AJP Reports最新文献

{"title":"Transvaginal Sonographic Assessment Following Cervical Pessary Placement for Preterm Birth Prevention.","authors":"William Schnettler, Shwetha Manoharan, Kate Smith","doi":"10.1055/s-0041-1742273","DOIUrl":"https://doi.org/10.1055/s-0041-1742273","url":null,"abstract":"<p><p><b>Background</b>  Transvaginal sonographic cervical length assessment identifies pregnant women at risk for preterm birth, and the subsequent placement of a cervical pessary may reduce this risk. The mechanism of action remains uncertain, and postplacement transvaginal sonography may provide further insight into the controversial efficacy of this therapy. <b>Objective</b>  To identify any pre- or postplacement sonographic findings associated with preterm delivery following cervical pessary insertion among at-risk women. <b>Materials and Methods</b>  This retrospective cohort study utilized electronic medical record and imaging review of all women identified within a large tertiary care health system having undergone cervical pessary placement for preterm birth risk reduction and subsequently delivered between January 2013 (the adoption of this therapeutic option in our system) and March 2017. Indications for cervical pessary placement were guided by maternal-fetal medicine consultation and required a functional cervical length measurement on transvaginal sonography of 25 mm or less. Criteria for initial transvaginal cervical assessment included obstetric history, multiple gestation, and current concern on transabdominal imaging for cervical shortening. All pre- and postplacement transvaginal sonographic measurements were determined for study purposes by re-review of each patient's images by a single author blinded to outcome. <b>Results</b>  A total of 88 women were identified as having undergone cervical pessary placement for preterm birth prevention, and 52 yielded complete delivery and imaging data for inclusion. As expected, this was a high-risk population with 51.9% carrying multiple gestations, 32.7% with a history of prior preterm birth, and 11.6% with a history of cervical conization. Although previously hypothesized to represent the mechanism of action, neither the change in uterocervical or intracervical angle was associated with gestational age at delivery. Alternatively, preplacement imaging measurements of cervical funneling, anterior cervical length, and cervical diameter were significantly associated with appropriate pessary placement and decreased preterm birth. Forty-two subjects (80.8%) demonstrated both the anterior and posterior aspects of the cervix within the pessary (appropriate placement) and 95.2% of these subjects demonstrated cervical funneling on initial imaging compared with 25% of those with inappropriate placement ( <i>p</i>  = 0.002). Anterior cervical length less than 20 mm and cervical diameter less than 33 mm were associated with preterm delivery less than 28 weeks (16.7 vs. 0%, <i>p</i>  = 0.039), and anterior cervical length less than 20 mm was associated with preterm delivery less than 32 weeks (41.7 vs. 10.7%, <i>p</i>  = 0.025). Cervical diameter less than 33 mm correlated with an \"inappropriately placed\" pessary among 83.3% in comparison to 48.7% ( <i>p</i>  = 0.048) of women with a cervical diamete","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e80-e88"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/59/10-1055-s-0041-1742273.PMC8816641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Loop Electrosurgical Excision Procedure and Cone Conundrum: The Role of Cumulative Excised Depth in Predicting Preterm Birth.","authors":"Danielle M Panelli,&nbsp;Rachel L Wood,&nbsp;Kevin M Elias,&nbsp;Whitfield B Growdon,&nbsp;Anjali J Kaimal,&nbsp;Sarah Feldman,&nbsp;Thomas F McElrath","doi":"10.1055/s-0041-1742271","DOIUrl":"https://doi.org/10.1055/s-0041-1742271","url":null,"abstract":"<p><p><b>Objective</b>  The objective was to determine factors associated with spontaneous preterm birth at less than 37 weeks in a cohort of patients who underwent a loop electrosurgical excision procedure (LEEP) or cone prior to pregnancy. <b>Study Design</b>  This was a nested case-control study within a cohort of patients who underwent at least one LEEP or cone and had care for the next singleton pregnancy at either of two institutions between 1994 and 2014. Cases had spontaneous preterm birth at less than 37 weeks. Exposures