants underwent transplantation ranged from 1 day to 6 months. This experience left us ...

The aim of this study was to compare the efficacy of two inotropic infusions in treating low BP in preterm neonates. Forty infants with median gestational age 27 weeks (range 23-33) were studied. At trial entry the infants, who all had a systolic BP < 40 mmHg despite receiving a ...

Renal immaturity is pronounced in very low-birth-weight infants with a gestational age < or = 30 weeks. We attempted to elucidate if conditions requiring mechanical ventilation, including patent ductus arteriosus, might further compromise renal function due to decreased renal perfusion. Forty infants studied between 4 and 28 days of age ...

To determine the relationship of phototherapy and patent ductus arteriosus, we analyzed prospectively collected data on 295 infants with birth weight of 501 to 999 gm admitted from 1984 through 1988. Seventy-four percent were evaluated by an imaging study to aid in the detection of a silent patent ductus arteriosus. ...

Indomethacin has been demonstrated to be effective for closure of hemodynamically symptomatic patent ductus arteriosus (PDA) in premature infants. The five cases in this study had acquired asymptomatic reopening of PDA a long time after successful closure by oral indomethacin. Providing adequate oxygen, giving another course of indomethacin, preventing excessive ...

Between January 1988 and December 1990, 132 neonates weighing < 800 g were admitted to our neonatal intensive care unit. Of the 76 who survived initial resuscitation, 42 had developed a hemodynamically significant patent ductus arteriosus (PDA) (mean +/- SD): gestational age 25.3 +/- 1.9 weeks, birth weight 650 +/- ...

This article reports a case of a very low birth weight infant who was given intravenous indomethacin for a symptomatic patent ductus arteriosus and subsequently had two isolated ileal perforations several days apart. Spontaneous or indomethacin-related ileal perforation appears to constitute a separate clinical and pathologic entity, different from necrotizing ...

Patency of the ductus arteriosus is one of the more common problems of the neonate. Although the ductus arteriosus usually closes within the first days of life, persistent patency can complicate the clinical status of a newborn. The ductus arteriosus also may play a role in the pathophysiology of persistent ...

The plethysmo time interval (PTI) is the time interval between the beginning of QRS complex on ECG and the upstroke of the pulse wave on the plethysmogram as measured by a pulse oximeter. We examined whether measuring the PTI has clinical value for evaluating neonatal peripheral circulation. We correlated PTI ...

A series of investigations has been performed to assess the timing of physiologic closure of the ductus arteriosus in premature infants with and without respiratory distress syndrome. The data from these studies emphasize the concept of physiologic ductal patency and give normative data for expected closure rates through the fourth ...

To study the effect of antenatal indomethacin or nylidrin hydrochloride treatment on the fetal and neonatal ductus arteriosus and tricuspid valve function, 84 pregnant women with threatened premature birth between 22.9 and 34.0 wk gestation and 94 of their offspring born at 24.7 to 41.6 wk of gestation were studied ...

The case of a 720-g infant born at 29 weeks of gestation who underwent successful surgical correction of a hypoplastic aortic arch and aortic coarctation is presented. The infant was initially brought to surgery with an echocardiographic diagnosis of patent ductus arteriosus with left to right shunt unresponsive to indomethacin ...

Seventeen term newborn infants (control subjects) and 17 whose mothers had been given intravaginal doses of prostaglandin E2 (PGE2) were examined serially by color Doppler echocardiography to determine whether maternal PGE2 prolonged ductal patency. No clinically relevant differences in closure times were found. Low-dose intravaginal PGE2 therapy was not associated ...

Premature newborns with patent ductus arteriosus can be managed by prostaglandin inhibition, but this medical treatment carries a high risk of renal failure, and other complications such as necrotizing enterocolitis and hematologic disorders have been described. Echocardiography gives an early confirmation of shunt and surgical treatment may be proposed. The ...

There is a significant incidence of inguinal hernia in premature infants and the optimal timing of repair is controversial. A high rate of postoperative respiratory complications has been reported in this group. In this study, the records of 47 premature infants (mean gestational age, 30.3 weeks) who underwent herniorrhaphy while ...

OBJECTIVE: To determine whether antenatal dexamethasone sodium phosphate administration constricts the fetal ductus arteriosus or improves spontaneous closure of the ductus in premature infants. DESIGN: A randomized double-blind study. SETTING: University hospital of Helsinki, Finland. PARTICIPANTS: Sixty-one pregnant women with threatened preterm delivery between 24 and 31.9 weeks' gestation and ...

A 37-week male infant is reported with microbrachycephaly, micrognathia, a cleft palate, a small tongue and a patent ductus arteriosus. Postmortem examination revealed micropolygyria, absence of the olfactory bulbs and tracts, absence of the corpus callosum, marked hydrocephalus and abnormal midbrain structures and basal ganglia. The cerebellum was very small ...

During a screening protocol of early echocardiographic diagnosis (ATL MK 600) and treatment of "silent" PDA in RDS preterms with BW < or = 1.750 kg, clinical data on premature twins were collected, including diagnosis of both PDA and BPD, to investigate whether twin birth influences PDA incidence and BPD ...

Some trials in premature infants with respiratory distress syndrome have shown an increased incidence of patent ductus arteriosus after exogenous surfactant therapy. The effect of prophylactic ethamsylate on patent ductus arteriosus after intratracheal administration of a single dose of porcine surfactant preparation (Curosurf, 2.5 ml/kg) was studied in a group ...

