morphine and Placental-Insufficiency

Meconium obstruction (MO) of prematurity can result in increased morbidity or mortality and prolonged hospitalization if not diagnosed and treated appropriately.. The aims of our study were to identify the incidence and risk factors associated with MO and to review the treatment outcomes.. A retrospective analysis was undertaken of 101 extremely low birth weight infants (ELBWIs) who were born between January 1, 2007, and April 1, 2009, at Seoul National University Hospital. Prenatal and neonatal factors were compared between the MO and control groups. The treatment outcomes were also reviewed.. Twenty-two (22%) patients were diagnosed as having MO. Eighteen of these patients (82%) had prenatal risk factors for MO. Respiratory distress syndrome was more prevalent in the MO group than in the control group (p = 0.001). Overall, 17 of the 22 patients (77%) were relieved with medical treatment and the rest underwent ileostomy. The times to full enteral feeding did not differ between the medically treated group and the control group. However, the surgically treated group required more time to achieve full enteral feeding, and some patients had persistent gastrointestinal problems.. MO is not a rare condition in ELBWIs, and the majority of ELBWIs have prenatal risk factors. Medical management was effective, and medically manageable cases had good prognoses for subsequent feeding, whereas some surgically managed cases had persistent gastrointestinal problems.

Topics: Adult; Comorbidity; Ductus Arteriosus, Patent; Female; Gestational Age; Humans; Ileostomy; Infant, Extremely Low Birth Weight; Infant, Newborn; Intensive Care Units, Neonatal; Intestinal Obstruction; Male; Meconium; Placental Insufficiency; Pregnancy; Republic of Korea; Respiratory Distress Syndrome, Newborn; Retrospective Studies; Sex Ratio; Ultrasonography, Prenatal

The fetal heart rate acceleration response to an acoustic stimulation was compared to the traditional nonstress test in regard to pregnancy outcome, as reflected by the incidence of intrapartum fetal distress, meconium staining of the amniotic fluid, 1- and 5-minute Apgar scores, and perinatal mortality. Fetuses with spontaneous or sound-generated reactivity had comparably good outcomes with respect to all outcome measures investigated. Fetuses who lacked spontaneous or sound-stimulated reactivity had an increased risk for intrapartum fetal distress. The acoustic stimulation test is a safe and rapid test of fetoplacental sufficiency that appears to perform comparably to the nonstress test. The acoustic stimulation test significantly shortens total antepartum testing time and expense.

Topics: Acoustic Stimulation; Amniotic Fluid; Apgar Score; Female; Fetal Distress; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Meconium; Placental Function Tests; Placental Insufficiency; Pregnancy; Risk; Ultrasonography

Topics: Adolescent; Adult; Apgar Score; Body Weight; Female; Fetal Monitoring; Humans; Meconium; Placenta Diseases; Placental Insufficiency; Pregnancy