- Email: [email protected]
PP-330. Tuberculin skin test and BCG scarring after BCG vaccination in preterms
Abstracts
pregnancy was 1.6%. 96.4% of them were twins, 3.1% were triplets and 0.4% were quadruplets. 78% of spontaneous multiple pregnancies were delivered by c/s in work-group. In IVF group, differences in maternal properties such as age of mother and PROM (premature rupture of membranes) were statistically found. Pre-eclampsia, gestational diabetes and hypertension ratio were in order of 9.8% and 9.7% (p ≥ 0.05). Gestational week in group 1 was 35.9 ± 2.62 and in group 2 was 35.1 ± 2.59. Birth weight was 2239 ± 505.9 g in group 1 and 2192 ± 495.4 g in group 2. In both groups, birth weight was between 1500 and 2500 g. In both groups, there was no difference in the first and fifth minute APGAR scores. In group 1 (13 cases) 3.2% and in group 2 4.6% (6 cases) had congenital anomaly. According to ICD-10 code, anomalies are first line and genitourinary anomalies in the second line. Frequency of hospitalization (for both two groups) 50% was second level, 31% third level most important reasons were respiratory problems and hypoglycemia. Hospitalization times in groups 1 and 2 are in order of 14.7 ± 12.17 days and 16.7 ± 16.0 days, for intensive care unit 16.5 ± 11.39 and 15.5 ± 8.30 days (p ≥ 0.005) (p ≥ 0.005). Ratios of using surfactant are in order of 80% and 90%. During observation, 4 cases (0.49%) in group 1 and 1 case (0.78%) in group 2 were exitus. Reasons for exitus in group 1 were 2 RDS and 2 transfusion from twin to twin and in group 2 was septicemia. Conclusions Multiple pregnancies because of having high perinatal risk factors cause important morbidity to fetus both in spontaneous or IVF pregnancy. Major factors are prematurity and problems related to prematurity. doi:10.1016/j.earlhumdev.2010.09.391
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spontaneous pregnancies (57 vs 10, p < 0.001, 10 vs 4, p < 0.001). Mean maternal age, the proportion of nulliparous women, preeclampsia, intrauterine fetal death and premature delivery, Apgar score, admission neonatal intensive care unit (NICU), anemia, intraventricular hemorrhage, pneumothorax, sepsis, retinopathy of prematurity, and duration of hospital stay were significantly higher in multiplets resulting from assisted pregnancies than in multiplets from spontaneous pregnancies. Incidence of respiratory distress syndrome, use of surfactant, necrotizing enterocolitis, patent ductus arteriosus, and bronchopulmonary dysplasia were not significantly different among the two groups. Unlike-sex pairs were at increase risk for admission of NICU, duration of hospital stay, incidence of patent ductus arteriosus and mortality.
Conclusions IVF multiple pregnancies are at greater risk for obstetric complications and poor neonatal outcome in comparison with spontaneously conceived multiple pregnancies. The difference in morbidity and mortality between male and female premature represents a male disadvantage as opposed to a female advantage and that this disadvantage may be transferred from boys to girls in unlike-sex pairs, perhaps via an intrauterine paracrine effect. doi:10.1016/j.earlhumdev.2010.09.392
PP-330. Tuberculin skin test and BCG scarring after BCG vaccination in preterms Sinem Oral Cebeci, Sultan Kavuncuoglu, Esin Aldemir Istanbul Bakirkoy Maternity and Children Hospital, Turkey
PP-329. Perinatal and neonatal outcome in multiple pregnancies: Assisted reproduction vs spontaneous conception
Aim
Banu Mutlu, Serife Suna Oguz, Ugur Dilmen Zekai Tahir Burak Maternity and Education Hospital, Turkey
In our study, tuberculin skin test response and BCG scarring development after vaccination in preterms were evaluated.
Aim Methods Over the last years, wide use of assisted reproduction techniques has led to an increased incidence of multiple pregnancies and consequently, of related obstetric-neonatal problems. The aim of the study was to evaluate and compare perinatal and neonatal outcomes of spontaneously conceived multiplets with multiplets conceived by assisted reproduction.
Newborns both preterm and term babies who were involved in our study were born at our hospital. Infants who were vaccinated with BCG due to routine Health Ministry vaccination schedule were called back to control 8–16 weeks after vaccination. Tuberculin skin test was made to infants; induration diameter in 48–72 h and BCG scar formation in transverse size were measured.
