Lung ultrasound in premature infants as an early predictor of bronchopulmonary dysplasia.

Purpose: Lung ultrasound (LUS) is a widely used technique in neonates to diagnose a lot of acute diseases. However, its role in the diagnosis of chronic lung conditions is still to be evaluated. We aimed to describe the changes in ultrasound images as well as the appearance of lung consolidations (LC) in very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD).

An outbreak of RSV infections in a neonatology clinic during the RSV-season.

Background: Respiratory syncytial virus (RSV) is the predominant cause of lower respiratory tract infections (LRTI) in infancy. Preterm infants with bronchopulmonary dysplasia (BPD) are at the highest risk of severe RSV-LRTI. This is a retrospective study that analyses a nosocomial outbreak of RSV infections in the Neonatology clinic of the University Hospital of Obstetrics and Gynecology, Sofia, 2019.

Cardiac Myosarcoma in a Newborn Infant-A Case Report and Literature Review.

Malignant cardiac neoplasms are extremely rare in neonates. Prenatal diagnosis is often not available. Initial symptoms can mimic non-cardiac diseases.

Triploidy in a Live-Born Extremely Low Birth Weight Twin: Clinical Aspects.

Triploidy is a rare chromosomal aberration characterized by a karyotype with 69 chromosomes. Triploid fetuses usually are miscarried in early pregnancy. We present a case of a triploid twin and a genetically unaffected co-twin, conceived through in vitro fertilization.

[ANTITHROMBOTIC MEDICATION IN PREGNANT WOMEN WITH PREVIOUS INTRAUTERINE GROWTH RESTRICTION].

Aim: To analyze pregnancy outcome in patients who were on antithrombotic medication (AM) because of previous pregnancy with fetal intrauterine growth restriction (IUGR).

Materials And Methods: The studied group (SG) included 21 pregnancies in 15 women with history of previous IUGR. The patients were on low dose aspirin (LDA) and/or low molecular weight heparin (LMWH).

[BRONCHOPULMONARY DYSPLASIA--WHAT DO WE KNOW TODAY?].

The survival of great number of extremely premature newborn babies is associated with increased risk of damage of the newborn lung and development of chronic lung disease/Broncopulmonary dysplasia. The lower the gestational age and weight, the greater the frequency of BPD. The disease leads to impairment of the normal alveolization and vascularization of the premature lung.

[TREATMENT WITH INO OF INFANTS WITH PPHN.].

PPHN is a life threatening disease that appears as a result of high pulmonary vascular resistance and persistent right to left shunt across foramen ovale and ductus arteriosus. The treatment of PPHN is complex and often ineffective. iNO is important part of the pathogenetic treatment of the disease.

[THE FETAL MIDDLE CEREBRAL ARTERY PEAK SYSTOLIC VELOCITY AS A PEDICTOR OF FETAL ANEMIA IN RH-ALLOIMMUNIZED PREGNANCY].

Unlabelled: Rh-isoimmunization is a pathological condition in which the fetal red blood cells of a Rh (+) fetus are destroyed by the isoantibodies of a Rh (-) woman sensitized in a previous event. Despite of the wide spread implementation of anti D-gammaglobolin prophylaxis this is still the most common cause for fetal anemia. Recently, sonographic measurement of the fetal middle cerebral artery peak systolic velocity (MCA-PSV) has been shown to be an accurate non-invasive test to predict low fetal hemoglobin levels.

[BRONCHOPULMONARY DYSPLASIA IN VERY LOW BIRTH WEIGHT INFANTS--THE OLD NEW PROBLEM].

Background: The advances in perinatal intensive care have increased the survival rate of extremely low birthweight (ELBW) and gestational age infants. Among them the risk of developing bronchopulmonary dysplasia (BPD) remains high.

Aim: To evaluate the frequency of BPD by birthweight and gestational age, to identify the main postnatal risk factors and the associated comorbidities.

[Perforated neonatal appendicitis in a preterm newborn].

Unlabelled: Abstract: Appendicitis is common in paediatric surgical praxis, but extremely rare in newborn infants.

Case Report: We report a premature male newborn from a twin pregnancy with gestational age of 31(+4) weeks, birth-weight 1580g, who underwent a laparotomy because of perforation. The baby was admitted to NICU after birth with transitory respiratory failure and early onset neonatal sepsis.

[Socio-demographic characteristics and vitamin D status in women born before 32 weeks'].

Unlabelled: Deficiency of vitamin D (25-OHD) is a health problem among prematurely born women and their newborns independently of the geographical location of the country.

Objectives: To study serum levels of vitamin D in patients born before 32 weeks and their newborns at birth. To analyse the socio-demographic factors, complications of pregnancy and their relationship with vitamin D status of women.

[Pulmonary hypertension of the newborn--recent advances in the management and treatment].

Pulmonary hypertension of the newborn is a clinical syndrome with diverse etiology in which the transition from fetal circulation with high pulmonary vascular resistance to postnatal circulation with low pulmonary vascular resistance failed. The persistence of high pulmonary vascular pressure leads to right-left shunts and marked cyanosis. Despite of the advances in neonatology, the treatment of some forms of PPHN is often difficult and mortality rate remains high.

[Pulmonary hypertension of the newborn - mechanisms of failed circulatory adaptation after birth, clinical presentation and diagnosis].

