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Neonatal ventriculomegaly often, but not always, follows intraventricular haemorrhage in infants born preterm. Serial cranial ultrasonography (CUS) is a very useful tool to evaluate the mechanism behind ventricular dilatation, to differentiate several types of cerebrospinal fluid retention, and to guide treatment. This review examines neonatal ventriculomegaly and its definition, pathophysiology, treatment, and prognosis from the perspective of CUS assessment. It also outlines the consensus statements formulated by the EurUS.Brain group, which are based on rounds of expert opinions on neonatal ventriculomegaly management, detailing the need and timing of ventricular access device placement, in the context of posthaemorrhagic ventricular dilation. The pathophysiology of neonatal ventriculomegaly is more complex than previously considered. CUS is a valuable, non‐invasive tool to determine pathophysiology, intervention thresholds, and prognosis in neonates with ventriculomegaly. Given new insights into the existence of glymphatics and water circulation in the cerebrum, further research in that area may bring new treatment options. What this paper adds: Cranial ultrasonography has a significant role in better understanding the complex pathophysiology of neonatal ventriculomegaly.The latest research suggests that treating posthaemorrhagic ventricular dilation in its early stages has several advantages.Proper definition, management, and a follow‐up plan are essential because they can impact the infant and their family, health care providers, educational systems, and society. [ABSTRACT FROM AUTHOR]

Few studies have evaluated whether topical anesthetic cream reduces pain during pneumococcal vaccination. This is crucial, since effective pain management should be evidence‐based. Previous studies have shown that topical lidocaine‐prilocaine (EMLA®) reduces vaccination‐related pain, measured using pain‐rating instruments and observation of crying time. This intervention study aimed to compare the efficacy of topical lidocaine‐prilocaine cream with that of the standard of care on the expression of pain during the first pneumococcal vaccination administered at age 3 months under the Swedish national vaccination program. A randomized controlled trial included 72 infants receiving their first pneumococcal vaccination (Prevenar 13®). The study showed that topical lidocaine‐prilocaine before pneumococcal vaccination significantly reduced infants' expression of pain according to the Face, Legs, Activity, Cry, Consolability (FLACC) score (P =.006) and increased latency to cry (P =.001). There were no statistically significant differences in the total crying time (P =.146) between the groups. Topical lidocaine‐prilocaine cream reduced pain expression and increased latency to cry in infants receiving their first pneumococcal vaccine. Systematic efforts are needed to successfully implement the use of topical anesthetic cream and other effective non‐pharmacological pain‐relieving strategies during infant vaccination procedures. [ABSTRACT FROM AUTHOR]

Aim: The aim was to determine whether preterm and full-term newborn infants could process maternal breast odour at a cortical level.Methods: Newborn infants were exposed to cloths containing their own mother's breast odour and freshly laundered control cloths for 10 seconds, while functional near-infrared spectroscopy measured cortical activation in their olfactory processing areas. We studied 45 newborn infants born at 28-41 weeks of gestation and divided them into three groups: full-term (37-41 weeks), late preterm (33-36 weeks) and very preterm (28-32 weeks). Cortical activation was defined as a regional increase of oxyhaemoglobin following maternal breast odour stimuli.Results: Full-term infants demonstrated bilateral activation of their olfactory cortices following exposure to maternal breast odour. Late preterm infants and very preterm boys exhibited unilateral cortical activation, unlike very preterm girls.Conclusion: Infants born from 32 weeks, and possibly earlier, could process low concentration maternal odours at a cortical level, which suggests they were more aware of their environment. These findings could make a significant contribution to improving the sensory environment of preterm infants and improve bonding. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine whether a correlation exists between the sonographic findings and the clinical outcomes, defined as surgery or death, in neonates with radiographically and/or histopathologically confirmed necrotizing enterocolitis (NEC). Material and Methods In this retrospective study, the case notes of 58 patients admitted to Karolinska University Hospital, Stockholm, Sweden, with radiographically confirmed NEC from September 2010 to August 2013, were reviewed. We included all newborns who underwent both plain abdominal radiographs and an abdominal ultrasound on the same day. The images were reviewed retrospectively. Patients' characteristics, clinical data, and histopathological data were recorded from the case notes. We excluded newborns who developed free gas before surgery. Abdominal ultrasound images were reviewed for free intraperitoneal gas, peritoneal fluid, pneumatosis intestinalis, portal gas, bowel vascularity, bowel wall thickness, and peristalsis. We correlated the sonographic features with the clinical outcomes; defined as the need for surgery or death. Results Overall, 25 neonates were included. Out of these, 11 patients underwent surgery and 5 patients died. The sonographic finding of complex fluid collection was statistically significant, predicting severe NEC that needed surgery. No other sonographic features were related to the need for surgery or death. Conclusion Complex fluid collection shown with abdominal ultrasound appears to be strongly correlated to the need for surgery in newborn infants with severe NEC. [ABSTRACT FROM AUTHOR]