An unusual cause of airway obstruction was demonstrated by MRI in two infants with congenital heart disease. The two infants experienced airway obstruction caused by a right aortic arch with right-sided patent ductus arteriosus. The diagnosis was established by MRI prior to surgery; angiography did not demonstrate the critical relationship ...

Forty one preterm infants (birth weight < 1500 g) were studied by daily Doppler echocardiography for the first week of life to examine the effect of a haemodynamically significant ductus arteriosus (HSDA) on systemic blood pressure. Hourly records of blood pressure were averaged for each infant to produce a 24 ...

During a 3-year period (1988 through 1990) an increase was observed in the number of infants born at 23- to 26-weeks' gestation who required cryotherapy for severe retinopathy of prematurity (0/20, 1988; 3/14, 1989; 6/18, 1990; P = .015). Inasmuch as this was not related to improved survival, a retrospective ...

Colour Doppler flow mapping was used to determine the time of closure of the arterial duct in 51 healthy newborn infants. Initial time of closure corresponded with previous reports: 20% on the first day, 82% by the second day, 96% by the third day, and 100% by the fourth day. ...

In situ cross-sectional morphology of the ductus venosus and related vessels was studied after rapid whole-body freezing of the fetal and neonatal rat. In the fetus, the ductus venosus was open widely, connecting the umbilical sinus and the inferior vena cava. The diameter of the ductus venosus was 50% of ...

When primary abdominal wall closure in a newborn with gastroschisis cannot be accomplished safely, placement of a reinforced Silastic silo facilitates delayed primary closure (DPC). In this report we describe our experience with the gastroschisis wringer clamp (GWC). The GWC is an autoclavable, 140-g, aluminum alloy device reminiscent of an ...

Pregnancy-induced hypertension (PIH) in general and preeclampsia in particular are major causes of maternal and perinatal morbidity. Data from our studies and from a number of prospective controlled trials have suggested that aspirin in doses of 60-150 md/day during the second and third trimester reduces the risk of PIH and ...

The aim of this study was to measure plasma atrial natriuretic peptide in preterm infants with a patent ductus arteriosus before and after closure with indomethacin. Atrial natriuretic peptide was measured in 28 preterm infants with clinical and echocardiographic evidence of a patent ductus arteriosus and in eight preterm infants ...

Percutaneous balloon aortic valvuloplasty (BAV) was performed in 14 patients, including one critically ill infant with congenital valvular aortic stenosis (AS). BAV was effective in 13 patients (except the infant). The peak systolic pressure gradient between the left ventricle (LV) and the ascending aorta decreased from 76.6 +/- 21.6 to ...

An overview is presented of 21 randomised controlled trials of either surgical closure of the ductus arteriosus or indomethacin therapy in preterm infants. All trials included backup treatment if the ductus arteriosus persisted. Overall, there is no significant effect on mortality or chronic lung disease. In trials treating at a ...

OBJECTIVES: This study details the incidence, by gestational age and birth weight, of specific neonatal morbidities in singleton neonates without major congenital anomalies. STUDY DESIGN: Data were prospectively collected on all deliveries at five tertiary centers in the United States during the years 1983 through 1986. Pregnancies were meticulously dated ...

Severe mechanical haemolysis occurred in a seven month old infant after the insertion of a 17 mm Rashkind double umbrella device. The placement of a second device 23 days after the initial procedure abolished haemolysis.

Twenty four preterm infants (median birth weight 1120 g and gestation 29 weeks) were studied on 83 occasions by measuring upper airway airflow. Airway patency was detected by the transmission of cardiac impulse up the airway and airway closure by its absence. A total of 309 apnoeas of at least ...

Nonnutritive sucking has been found to affect movement, sleep, state regulation and arousal, oxygenation, and nutrition and growth. Its quality is used as an indicator of central nervous system well-being. Speculations have been suggested about improved outcomes from respiratory distress syndrome, patent ductus arteriosus, and necrotizing enterocolitis. The possible effect ...

To determine the incidence and risk factors for neonatal hypertension we studied the entire population of 3179 infants admitted to our neonatal intensive care unit over a 6-year period. We report a 0.81% (26/3179) incidence of hypertension in this population. In 13 patients (50%) the hypertension was renal in origin. ...

A patient developed hemolysis and hematuria 2 d after placement of a 12 mm Rashkind PDA occlusion device. Six days after placement, the device was snared from the ductus arteriosus and removed through a modified transseptal sheath. A 17 mm PDA occlusion device was successfully placed in the PDA, with ...

Long-term variability (LTV) of heart rate was calculated continuously by a microprocessor in 25 preterm infants undergoing indomethacin treatment for closure of patent ductus arteriosus (PDA), in 24 preterm infants without signs of PDA, and in 10 neonates treated with prostaglandin E1 for cyanotic heart malformation. In infants with patent ...

Forty-one preterm infants with a mean gestational age and birthweight of 29.7 weeks and 1322 g, respectively, were treated with an enteral preparation of indomethacin for the closure of haemodynamically significant patent ductus arteriosus. The indomethacin was prepared by diluting the content of the commercially available 25-mg indomethacin capsule with ...

The effects of the transition from fetal to postnatal circulation on left ventricular geometry, wall motion, and echocardiographic measurements of function in the human preterm infant are largely unknown. To determine whether abnormalities in left ventricular geometry are present in the normal preterm infant after birth and, if so, for ...

Systolic blood pressure was measured using the Doppler technique in 149 infants who attended the neonatal follow-up clinic. One hundred and six of these infants were graduates of the neonatal intensive care unit and 81% were prematurely delivered. Most of the participants were examined only once and their postnatal age ...