Navegando por Palavras-chave "asphyxia neonatorum"
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- ItemAcesso aberto (Open Access)Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis(Sociedade de Pediatria de São Paulo, 2013-03-01) Daripa, Mandira [UNIFESP]; Caldas, Helena Maria G. [UNIFESP]; Flores, Luis Patricio O.; Waldvogel, Bernadette Cunha; Guinsburg, Ruth [UNIFESP]; Almeida, Maria Fernanda Branco de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação SEADE Divisão de Produção de Indicadores Demográficos; Fundação SEADEOBJECTIVE: To compare the epidemiological profile of avoidable early neonatal deaths associated with perinatal asphyxia according to region of death in the State of São Paulo, Brazil. METHODS: Population-based cohort study including 2,873 avoidable deaths up to six days of life associated with perinatal asphyxia from January 2001 to December 2003. Perinatal asphyxia was considered if intrauterine hypoxia, birth asphyxia, or meconium aspiration syndrome were written in any line of the original Death Certificate. Epidemiological data were also extracted from the Birth Certificate. RESULTS: During the three years, 1.71 deaths per 1,000 live births were associated with perinatal asphyxia, which corresponded to 22% of the early neonatal deaths. From the 2,873 avoidable deaths, 761 (27%) occurred in São Paulo city; 640 (22%), in the metropolitan region of São Paulo city; and 1,472 (51%), in the countryside of the state. In the first two regions, deaths were more frequent in public hospitals, among newborns with gestational age of 36 weeks or less, and among babies weighing less than 2500g. In the countryside, mortality was more frequent in philanthropic hospitals, in term newborns and in neonates weighing over 2500g. Most of these neonates were born during daytime in their hometown and died at the same institution in which they were born within the first 24 hours after delivery. Meconium aspiration syndrome was related to 18% of the deaths. CONCLUSIONS: Perinatal asphyxia is a frequent contributor to the avoidable early neonatal death in the state with the highest gross domestic product per capita in Brazil, and it shows the need for specific interventions with regionalized focus during labor and birth care.
- ItemSomente MetadadadosAn avoidable tragedy: neonatal deaths associated to perinatal asphyxia(Soc Iberoamericana Informacion Cientifica-s I I C, 2008-04-01) Guinsburg, Ruth [UNIFESP]; Branco de Almeida, Maria Fernanda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Early neonatal mortality is an indicator of human development around the world. Asphyxia contributes to about 20-25% of these early deaths. In order to reduce early neonatal mortality rates, effective efforts should be directed to decrease social inequities by improving the access of pregnant women to health services, including appropriate care during the pre-natal period, labor and delivery. The newborn infants should be assisted by professionals skilled in recognizing the need for life support procedures and in executing them.
- ItemAcesso aberto (Open Access)A reanimação do prematuro extremo em sala de parto: controvérsias(Sociedade Brasileira de Pediatria, 2005-03-01) Almeida, Maria Fernanda Branco de [UNIFESP]; Guinsburg, Ruth [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); American Academy of Pediatrics Programa de Reanimação Neonatal; American Heart Association; Sociedade Brasileira de Pediatria Programa de Reanimação NeonatalOBJECTIVE: To describe the main controversies about resuscitation procedures performed in extremely low birth weight infants in the delivery room. SOURCES OF DATA: Systematic review including articles from MEDLINE, SciELO and Cochrane Library, and abstracts published in national and international proceedings, using the keywords resuscitation, asphyxia, and newborn infant. SUMMARY OF THE FINDINGS: The main controversies concern the oxygenation and ventilation of extremely low birth weight infants. The effects of oxygen concentrations between 21 and 100% need to be addressed. Appropriate inspiratory pressure, lung volume, and positive end-expiratory pressure parameters also need to be established in order to decrease barotrauma and volutrauma. The benefits of nasal continuous positive airway pressure may be determined through randomized clinical trials. On top of that, manual resuscitation devices have to be developed in order to optimize these ventilatory parameters and to reduce lung injury. So far, clinical trials on the administration of epinephrine, volume expanders, and sodium bicarbonate to extremely low birth weight infants have not been published. In addition, the main ethical dilemma concerns the decision of health professionals and parents not to initiate resuscitation procedures at very low gestational ages. CONCLUSIONS: In the future, guidelines may be modified based on the results of randomized and controlled clinical trials, as well as neurodevelopmental follow-up studies, involving extremely low birth weight infants submitted to resuscitation procedures in the delivery room.