The Experts below are selected from a list of 150 Experts worldwide ranked by ideXlab platform
Seetha Shankaran - One of the best experts on this subject based on the ideXlab platform.
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complications of Neonatal Intracranial Hemorrhage
Neoreviews, 2000Co-Authors: Seetha ShankaranAbstract:After completing this article, readers should be able to: 1. Describe the pathologic injury to the brain caused by postHemorrhage ventriculomegaly (PHVM). 2. List the clinical diagnostic criteria for PHVM. 3. Describe findings on ultrasonography seen with PHVM. 4. Delineate the positive and negative aspects of techniques employed to manage PHVM. 5. Describe the neurologic and cognitive outcome of PHVM. The complications of Intracranial Hemorrhage (ICH) in preterm neonates are related to the location and severity of Hemorrhage. Hemorrhage in the subependymal region resolves with no residual effects. The resolution of Hemorrhage in the parenchymal region is based on location of the Hemorrhage. Over the course of weeks, parenchymal Hemorrhage evolves either into posthemorrhagic cysts or porencephalic dilatation of the ventricular system. Among infants who have intraventricular Hemorrhage (IVH), in whom the initial Hemorrhage in the periventricular germinal matrix progresses into the ventricular spaces, progressive posthemorrhagic ventricular dilation is the most frequent and serious complication. Ventricular size also can increase from blood clots at the time of the occurrence of IVH during the first week of life. Although this acute ventricular distention often subsides, 60% to 70% of infants who have IVH experience a progressive increase in ventricular size within 2 weeks of the initial occurrence due to accumulation of cerebrospinal fluid (CSF). Posthemorrhagic ventriculomegaly (PHVM) can progress slowly or rapidly. In the majority of cases (65%), slowly progressive PHVM spontaneously arrests. In the remaining 30% to 35% of affected infants, ventricular size increases rapidly over the course of days to weeks. PHVM is caused by obstruction of the CSF pathway by blood clots, usually at the posterior fossa cisterns and less commonly at the aqueduct of Sylvius or the foramen of Monroe. The PHVM caused by occlusion of the CSF pathways often progresses rapidly. In contrast, posthemorrhagic inflammatory changes in the arachnoid villi contribute …
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the effect of antenatal phenobarbital therapy on Neonatal Intracranial Hemorrhage in preterm infants
The New England Journal of Medicine, 1997Co-Authors: Linda L. Wright, Seetha Shankaran, Lu Ann Papile, Richard A Ehrenkranz, Lisa Mele, James A Lemons, Sheldon B Korones, David K Stevenson, Edward F DonovanAbstract:Background The administration of phenobarbital to pregnant women before delivery has been thought to decrease the frequency of Intracranial Hemorrhage in preterm infants. To evaluate this potential neuroprotective therapy further, we determined the effect of antenatal administration of phenobarbital on the frequency of Neonatal Intracranial Hemorrhage and early death. Methods We studied 610 women who were 24 to 33 weeks pregnant and who were expected to deliver their infants within 24 hours. The women were randomly assigned to receive either phenobarbital (10 mg per kilogram of body weight) or placebo intravenously, followed by maintenance doses until delivery or 34 weeks of gestation. The infants born to these women underwent cranial ultrasonography to detect the presence of Intracranial Hemorrhage. Results There were 309 women in the phenobarbital group and 301 in the placebo group. A total of 247 women (80 percent) in the phenobarbital group and 235 (78 percent) in the placebo group delivered within 24...
