| Perinatal variables and neonatal outcomes in severely growth restricted preterm fetuses. | |
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MedLine Citation:
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PMID: 20804344 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the impact of severe preterm intrauterine growth restriction on perinatal and neonatal outcomes. DESIGN: Retrospective cohort study. SETTING: Tertiary referral fetal medicine unit in London. POPULATION: A total of 60 pregnancies affected by early onset severe intrauterine growth restriction with fetal abdominal circumference below the third centile and abnormal arterial or venous Dopplers between October 2003 and October 2007, and control cohort of 77 appropriate-for-gestational age preterm neonates. METHODS: Cases were identified from the departmental databases. The neonatal outcomes in 44 growth restricted survivors were compared with 77 gestation matched appropriate-for-gestational age preterm neonates. MAIN OUTCOME MEASURES: Neonatal morbidity and neonatal mortality. RESULTS: Of the 60 pregnancies affected by severe intrauterine growth restriction, seven were terminated, nine resulted in stillbirth and 44 resulted in live births. The growth restricted neonates had increased odds of developing respiratory distress compromise (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-6.2) and thrombocytopenia (OR 9.4, 95%CI 2.9-30.8) in comparison to average-for-gestational age cohorts. We also noted an increased risk of neonatal sepsis (OR 2.5, 95%CI 1.1-6.0) and necrotising enterocolitis (OR 9.7, 95%CI 1.1-86.0). Sepsis was the major contributing factor towards neonatal mortality in the growth restricted cohorts. CONCLUSION: Despite intensive fetal surveillance and tertiary level neonatal care, the survival for growth restricted fetuses before 28 weeks gestation remains poor with neonatal outcome predominantly affected by respiratory morbidity, sepsis and metabolic compromise. |
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Authors:
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Neelam Engineer; Sailesh Kumar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 89 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-31 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: England |
Other Details:
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Languages: eng Pagination: 1174-81 Citation Subset: IM |
Affiliation:
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Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College, London, United Kingdom. nejengineer@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Induced
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statistics & numerical data Acidosis / epidemiology Adolescent Adult Anemia, Neonatal / epidemiology Case-Control Studies Cohort Studies Enterocolitis, Necrotizing / epidemiology Female Fetal Growth Retardation / epidemiology* Humans Hypoglycemia / epidemiology Infant Mortality Infant, Newborn Infant, Premature Intensive Care Units, Neonatal Length of Stay / statistics & numerical data Live Birth / epidemiology Middle Aged Pre-Eclampsia / epidemiology Pregnancy Pregnancy Outcome* Premature Birth Respiratory Distress Syndrome, Newborn / epidemiology, therapy Retrospective Studies Sepsis / epidemiology Severity of Illness Index Stillbirth / epidemiology Thrombocytopenia / epidemiology Umbilical Arteries / ultrasonography |
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