Materials and methods Results 367 neonates from spontaneous multiple pregnancies and 596 from assisted multiple pregnancies were taken into consideration with regard to: maternal characteristics, obstetric complications, premature birth, low-birth weight, intrauterine growth retardation, weight discordance, Apgar score, admission of neonatal intensive care unit, major neonatal diseases, duration of hospital stay and mortality. The incidence of morbidity and mortality was compared in male and female infants from like-sex and unlike-sex pairs.
Results Perinatal and neonatal mortalities were significantly increased in multiplets resulting from assisted reproduction compared with
216 newborns were included in this study. 65 of them were below 32 gestational weeks (gw), 79 of them were between 33 and 36 gw and 72 of them were term babies. Ratio of infants who born below 1500 g was 25% and above 2500 g was 25.9%. Mean weight during BCG vaccination was 4442 ± 1084, 1 g and postnatal age was 11.28 ± 3.44 weeks. During vaccination 21.8% of newborns' actual weight was below 3500 g. Mean weight at the time of tuberculin skin test was 6747.6 ± 1255.7 g; postnatal age was between 16 and 40 weeks. Tuberculin skin test response was found to be ≤4 mm in 43.1% of cases; 5–10 mm in 52.8% of cases; and >10 mm in 4.2% of cases. The number of cases was 121 (56%) in which scar response was above 2 mm. BCG scar response was found to be 60% in infants below ≤32 gestastion weeks; 49.4% in 33–36 gestation weeks. Tuberculin skin
S148
Abstracts
test positivities in the same gestation weeks were 47.7% and 55.7% respectively. BCG scar response is related to gender and birth weight in preterms. There is a significant relation between scar response and tuberculin skin test positivity. Conclusion According to WHO; BCG vaccine protectivity is important in very low birth weight infants. That's why the preterm infants should be vaccinated with BCG due to vaccination schedule and vaccine protectivity should be checked with tuberculin skin test. doi:10.1016/j.earlhumdev.2010.09.393
PP-331. Influence of cytomegalovirus infection on cerebrum of premature infants Samaya Alizade The Azerbaijan International University, Azerbaijan Aim Intra-uterine infections (IUI) of fetus for today are rather actual problem for all pediatrics as a whole among which cytomegalovirus infection (CMVI) represents the most interest. Our main goal is to study the influence of CMVI on the cerebrum of premature infants. Materials and methods The 54 premature infants are surveyed by us with suspicion on IUI at the age from 1st day till 1 month of life. The diagnosis of congenital CMVI was based on the data of antenatal anamnesis, clinical complex of symptoms of the illnesses, in the first 2–3 weeks of life of the child, revealing pathognomonic cells “an owl's eye” type cages for CMVI, specific markers of an infection in the same terms, and also revealing of virus DNA in blood and urine. Results CMVI is revealed at 16 premature infants. From them: premature I degree—8 of children, gestational age—36–37 weeks, body weight at birth 2290 g, growth 43.5 sm; premature II degree—2 of children, gestational age—34–35 weeks, body weight at birth 1625 g, growth 42.7 sm; premature III degree—5 of children, gestational age—32– 33 weeks, body weight 1350 g, growth 41.3 sm; premature IV degree —1 child, gestational age—28–29 weeks, body weight 1020 g, growth 37 sm. Characteristics for CMVI were toxic–hypoxic lesions of CNS with various syndromes: a syndrome of hypertension, a convulsive syndrome, a syndrome of hydrocephaly, and intracranial hemorrhages. Also adynamy, consciousness oppression, painful monotonous shout, and clonic spasms were observed at children. The neurologic semiology at newborns was observed from the first days of life.