This article reviews the recent advances in understanding the mechanisms of the persistent pulmonary hypertension of the newborn, the pathways for persistence of high pulmonary vascular resistance and disruption of the normal perinatal fetal to neonatal circulatory transition. Despite the advancements of the neonatal intensive care in the last decades pulmonary hypertension of the newborn represents a clinical, diagnostic and treatment challenge for neonatologists. In most cases pulmonary hypertension is a secondary complication of a primary disease of the fetus and newborn characterized by failure to decrease the pulmonary vascular resistance after birth associated with right to left shunts, severe hypoxemia and respiratory failure.

[Neonatal bacteremia--frequency, spectrum of organisms and correlation between clinical symptoms and laboratory data for early onset sepsis].

Unlabelled: Improved obstetrical management and evidence-based peripartum antimicrobial therapy in the last decades reduce the frequency of early-onset neonatal sepsis (EONS) and improve the outcome. The spectrum of the microrganisms is different according to regions, countries and periods of time. Appropriate diagnosis and treatment improve the outcome.

[Fetal growth curve based on gestational age and fetal maturity].

Most of the fetal growth charts available in the literature were created too long ago, based on various populations and using various eligibility criteria. The purpose of our study was to develop a nomogram of fetal weights based on the gestational age and neonatal maturity. The study is prospective and retrospective in nature.

[Congenital cystic lung lesions--review of the literature with three clinical cases].

Congenital cystic lung lesions are rare. Mainly affects the lower respiratory patishta.i are congenital cystic malformation and adematozna bronchopulmonary sequestration (BPS).

[Newaspects of neonatal resuscitation guidelines and their practical application].

In this article we discuss the changes in the guidelines for newborn resuscitation, 2010, the International Liaison Committee on Resuscitation and their practical application at national level. The Resuscitation algorithm is simplified, the assessment of the need for resuscitation and progression to the next stage are based on heart rate and respiration only, that makes it easy for routine use and staff training. Routine suctioning of airways is not more recommended, even if meconium stained amniotic fluid is available endotracheal aspiration remains controversial.

[Problems and neonatal outcome of very low birth weight newborn infants after in vitro fertilization].

Unlabelled: The use of assisted reproduction technologies is undoubtedly successful in the treatment of sterility. However it sets up numerous of issues for the obstetricians and neonatologists.

Aims: To evaluate the incidence, the specific problems and the neonatal outcome of newborns with very low birth weight (VLBW) <1500 g born from pregnancies after in vitro fertilization (IVF).

[Frequency, severity and risk factors for bronchopulmonary dysplasia among very low birth weight premature infants admitted in the NICU of the University Obstetrics and Gynecology Hospital, Sofia].

Background: The progress in the perinatology improved the survival rate of the infants with extremely low birth weight and gestational age. Among the most immature of them the frequency of bronchopulmonary dysplasia (BPD) remains high..

[CRIB II score and method of delivery for very low and extremely low birth weight infants].

Unlabelled: The purpose of this study is to determine the influence of method of delivery on CRIB II score in preterm infants born in vertex presentation < or = 32 weeks of gestation.

Material And Methods: Prospective study over five years period (2006-2010) that includes 162 cases. 115 (71%) of patients are delivered vaginally and 47 (29%) with cesarean section.

["In vitro" babies--dreams, that turned real, but a lot of questions and unknown items].

Unlabelled: In vitro babies bring happiness to a lot of families. Their development, health and social problems are being studied in details.

Objectives: To establish the well being of babies, born at the University Maternity Hospital "Maichin dom" following assisted reproduction (AR), probable risk factors immediately after birth and afterwards.

[Vitamin D levels in maternal--VLBW infants pairs].

Unlabelled: Normal foetal growth depends on sufficient mother's vit D intake. Premature birth interrupts vit D and mineral mother-to-foetus transfer and leads to vit D deficiency and disturbs newborn mineral bone metabolism.

Objectives: To determine vit.

[Osteopenia of prematurity--prophylaxis, diagnostics and treatment].

Unlabelled: Osteopenia of prematurity is a metabolic bone disease of premature infants with birth weight < 1500 g and gestational age < 32 weeks. Sub-optimal bone matrix, poor skeletal support and an increased risk of fractures characterized the disease. Its importance is determined by relatively high frequency--between 30-70% of infants at risk, multifactorial etiology and impact on early and late morbidity of the newborns.

[Scoring systems for assessing illness severity and predicting outcome in very low birth weight infants].

The very low gestational age (VLGA) and birth weight (VLBW) in newborns and the related morbidities are one of the main causes of death in the neonatal period and during the first year of life. In the last two decades a number of neonatal scores for assessing the illness severity and the initial risk were developed. They are applied for different goals: to predict the risk of death and serious morbidity, to assure a more accurate evaluation of results between different NICU's, as a reliable basis for randomization of the patients in multicenter and longitudinal studies, for comparison of the effect when new therapeutic strategies are used.

[The very low birth weight and very low gestational age neonates--survival, prognosis and perspectives].

The advances in perinatal medicine during the last decades lead to a reduction in neonatal mortality rates in risk newborns and a gradual lowering of the gestational age when survival is possible to 22 weeks of gestation. In the present survey we are making a review of the studies about the survival and the prognosis in neonates with very low birth weight and gestational age (VLBW, VLGA). Infants weighting more than 1000 g and with gestational age above 28 g.