Epidural Analgesia and Perinatal Retinal Haemorrhages

The incidence and magnitude of retinal haemorrhages in a group of neonates delivered spontaneously (n = 50), whose mothers received epidural analgesia during labour, has been compared to those of a spontaneously delivered control group (n=50) who received conventional analgesia. The second stage of labour was significantly longer in the epidural group ( P <0.001), which contained a higher number of primiparas than did their controls. Still, a lower incidence of retinal haemorrhages was noted in the epidural group (P<0.01).
The study indicates that epidural analgesia offers a certain degree of protection against perinatal retinal haemorrhages in the spontaneously delivered neonate.     

Symptomatic, expansive middle cranial fossa arachnoid cyst treated by a cysto-peritoneal shunt Case report and evaluation of treatment options

We report a symptomatic space-occupying arachnoid cyst in a 16-year-old boy. During the last two years, he was frequently absent from school because of headaches. Due to symptoms of nausea, fever and headache the patient was primarily referred to a surgical unit, where appendectomy was performed, revealing a normal appendix. Postoperatively, the patient complained of severe headache. Computed tomography (CT) of the head demonstrated a large left-sided middle cranial fossa arachnoid cyst. The patient was operated with insertion of a cysto-peritoneal shunt. A total regress of the clinical symptoms was seen at follow-up examination 3 months after shunting.     

Retrolental fibroplasia in premature infants with patent ductus arteriosus treated with indomethacin

Sixteen premature infants were treated with indomethacin, either orally or intravenously, in order to close a symptomatic patent ductus arteriosus requiring mechanical ventilation. Positive effect was obtained in 4 of the 10 orally treated patients and in 1 of the 6 with intravenous administration. Immediate side effects were impairment of renal function, abdominal distension, and restlessness.Although the oxygen administration was guided using a transcutaneous oxymonitor, three severe cases of retrolental fibroplasia occurred. As indomethacin is a nonselective inhibitor of all prostaglandins, it might also cause a constriction of the retinal arteries, and as such be a factor in the development of retrolental fibroplasia in small premature infants.