included potential risk factors for preterm birth such as cumulative depth of excised cervix and time since excision. Reverse stepwise selection was used to identify the covariates for multivariable logistic regression. <b>Results</b>  A total of 134 patients were included. Eighteen (13%) had a spontaneous preterm birth at less than 37 weeks. Median second-trimester cervical lengths were similar between those who delivered preterm and term (3.9-cm preterm and 3.6-cm term, <i>p</i>  = 0.69). Patients who delivered preterm had a significantly greater median total excised depth of cervix (1.2 vs. 0.8 cm, <i>p</i>  = 0.04). After adjustment for confounders, total excised depth remained significantly associated with preterm birth (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [CI]: 1.3-3.8). <b>Conclusion</b>  Total excised depth should be considered in addition to cervical length screening when managing subsequent pregnancies. <b>Key Points</b> A history of a LEEP or cone excision has been associated with spontaneous preterm birth.A two-fold increase in spontaneous preterm birth was seen per cumulative centimeter excised.There was no difference in second-trimester cervical length between the term and preterm groups.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e41-e48"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/42/10-1055-s-0041-1742271.PMC8816626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Respiratory Compromise following Cesarean Birth: The Impact of Obesity and Systemic Opioids.","authors":"Jessica L Walker, Jacquelyn H Adams, Aimee T Broman, Peter G Pryde, Kathleen M Antony","doi":"10.1055/s-0041-1741539","DOIUrl":"10.1055/s-0041-1741539","url":null,"abstract":"<p><p><b>Objective</b>  The aim of this study was to measure the effect of obesity and systemic opioids on respiratory events within the first 24 hours following cesarean. <b>Methods</b>  Opioid-naive women undergoing cesarean between January 2016 and December 2017 were included in this retrospective cohort study. The primary outcome was the proportion of women experiencing at least one composite respiratory outcome (oxygen saturation less than 95% lasting 30+ seconds or need for respiratory support) within 24 hours of cesarean. The impact of obesity and total systemic opioid dose in 24 hours (measured in morphine milligram equivalents [MMEs]) on the composite respiratory compromise outcome were evaluated. <b>Results</b>  Of 2,230 cesarean births, 790 women had at least one composite respiratory event. Predictors of the composite respiratory outcome included body mass index (BMI) as a continuous variable (odds ratio = 1.063 for every one unit increase in BMI [95% confidence interval (CI): 1.021-1.108], <i>p</i>  = 0.003), and MME (odds ratio = 1.005 [95% CI: 1.002-1.008], <i>p</i>  = 0.003), adjusting for magnesium sulfate use. The interaction between obesity and opioid dose demonstrated an odds ratio of 1.000 (95% CI: 0.999-1.000, <i>p</i>  = 0.030). <b>Conclusion</b>  The proportion of women experiencing respiratory events following cesarean birth increases with the degree of obesity and opioid dose. <b>Key Points</b> Respiratory events increase with obesity.Respiratory events increase with systemic opioid use.Odds ratio of respiratory events is 1.063/unit BMI increase.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e1-e9"},"PeriodicalIF":0.8,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/a3/10-1055-s-0041-1741539.PMC8758249.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Presentation of Limb–Body Wall Complex in a Neonate: Case Report and Review of Literature","authors":"Omoloro Adeleke, Farrukh Gill, R. Krishnan","doi":"10.1055/s-0042-1744215","DOIUrl":"https://doi.org/10.1055/s-0042-1744215","url":null,"abstract":"The Limb Body Wall Complex (LBWC) aka. Body Stalk Syndrome is an uncommon congenital disorder characterized by severe malformations of limb, thorax, and abdomen, characterized by the presence of thoracoschisis, abdominoschisis, limb defects, and exencephaly. This condition is extremely rare with an incidence of 1 per 14,000 and 1 per 31,000 pregnancies in large epidemiologic studies. Majority of these malformed fetuses end up with spontaneous abortions. We present this rare case with occurrence in a preterm infant of 35 weeks gestation. Our report highlights majority of the clinical presentations as reported in previous literature, but the significant pathological findings of absent genitalia and malformed genitourinary, anorectal malformations make this case presentation an even more rare occurrence. Infant karyotyping was normal male and there is no specific underlying genetic correlation in this condition which has fatal prognosis.