Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is...Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is to assess their skills that this work was undertaken with the objective of evaluating the practice of neonatal resuscitation in the delivery room of the RHC maternity hospital in District V of Bamako. Methodology: This was a descriptive cross-sectional study over a four-month period. We included in the study all live newborns who had a gestational age greater than or equal to 32 weeks and who had an Apgar score at the first minute of less than 7. At each birth, we observe the health agent responsible for the care of the newborn by observing the preparation of resuscitation and compliance with the neonatal resuscitation algorithm. We have excluded all newborns who met our inclusion criteria, were reanimated outside of our collection time and had visible or diagnosed anomalies or malformations in the prenatal period, and those whose parents refused to give their consent to participate in the study. Data were collected from the survey sheet and analyzed with the Statistical Package for Social Sciences (SPSS) software version 25. Results: We observed a 24.66% frequency of neonatal resuscitation. Pregnancies were too close in 15% (less than one year). Caesarean section delivery represented 34% of the sample. They were at term in 93% of cases. All newborns were well dried (98.5%), with wet linen change only at 49.5%. Apgar was less than 3 in 7.5% of newborns at first. The resuscitation needs were for the absence of a scream in 78.5% of cases and or heart rate Conclusion: The study evaluated neonatal resuscitation practices at a maternity hospital in Bamako, Mali. It found a 24.66% resuscitation rate, with a 95.5% success rate despite technical limitations. Most steps were correctly applied, though some improvements are needed in areas like preventing hypothermia and equipment preparation.展开更多
The incidence of allergic airway diseases continues to increase in industrial countries while remaining much more stable in developing countries. Allergens inhaled are eventually also swallowed and evidently the gastr...The incidence of allergic airway diseases continues to increase in industrial countries while remaining much more stable in developing countries. Allergens inhaled are eventually also swallowed and evidently the gastrointestinal immune system has a role in regulating allergic responses in the pulmonary as well as the GI system. While some studies have pointed out the role of probiotic bacteria as a supplementary protection against the early development of various allergies, little attention has been paid to the composition of the airborne microflora first and continuosly inhaled by newborns and infants. This study compares the composition of two airborne microbial communities, one from hospital delivery rooms and the other from a nature reserve, evidently in use as a birthing place as early as 7500 B.C. around the air from the outdoor birthing place was marked by a far greater variation in microbial composition and a much higher representation of fungi than the air from the hospitals. The dominant bacterial species from the delivery rooms were Staphylococcus areus and Micrococcus luteus, originating from the staff and the hospital environment;the outdoor flora, however, was dominated by Pseudomonas spp. and Bacillus spp. In addition, 56% of all the bacterial isolates from the delivery rooms were most closely related to strains previously associated with clinical infections, whereas only 15% of isolates in the outdoor bacterial sample had such relationships. The role of airborne microorganisms could be important to infants with developing immune systems considering the microbial bias of hospital air presented in this study.展开更多
