Changes in perinatal management and outcomes in infants born at 23 weeks of gestational age during the last decade in Spain.

Introduction: The 2021-updated guidelines of the Spanish Society of Neonatology Guidelines have moved the zone of parental discretion to 23 + 0-23 + 6 weeks. The objective of this study was to describe the changes in perinatal management at this gestational age along the last decade and to determine if a more active perinatal management has contributed to improved outcomes.

Methods: Retrospective analysis of prospectively collected data from the 23-week infants included in the Spanish SEN 1500 neonatal network during the period 2010-2019.

[Recommendations on making decisions and end of life care in neonatology].

Healthcare-professionals who work in neonatal units believe that a very important part of their work is the care of sick newborns, and their families if the neonate has an incurable disease or will die. The effort is focused on preventing disproportionate and unnecessary treatments that result in pain and discomfort, and also separate the child from his family. These situations usually occur when the infant has a terminal illness, extreme immaturity with complications, or severe birth defects.

[Survey on scientific research activity in Spanish neonatal divisions between 2000 and 2004].

Research is an essential activity in neonatology. Following the recommendation of the Spanish Neonatal Society (SEN), a questionnaire on the state of research activity was sent to all Spanish neonatal divisions belonging to all public and private institutions with structured neonatal activity. The following items were included: (i) clinical level of the units; (ii) academic degrees and professional qualifications of the staff members; (iii) characteristics of the scientific activity performed, and (iv) financial and technical aid supporting research.

[Vein of Galen arteriovenous malformations and neonatal convulsions].

Introduction: Vein of Galen arteriovenous malformation (VGAM) appears during the embryonic period and gives rise to a complex network of arterial and venous vessels that generates a blood shift, from the brain parenchyma towards the malformation, with haemodynamic repercussions. Heart failure is the most frequent presenting symptom during the neonatal period, yet, convulsions or other neurological signs have occasionally been reported in this stage of life.

Case Report: A term infant with symptoms of heart failure and convulsions that began during the first 12 hours of life.

Age-related differences in vasoconstrictor responses to isoprostanes in piglet pulmonary and mesenteric vascular smooth muscle.

Isoprostanes are prostaglandin (PG)-like compounds produced nonenzymatically by free radical-catalyzed peroxidation of arachidonic acid. Isoprostanes evoke potent vascular effects but their actions in the neonatal vasculature are poorly known. We aimed to study the effects of 8-iso-PGE(1), 8-iso-PGE(2), 8-iso-PGF(1alpha), 8-iso-PGF(1beta), 8-iso-PGF(2alpha), and 8-iso-PGF(2beta) in pulmonary arteries (PA), pulmonary veins (PV), and mesenteric arteries (MA) from newborn and 2-wk-old piglets.

Role of cytokines (interleukin-1beta, 6, 8, tumour necrosis factor-alpha, and soluble receptor of interleukin-2) and C-reactive protein in the diagnosis of neonatal sepsis.

Aim: To investigate whether the serum levels of interleukin-1beta, 6, 8, tumour necrosis factor-alpha and the soluble receptor of IL-2 are useful in the diagnosis of neonatal sepsis, and whether their diagnostic power is increased when in combination with classical markers such as C-reactive protein and white blood cell count.

Methods: Blood samples were collected at admission from 40 neonates with suspected infection. Patients were included in different groups according to the bacteriological and laboratory results: Group I consisted of 20 newborns with positive blood cultures and other biological tests suggestive of infection.

Cord blood levels of cytokines as predictors of early neonatal sepsis.

Aim: To investigate whether cord blood levels of C-reactive protein, interleukin-1beta, interleukin-6, interleukin-8, tumour necrosis factor-alpha and the soluble receptor of interleukin-2, are useful markers in the diagnosis of early neonatal sepsis.

Design: Umbilical cord blood samples were obtained at birth from 261 neonates, but 5 of these newborns were excluded from the study. Group I included 10 newborns that developed early neonatal sepsis with a positive blood culture; Group II included 11 newborns with non-infectious perinatal diseases; Group III, which served as the control group, included 10 randomly selected patients, matched for gestational age, among the 235 healthy newborn babies.

Early sepsis, obstructive jaundice and right-sided diaphragmatic hernia in the newborn.

A male newborn was admitted to our Unit because of early sepsis and shock. He required antimicrobial therapy and mechanical ventilation and initially did well, although he exhibited jaundice and cholestasis. During the second week he deteriorated, with radiological opacification of the right hemithorax and pleural effusion, and did poorly in spite of antibiotical therapy and drainage of the effusion.