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The cardiovascular response of the acidotic newborn to sodium bicarbonate
ABSTRACTS
GENERAL
837
CONSIDERATIONS
Congenital Malformations Bornto Epileptic Women. 1:9-IO (January), 1973.
Among Infants C. R. Lowe. Lancet
. A survey was conducted at the Welsh National School of Medicine, Cardiff, into the incidence of congenital malformations in infants born to epileptic mothers. Over a 7-yr period the malformation rate in the control population was 2.77” compared with 6.7”,, in the group of epileptic mothers who had taken anticonvulsants during the first trimester of pregnancy. Unlike previous reported series where a predominance of cleft lip/palate deformities had been noted, in this series no one type of abnormality predominated. The conclusion is drawn that the advantages to the pregnant mother and the fetus of the control of fits by an;iconvulsants outweigh the disadvantages.--M. H. Gough Neonatal Emergency Surgery. H. H. Nixon. Br. J Hosp. Med 873-80 (July), 1972. Mr. Nixon begins his review by saying that it is necessarily brief and he deals with the Eommoner intestinal neonatal emergencies, though he does say a few words on urological and neurological abnormalities and mentions some neonatal tumors. His final section on management covers the important points common to all emergencies of the neonate. His section on acute intestinal obstruction deals with atresias and stenoses, malrotation, and meconium ileus. There are also sections on Hirschsprung’s disease and imperforate anus. He also considers functional obstructions and necrotizing entercolitis which may be secondary to Hirschsprung’s disease or due to other forms of stress. This is followed by a section on acute respiratory distress which after mentioning bilateral choanal atresia then deals at greater length with diaphragmatic hernias and esophageal atresias as well as H-fistulae. He purposely avoids discussing cardiac surgery. Management is covered in three sections-transport, preoperative preparation. and postoperative care. The important points which enable safe transfer of these infants is stressed, such as warmth, and the availability of nasopharyngeal suction which is more important than available oxygen, Preoperative rehydration is needed only in severe cases, but rewarming is important, Infants with esophageal atresia, once under expert care, can safely be left a day or two while
a collapsed lobe is reexpanded. Postoperative management requires humidity to alleviate inspissation of mucus. The importance of preventing overhydration is also stressed and that serum sodium of about 120 meq/liter is frequently caused by water retention. A close watch on the blood sugar is needed postoperatively.7. G. D. Shannon
Mat&al Fetal
Varicella Infection Malformations. M.
Moosa.
and R. R. Gordon.
(February),
as a Cause of 0. Savage, A. Lancet 11352 354
1973.
The distinction is made between congenital disease produced by persisting viral infections (such as rubella or cytomegalic inclusion disease), and specific congenital malformations (such as those produced by rubella) which are due to a direct teratogenic effect on the developing fetus. Congenital varicella after maternal infection in the last 2 wk of pregnancy is well recognized and congenital malformations of the eye, skin, and limbs have been reported after herpes zoster infection in early pregnancy. This paper describes the malformations found in an infant, who survived only 3 mo. whose mother contracted varicella during the ninth week of pregnancy. The abnormalities were a reduction deformity of the left upper limb; depressed, depigmented skin scars along this limb, the right laker limb and the scalp: hypoesthesia to pinprick; Homer’s syndrome; pharyngeal incoordination. The neurotropism of the varicella zoster virus is apparent in these anomalies. the reduction deformity of the upper limb was prdbably secondary to denervation.M. H. Cough.
The Cardiovascular Response of the Newborn to Sodium Bicarbonate. Rouse and A. Arango. Arch. Surg. 332 (March), 1973.
Acidotic M. 1. 106:327
To decide whether the therapeutic response of bled puppies to sodium bicarbonate was due to correction of the acidosis or to simple osmolar function of the solution, sodium chloride solution (same sodium content as sodium bicarbonate) and mannitol (same osmolality as sodium bicarbonate) were employed. It is suggested that the improved cardiovascular function after sodium bicarbonate infusion may be due to osmolality rather than buffering. ~~ Edward
J. Berman
GENERAL
837
CONSIDERATIONS
Congenital Malformations Bornto Epileptic Women. 1:9-IO (January), 1973.
