Day 1 :
- Neonatology and Perinatology
Session Introduction
Zsuzsanna Varga
Semmelweis University, Hungary
Title: Parental educational level modulates the cognitive developmental outcome in infants with neonatal encephalopathy
Biography:
Zsuzsanna Varga is a cognitive psychologist who is working at the Pediatric Clinic, Division of Neonatology of the Semelweis University in Budapest, Hungary. She carries out developmental follow-up examinations in preterm infants and in infants born with Neonatal Encephalopathy (NE). Her research area is the cognitive development of infants born with NE. During her PhD years, she examined the event-related brain potential correlates of the language development of preterm and full-term infants.
Abstract:
Aim: Despite advanced imaging and neurophysiological tests, prognostication of neurodevelopmental outcomes in NE is still not precise. Our aim was to consider the predictive value of Socio-Economic Status (SES) for developmental outcomes independent of physiological variables and disease severity in NE infants.
Methods: A cohort of 93 NE infants who had MRI examination with Barkovich scorings in the neonatal period were examined and prospectively followed until 16-42 months of age. Besides the registration of the Bayley Scales of Infant Development II, we collected SES variables, including combined parental education to reveal associations between SES and outcomes.
Results: At mean follow-up of 23.0 ± 6.7 months, higher parental education was strongly associated with good cognitive outcome (OR 2.20; 95% CI: 1.16-4.36), but not with motor outcome. One point for brain injury on neonatal MRI was associated with decreased odds for good cognitive outcome (OR 0.70; 95% CI: 0.50-0.89). In the subgroup of NE infants with any brain injury on MRI (n=21), literacy environment (OR 40; 95% CI: 3.7-1352) seems to have a marked effect on cognitive development.
- Neonatology
Session Introduction
Sundus Khuder
Dibba Al-Fujairah Hospital, UAE.
Title: New approach and management of persistent pulmonary hypertension in newborn
Biography:
Sundus Khuder is a Pediatric consultant at Dibba Al-Fujairah Hospital. Board director of global newborn society GNS. Instructor of the neonatal resuscitation committee. Completed fellowship of the arab board of health at neonatologist subspecialty. Instructor in mechanical ventilation course. Director of mechanical ventilation course, Iraq and Syria.
Abstract:
Pulmonary hypertension (PH) is a life-threatening condition in newborns characterized by high blood pressure in the arteries of the lungs. It can lead to significant morbidity and mortality if not managed appropriately. The approach to managing newborns with PH involves a thorough evaluation of the underlying cause and severity of the disease. Early recognition and diagnosis are crucial for prompt intervention and improved outcomes. The role of three help us to understand and manage pphn much better There are three causes of pphn, there are three molecule pathways affect the pulmonary vessels, there are three types of management depend in the etiology and there are three echocardiography findings. In general, management strategies for PH in newborns aim to improve oxygenation, reduce pulmonary vascular resistance, and enhance cardiac function. Initial management includes supportive care measures such as supplemental oxygen, mechanical ventilation, and inotropic support. In addition, pharmacologic interventions such as inhaled nitric oxide, prostaglandins, and sildenafil may be used to reduce pulmonary vascular resistance and improve oxygenation. However, the use of these agents requires close monitoring and should be used judiciously to avoid adverse effects.
Extracorporeal membrane oxygenation (ECMO) may be used as a rescue therapy in refractory cases.
- Neonatology
Session Introduction
Sadok Hannachi
University of Tunis El Manar, Tunisia
Title: Congenital bleeding disorders: When to evoke in neonates?
Biography:
Sadok Hannachi is affiliated to University of Tunis El Manar, Universitaire Farhat Hached, Tunis 1068, Tunisia.
Abstract:
Introduction: Congenital Bleeding Disorders (CBD) comprises a heterogeneous group of diseases that reflect abnormalities of blood vessels, coagulation proteins and platelets. Patients with rare CBD may have a broad spectrum of clinical symptoms, ranging from mucocutaneous bleeding to life-threatening hemorrhages, such as those occurring in the central nervous system.
Methods: A retrospective descriptive study of all neonatal cases of CBD registered in the Neonatal Intensive Care Unit of the Military Hospital of Tunis, through the 20 previous years.
Results: The first observation was about a full term male infant, with no significant familial history, who declared at 4 hours of life an overwhelming hemorrhage. Initial blood tests revealed biologic signs of disseminated intravascular coagulation. The assays of IX, VIII and Von Willebrand factors were normal. Brain MRI showed an intraventricular hemorrhage with quadriventricular hydrocephalus. Analysis of the plasma revealed a severe deficiency of ADAMTS13. The patient has since required periodic prophylactic Fresh Frozen Plasma (FFP) infusions. With a decline of seven years, he kept moderate encephalopathy. Genetic study confirmed the diagnosis of Upshaw-Schulman syndrome. The second case was about a newborn with an enormous caput succedaneum. The blood count was consistent with severe anemia and coagulation studies revealed a prolonged Activated Partial Thromboplastin Time (APTT). Coagulation factors were measured, with a very low factor VIII activity (<1%) which was compatible with severe type-A hemophilia. Despite introducing the specific treatment, the infant died at the age of 18 months due to a severe hemorrhagic episode.The third and fourth cases were about a brother and his sister who presented an umbilical hemorrhage that wasn’t initially explored. Both of them have had seizures due to an intracranial hypertension and multiple episodes of bruising. The blood tests showed no anomalies aside from a low rate of XIII factor.