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Prenatal and perinatal risk and protective factors for Neonatal Intracranial Hemorrhage
JAMA Pediatrics, 1996Co-Authors: Seetha Shankaran, Raymond P. Bain, Charles R Bauer, Linda L. Wright, Julia ZacharyAbstract:Objective: To identify prenatal and perinatal risk and protective factors for grade III and IV Intracranial Hemorrhage (ICH) in 4795 singleton infants (weight, ≤1500 g). Method: Prenatal and perinatal risk and protective factors for ICH were examined initially by univariate analysis and adjusted for year of birth, followed by multivariate logistic regression analysis that adjusted simultaneously for the effects of year of birth and prenatal and perinatal characteristics. Setting: Seven tertiary care Neonatal-perinatal centers. Results: By univariate analysis, African-American race, prenatal care, older maternal age, hypertension or preeclampsia, antenatal steroid administration, cesarean section delivery, increasing birth weight, increasing gestational age, and female gender of the infant were protective prenatal or perinatal factors. Antepartum Hemorrhage, the presence of labor, and breech presentation were perinatal factors that were associated with an increased risk of ICH. By using staged logistic regression, a model of combined prenatal and perinatal characteristics that influenced grade III and IV ICH was developed. Significant protective factors against ICH included a complete course of antenatal steroid therapy, African-American maternal race, female gender of the infant, hypertension or preeclampsia with no antepartum Hemorrhage, increasing gestational age, and increasing birth weight. Conclusion: Antenatal steroid administration is a therapeutic intervention that is associated with a decreased risk for Neonatal grade III and IV ICH. (Arch Pediatr Adolesc Med. 1996;150:491-497)
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antenatal phenobarbital therapy and Neonatal outcome i effect on Intracranial Hemorrhage
Pediatrics, 1996Co-Authors: Seetha Shankaran, Eugene Cepeda, Gerry Muran, Federico G Mariona, S Johnson, S N Kazzi, Ronald L Poland, Mary P BedardAbstract:Objective To evaluate the effect of antenatal phenobarbital (PB) therapy on Neonatal Intracranial Hemorrhage (ICH) in preterm infants. Design Prospective, randomized, controlled trial. Setting Single institution study. Subjects and interventions Women in preterm labor ( Outcome measures Incidence of Neonatal ICH in all infants, infants weighing less than 1250 g, and infants of multiple gestations. Results The study population comprised 110 women, 60 in the control group and 50 in the PB group. Neonates in the control group (n = 74, including 10 pairs of twins and 2 sets of triplets) were comparable to those in the treatment group (n = 62, including 7 pairs of twins, 1 set of triplets, and 1 set of quadruplets) regarding birth weight, gestational age, and other clinical risk factors for ICH. There was a trend for the incidence of any grade of Hemorrhage to be lower in the PB group (22% [14 of 62]) compared with the control group (35% [26 of 74]). Moderate and severe Hemorrhages were significantly lower in the PB group (1.6% [1 of 62]) compared with the control group (9.4% [7 of 74]). Among infants weighing less than 1250 g, overall ICH was lower in the PB group (23% [6 of 26]) compared with the control group (51% [18 of 35]). Among multiple-gestation infants, overall ICH was 4.7% (1 of 21) in the PB group, compared with 31% (8 of 26) in the control group. Conclusions Antenatal PB therapy results in a significant decrease in moderate and severe ICH in infants born at less than 35 weeks' gestation. Antenatal PB therapy also resulted in a decrease in the incidence of all grades of ICH in infants weighing less than 1250 g and infants born of multiple gestations.
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does antenatal phenobarbital prevent Neonatal Intracranial Hemorrhage in preterm infants randomized controlled trial 1452
Pediatric Research, 1996Co-Authors: Seetha Shankaran, Linda L. Wright, Lu Ann Papile, Richard A Ehrenkranz, Joel Verter, Lisa MeleAbstract:Objective: To determine efficacy of antenatal phenobarbital (PB) in reducing the rate of Intracranial Hemorrhage (ICH) and early death (<72 h) in preterm infants.
Linda L. Wright - One of the best experts on this subject based on the ideXlab platform.