目的探讨产房复苏质量改进对极低/超低出生体重儿的影响。方法回顾性收集南京医科大学附属妇产医院儿科新生儿重症监护病房（neonatal intensive care unit，NICU）收治的极/超低出生体重儿的临床资料。其中，2015年1月至2015年12月的17...目的探讨产房复苏质量改进对极低/超低出生体重儿的影响。方法回顾性收集南京医科大学附属妇产医院儿科新生儿重症监护病房（neonatal intensive care unit，NICU）收治的极/超低出生体重儿的临床资料。其中，2015年1月至2015年12月的176例为改进前组，实施产房质量改进措施后的2016年1月至2016年12月的199例为改进后组。主要观察指标为入NICU的体温、产房复苏插管情况和呼吸系统相关情况，次要观察指标为产房复苏时任何阶段给予持续气道正压通气（continuous positive airway pressure，CPAP）、使用T-组合复苏器正压通气、产房球囊加压给氧以及入NICU的血pH值等。采用χ2检验（或Fisher精确概率法）、t检验或秩和检验对数据进行统计学分析。结果2组患儿的胎龄、出生体重、性别构成、分娩方式和生后Apgar评分等差异均无统计学意义。经过质量改进后，在产房任意复苏阶段CPAP使用率升高[85.9%（171/199）与66.3%（112/176），χ2=19.881，P〈0.01]，用T-组合复苏器给予吸气峰压＋呼气末正压复苏率也升高[33.8%（67/199）与10.8%（12/176），χ2=19.819，P〈0.01]，球囊正压给氧率下降[6.0%（12/199）与39.3%（44/176），χ2=53.682，P〈0.01]，产房内气管插管率差异无统计学意义（P〉0.05）。质量改进后，患儿入NICU平均体温提高[M（P25-P75），36.2（35.8-36.5）与35.6（35.4-35.7）℃，Z=－9.681，P〈0.01]，生后1周内肺出血发生率降低[1.5%（3/199）与5.1%（9/176），χ2=3.921，P〈0.05]，Ⅲ/Ⅳ级颅内出血发生率降低[1.1%（2/199）与11.9%（21/176），χ2=33.885，P〈0.01]，有创通气时间缩短[3（1-6）与4（2-9）d，Z=－2.286，P〈0.05]。结论通过产房复苏质量改进，规范了产房复苏措施，可改善极/超低出生体重儿的结局。展开更多
文摘Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is to assess their skills that this work was undertaken with the objective of evaluating the practice of neonatal resuscitation in the delivery room of the RHC maternity hospital in District V of Bamako. Methodology: This was a descriptive cross-sectional study over a four-month period. We included in the study all live newborns who had a gestational age greater than or equal to 32 weeks and who had an Apgar score at the first minute of less than 7. At each birth, we observe the health agent responsible for the care of the newborn by observing the preparation of resuscitation and compliance with the neonatal resuscitation algorithm. We have excluded all newborns who met our inclusion criteria, were reanimated outside of our collection time and had visible or diagnosed anomalies or malformations in the prenatal period, and those whose parents refused to give their consent to participate in the study. Data were collected from the survey sheet and analyzed with the Statistical Package for Social Sciences (SPSS) software version 25. Results: We observed a 24.66% frequency of neonatal resuscitation. Pregnancies were too close in 15% (less than one year). Caesarean section delivery represented 34% of the sample. They were at term in 93% of cases. All newborns were well dried (98.5%), with wet linen change only at 49.5%. Apgar was less than 3 in 7.5% of newborns at first. The resuscitation needs were for the absence of a scream in 78.5% of cases and or heart rate Conclusion: The study evaluated neonatal resuscitation practices at a maternity hospital in Bamako, Mali. It found a 24.66% resuscitation rate, with a 95.5% success rate despite technical limitations. Most steps were correctly applied, though some improvements are needed in areas like preventing hypothermia and equipment preparation.
文摘The incidence of allergic airway diseases continues to increase in industrial countries while remaining much more stable in developing countries. Allergens inhaled are eventually also swallowed and evidently the gastrointestinal immune system has a role in regulating allergic responses in the pulmonary as well as the GI system. While some studies have pointed out the role of probiotic bacteria as a supplementary protection against the early development of various allergies, little attention has been paid to the composition of the airborne microflora first and continuosly inhaled by newborns and infants. This study compares the composition of two airborne microbial communities, one from hospital delivery rooms and the other from a nature reserve, evidently in use as a birthing place as early as 7500 B.C. around the air from the outdoor birthing place was marked by a far greater variation in microbial composition and a much higher representation of fungi than the air from the hospitals. The dominant bacterial species from the delivery rooms were Staphylococcus areus and Micrococcus luteus, originating from the staff and the hospital environment;the outdoor flora, however, was dominated by Pseudomonas spp. and Bacillus spp. In addition, 56% of all the bacterial isolates from the delivery rooms were most closely related to strains previously associated with clinical infections, whereas only 15% of isolates in the outdoor bacterial sample had such relationships. The role of airborne microorganisms could be important to infants with developing immune systems considering the microbial bias of hospital air presented in this study.