Among Infants C. R. Lowe. Lancet
. A survey was conducted at the Welsh National School of Medicine, Cardiff, into the incidence of congenital malformations in infants born to epileptic mothers. Over a 7-yr period the malformation rate in the control population was 2.77” compared with 6.7”,, in the group of epileptic mothers who had taken anticonvulsants during the first trimester of pregnancy. Unlike previous reported series where a predominance of cleft lip/palate deformities had been noted, in this series no one type of abnormality predominated. The conclusion is drawn that the advantages to the pregnant mother and the fetus of the control of fits by an;iconvulsants outweigh the disadvantages.--M. H. Gough Neonatal Emergency Surgery. H. H. Nixon. Br. J Hosp. Med 873-80 (July), 1972. Mr. Nixon begins his review by saying that it is necessarily brief and he deals with the Eommoner intestinal neonatal emergencies, though he does say a few words on urological and neurological abnormalities and mentions some neonatal tumors. His final section on management covers the important points common to all emergencies of the neonate. His section on acute intestinal obstruction deals with atresias and stenoses, malrotation, and meconium ileus. There are also sections on Hirschsprung’s disease and imperforate anus. He also considers functional obstructions and necrotizing entercolitis which may be secondary to Hirschsprung’s disease or due to other forms of stress. This is followed by a section on acute respiratory distress which after mentioning bilateral choanal atresia then deals at greater length with diaphragmatic hernias and esophageal atresias as well as H-fistulae. He purposely avoids discussing cardiac surgery. Management is covered in three sections-transport, preoperative preparation. and postoperative care. The important points which enable safe transfer of these infants is stressed, such as warmth, and the availability of nasopharyngeal suction which is more important than available oxygen, Preoperative rehydration is needed only in severe cases, but rewarming is important, Infants with esophageal atresia, once under expert care, can safely be left a day or two while
a collapsed lobe is reexpanded. Postoperative management requires humidity to alleviate inspissation of mucus. The importance of preventing overhydration is also stressed and that serum sodium of about 120 meq/liter is frequently caused by water retention. A close watch on the blood sugar is needed postoperatively.7. G. D. Shannon
Mat&al Fetal
Varicella Infection Malformations. M.
Moosa.
and R. R. Gordon.
(February),
as a Cause of 0. Savage, A. Lancet 11352 354
1973.
The distinction is made between congenital disease produced by persisting viral infections (such as rubella or cytomegalic inclusion disease), and specific congenital malformations (such as those produced by rubella) which are due to a direct teratogenic effect on the developing fetus. Congenital varicella after maternal infection in the last 2 wk of pregnancy is well recognized and congenital malformations of the eye, skin, and limbs have been reported after herpes zoster infection in early pregnancy. This paper describes the malformations found in an infant, who survived only 3 mo. whose mother contracted varicella during the ninth week of pregnancy. The abnormalities were a reduction deformity of the left upper limb; depressed, depigmented skin scars along this limb, the right laker limb and the scalp: hypoesthesia to pinprick; Homer’s syndrome; pharyngeal incoordination. The neurotropism of the varicella zoster virus is apparent in these anomalies. the reduction deformity of the upper limb was prdbably secondary to denervation.M. H. Cough.
The Cardiovascular Response of the Newborn to Sodium Bicarbonate. Rouse and A. Arango. Arch. Surg. 332 (March), 1973.
Acidotic M. 1. 106:327
To decide whether the therapeutic response of bled puppies to sodium bicarbonate was due to correction of the acidosis or to simple osmolar function of the solution, sodium chloride solution (same sodium content as sodium bicarbonate) and mannitol (same osmolality as sodium bicarbonate) were employed. It is suggested that the improved cardiovascular function after sodium bicarbonate infusion may be due to osmolality rather than buffering. ~~ Edward
J. Berman