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This article makes a review of literature data on an extremely special category of infants - premature neonates with intrauterine growth restriction (IUGR). The antenatal recognition of a true fetal growth restriction helps prevent or decrease the mortality rate and neonatal morbidity. Prenatal and postnatal Doppler velocimetry has a great contribute to the differentiation of healthy SGA and real IUGR but also a challenge to predict which of the fetuses are at high risk for negative outcomes, and there are currently few understandable things about monitoring and treatment strategies most appropriate for preterm infants with RCIU. An international initiative to address these issues would be of great importance to improve the care of the group with IUGR. [ABSTRACT FROM AUTHOR]

Retinopathy of Prematurity (ROP) represents a major health issue in the modern society, being the main cause for blinding in children all over the world. We analyzed the results of a retrospective study performed on a 6-year period (2009-2014), within the Neonatal Unit of the County Emergency Hospital from Timisoara. We assessed 1948 premature infants with GA < 35 weeks and BW < 1500 grams (GA = gestational age; BW = birth weight). Incidence of retinopathy in the study group was 48.55% (945 infants). Laser therapy was applied to 155 of these (7.95%). The disease evolution was favourable in 143 infants (86.5%). The unfavourable evolution in one eye, yet favourable in the other eye, was noticed in 14 of the assessed children (9%), and the severe loss of the visual acuity / blindness was noted in 7 cases (4.5%). The screening of ROP is essential for a timely diagnosis, allowing the application of a therapy at the right moment. The examination is performed by the ophthalmologist, upon request from the neonatologist. Finding an alternative screening method (telemedicine, the study of genetic polymorphisms), which is much easier to perform, would allow a more efficient selection of infants at a risk for severe ROP. [ABSTRACT FROM AUTHOR]

Introduction: Necrotising enterocolitis (NEC) is an acquired gastrointestinal disease associated with significant morbidity and mortality in preterm newborns. Taking into account the catastrophic development of this disease, it is necessary to focus research on prevention strategies and identify predictive risk factors for its occurrence. Aim: The aim of this study was to determine the incidence of NEC and to identify the main risk factors associated with NEC in preterm infants with gestational age(GA) ≤32 weeks admitted to neonatal intensive care units(NICUs) in Romania. Material and methods: This was a retrospective study based on the data collected in a standardised format for all preterm infants with GA ≤32 weeks born over a period of 2 years (January 2010-december 2011) and admitted to 12 tertiary-level NICUs in Romania. It was used data registered in the National Registry of Neonatal Respiratory Distress (NRNRD). A diagnosis of NEC was made based on clinical, radiological and/or histopatological evidence of stage II or III, acording to Bell's criteria. Logistic regression analysis was performed to determine the significant risk factors associated with NEC. Results: There were 1696 neonates under 32 weeks of gestation that met inclusion criteria; 1605 did not have NEC, while 91(5,3%) met criterion for NEC. Lenght of hospital stay and mortality were higher in neonates with NEC than those without NEC. Logistic regression analysis showed that smal for gestational age(SGA) and nosocomial infections were the most important risk factors for NEC. Other factors that were associated with an increased risk of NEC were bronchopulmonary displasia (BPD), use of nasal continuos positive airway pressure (CPAP), sepsis, apnea of prematurity, the lack of antenatal glucocorticoids and outborn pacients. Male gender and PDA were not statistical significantly correlated with NEC (borderline statistical significance). Conclusions: The incidence of NEC was higher in this study (5,3%). Low birth weight, nosocomial infections, BPD, CPAP, apnea and lack of antenatal glucocorticoids were associated with an increased risk of NEC in Romanian preterm infants under 32 weeks of gestation. Male gender and PDA were not statistical significantly correlated with NEC (at the limit of statistical significance). [ABSTRACT FROM AUTHOR]

Congenital heart disease is a major risk factor for the development of necrotising enterocolitis (NEC), although its pathophysiology remains incompletely understood. NEC is a multifactorial disease that occurs in a high risk newborn. NEC incidence is inversely proportional to gestational age, only 10% of term infants develop disease. We present the case of a term newborn with intrauterine growth restriction and complex congenital heart disease (CHD), who developed in the underlying disease, enterocolitis at 10 days of life. Early diagnosis was established using near-infrared spectroscopy (NIRS) which showed significant mesenteric oxygen desaturation secondary to significant decrease in aortic blood flow. The standard treatment of NEC with antibiotics, enteral feeding cessation and cardio-circulatory support did not work in this newborn due to decreased mesenteric blood flow and significant ischemia. CHD that caused extremely low blood flow in mesenteric territory and which could not be surgically corrected caused child's death. NIRS is a noninvasive diagnostic method that monitors highly accurate regional tissue oxygenation and could detect mesenteric ischemia in early stages. The authors want to emphasize through this rare case of CHD, that any heart disease with decreased aortic flow lead to impaired mesenteric oxygen delivery beeing a risk factor for NEC. Tissue hypoxia secondary to decreases in mesenteric blood flow is the central pathophysiological cause of NEC in this term infant. We also want to highlight the usefulness of NIRS for noninvasive measurement of tissue perfusion in all high risk neonates. [ABSTRACT FROM AUTHOR]