Relationship between brainstem auditory function during the neonatal period and depressed Apgar score

Objective.?To understand whether infants with depressed Apgar scores are at high risk of brainstem auditory impairment, we examined the relationship between brainstem auditory function during the neonatal period and depressed Apgar score.

Methods.?Brainstem auditory evoked responses (BAERs) were recorded from day 1 to day 30 in 145 term infants with Apgar scores?≤?6.

Results.?For 1-min Apgar score none of BAER response wave latencies and interpeak intervals during the first 15 days correlated significantly with the score. On day 30, all wave latencies but no intervals correlated negatively with the score (all p?<?0.05). For 5-min Apgar score, only on day 3 wave V latency and I–V and III–V intervals correlated negatively with the score (all p?<?0.05). For 10-min Apgar score, only III–V interval correlated negatively with the score (p?<?0.05). No correlation was found between BAER variables on any other days and 5 and 10-min Apgar scores. Wave V latency and I–V and III–V intervals on day 3 were all significantly longer in infants with 5-min Apgar scores?≤?6 than in those with scores?>?6.

Conclusions.?During the neonatal period, only on day 3 after birth a depressed 5-min Apgar score is an indicator associated with central auditory impairment. A depressed 1-min score may be associated with later peripheral auditory impairment.     

窒息新生儿血清血管内皮生长因子的动态变化

为观察窒息新生儿血清血清血管内皮生长因子（ＶＥＧＦ）水平的动态变化并探讨其临床意义，我们应用双抗体夹心酶联免疫吸附法（ＥＬＩＳＡ）对正常新生儿（对照组３０例）、窒息新生儿（窒息组４７例）出生后即刻、第一天和第３天３个时间点血甭ＶＥＧＦ水平进行检测。结果显示窒息组出生时血清ＶＥＧＦ水平显著上升，与对照组相比有极显著的差异（Ｐ〈０．０１），其中站升的程度与新生儿窒息的严重程度有关，与血ＰＨ值及１分ｐａ     

The umbilical coiling index and adverse perinatal outcome.

OBJECTIVE: Evaluation of the relationship between umbilical coiling index (UCI) and adverse perinatal outcome. METHOD: A prospective study was performed on 699 pregnant women who were 37-40 weeks. UCI was determined by dividing the total number of the complete vascular coiling by the total umbilical cord length in centimeters. Then the relationship between UCI and neonatal weight, amniotic fluid index, meconium, Apgar score, and fetal distress were evaluated. RESULTS: There was a significant difference between normo- and hypocoiled groups according to the Apgar score less than 7 in minute 5, AFIApgar score less than 7 in minute 5, AFI相似文献   

新生儿窒息的抢救及护理

新生儿窒息是指胎儿娩出1 min仅有心跳而无呼吸或未建立规则呼吸的缺氧状态[1],一般医院发病率约5%.严重时,新生儿呼吸功能障碍,氧和二氧化碳交换能力丧失,导致血氧浓度降低,二氧化碳聚集产生酸中毒,造成缺血缺氧性脑损伤、小儿智力低下、癫痫等后遗症,甚至导致新生儿死亡[2].……     

43例新生儿缺氧缺血性脑病围产因素分析

目的:探讨新生儿缺氧缺血性脑病(HIE)与围产期因素的关系.方法:对经头颅CT证实为HIE的43例患儿资料进行回顾性分析.结果:足月新生儿较早产儿和过期产儿HIE的发生数较高;极低出生体重儿、巨大儿、宫内窘迫经产道分娩儿的病情较危重;Apgar评分越低,HIE分度表现越重;5分钟评分对判断预后尤为重要.结论:准确判断和处理围产期不利因素、及时正确进行窒息新生儿复苏,对减少HIE发生至关重要.     

助孕与自然受孕围生期结局的差异

目的：比较助孕与自然受孕围生期结局的差异,分析和评价助孕围生期结局的安全性.方法：选取资料完整的技术助孕儿66例为研究组,随机抽样选择同期自然受孕儿66例为对照组;比较两组婴儿的胎龄、体重、身长、Apgar评分以及早产儿和低体重儿发生率,统计分析两者差异.结果：两组出生时身长、胎龄、体重、Apgar评分均无显著性差异（P＞0.05）,早产儿及低体重儿的发生率也无显著差异（P＞0.05）.结论：助孕与自然受孕围生期结局总体上无明显差异,技术助孕儿具有与自然受孕儿基本相同的生存质量.     