PP-332. Late hydrocortisone treatment for bronchopulmonary dysplasia in preterm infants: A single center experience Banu Mutlu, Gonca Sandal, Serife Suna Oguz, Omer Erdeve, Nurdan Uras, Ugur Dilmen Zekai Tahir Burak Maternity and Education Hospital, Neonatal Intensive Care Unit, Turkey
Aim Despite modern intensive care techniques, chronic lung disease remains a problem in pretem born infants. Corticosteroids have been used to either prevent or treat CLD because of their potent antiinflammatory effects. The aim of this study was to evaluate the effectiveness of late hydrocortisone treatment in established bronchopulmonary dysplasia (BPD) infants. Materials and methods The medical records of 76 patients followed up with diagnosis of bronchopulmonary dysplasia admitted to neonatal intensive care unit between January 2008 and April 2010 and (BPD) were studied retrospectively. All patients diagnosed with BPD were given hydrocortisone treatment, 1 mg/kg/day per oral. Demographic features and clinical outcomes were recorded. Results Mean maternal age was 26.7 ± 5.2, mean birth weight was 1017 ± 295.2 g, mean gestational age was 27.4 ± 2.3. Early neoatal sepsis was observed in 10 (13.2%) patients and late neonatal sepsis was observed in 60 (78.9%). Severe IVH in 20 (26%) patients was found. 72 (94.7%) infants had oxygen support needed at the 28th day. 67 (88.2%) infants received mechanical ventilation support at the 28th day. 46 (60.5%) infants had oxygen support needed at postconceptional 36th weeks. Pneumothorax, PDA, NEC, and spontaneous intestinal perforation incidences were 7 (9.2%), 55 (72.4%), 8 (10.5), and (5.3%) infants, respectively. ROP was seen in 65 (85.5%) patients. Mean onset time of hydrocortisone was 41.8 ± 20.1 d, mean duration of hydrocortisone treatment was 22.8 ± 14.7 d, mean duration of oxygen was 65.8 ± 24.9 d. 7 (9.2%) infants had early complication of hydrocortisone treatment. Hypertansion occured in one infant, cardiomyopathy occured in 2 infants, and sepsis occured in 2 infants. Mean duration of hospital stay was 78.7 ± 24.4 days. 10 (13.2%) infants need home oxygen. Conclusions The dosage and duration of late corticosteroid given to small premature infants influence the risk of the side-effects and the early outcome. doi:10.1016/j.earlhumdev.2010.09.395
Conclusions Coexisting of congenital chylous ascıtes and congenital hypothroidısm: A case presentation
According to the Doppler's researches, essential increase of an index of resistance is revealed at lesion of CNS at children with hydrocephaly. Acceleration of the maximum linear speed of a bloodgroove on the amazed party was observed at 9 children with posthypoxic encephalopathy and hemi syndrome.
Hüseyin Altunhan, Ali Annagür, Hasan Ali Yüksekkaya, Sabahattin Ertuğrul, Rahmi Örs Selcuk University, Meram Medical Faculty, Konya, Turkey
doi:10.1016/j.earlhumdev.2010.09.394
doi:10.1016/j.earlhumdev.2010.09.396
pregnancy was 1.6%. 96.4% of them were twins, 3.1% were triplets and 0.4% were quadruplets. 78% of spontaneous multiple pregnancies were delivered by c/s in work-group. In IVF group, differences in maternal properties such as age of mother and PROM (premature rupture of membranes) were statistically found. Pre-eclampsia, gestational diabetes and hypertension ratio were in order of 9.8% and 9.7% (p ≥ 0.05). Gestational week in group 1 was 35.9 ± 2.62 and in group 2 was 35.1 ± 2.59. Birth weight was 2239 ± 505.9 g in group 1 and 2192 ± 495.4 g in group 2. In both groups, birth weight was between 1500 and 2500 g. In both groups, there was no difference in the first and fifth minute APGAR scores. In group 1 (13 cases) 3.2% and in group 2 4.6% (6 cases) had congenital anomaly. According to ICD-10 code, anomalies are first line and genitourinary anomalies in the second line. Frequency of hospitalization (for both two groups) 50% was second level, 31% third level most important reasons were respiratory problems and hypoglycemia. Hospitalization times in groups 1 and 2 are in order of 14.7 ± 12.17 days and 16.7 ± 16.0 days, for intensive care unit 16.5 ± 11.39 and 15.5 ± 8.30 days (p ≥ 0.005) (p ≥ 0.005). Ratios of using surfactant are in order of 80% and 90%. During observation, 4 cases (0.49%) in group 1 and 1 case (0.78%) in group 2 were exitus. Reasons for exitus in group 1 were 2 RDS and 2 transfusion from twin to twin and in group 2 was septicemia. Conclusions Multiple pregnancies because of having high perinatal risk factors cause important morbidity to fetus both in spontaneous or IVF pregnancy. Major factors are prematurity and problems related to prematurity. doi:10.1016/j.earlhumdev.2010.09.391
S147
spontaneous pregnancies (57 vs 10, p < 0.001, 10 vs 4, p < 0.001). Mean maternal age, the proportion of nulliparous women, preeclampsia, intrauterine fetal death and premature delivery, Apgar score, admission neonatal intensive care unit (NICU), anemia, intraventricular hemorrhage, pneumothorax, sepsis, retinopathy of prematurity, and duration of hospital stay were significantly higher in multiplets resulting from assisted pregnancies than in multiplets from spontaneous pregnancies. Incidence of respiratory distress syndrome, use of surfactant, necrotizing enterocolitis, patent ductus arteriosus, and bronchopulmonary dysplasia were not significantly different among the two groups. Unlike-sex pairs were at increase risk for admission of NICU, duration of hospital stay, incidence of patent ductus arteriosus and mortality.