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"22 1","pages":"e108 - e112"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77895525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal Carbon Monoxide Poisoning: Treatment of a 2-Hour-Old Neonate with Hyperbaric Oxygen","authors":"A. Kreshak, S. Lawrence, Sam T. Ontiveros, Tiffany Castellano, Karen B. VanHoesen","doi":"10.1055/s-0042-1744216","DOIUrl":"https://doi.org/10.1055/s-0042-1744216","url":null,"abstract":"A 41-year-old gravida 4 para 3 (G4P3) and 38 5/7 weeks pregnant woman presented to labor and delivery with dizziness, headache, and decreased fetal movement after 12 hours of exposure to carbon monoxide (CO) from a grill that was used inside for heat. The mother was hemodynamically stable, and her neurologic examination was intact. Her carboxyhemoglobin level, which was obtained 12 hours after removal from the CO exposure, was 7.4%. The fetus's heart rate was 173 beats per minute with moderate variability and one late appearing deceleration, not associated with contractions. The biophysical profile score was 2 of 8. The obstetrics team performed a routine cesarean section. The 1- and 5-minute Apgar's scores were 7 and 8, respectively. The arterial cord gas result was as follows: pH = 7.05, PCO 2  = 71 mm Hg, pO 2  = 19 mm Hg, bicarbonate = 14 mmol/L, and carboxyhemoglobin = 11.9%. The mother and infant were treated with hyperbaric oxygen therapy consisting of 100% oxygen at 2.4 atmosphere absolutes (ATA) for 90 minutes at 2.5 hours after delivery. Following one hyperbaric oxygen treatment, the infant was transitioned to room air and routine postpartum treatment and was discharged 3 days later in good condition. Hyperbaric oxygen treatment was well tolerated in this neonate.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"34 1","pages":"e113 - e116"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90674925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic Disparities in Coronavirus Disease 2019 after the Implementation of Universal Screening in Hartford, Connecticut.","authors":"Veronica Maria Pimentel,&nbsp;Frank Ian Jackson,&nbsp;Anthony Dino Ferrante,&nbsp;Reinaldo Figueroa","doi":"10.1055/s-0041-1740562","DOIUrl":"https://doi.org/10.1055/s-0041-1740562","url":null,"abstract":"<p><p><b>Objective</b>  The aim of this article was to estimate the prevalence of coronavirus disease 2019 (COVID-19) in Connecticut, examine racial/ethnic disparities, and assess pregnancy outcomes in pregnant women following the implementation of universal screening for the virus. <b>Materials and methods</b>  This is a retrospective cohort study of all obstetric patients admitted to our labor and delivery unit during the first 4 weeks of implementation of universal screening of COVID-19. Viral studies were performed in all neonates born to mothers with severe acute respiratory syndrome coronavirus 2. We calculated the prevalence of COVID-19, compared the baseline characteristics and pregnancy outcomes between those who tested positive and negative for the virus, and determined the factors associated with COVID-19. <b>Results</b>  A total of 10 (4.6%) of 220 women screened positive for the virus. All were asymptomatic. Week 1 had the highest prevalence of infection, nearing 8%. No neonates were infected. Hispanics were more likely to test positive (odds ratio: 10.23; confidence interval: [2.71-49.1], <i>p</i>  = 0.001). Obstetric and neonatal outcomes were similar between the groups ( <i>p</i>  > 0.05). <b>Conclusion</b>  Although the rate of asymptomatic COVID-19 was low, ethnic disparities were present with Hispanics being more likely to have the infection. <b>Key Points</b> 4.6% of pregnant women in labor and delivery tested positive for COVID-19 while being asymptomatic.Hispanic women were more likely to test positive for severe acute respiratory syndrome coronavirus 2.Pregnancy outcomes were similar between COVID-19 positive and negative women.No vertical transmission was detected.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 4","pages":"e147-e153"},"PeriodicalIF":0.9,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/9e/10-1055-s-0041-1740562.PMC8695059.