自控腰硬联合分娩镇痛不同的停泵时机对产程和分娩结局的影响

目的探讨自控腰硬联合分娩镇痛麻醉下,初产妇分娩过程中不同的停泵时机对产程、分娩结局和产妇满意度的影响。方法选择2013年4月-2013年12月间符合条件的初产妇120例,按先后顺序分到A、B、C三组,每完成10个另起一组,每组40例,腰硬联合麻醉分娩镇痛,A组宫口开全停泵,不再开泵;B组宫口开全停泵,胎儿娩出后立即开泵;C组一、二、三产程持续镇痛,三组均于第三产程结束,会阴缝合术毕结束镇痛并拔硬外镇痛管。观察比较产妇基本情况、镇痛效果（VAS）评分、第1、2、3产程时间、产后2h内出血量、缩宫素使用、剖宫产率、钳产率、羊水性质、产妇满意度,新生儿Apgar评分。结果三组间产后2h出血、新生儿Apgar评分、第三产程时间差异无统计学意义;A、B组产妇分娩痛比例较c组增加,会阴缝合痛或不适者较C组多,C组产妇满意度较A、B组增加,差异有统计学意义,A、B组间各项指标间差异无统计学意义。结论不同的停泵时机不增加第二产程,不影响新生儿Aparg评分,不增加产后出血,持续用药组增加缩宫素使用率,差异有统计学意义（P〈0．05）,可能增加剖宫产趋势,但可提高产妇满意度。     

宫内缺氧致新生儿缺氧缺血性脑病Apgar评分与病情预后的关系

目的:研究宫内缺氧致新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)出生后Apgar评分与病情预后的关系。方法:选择我院2001年1月~2006年5月收治的210例宫内缺氧致HIE的临床及随访资料进行分析。结果:210例中出生后1分钟内Apgar评分1~3分54例,4~7分141例,8~10分15例。随访时间(10.6±3.7)个月。Apgar评分1~3分组出现神经系统后遗症3例,死亡3例,放弃治疗2例,侧脑室扩大3例;4~7分组出现语言功能障碍1例,硬膜下积液2例;8~10分组出现脑瘫、第三脑室扩大、侧脑室扩大各1例。结论:胎儿有宫内缺氧时出生后可能患HIE,出生后1分钟内Apgar评分1~3分的患儿预后较差,但即使Apgar评分正常,也有可能出现神经系统严重后遗症。     

Operating room‐to‐incision interval and neonatal outcome in emergency caesarean section: a retrospective 5‐year cohort study

We conducted a 5‐year retrospective cohort study on women undergoing caesarean section to investigate factors influencing the operating room‐to‐incision interval. Time‐to‐event analysis was performed for category‐1 caesarean section using a Cox proportional hazards regression model. Covariates included: anaesthetic technique; body mass index; age; parity; time of delivery; and gestational age. Binary logistic regression was performed for 5‐min Apgar score ≥ 7. There were 677 women who underwent category‐1 caesarean section and who met the entry criteria. Unadjusted median (IQR [range]) operating room‐to‐incision intervals were: epidural top‐up 11 (7–17 [0–87]) min; general anaesthesia 6 (4–11 [0–69]) min; spinal 13 (10–20 [0–83]) min; and combined spinal‐epidural 24 (13–35 [0–75]) min. Cox regression showed general anaesthesia to be the most rapid method with a hazard ratio (95%CI) of 1.97 (1.60–2.44; p < 0.0001), followed by epidural top‐up (reference group), spinal anaesthesia 0.79 (0.65–0.96; p = 0.02) and combined spinal‐epidural 0.48 (0.35–0.67; p < 0.0001). Underweight and overweight body mass indexes were associated with longer operating room‐to‐incision intervals. General anaesthesia was associated with fewer 5‐min Apgar scores ≥ 7 with an odds ratio (95%CI) of 0.28 (0.11–0.68; p < 0.01). There was no difference in neonatal outcomes between the first and fifth quintiles for operating room‐to‐incision intervals. General anaesthesia is associated with the most rapid operating room‐to‐incision interval for category‐1 caesarean section, but is also associated with worse short term neonatal outcomes. Longer operating room‐to‐incision intervals were not associated with worse neonatal outcomes.