Conclusions IVF multiple pregnancies are at greater risk for obstetric complications and poor neonatal outcome in comparison with spontaneously conceived multiple pregnancies. The difference in morbidity and mortality between male and female premature represents a male disadvantage as opposed to a female advantage and that this disadvantage may be transferred from boys to girls in unlike-sex pairs, perhaps via an intrauterine paracrine effect. doi:10.1016/j.earlhumdev.2010.09.392
PP-330. Tuberculin skin test and BCG scarring after BCG vaccination in preterms Sinem Oral Cebeci, Sultan Kavuncuoglu, Esin Aldemir Istanbul Bakirkoy Maternity and Children Hospital, Turkey
PP-329. Perinatal and neonatal outcome in multiple pregnancies: Assisted reproduction vs spontaneous conception
Aim
Banu Mutlu, Serife Suna Oguz, Ugur Dilmen Zekai Tahir Burak Maternity and Education Hospital, Turkey
In our study, tuberculin skin test response and BCG scarring development after vaccination in preterms were evaluated.
Aim Methods Over the last years, wide use of assisted reproduction techniques has led to an increased incidence of multiple pregnancies and consequently, of related obstetric-neonatal problems. The aim of the study was to evaluate and compare perinatal and neonatal outcomes of spontaneously conceived multiplets with multiplets conceived by assisted reproduction.
Newborns both preterm and term babies who were involved in our study were born at our hospital. Infants who were vaccinated with BCG due to routine Health Ministry vaccination schedule were called back to control 8–16 weeks after vaccination. Tuberculin skin test was made to infants; induration diameter in 48–72 h and BCG scar formation in transverse size were measured.
Materials and methods Results 367 neonates from spontaneous multiple pregnancies and 596 from assisted multiple pregnancies were taken into consideration with regard to: maternal characteristics, obstetric complications, premature birth, low-birth weight, intrauterine growth retardation, weight discordance, Apgar score, admission of neonatal intensive care unit, major neonatal diseases, duration of hospital stay and mortality. The incidence of morbidity and mortality was compared in male and female infants from like-sex and unlike-sex pairs.
Results Perinatal and neonatal mortalities were significantly increased in multiplets resulting from assisted reproduction compared with
216 newborns were included in this study. 65 of them were below 32 gestational weeks (gw), 79 of them were between 33 and 36 gw and 72 of them were term babies. Ratio of infants who born below 1500 g was 25% and above 2500 g was 25.9%. Mean weight during BCG vaccination was 4442 ± 1084, 1 g and postnatal age was 11.28 ± 3.44 weeks. During vaccination 21.8% of newborns' actual weight was below 3500 g. Mean weight at the time of tuberculin skin test was 6747.6 ± 1255.7 g; postnatal age was between 16 and 40 weeks. Tuberculin skin test response was found to be ≤4 mm in 43.1% of cases; 5–10 mm in 52.8% of cases; and >10 mm in 4.2% of cases. The number of cases was 121 (56%) in which scar response was above 2 mm. BCG scar response was found to be 60% in infants below ≤32 gestastion weeks; 49.4% in 33–36 gestation weeks. Tuberculin skin
S148
Abstracts
test positivities in the same gestation weeks were 47.7% and 55.7% respectively. BCG scar response is related to gender and birth weight in preterms. There is a significant relation between scar response and tuberculin skin test positivity. Conclusion According to WHO; BCG vaccine protectivity is important in very low birth weight infants. That's why the preterm infants should be vaccinated with BCG due to vaccination schedule and vaccine protectivity should be checked with tuberculin skin test. doi:10.1016/j.earlhumdev.2010.09.393
PP-331. Influence of cytomegalovirus infection on cerebrum of premature infants Samaya Alizade The Azerbaijan International University, Azerbaijan Aim Intra-uterine infections (IUI) of fetus for today are rather actual problem for all pediatrics as a whole among which cytomegalovirus infection (CMVI) represents the most interest. Our main goal is to study the influence of CMVI on the cerebrum of premature infants. Materials and methods The 54 premature infants are surveyed by us with suspicion on IUI at the age from 1st day till 1 month of life. The diagnosis of congenital CMVI was based on the data of antenatal anamnesis, clinical complex of symptoms of the illnesses, in the first 2–3 weeks of life of the child, revealing pathognomonic cells “an owl's eye” type cages for CMVI, specific markers of an infection in the same terms, and also revealing of virus DNA in blood and urine. Results CMVI is revealed at 16 premature infants. From them: premature I degree—8 of children, gestational age—36–37 weeks, body weight at birth 2290 g, growth 43.5 sm; premature II degree—2 of children, gestational age—34–35 weeks, body weight at birth 1625 g, growth 42.7 sm; premature III degree—5 of children, gestational age—32– 33 weeks, body weight 1350 g, growth 41.3 sm; premature IV degree —1 child, gestational age—28–29 weeks, body weight 1020 g, growth 37 sm. Characteristics for CMVI were toxic–hypoxic lesions of CNS with various syndromes: a syndrome of hypertension, a convulsive syndrome, a syndrome of hydrocephaly, and intracranial hemorrhages. Also adynamy, consciousness oppression, painful monotonous shout, and clonic spasms were observed at children. The neurologic semiology at newborns was observed from the first days of life.
