2nd World Congress on Midwifery and Neonatal Nursing August 28-30, 2017 Philadelphia, Pennsylvania, USA

Biography:

Amal Zubani is a Consultant Neonatologist at King Faisal Specialist Hospital and Research Center- Jeddah, which is a tertiary care Hospital located in Jeddah on the West Coast of the Kingdom of Saudi Arabia. She is an advisor and active member in different committees in the Ministry of Health in Saudi Arabia. She graduated from King Abdul Aziz University in Jeddah in 2000 then she joined University of Manitoba, Winnipeg, Canada as Resident and then became a Fellow. She has her Canadian Board in Pediatric and Perinatal-Neonatal Medicine in 2005 and 2007. Her major interest and research subjects are nutrition in preterm infant and their neurodevelopmental outcome. She has several publications and presentations nationally and internationally.

Abstract:

Neonatal encephalopathy (NE) is a heterogeneous syndrome characterized by signs of central nervous system dysfunction in newborn infants. It can result from a wide variety of conditions but often remains unexplained. Approximately 70% of NE cases are associated with events arising before the onset of labor. On the other hand hypoxic-ischemic encephalopathy (HIE) is one of the many possible contributors to NE. The term is appropriately used when NE due to hypoxic-ischemic brain injury. Guidelines from the American Academy of Pediatrics and the American College of Obstetrics and Gynecology for HIE indicate that all of the following must be present for the designation of perinatal asphyxia or HIE: 1) profound metabolic or mixed acidemia (pH <7) in an umbilical artery blood sample
, 2) persistence of an Apgar score of 0 to 3 for more than 5 minutes
, 3) neonatal neurologic abnormalities and 4) multiple organ involvement. The asphyxia insult is due to impaired cerebral blood flow, as a consequence of interrupted maternal and/or fetal placental blood flow and gas exchange. The most important effects appear to include apoptosis and inflammation, which occur in the sub-acute phase after injury (hours to days after a hypoxic-ischemic event). There should be a comprehensive evaluation including assessment of neonatal clinical status, all potentially contributing factors and radiological studies. Therapeutic hypothermia is the only treatment currently shown to reduce death and/or disability after a hypoxic-ischemic insult in newborn infants with moderate to severe encephalopathy in the first 6 hours after birth. This intervention needs to be implemented according to the established published protocols and guidelines. Newborns with mild encephalopathy usually develop normally, while infants with moderate to severe encephalopathy are more likely to develop long-term neurologic sequela and morbidity.

Biography:

Kuldeep Singh has been practicing ultrasound for over 18 years in South Delhi, India. He is known for his ultrasound skills in Anomaly Scanning, Color Doppler Scanning and High risk pregnancy evaluation. He has more than 150 lectures in various national and international conferences. He has more than 100 articles and chapters to his credit and has authored 16 books on Ultrasound in Obstetrics, Gynecology and Infertility. His books have been translated into Spanish, Chinese and Portugese. The Imaging Science Award was honoured to him at the AICOG 2008. He is presently the President of the Delhi Chapter of IFUMB. He has been appointed as Associate Director of Ian-Donald Inter University School of Medical ultrasound.

           

Abstract:

Ultrasound is an essential tool for any obstetric practice. When it started five decades ago little did we realize that this invention is a technological marvel. One could look into the presentation and the viability of the fetus. Acrania could be excluded in the third trimester and with ultrasound machines and probes getting better we could exclude that in the second trimester so called Level II scan. With high resolution probes and high frequency transvaginal probes one can now diagnose fetal abnormalities in the late first trimester. This avoids the mental trauma the mother and the family have to go through and lethal abnormalities can be terminated much earlier. Acrania, anencephaly, gross dysgraphia disorganization of the fetal spine, anterior thoracic and abdominal wall defects and gross limb abnormalities are few structural malformations that can be detected with ease as early as 11-12 weeks. Apart from structural abnormalities the index of suspicion for chromosomal abnormalities also is there with looking at the nuchal translucency, nasal bone and flow through the tricuspid valve and in the ductus venosus. Combined testing with a dual test increases the sensitivity manifold. What is most important is the knowhow of what to look and how to look in your 11-14 weeks scan.

Biography:

Hala Shalaby has completed her Medical College from Zagazig University in Egypt (1989), then got DCH from the same university in 1996 and finally passed MRCPCH and became Member of The Royal College of Pediatric and Childhood in London/England since 2015. She is a Senior Registrar of Pediatric and Neonates in Riyadh Care Hospital in Riyadh, Saudi Arabia and has been working there for 15 years. She has published in the last year’s conference proceedings of 5^th International Conference on Pediatric Nursing & Health in Cologne Germany and presented many lectures in Saudi Arabia.

Abstract:

Objectives: Discuss the etiology, diagnosis and management of ovarian cysts in neonates with spotlight on alarming symptoms and signs after birth.

Background: Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts in particular with ultrasonography. The management of fetal ovarian cysts is still controversial.

