Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted ...Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted to determine whether late clamping actually increases the incidence of phototherapy for jaundice and other poor outcomes of the term “low-risk newborns”. Methods: With the approval of the Brazilian Registry of Clinical Trials (REBEC), a total of 357 low-risk newborns (singleton, uncomplicated pregnancy/delivery, in a Brazilian public institution) were randomized into two groups: group I (n = 114): cord clamping 1 minute (early clamping) or group II (n = 243): cord clamping between 1 - 3 minutes (late clamping). Statistics were used appropriately (i.e., measures of central tendency, dispersion for continuous variables, Shapiro-Wilk, Mann-Whitney test, or Chi-square test). Results: Phototherapy was performed in 5.3% in both groups. Also, there were no statistical differences in the occurrence of secondary outcomes, such as sepsis, neonatal ICU admission, and transient tachypnea of the newborns: i.e., 0.9%, 15.8%, and 3.5%, respectively for group I versus 1.2%, 15.6%, and 5.8%, respectively for group II. Conclusion: Late umbilical cord clamping does not increase the need for phototherapy in low-risk neonates. This result corroborates the current recommendation of late cord clamping, whenever appropriate.展开更多
Introduction： The anti Kell is a major cause of hemolytic disease of the newborn; the third cause after ABO and Rhesus in frequency; and the second in terms of severity after rhesus type incompatibility. In Africa, 6...Introduction： The anti Kell is a major cause of hemolytic disease of the newborn; the third cause after ABO and Rhesus in frequency; and the second in terms of severity after rhesus type incompatibility. In Africa, 60% of the population is Kell negative. In Congo, Kell blood group determination is not systematically performed and almost non-existent in perinatology. We aimed to report a case of this immunization in routine practice. Method： This study is a clinical report of Kell immunization. Physical examination was performed and blood group determined. Clinical and biological follow up of the case： a review of the literature of Kell immtmizations is included. Result： A female newborn on day 4 of life with weight of 3,250 g born at term admitted to Sendwe＇s Hospital emergency for pallor and respiratory distress. History reveals jaundice at birth. The mother is P1G4A3D0, blood group Orh＋. Clinically the child is pale, jaundiced, present tachycardia, hepatomegaly, polypnea Brh＋. The diagnostic orientation is a maternal-fetal incompatibility. The realization of blood grouping Kell, Duffy and irregular antibodies research Kell type confirms the diagnosis of Kell hemolytic disease of the newborn. We discharged him after 14 days. Conclusions： The Kell type IFME is a purveyor of grave hemolytic disease of the newborn. His knowledge, prevention and proper care by a multidisciplinary team can prevent dramatic situations.展开更多
文摘Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted to determine whether late clamping actually increases the incidence of phototherapy for jaundice and other poor outcomes of the term “low-risk newborns”. Methods: With the approval of the Brazilian Registry of Clinical Trials (REBEC), a total of 357 low-risk newborns (singleton, uncomplicated pregnancy/delivery, in a Brazilian public institution) were randomized into two groups: group I (n = 114): cord clamping 1 minute (early clamping) or group II (n = 243): cord clamping between 1 - 3 minutes (late clamping). Statistics were used appropriately (i.e., measures of central tendency, dispersion for continuous variables, Shapiro-Wilk, Mann-Whitney test, or Chi-square test). Results: Phototherapy was performed in 5.3% in both groups. Also, there were no statistical differences in the occurrence of secondary outcomes, such as sepsis, neonatal ICU admission, and transient tachypnea of the newborns: i.e., 0.9%, 15.8%, and 3.5%, respectively for group I versus 1.2%, 15.6%, and 5.8%, respectively for group II. Conclusion: Late umbilical cord clamping does not increase the need for phototherapy in low-risk neonates. This result corroborates the current recommendation of late cord clamping, whenever appropriate.
文摘Introduction： The anti Kell is a major cause of hemolytic disease of the newborn; the third cause after ABO and Rhesus in frequency; and the second in terms of severity after rhesus type incompatibility. In Africa, 60% of the population is Kell negative. In Congo, Kell blood group determination is not systematically performed and almost non-existent in perinatology. We aimed to report a case of this immunization in routine practice. Method： This study is a clinical report of Kell immunization. Physical examination was performed and blood group determined. Clinical and biological follow up of the case： a review of the literature of Kell immtmizations is included. Result： A female newborn on day 4 of life with weight of 3,250 g born at term admitted to Sendwe＇s Hospital emergency for pallor and respiratory distress. History reveals jaundice at birth. The mother is P1G4A3D0, blood group Orh＋. Clinically the child is pale, jaundiced, present tachycardia, hepatomegaly, polypnea Brh＋. The diagnostic orientation is a maternal-fetal incompatibility. The realization of blood grouping Kell, Duffy and irregular antibodies research Kell type confirms the diagnosis of Kell hemolytic disease of the newborn. We discharged him after 14 days. Conclusions： The Kell type IFME is a purveyor of grave hemolytic disease of the newborn. His knowledge, prevention and proper care by a multidisciplinary team can prevent dramatic situations.