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the effect of antenatal phenobarbital therapy on Neonatal Intracranial Hemorrhage in preterm infants
The New England Journal of Medicine, 1997Co-Authors: Linda L. Wright, Seetha Shankaran, Lu Ann Papile, Richard A Ehrenkranz, Lisa Mele, James A Lemons, Sheldon B Korones, David K Stevenson, Edward F DonovanAbstract:Background The administration of phenobarbital to pregnant women before delivery has been thought to decrease the frequency of Intracranial Hemorrhage in preterm infants. To evaluate this potential neuroprotective therapy further, we determined the effect of antenatal administration of phenobarbital on the frequency of Neonatal Intracranial Hemorrhage and early death. Methods We studied 610 women who were 24 to 33 weeks pregnant and who were expected to deliver their infants within 24 hours. The women were randomly assigned to receive either phenobarbital (10 mg per kilogram of body weight) or placebo intravenously, followed by maintenance doses until delivery or 34 weeks of gestation. The infants born to these women underwent cranial ultrasonography to detect the presence of Intracranial Hemorrhage. Results There were 309 women in the phenobarbital group and 301 in the placebo group. A total of 247 women (80 percent) in the phenobarbital group and 235 (78 percent) in the placebo group delivered within 24...
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Prenatal and perinatal risk and protective factors for Neonatal Intracranial Hemorrhage
JAMA Pediatrics, 1996Co-Authors: Seetha Shankaran, Raymond P. Bain, Charles R Bauer, Linda L. Wright, Julia ZacharyAbstract:Objective: To identify prenatal and perinatal risk and protective factors for grade III and IV Intracranial Hemorrhage (ICH) in 4795 singleton infants (weight, ≤1500 g). Method: Prenatal and perinatal risk and protective factors for ICH were examined initially by univariate analysis and adjusted for year of birth, followed by multivariate logistic regression analysis that adjusted simultaneously for the effects of year of birth and prenatal and perinatal characteristics. Setting: Seven tertiary care Neonatal-perinatal centers. Results: By univariate analysis, African-American race, prenatal care, older maternal age, hypertension or preeclampsia, antenatal steroid administration, cesarean section delivery, increasing birth weight, increasing gestational age, and female gender of the infant were protective prenatal or perinatal factors. Antepartum Hemorrhage, the presence of labor, and breech presentation were perinatal factors that were associated with an increased risk of ICH. By using staged logistic regression, a model of combined prenatal and perinatal characteristics that influenced grade III and IV ICH was developed. Significant protective factors against ICH included a complete course of antenatal steroid therapy, African-American maternal race, female gender of the infant, hypertension or preeclampsia with no antepartum Hemorrhage, increasing gestational age, and increasing birth weight. Conclusion: Antenatal steroid administration is a therapeutic intervention that is associated with a decreased risk for Neonatal grade III and IV ICH. (Arch Pediatr Adolesc Med. 1996;150:491-497)
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does antenatal phenobarbital prevent Neonatal Intracranial Hemorrhage in preterm infants randomized controlled trial 1452
Pediatric Research, 1996Co-Authors: Seetha Shankaran, Linda L. Wright, Lu Ann Papile, Richard A Ehrenkranz, Joel Verter, Lisa MeleAbstract:Objective: To determine efficacy of antenatal phenobarbital (PB) in reducing the rate of Intracranial Hemorrhage (ICH) and early death (<72 h) in preterm infants.
Lisa Mele - One of the best experts on this subject based on the ideXlab platform.
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the effect of antenatal phenobarbital therapy on Neonatal Intracranial Hemorrhage in preterm infants
The New England Journal of Medicine, 1997Co-Authors: Linda L. Wright, Seetha Shankaran, Lu Ann Papile, Richard A Ehrenkranz, Lisa Mele, James A Lemons, Sheldon B Korones, David K Stevenson, Edward F DonovanAbstract:Background The administration of phenobarbital to pregnant women before delivery has been thought to decrease the frequency of Intracranial Hemorrhage in preterm infants. To evaluate this potential neuroprotective therapy further, we determined the effect of antenatal administration of phenobarbital on the frequency of Neonatal Intracranial Hemorrhage and early death. Methods We studied 610 women who were 24 to 33 weeks pregnant and who were expected to deliver their infants within 24 hours. The women were randomly assigned to receive either phenobarbital (10 mg per kilogram of body weight) or placebo intravenously, followed by maintenance doses until delivery or 34 weeks of gestation. The infants born to these women underwent cranial ultrasonography to detect the presence of Intracranial Hemorrhage. Results There were 309 women in the phenobarbital group and 301 in the placebo group. A total of 247 women (80 percent) in the phenobarbital group and 235 (78 percent) in the placebo group delivered within 24...
