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Objective: Recent advances in neonatal medicine have led to the improvements in diagnosis, prevention and management of fetal hydrops (HF). Although incidence of immune HF has significantly decreased, the incidence of non-immune HF has remained largely unchanged and mortality rate continues to be high, with rates up to 75.5%. Methods: A retrospective chart review of newborns who were admitted due to HF to the Institute of Child and Youth Healthcare of Vojvodina, Novi Sad, Serbia, from January 1st, 2001 to January 1st, 2018. It involved the analysis of demographic, antenatal, and postnatal parameters as well as examination of etiology and outcome. Results: There were 18 cases of HF, comprising 12/18 (66.66%) males, 6/18 (33.34%) females. Mean gestational age was 34.96±3.15gw (min-max 29.43-41.00); mean birth weight 2564.44±652.45g (min-max 1510.00-3650.00), Etiology of fetal hydrops was determined in 14/18 (77.78%), newborns; in 6/18 (33.33%) newborns was of immune, and in 8/18 (44.45%) of non-immune origin. Death occurred in 10/18 (55.56%) newborns. Patients who did not survive were more frequently born from multiple pregnancies (p=0.03), had lower values of Apgar score 1st and 5th minutes (p=0.011; p=0.001, respectively), more frequently presented with pericardial effusions (p=0.002) and multiple sites of effusions (p=0.02), cardiac insufficiency (p=0.019), acute kidney injury (p=0.004) and lower values of pH (p=0.035). High-frequency oscillatory ventilation was more frequently used in this group (p=0.018). Conclusion: Mortality among newborn with HF remains high. Poor prognosis is associated with multiple pregnancies, lower Apgar scores, severe acidosis, as well as the presence of pericardial effusion, multiple sites of effusions, cardiac insufficiency and acute kidney injury, and use of high-frequency oscillatory ventilation as a life-saving mode of ventilation. [ABSTRACT FROM AUTHOR]

Aim: To identify risk factors associated with the failure of extubation of mechanically ventilated very-low-birth-weight newborns.Study Design: Prospective observational study. Assessment of the occurrence of extubation failure in relation to demographic and ventilation parameters, the SpO2/FiO2 ratio, the spontaneous breathing test (SBT) and values of the Silverman-Andersen score (SAS). Extubation failure was defined as the need for reintubation for any reason within 72 h after extubation.Results: Extubation failed in 14/50 (28%) patients. Tidal volume applied at the moment of extubation (p = 0.030), the values of the SpO2/FiO2 ratio (p = 0.006), SBT (p = 0.034) and SAS measured for 60 min after extubation and later (p = 0.010, p = 0.000001, p∼0.000, respectively) showed a significant association with reintubation.Conclusions: Measured TV, SpO2/FiO2 ratio, SBT at the moment of extubation and values of SAS starting 1 h after extubation might be valuable parameters in identifying those VLBW newborns in the risk to fail extubation. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the usefulness of four neonatal pain scales (DAN, NIPS, PIPP, and NPAS) in describing newborn's response to a painful event in clinical settings. Methods. Prospective observational study at university-affiliated neonatal unit. Three hundred-sixty newborns were observed during venepuncture and heel lancing as a part of routine blood workout. Values of pain scales were determined in three time frames (start of procedure -- T0, maximal response -- T1, end of procedure -- T2). Results. In T0 versus T1 time frame, a sharp increase of percentage was observed in all pain scales independently of procedure with high statistical significance ( P ∼∼ 0.00). NIPS showed the highest (venepuncture 742%%; heel lancing 1472%%) and PIPP the lowest increase (venepuncture 303%%; heel lancing 510%%). In T1 versus T2 time frame, for venepuncture NIPS showed the highest (49%%) and PIPP the lowest (38%%) percentage of decrease, whereas for heel lancing PIPP had the highest (28%%) and NIPS the lowest (20%%) one. All pain scales showed significant individual and overall variability (CV > 30%%). PIPP had the lowest (42.7 ++ 14.3) and NIPS the highest (103.8 ++ 91.3) overall coefficient of variation. DAN's confidence parameters were the most uniform ones (se 1.0, sp 0.93, ppv 0.93, npv 1.0), whereas PIPP's confidence parameters were the highest while measuring high intensity pain (se 0.94, sp 1.0, ppv 1.0, npv 0.94). Conclusion. DAN is a pain scale convenient for the use in clinical settings, especially if a fine distinction of magnitude of the present pain is not needed, whereas PIPP can be used if adequate equipment is available. [ABSTRACT FROM AUTHOR]

The case of intrauterine idiopathic bladder rupture with consecutive urinary ascites is presented. Conservative management resulted in complete resolution of the lesion. [ABSTRACT FROM AUTHOR]