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39648647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Meeting Obstetric Care Consensus Guidelines for Nulliparous, Term, Singleton, Vertex Cesarean Births.","authors":"Tiffany Wang, Inga Brown, Jim Huang, Tetsuya Kawakita, Michael Moxley","doi":"10.1055/s-0041-1740563","DOIUrl":"10.1055/s-0041-1740563","url":null,"abstract":"<p><p><b>Objective</b>  This study aimed to identify factors associated with meeting the Obstetric Care Consensus (OCC) guidelines for nulliparous, term, singleton, and vertex (NTSV) cesarean births. <b>Materials and methods</b>  This was a retrospective case control study of women with NTSV cesarean births between January 2014 and December 2017 at single tertiary care center. Demographics and clinical characteristics were compared between women with NTSV cesarean births which did or did not meet OCC guidelines. A multivariable logistic regression model was used to evaluate the effect of each variable on the odds of meeting OCC guidelines. <b>Results</b>  There were 1,834 women with NTSV cesarean births of which 744 (40.6%) met OCC guidelines for delivery and 1,090 (59.4%) did not. After controlling for confounding factors, the odds of meeting OCC guidelines were increased for in-house providers managing with residents (adjusted odds ratio [aOR] = 2.03, 95% confidence interval [CI]: 1.44-2.87) and without residents (aOR = 1.66, 95% CI: 1.30-2.12), compared with non-in-house providers managing without residents. There was no significant difference in the odds of meeting OCC guidelines for in-house providers managing with or without residents (aOR = 1.23, 95% CI: 0.84-1.79). <b>Conclusion</b>  After adjusting for confounding factors, in-house provider coverage, regardless of resident involvement, is associated with increased odds of NTSV cesarean births meeting OCC guidelines. <b>Key Points</b> Frequency of adherence to OCC guidelines for NTSV cesarean births was 40.6%.Neither patient demographics nor comorbidities was associated with the odds of meeting OCC guidelines.In-house providers are associated with increased odds of meeting OCC guidelines.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 4","pages":"e142-e146"},"PeriodicalIF":0.9,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/82/10-1055-s-0041-1740563.PMC8674087.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39601168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative Management of Presumed Fetal Anemia Secondary to Maternal Chemotherapy for Acute Myeloid Leukemia.","authors":"Christina M Nowik, Alina S Gerrie, Jonathan Wong","doi":"10.1055/s-0041-1740561","DOIUrl":"10.1055/s-0041-1740561","url":null,"abstract":"<p><p>Acute myeloid leukemia occurs rarely during pregnancy. When it is diagnosed remote from term, treatment in the form of daunorubicin plus cytarabine induction with consolidative cytarabine is typically undertaken after the first trimester. There is little data to guide fetal monitoring, in particular, whether and how often middle cerebral artery peak systolic velocity (MCA PSV) should be measured to screen for fetal anemia. Cytarabine may be particularly myelosuppressive to the fetus, but information pertaining to the management of this complication is also lacking in published literature. To our knowledge, we present the first case of presumed severe fetal anemia related to in utero exposure to chemotherapy that was managed conservatively with close sonographic monitoring, including serial measurement of MCA PSV. This case suggests that in the absence of hydrops fetalis or other signs of fetal decompensation, expectant management with ultrasound twice weekly, including MCA PSV, is appropriate. Ultrasounds may be decreased to weekly when MCA PSV does not suggest fetal anemia. Screening for fetal anemia can provide helpful information to guide the timing of chemotherapy administration and delivery. <b>Key Points</b> Chemotherapy for acute myeloid leukemia can cause fetal anemia.Fetal MCA PSV can be used to safely and effectively screen for fetal anemia.Observation of fetal anemia due to chemotherapy is reasonable, in the absence of hydrops.Monitoring of fetal MCA PSV can help guide timing of chemotherapy and delivery.