PP-332. Late hydrocortisone treatment for bronchopulmonary dysplasia in preterm infants: A single center experience Banu Mutlu, Gonca Sandal, Serife Suna Oguz, Omer Erdeve, Nurdan Uras, Ugur Dilmen Zekai Tahir Burak Maternity and Education Hospital, Neonatal Intensive Care Unit, Turkey
Aim Despite modern intensive care techniques, chronic lung disease remains a problem in pretem born infants. Corticosteroids have been used to either prevent or treat CLD because of their potent antiinflammatory effects. The aim of this study was to evaluate the effectiveness of late hydrocortisone treatment in established bronchopulmonary dysplasia (BPD) infants. Materials and methods The medical records of 76 patients followed up with diagnosis of bronchopulmonary dysplasia admitted to neonatal intensive care unit between January 2008 and April 2010 and (BPD) were studied retrospectively. All patients diagnosed with BPD were given hydrocortisone treatment, 1 mg/kg/day per oral. Demographic features and clinical outcomes were recorded. Results Mean maternal age was 26.7 ± 5.2, mean birth weight was 1017 ± 295.2 g, mean gestational age was 27.4 ± 2.3. Early neoatal sepsis was observed in 10 (13.2%) patients and late neonatal sepsis was observed in 60 (78.9%). Severe IVH in 20 (26%) patients was found. 72 (94.7%) infants had oxygen support needed at the 28th day. 67 (88.2%) infants received mechanical ventilation support at the 28th day. 46 (60.5%) infants had oxygen support needed at postconceptional 36th weeks. Pneumothorax, PDA, NEC, and spontaneous intestinal perforation incidences were 7 (9.2%), 55 (72.4%), 8 (10.5), and (5.3%) infants, respectively. ROP was seen in 65 (85.5%) patients. Mean onset time of hydrocortisone was 41.8 ± 20.1 d, mean duration of hydrocortisone treatment was 22.8 ± 14.7 d, mean duration of oxygen was 65.8 ± 24.9 d. 7 (9.2%) infants had early complication of hydrocortisone treatment. Hypertansion occured in one infant, cardiomyopathy occured in 2 infants, and sepsis occured in 2 infants. Mean duration of hospital stay was 78.7 ± 24.4 days. 10 (13.2%) infants need home oxygen. Conclusions The dosage and duration of late corticosteroid given to small premature infants influence the risk of the side-effects and the early outcome. doi:10.1016/j.earlhumdev.2010.09.395
Conclusions Coexisting of congenital chylous ascıtes and congenital hypothroidısm: A case presentation
According to the Doppler's researches, essential increase of an index of resistance is revealed at lesion of CNS at children with hydrocephaly. Acceleration of the maximum linear speed of a bloodgroove on the amazed party was observed at 9 children with posthypoxic encephalopathy and hemi syndrome.
Hüseyin Altunhan, Ali Annagür, Hasan Ali Yüksekkaya, Sabahattin Ertuğrul, Rahmi Örs Selcuk University, Meram Medical Faculty, Konya, Turkey
doi:10.1016/j.earlhumdev.2010.09.394
doi:10.1016/j.earlhumdev.2010.09.396