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does antenatal phenobarbital prevent Neonatal Intracranial Hemorrhage in preterm infants randomized controlled trial 1452
Pediatric Research, 1996Co-Authors: Seetha Shankaran, Linda L. Wright, Lu Ann Papile, Richard A Ehrenkranz, Joel Verter, Lisa MeleAbstract:Objective: To determine efficacy of antenatal phenobarbital (PB) in reducing the rate of Intracranial Hemorrhage (ICH) and early death (<72 h) in preterm infants.
Edward F Donovan - One of the best experts on this subject based on the ideXlab platform.
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the effect of antenatal phenobarbital therapy on Neonatal Intracranial Hemorrhage in preterm infants
The New England Journal of Medicine, 1997Co-Authors: Linda L. Wright, Seetha Shankaran, Lu Ann Papile, Richard A Ehrenkranz, Lisa Mele, James A Lemons, Sheldon B Korones, David K Stevenson, Edward F DonovanAbstract:Background The administration of phenobarbital to pregnant women before delivery has been thought to decrease the frequency of Intracranial Hemorrhage in preterm infants. To evaluate this potential neuroprotective therapy further, we determined the effect of antenatal administration of phenobarbital on the frequency of Neonatal Intracranial Hemorrhage and early death. Methods We studied 610 women who were 24 to 33 weeks pregnant and who were expected to deliver their infants within 24 hours. The women were randomly assigned to receive either phenobarbital (10 mg per kilogram of body weight) or placebo intravenously, followed by maintenance doses until delivery or 34 weeks of gestation. The infants born to these women underwent cranial ultrasonography to detect the presence of Intracranial Hemorrhage. Results There were 309 women in the phenobarbital group and 301 in the placebo group. A total of 247 women (80 percent) in the phenobarbital group and 235 (78 percent) in the placebo group delivered within 24...
Richard A Ehrenkranz - One of the best experts on this subject based on the ideXlab platform.
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the effect of antenatal phenobarbital therapy on Neonatal Intracranial Hemorrhage in preterm infants
The New England Journal of Medicine, 1997Co-Authors: Linda L. Wright, Seetha Shankaran, Lu Ann Papile, Richard A Ehrenkranz, Lisa Mele, James A Lemons, Sheldon B Korones, David K Stevenson, Edward F DonovanAbstract:Background The administration of phenobarbital to pregnant women before delivery has been thought to decrease the frequency of Intracranial Hemorrhage in preterm infants. To evaluate this potential neuroprotective therapy further, we determined the effect of antenatal administration of phenobarbital on the frequency of Neonatal Intracranial Hemorrhage and early death. Methods We studied 610 women who were 24 to 33 weeks pregnant and who were expected to deliver their infants within 24 hours. The women were randomly assigned to receive either phenobarbital (10 mg per kilogram of body weight) or placebo intravenously, followed by maintenance doses until delivery or 34 weeks of gestation. The infants born to these women underwent cranial ultrasonography to detect the presence of Intracranial Hemorrhage. Results There were 309 women in the phenobarbital group and 301 in the placebo group. A total of 247 women (80 percent) in the phenobarbital group and 235 (78 percent) in the placebo group delivered within 24...
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does antenatal phenobarbital prevent Neonatal Intracranial Hemorrhage in preterm infants randomized controlled trial 1452
Pediatric Research, 1996Co-Authors: Seetha Shankaran, Linda L. Wright, Lu Ann Papile, Richard A Ehrenkranz, Joel Verter, Lisa MeleAbstract:Objective: To determine efficacy of antenatal phenobarbital (PB) in reducing the rate of Intracranial Hemorrhage (ICH) and early death (<72 h) in preterm infants.