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 4","pages":"e137-e141"},"PeriodicalIF":0.8,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/55/10-1055-s-0041-1740561.PMC8674095.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39601167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications of Second and Third Trimester Surveillance Ultrasounds of Growth-Restricted Fetuses.","authors":"Amanda M Craig,&nbsp;Karampreet Kaur,&nbsp;Sarah A Heerboth,&nbsp;Heidi Chen,&nbsp;Chelsea J Lauderdale,&nbsp;Chevis Shannon,&nbsp;Lisa C Zuckerwise","doi":"10.1055/s-0041-1740170","DOIUrl":"https://doi.org/10.1055/s-0041-1740170","url":null,"abstract":"<p><p><b>Objective</b>  We sought to investigate the positive predictive value of ultrasound-diagnosed fetal growth restriction (FGR) for estimating small for gestational age (SGA) at birth. Secondary objectives were to describe clinical interventions performed as a result of FGR diagnosis. <b>Study Design</b>  This was a retrospective cohort of pregnancies diagnosed with FGR over 3 years at a single institution. Maternal demographics, antenatal and delivery data, and neonatal data were collected. Descriptive statistics and linear regression were conducted. <b>Results</b>  We included 406 pregnancies with diagnosis of FGR in second or third trimester. Median birth weight percentile was 17 (interquartile range: 5-50) and only 35.0% of these fetuses were SGA at birth. The positive predictive value of a final growth ultrasound below the 10th percentile for SGA at birth was 56.9%. Patients averaged eight additional growth ultrasounds following FGR diagnosis. One hundred and fourteen (28.1%) received antenatal steroids prior to delivery, and 100% of those delivered after more than 7 days following administration. There were 6 fetal deaths and 14 neonatal deaths. <b>Conclusion</b>  In the majority of cases, pregnancies diagnosed with FGR during screening ultrasounds resulted in normally grown neonates and term deliveries. These patients may be receiving unnecessary ultrasounds and premature courses of corticosteroids.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 4","pages":"e132-e136"},"PeriodicalIF":0.9,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/11/10-1055-s-0041-1740170.PMC8610751.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurally Adjusted Ventilatory Assist in Very Prematurely Born Infants with Evolving/Established Bronchopulmonary Dysplasia.","authors":"Sandeep Shetty,&nbsp;Katie Evans,&nbsp;Peter Cornuaud,&nbsp;Anay Kulkarni,&nbsp;Donovan Duffy,&nbsp;Anne Greenough","doi":"10.1055/s-0041-1739458","DOIUrl":"https://doi.org/10.1055/s-0041-1739458","url":null,"abstract":"<p><p><b>Background</b>  During neurally adjusted ventilatory assist (NAVA)/noninvasive (NIV) NAVA, a modified nasogastric feeding tube with electrodes monitors the electrical activity of the diaphragm (Edi). The Edi waveform determines the delivered pressure from the ventilator. <b>Objective</b>  Our objective was to determine whether NAVA/NIV-NAVA has advantages in infants with evolving/established bronchopulmonary dysplasia (BPD). <b>Methods</b>  Each infant who received NAVA/NIV-NAVA and conventional invasive and NIV was matched with two historical controls. Eighteen NAVA/NIV-NAVA infants' median gestational age, 25.3 (23.6-28.1) weeks, was compared with 36 historical controls' median gestational age 25.2 (23.1-29.1) weeks. <b>Results</b>  Infants on NAVA/NIV-NAVA had lower extubation failure rates (median: 0 [0-2] vs. 1 [0-6] <i>p</i>  = 0.002), shorter durations of invasive ventilation (median: 30.5, [1-90] vs. 40.5 [11-199] days, <i>p</i>  = 0.046), and total duration of invasive and NIV to the point of discharge to the local hospital (median: 80 [57-140] vs. 103.5 [60-246] days, <i>p</i>  = 0.026). The overall length of stay (LOS) was lower in NAVA/NIVNAVA group (111.5 [78-183] vs. 140 [82-266] days, <i>p</i>  = 0.019). There were no significant differences in BPD (17/18 [94%] vs. 32/36 [89%] <i>p</i>  = 0.511) or home oxygen rates (14/18 [78%] vs. 23/36 [64%] <i>p</i>  = 0.305). <b>Conclusion</b>  The combination of NAVA/NIV-NAVA compared with conventional invasive and NIV modes may be advantageous for preterm infants with evolving/established BPD.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 4","pages":"e127-e131"},"PeriodicalIF":0.9,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/9e/10-1055-s-0041-1739458.PMC8608553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}