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Pendse A, Panchal H, Athalye-Jape G, Campbell C, Nathan E, Rao S, Dickinson JE. Neonatal outcomes following previable prelabour rupture of membranes before 23 weeks of gestation - A retrospective cohort study. J Neonatal Perinatal Med 2020; 14:9-19. [PMID: 32224534 DOI: 10.3233/npm-190366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare outcomes of hospitalized preterm infants following previable prelabour rupture of membranes (PPROM) at≤23 weeks of gestation. METHODS Retrospective cohort study of preterm infants admitted for intensive care, between January 2006 and December 2016 following PPROM, was conducted. Short term clinical outcomes included severity of respiratory morbidity, length of hospital stay and mortality. Neurodevelopment in survivors was assessed using Bayley's Scales of Infant Development (3rd edition) at 24 months corrected age. RESULTS A total of 82 preterm infants were admitted following PPROM at < 23 weeks and were grouped as: Group 1 (n = 28) with PPROM < 20 weeks and Group 2 (n = 54) with PPROM between 20-22 + 6 weeks. Median latency following PPROM was significantly longer in Group 1 infants [69(Interquartile range (IQR): 43-74; Range (R): 25-100 vs. 29(IQR: 10-53; R: 2-72) days, p < 0.001]. Median gestation at delivery was 27.4 weeks (Group 1) vs. 25.1 weeks (Group 2). Group 1 had a significantly higher incidence of oligohydramnios [13(46.4%) vs. 8(14.8%), p = 0.002], lower Apgar scores (<7) at 5 minutes [19(67.9%) vs. 24(44.4%), p = 0.044], increased pulmonary hypoplasia [13(46.4%) vs. 5(9.3%), p < 0.001], joint contractures [3(10.7%) vs. 0, p = 0.037] and mortality [10(35.7%) vs. 7(13.0%), p = 0.016]. Neurodevelopmental outcomes at 24 months corrected age were comparable in the 36 surviving infants (9/18 vs. 27/547). CONCLUSION Morbidity and mortality is high in infants born after previable PPROM; specifically, in those with PPROM < 20 weeks although early childhood neurodevelopmental outcomes were comparable. Larger prospective studies focussing on long term neonatal outcomes are needed to confirm these findings.
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Affiliation(s)
- A Pendse
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Australia.,Neonatal Directorate, Perth Children's Hospital, Perth, Australia
| | - H Panchal
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Australia.,Neonatal Directorate, Perth Children's Hospital, Perth, Australia.,Centre for Neonatal Research and Education, University of Western, Australia, Perth, Australia
| | - G Athalye-Jape
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Australia.,Neonatal Directorate, Perth Children's Hospital, Perth, Australia.,School of Paediatrics, University of Western Australia, Perth, Australia.,Centre for Neonatal Research and Education, University of Western, Australia, Perth, Australia
| | - C Campbell
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Australia.,Department of Psychological Medicine, King Edward Memorial Hospital for Children, Perth, Australia
| | - E Nathan
- Women and Infants Research Foundation, King Edward Memorial Hospital for Women, Perth, Australia.,Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Australia
| | - S Rao
- Neonatal Directorate, Perth Children's Hospital, Perth, Australia.,School of Paediatrics, University of Western Australia, Perth, Australia.,Centre for Neonatal Research and Education, University of Western, Australia, Perth, Australia
| | - J E Dickinson
- Women and Infants Research Foundation, King Edward Memorial Hospital for Women, Perth, Australia.,Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Australia.,Department of Obstetrics and Gynaecology, King Edward Memorial Hospital, Perth, Australia
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Abstract
This study reviews the results of Surface Replacement Trapeziometacarpal (SR TMC, Avanta, San Diego, CA) total joint arthroplasty. Fifty patients (62 joints) were included in the study. Forty-three patients (54 joints) were seen at final follow up. Seven patients (eight joints) were interviewed over the phone. Seven patients were revised to trapeziectomy and ligament reconstruction with tendon interposition, five for aseptic loosening and two for dislocation. At final follow up, the mean Quick DASH score was 30.4 and the Sollerman Score was 77.3. Radiological review of the surviving 55 joints showed subsidence of four trapezial components in asymptomatic patients. Cumulative survival rate was 91% at 3 years. Eighty-five percent of the patients were satisfied with the outcome of their treatment.
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Affiliation(s)
- A Pendse
- Rotherham District General Hospital NHS Foundation Trust, Rotherham, South Yorkshire, UK
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Abstract
The aim of this study was to review the short-term results of joint replacement in the hand, comparing those done as day cases with those done as inpatients. Procedures included trapeziometacarpal, metacarpophalangeal and proximal interphalangeal joint arthroplasties. For day cases a portable laminar flow machine was used, whereas inpatient procedures were carried out in a laminar flow theatre. The postoperative regime was the same in the two groups. The mean follow-up was 12 months. There was no difference in complications, revisions, pain scores and Quick-DASH scores. No early loosening has been detected in any patients at a minimum of 12 months' follow-up. All patients who had day surgery were satisfied with the care. The results of day case small joint arthroplasty of the hand are similar to those in inpatients.
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Affiliation(s)
- A Nisar
- From Rotherham General Hospital, Rotherham, South Yorkshire, UK.
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