abeluchin

It’s a very interesting study. Thanks for sharing it!

Hi there seem to be enough evidence about the lack of beneficial effect of treatment of the PDA! The approach to a hemodinámica significant ductus has changed significantly in the last 10 years. Years ago we weee so obsessed that indocin prophylaxis was standard in many NICUs and early treatment became standard across the board. I remember going to Dr Clayman PDA lecture at PAS where the PDA was seen as a demon many babies had been exposed to surgical ligation with a known consecuentes of a surgery on a small premie baby since William Benitez published his meta analysis about PDA there has been a definitive change in some centers on how to approach it and some has gone away from early treatment and surgery there are other centers that continue to ignore the Trent and treat the PDA like we used to 10 years ago. we I have noted in my practice is that regardless of the PDA size; baby that are on Mechanical ventilation after 7-10 days we give a course of tapering Decadeon (DATRT) and they get extubated i Belice fluid/sedation/lung protective strategy and steroids when use appropriately will result in better outcomes for our micro premie of 22-26 weeks whats are you doing in your practice? thanks

No other antibodies were present in mother's circulation.

Hi I took care of a baby who's mother is B+ and baby is A+ with a DAST/Coombs+. The DAT was sent inarventently since we only sent DAT in mother's with blood tupe O or rh negative. I was surprised to see this results since I have always understand that ABO incompatibility that cause significant hemolysis is only produced when mother is O and baby is A or B group. The reason for this ABO incompatibility set is not too clear. I understand its because when mama is O and baby is A or B; IgG antibodies casn be produced during gestation that will cross the placentas . Unlike when mama is A and baby is B or mama is B and baby is A only igM antibodies are produce yhjat will not cross the placenta. I am not sure why this is produced this way?? Any input or insights will be apreciated

Hi Johan; thanks for your insight. That’s the reality of my hospital. The anti lactation has taken this unpublished recommendation to prevent mother to lactate their infants

Hi group; our OB colleagues use Methergine (ergonovine) for treatment or prophylaxis of postpartum hemorrhage. The medication label from the manufacturer recommends to hold breast feeding up to 12 hours after last dose due to unpublished reported side effects in the babies i did a literature search and found only one article published in Pubmed that covers that topic: https://pubmed.ncbi.nlm.nih.gov/27846760/ min this prospective study they found no side effects in breastfed babies Are there any other reference on this topic that you can share? is this something that affects your newborn nursery practice in your hospital? Thanks for any input

Baby went home a couple of days ago. Wbc count at the lowest 26k and platelet count persistently above 120k

46 days old; former 28 weeker premature baby with persistent leukocytosis for over four weeks now. Uncomplicated NICU course so far. Since about the second week of life, the baby has had persistent leukocytosis with wbc count in the low to high 30k's. Baby has had multiple crp done and all normals. Culture from blood and Urine including fungal normal as well. Had a course of Meropenem for suspected UTI with 10k colonies of enterococcus fecalis in the urine; but despite negative repeat urine culture and after treatment; leukocytosis persisted. About two weeks ago; now baby with mild thrombocytopenia 80-90k. Cardiac echo done, renal and abdominal US all normal. Viral culture, RPR and urine CMV all negative as well. Currently baby is on room air; growing great. Feeding great. Had completed a 7 days with Fluconazole; without any improvement Hem consulted. Requested a flow cytometry; with left sided neutrophilia with 4% blast. Bone marrow not entertained at this point! What do you think? Anything comes to mind? Thanks

Thanks

I just had a LGA term baby born through shoulder dystocia; noted with respiratory distress shortly after birth. Placed on HFNC, need ~35% FiO2 on 2 LPM. Xray with right hemidiapragm elevation. Question: How long is prudent to wait for surgical intervention in these babies? Thanks

Thanks to you all for your response. The baby was transfered for neuro eval and expectant management was carried out.

Dr. Vijayashankara, would you please, explain a bit more why your practice was change from multiple to a single dose of surfactant? Thanks

It has recently been brought to my attention that the suture of the pedunculated vestigial digit in post-axial polydactilly has been associated with development of painful neuroma over time! I have always ligated these vestigial non-bonny digits and have them follow up with their PCP.Here is some of the articles: Pediatr Dermatol. 2010 Jan-Feb;27(1):39-42. doi: 10.1111/j.1525-1470.2009.01071.x. A selective approach to treatment of ulnar polydactyly: preventing painful neuroma and incomplete excision. Mullick S1, Borschel GH. Pediatr Dermatol. 2009 Jan-Feb;26(1):100-2. doi: 10.1111/j.1525-1470.2008.00835.x. Traumatic amputation of a supernumerary digit: a 16-year-old boy's perspective of suture ligation. Hartzell TL1, Taylor H. Pediatr Dermatol. 2003 Mar-Apr;20(2):108-12. Surgical excision of pedunculated supernumerary digits prevents traumatic amputation neuromas. Leber GE1, Gosain AK. what's your personal experience in this topic? Thanks

Hi, I recently care of a couple of 34 weeks Mono-Di twin male infants, one of them with a Hct of 37% and the other 47%. The BW was very similar in both twins at 1890g and 1900g and no h/o olygo was recorded in any of them. I ordered a retic count in the anemic boy, as well as a CUS and a KB test on the mother. KB test was reported as 0.15; with an estimated of fetal blood loss of 12ml. Retic count was 16% and came down nicely over three days to 8%. Hct remained stable in the low 30%. Both kids were asymptomatic since birth and are feeding and growing well. Questions: is this presentation consistent with significant Feto-Maternal Hemorrhage (FMH)? Can FMH affect preferentially one twin in Monochorionic twin pregnancies? Mother weight 83kg. I estimated 12ml of fetal blood loss based on the following calculations: maternal blood volume 70ml x weight in kg= 5810ml plus an increased in 40% of blood volume during pregnancy equals 8134ml. If 0.15% was fetal blood that equals 12.2ml of feto-placental blood loss. If feto-placental blood volume is ~100ml/kg of fetal weight, then 1.890 x100 is 198ml of total feto-placental blood, so 12.2ml represents <5% of the total feto-placental blood volume, which for me does not explain the reticulocytosis or anemia present in this infant, what's your opinion? thanks for any feedback!

What is your experience with this condition and performing frenotomy? Thanks