Few studies have evaluated whether topical anesthetic cream reduces pain during pneumococcal vaccination. This is crucial, since effective pain management should be evidence-based. Previous studies have shown that topical lidocaine-prilocaine (EMLA ® ) reduces vaccination-related pain, measured using pain-rating instruments and observation of crying time. This intervention study aimed to compare the efficacy of topical lidocaine-prilocaine cream with that of the standard of care on the expression of pain during the first pneumococcal vaccination administered at age 3 months under the Swedish national vaccination program. A randomized controlled trial included 72 infants receiving their first pneumococcal vaccination (Prevenar 13 ® ). The study showed that topical lidocaine-prilocaine before pneumococcal vaccination significantly reduced infants' expression of pain according to the Face, Legs, Activity, Cry, Consolability (FLACC) score ( P  = .006) and increased latency to cry ( P  = .001). There were no statistically significant differences in the total crying time ( P  = .146) between the groups. Topical lidocaine-prilocaine cream reduced pain expression and increased latency to cry in infants receiving their first pneumococcal vaccine. Systematic efforts are needed to successfully implement the use of topical anesthetic cream and other effective non-pharmacological pain-relieving strategies during infant vaccination procedures., (© 2021 The Authors. Paediatric and Neonatal Pain published by John Wiley & Sons Ltd.)

Importance: Establishing stable breathing is a key event for preterm infants after birth. Delivery of pressure-stable continuous positive airway pressure and avoiding face mask use could be of importance in the delivery room., Objective: To determine whether using a new respiratory support system with low imposed work of breathing and short binasal prongs decreases delivery room intubations or death compared with a standard T-piece system with a face mask., Design, Setting, and Participants: In this unblinded randomized clinical trial, mothers threatening preterm delivery before week 28 of gestation were screened. A total of 365 mothers were enrolled, and 250 infants were randomized before birth and 246 liveborn infants were treated. The trial was conducted in 7 neonatal intensive care units in 5 European countries from March 2016 to May 2020. The follow-up period was 72 hours after intervention., Interventions: Infants were randomized to either the new respiratory support system with short binasal prongs (n = 124 infants) or the standard T-piece system with face mask (n = 122 infants). The intervention was providing continuous positive airway pressure for 10 to 30 minutes and positive pressure ventilation, if needed, with the randomized system., Main Outcomes and Measures: The primary outcome was delivery room intubation or death within 30 minutes of birth. Secondary outcomes included respiratory and safety variables., Results: Of 246 liveborn infants treated, the mean (SD) gestational age was 25.9 (1.3) weeks, and 127 (51.6%) were female. A total of 41 infants (33.1%) receiving the new respiratory support system were intubated or died in the delivery room compared with 55 infants (45.1%) receiving standard care. The adjusted odds ratio was statistically significant after adjusting for stratification variables (adjusted odds ratio, 0.53; 95% CI, 0.30-0.94; P = .03). No significant differences were seen in secondary outcomes or safety variables., Conclusions and Relevance: In this study, using the new respiratory support system reduced delivery room intubation in extremely preterm infants. Stabilizing preterm infants with a system that has low imposed work of breathing and binasal prongs as interface is safe and feasible., Trial Registration: ClinicalTrials.gov Identifier: NCT02563717.