Marcus C. Hermansen

The prenatal diagnosis of ventral abdominal wall defects

Ventral abdominal defects are frequently diagnosed by prenatal ultrasonography. This review of 47 infants with ventral defects was designed to determine the effect of prenatal diagnosis on neonatal outcome. All nine infants with prenatal diagnosis were delivered by cesarean section at tertiary level hospitals. Only 13 (34%) of 38 infants with unsuspected defects were delivered by cesarean section and 15 (39%) were delivered at tertiary level hospitals. There was no difference in mortality between infants with prenatal diagnosis (44%) and those with unsuspected defects (37%). Increased mortality correlated with the presence of other major anomalies (79% mortality), with birth weight less than 1500 gm (80%), and with omphaloceles (65%). We conclude that infants with other associated defects or with birth weight less than 1500 gm have poor outcomes and cesarean section may not be justifiable. However, in larger infants without other anomalies, prenatal diagnosis was followed by cesarean section and a good prognosis.

Neonatal supraventricular tachycardia following prolonged maternal ritodrine administration

get-y for gynecologic malignancy have shown that the deposition of “‘In-labeled platelets in the postoperative field is inconsequential in the imaging of a normal venous blood pool in the pelvis. To our knowledge, the present case demonstrates the first diagnosis of an asymptomatic pelvic vein thrombosis and subsequent pulmonary embolus by a noninvasive diagnostic technique, “‘In-labeled platelet imaging. Although further experience is required to delineate the diagnostic sensitivity and specificity of “‘In-labeled platelet imaging, this noninvasive &agnostic technique may allow the early diagnosis of previously occult thrombosis in pelvic veins. Institution of anticoagulant therapy may further reduce the morbidity and mortality of pehic surgery and childbirth.

Abolition of Feeding Intolerance Following Ophthalmologic Examination of Neonates

Administration of mydriatic medication and ophthalmologic examination have previously been associated with feeding intolerance, characterized by large retained gastric aspirates and abdominal distention. In an attempt to eliminate this problem, we instituted a policy of withholding feedings for four hours following ophthalmologic examination. A prospective series of 50 consecutive patients was then followed to determine the incidence of feeding intolerance 24 hours prior to and 24 hours following the examination. All infants had received cyclopentolate hydrochloride and phenylephrine hydrochloride prior to the examination. A critical review of the nursing notes revealed no increased incidence in feeding intolerance during the 24-hour period following examination. There were no cases of necrotizing enterocolitis during either period. This study provides evidence that the incidence of feeding intolerance following ophthalmologic examinations might be reduced by withholding feeding for four hours after the examinations.