MRI following severe perinatal asphyxia: preliminary experience.

In 30 children suffering from severe perinatal asphyxia an attempt was made to determine the early prognostic signs of severe hypoxic-ischemic brain injury with magnetic resonance imaging (MRI). Ten early (1-4 days of age), 16 intermediate (2-4 weeks of age), and 38 late MRI (older than 1 month of age) procedures were performed on a 2.35 T MR-system. Severe cerebral necrosis was suspected by T2 hyperintensity of the white matter, with blurred limits to the cortex in early MRI, and was confirmed by T1 hyperintensity of the cortex in intermediate MRI. Severe cerebral necrosis was established at 3 months of age. Of the 11 children with this pattern (group A), 8 had severe and 3 had moderate cerebral palsy on subsequent examination. Thirteen children (group B) had normal late MRI scans; none developed severe cerebral palsy or marked mental retardation. Two children (group C) had focal ischemic lesions. Four children had intracranial hemorrhage (group D). Groups A and B did not differ in the severity of their perinatal histories and findings, suggesting that MRI during the first 3 months is of significant prognostic value.

Report on Perinatal Statistics for 1999

The principal aim of the National Perinatal Reporting Scheme (NPRS) is the provision of national statistics on perinatal events. Since 1999, the Economic and Social Research Institute (ESRI) has been contracted by the Department of Health and Children to oversee the collection, processing, management and reporting of data submitted to the NPRS. In this report, data on pregnancy outcomes, with particular reference to perinatal mortality and important aspects of perinatal care, are presented for 1999. In addition, descriptive social and biological characteristics of mothers giving birth and babies born in 1999 are recorded. Download document here

Quality Of Attachment, Perinatal Risk, And Mother-Infant Interaction In A High-Risk Premature Sample

Thirty-three families, each with a premature infant born less than 33 gestational weeks, were observed in a longitudinal exploratory study. Infants were recruited in a neonatal intensive care unit, and follow-up visits took place at 4 months and 12 months of corrected age. The severity of the perinatal problems was evaluated using the Perinatal Risk Inventory (PERI; A.P. Scheiner & M.E. Sexton, 1991). At 4 months, mother infant play interaction was observed and coded according to the CARE-index (P.M. Crittenden, 2003); at 12 months, the Strange Situation Procedure (SSP; M.D.S. Ainsworth, M.C. Blehar, E. Waters. & S. Wall, 1978) was administered. Results indicate a strong correlation between the severity of perinatal problems and the quality of attachment at 12 months. Based on the PERI, infants with high medical risks more frequently tended to be insecurely attached. There also was a significant correlation between insecure attachment and dyadic play interaction at 4 months (i.e., maternal controlling behavior and infant compulsive compliance). Moreover, specific dyadic interactive patterns could be identified as protective or as risk factors regarding the quality of attachment. Considering that attachment may have long-term influence on child development, these results underline the need for particular attention to risk factors regarding attachment among premature infants.

Report on Perinatal Statistics for 2002

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HSE Midland Regional Hospital, Portlaoise Perinatal Deaths (2006-date)

The Minister for Health requested the Chief Medical Officer to prepare a Report for him on issues that arose following a Primetime Investigates programme relating to Portlaoise Hospital Maternity Services (PHMS) on 30th January 2014. This Report provides a preliminary assessment of PHMS focusing on perinatal deaths (2006-date) and related matters. Through a series of recommendations it sets out the need for further examination or actions where the findings of this preliminary assessment suggest such a need. It also makes clear who should be responsible for these further examinations or actions.   Download the Report

Die Säuglingssterblichkeit in der Schweiz: multivariate Betrachtung. [Perinatal mortality in Switzerland: a multivariate analysis]

A regression analysis using a linked file of all Swiss births und perinatal deaths 1979-1981 showed a significant relation between birthweight and canton. Sex of infant and multiplicity of birth were significant, too. For live births, marital and socio-economic status of mother and father relate to birthweight. Logistic regressions brought out relationships between the risk of stillbirth and occupation of father, nationality and marital status of mother, apart from birthweight. For live births, only sex and (weakly) marital status and rank of the child were influencial after correction for birthweight.

Perinatal arrhythmias.

Cardiac arrhythmias are very frequent in fetuses and newborns. The prognosis depends on the nature of the arrhythmias but is most often either spontaneously benign or following short-term medication administration. A correct diagnosis is essential for both management and prognosis. It is based on echocardiography during the fetal period and mainly on history, physical exam, and electrocardiogram after birth, but other modalities are available to record transient arrhythmic events. Irregular rhythms are mostly benign and rarely require therapy. In most fetuses and infants, tachyarrhythmias resolve spontaneously or require short-term administration of antiarrhythmics. Approximately one third of these may recur later on, especially during adolescence. Persistent bradyarrhythmias might require pacemaker implantation when associated with failure to thrive or with risk of sudden death. CONCLUSION: Arrhythmias in fetuses and infants are very common and mostly benign. History, physical exam, and recording of the arrhythmia are essential to make a correct diagnosis and establish an appropriate management for the rare potentially harmful arrhythmias.