Etiology: It can happen due to excessive maternal hormone stimulation from HCG. The secretion of FSH from the fetal pituitary, beginning at 20 weeks of gestation may increase the number and size of the follicles. It can also result due to pathological disorders in the mechanism of folliculogenesis. It happens when after birth E2 and HCG decrease rapidly while, FSH declines more slowly. The association of fetal ovarian cysts with maternal diabetes or fetal hypothyroidism has been described.

Incidence: It has been estimated at more than 30% based on investigation of still born or infants who died within 28 days after birth.

Diagnosis: Through serial abdominal ultrasound scans. Antenatal diagnosis is possible especially with the third trimester and it is usually unilateral.

Complications: The complications associated include ovarian torsion, compression of other viscera and possible intestinal obstruction. Rupture with hemorrhage of large sized cyst and signs of Polyhydraminos.

Management: It depends according to its size and the complications associated with it such as; torsion for example or viscera compression. Usually, the management is surgical as; simple cystectomy in case of unilateral cyst or oophorectomy and cystectomy if bilateral cysts exists.

Case presentation: A term female baby was delivered in our hospital RCH on November 2015 and developed abdominal distension with palpable mass followed by respiratory distress and irritability. She was diagnosed to have unilateral ovarian cyst & was operated successfully.

Biography:

Ali Bilal is a Neonatologist, Working at  Center Hospitalier Intercommunal, in Department of Neonatology 40 avenue de Verdun, 94000 Créteil, France

Abstract:

Introduction

Neonatal meningitis contributes substantially to neurological disability worldwide. Neonates are at increased risk of sepsis and meningitis than other age groups .The most frequent cause of neonatal bacterial meningitis is Streptococcus agalactiae (59%) and the second most frequent is Escherichia coli (28%) and Listeria monocytogenes is considered the third most frequent pathogen in the United States (5-10%) and France (< 3%). Neisseria meningitidis is occasionally implicated in neonatal bacterial meningitis. The objectify of this study is to describe epidemiological, clinical and bacteriological characteristics of N. meningitidis in France

Methods

In total, 233 pediatric wards covering 61% of French pediatric wards participated in this network. Pediatric

wards included 45% neonatal units in France. All patients ≤ 28 days of age with confirmed bacterial meningitis

were included. Isolates were identified in the microbiology laboratory of each hospital.

Neonatal meningitis was defined as early-onset (when occurring between days 0 and 4) and late-onset meningitis

(when occurring between days 5 and 28).

We crosschecked the databases of the (NRCM) for microbiological data and GPIP/ACTIV for clinical data. The

data collection was approved by the French National Data Protection Commission (Commission National

Informatique et Libertés, CNIL, no. 913006).

Results

Between 2001 and 2013, data for 5,139 cases of bacterial meningitis were collected; 831 cases were neonatal

bacterial meningitis (16.2%). Bacterial species implicated in the neonatal period were S. agalactiae (n=464;

55.8%), E. coli (n=232; 27.9%), N. meningitidis (n=23; 2.8%), L. monocytogenes (n=20; 2.4%), S. pneumoniae

(n=18, 2.2%), other streptococcus (n=16; 2%), and other bacterial species (n=58; 7%).

Among 23 patients with N. meningitidis, 12 were male (52%). The median gestational age at birth was 39.2

weeks. The median age was 17.9 days. Among the 23 cases, only 1 was early-onset (day 4); the remainders were

late-onset (96%). Seasonal variation occurred, with the highest proportion of cases reported in winter. At

diagnosis, 6 patients (27.3%) presented at least 1 sign of disease severity: all showed signs of shock (27.3%), 3

needed mechanical ventilation (13.6%), 2 were in a coma (9.1%), and 2 presented extensive purpura (9.1%); no

seizures were reported. In the 434/807 term-born patients (53.8%) with late-onset meningitis, the proportion of

NMM was 5.1% (22/434).

N. meningitidis was isolated in 91% in CSF 2 had negative CSF culture (9%), one was diagnosed with positive

PCR in CSF and other one had positive antigens.

The serogroup distribution was serogroup B for 18 cases (78%), C for 3 cases (13%) and others for 2 cases (9%).

The minimum inhibitory concentration was tested for cefotaxime, amoxicillin and penicillin G for 17 strains. All

tested isolates were susceptible to cefotaxime. (12%) showed intermediate susceptibility to amoxicillin and

penicillin G.

Two patients died (both were girls, who showed late-onset meningitis at days 10 and 23, respectively).

Conclusions

Among 831 cases of neonatal bacterial meningitis occurring from 2001 to 2013, Neisseria meningitidis was the

third most frequent bacterial species found. All cases occurred only in term neonates and were mainly late-onset.

Serogroup B accounted for 78.3% of cases. At diagnosis, 27.3% of cases had at least 1 sign of disease severity.

All strains were susceptible to cefotaxime, but 12% showed intermediate susceptibility to penicillin G and to

aminopenicillin.