Perinatal Mortality 2007

This report is the fifth annual perinatal mortality surveillance report conducted under the auspices of the Confidential Enquiry into Maternal and Child Health (CEMACH). CEMACH was established in 2003 as the successor organisation to two previous national confidential enquiries, the Confidential Enquiry into Maternal Deaths (CEMD) and the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI). The programme of national confidential enquiries was started by CEMD in 1952 and by CESDI from 1992. Since its inception in 2003, CEMACH has successfully extended its remit to encompass a new national enquiry into child health and research on a wide range of relevant topics that include morbidity as well as mortality.

Perinatal Mortality 2008

CMACE provides information on perinatal deaths at local, regional and national level for health careproviders, commissioners and policy makers. This UK report complements the perinatal mortality reports which CMACE produces for the UK nations separately, Strategic Health Authorities (SHAs) in England and maternity providers.

Perinatal Mortality 2009

The CMACE report Perinatal Mortality 2009 completes a decade of reports from CMACE and its predecessor organizations CESDI and CEMACH. As in previous years, the findings are both heartening and challenging.During the last decade the United Kingdom has seen a dramatic 16%increase in the number of births to just over 790,000 in 2009. Despite promising improvements, there were still 6,600 babies who died during pregnancy or in the first 4 weeks of life in 2009. The impact on mothers and families from such tragedies cannot be overestimated.�

Perinatal and Maternal Mortality report

The findings in this report are based on stillbirths and neonatal deaths with a date of birth between 1 January 2008 and 31 December 2008 notified to AWPS/CMACE and reported to the Office for National Statistics (ONS). For maternity provider rates, denominators are based on live births reported to AWPS/CMACE by hospitals. For country rates, denominators are based on live births reported to ONS and NISRA-GRO.Perinatal mortality rates for 2008 are assigned to a geographical area. Country specific findings are derived using maternal postcode of residence. Findings for maternity providers within Northern Ireland are derived using the place of death, and any deaths at home are allocated to the maternity provider that provided the care at the time of death.

Perinatal and Maternal Mortality report 2009

The findings in this report are based on stillbirths and neonatal deaths with a date of birth between 1 January 2009 and 31 December 2009 notified to CMACE and reported to the Office for National Statistics (ONS). For Trust rates, denominators are based on live births reported to CMACE by hospitals. For Strategic Health Authority (SHA) and country rates, denominators are based on live births reported to ONS and Northern Ireland Statistics and Research Agency (NISRA).Perinatal mortality rates for 2009 are assigned to a geographical area and are derived using maternal postcode of residence. Findings for Trusts are derived using the place of death, and any deaths at home are allocated to the Trusts that provided the care at the time of death.

Perinatal Mental Health Care Pathway

�This regional care pathway provides�guidance for all Health and Social Care (HSC) professionals who come into contact with pregnant women. In addition, each Trust has developed a local adaptation of this pathway for their population.�

Determinants and trends in perinatal human immunodeficiency virus type 1 (HIV-1) transmission in the metropolitan area of Belo Horizonte, Brazil: 1998 - 2005

Significant decrease in human immunodeficiency virus type 1 (HIV-1) vertical transmission has been observed worldwide in centers where interventions such as antiretroviral therapy (ART), elective cesarean section, and avoidance of breastfeeding have been implemented. This prospective cohort study aimed to assess the determinants of and the temporal trends in HIV-1 vertical transmission in the metropolitan area of Belo Horizonte, Brazil from January 1998 to December 2005. The rate of HIV-1 vertical transmission decreased from 20% in 1998 to 3% in 2005. This decline was associated with increased use of more complex ART regimens during pregnancy. Multivariate analysis restricted to clinical variables demonstrated that non ART, neonatal respiratory distress/sepsis and breastfeeding were independently associated with HIV-1 vertical transmission. When laboratory parameters were included in the model, high maternal viral load and non maternal ART were associated with HIV-1 vertical transmission. The results from this study confirm the impact of ART in the reduction of HIV-1 vertical transmission and indicate the need for improvement in the care and monitoring of mother and infant pairs affected by HIV-1.

Buenas prácticas en atención perinatal : proyecto de humanización de la atención perinatal en Andalucía

Esta publicación se realiza en el marco de actividades del Proyecto de Humanización de la Atención Perinatal en Andalucía que se desarrolla a partir del convenio entre el Ministerio de Sanidad y Política Social (Observatorio de Salud de la Mujer. Plan de Calidad del Sistema Nacional de Salud) y la Consejería de Salud de la Junta de Andalucía para impulsar la Estrategia de Atención al Parto Normal así como la humanización de todo el proceso de atención perinatal desde una perspectiva de género.En la port.: Estrategia de Atención al Parto Normal en el Sistema Nacional de Salud.