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Background: In both term and premature neonates, changes in the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV) reflect the degree of neonatal myocardial immaturity and the co-existence of foetal circulation as well as the presence of concurrent diseases., Aim: To evaluate the changes in values of systolic and diastolic LV and RV function using pulse tissue Doppler imaging (TDI) in 20 healthy term newborn infants from birth to the 28th day of life., Methods: Ventricular peak myocardial velocities were recorded during early diastole (Em wave), atrial contraction (Am wave), and systole (Sm wave). TDI derived atrioventricular (AV) intervals were measured as the period from atrial contraction (Am) to isovolumic contraction (IV), from Am to ventricular systole (Sm), from Sm to the following Am, and from IV to the following Am. The first measurements were taken as soon as possible after birth, the second on the third day, and the final one on the 28th day of life., Results: The diastolic myocardial velocities recorded in the RV were higher than those in the LV. Statistically significant differences were observed for time intervals in the RV: Am-IV and Am-Sm (day 1-3), p < 0.02; IV-Am (day 1-28), p < 0.005; Sm-Am (day 1-28), p < 0.01. Statistically significant differences for time intervals were also evident in the LV: Am-IV (day 1-28), p < 0.05; and for Sm-Am (day 1-28), p < 0.01. Mean isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) intervals remained stable for all measurements recorded in the RV. However, a statistically significant difference was evident for both ICT and IRT intervals in the LV between days 1 and 28 of life (p < 0.01)., Conclusions: 1. Cardiac TDI is feasible in the neonate. 2. In neonates, the diastolic and systolic function recorded in the RV was better than that in the LV. This may reflect the 'persistent' foetal status of this ventricle in the first day of life. 3. The differences observed in conduction times also reflect the haemodynamic changes which occur in the circulatory system of the neonate in the first month of life. 4. Further investigation of a larger population of neonates throughout the whole neonatal period is indicated.

The objective of the study was to assess cerebral mass, based on head circumference measurements in neonates exposed to tobacco smoke in utero, and to determine the relative proportions of the cerebral and body mass. The study included 147 neonates born in the period 2003-2004 at the Princess Anna Mazowiecka University Hospital and admitted to the Neonatal and Intensive Care Department of the Medical University in Warsaw. Subjects were divided into three groups on the basis of maternal status as active, passive, or nonsmokers determined by maternal urinary cotinine concentration and a questionnaire. Neonates whose mothers were active smokers throughout the whole period of pregnancy had a lower head circumference and in consequence a lower cerebral mass significantly more frequently when compared with those whose mothers were nonsmokers, P= 0.002. (Median difference in cerebral mass was 48.27 g.) The risk of lower cerebral mass was 3.9 (1.4-10.8, CI 95%) in the group of neonates whose mothers actively smoked cigarettes during pregnancy. A negative correlation was seen between cerebral mass and maternal urinary cotinine concentration (correlation coefficient r=-23, P= 0.006). The ratio of the cerebral to body mass was similar for neonates in all three groups. Active smoking during pregnancy had a negative effect on the cerebral mass of the neonate, however no such effect was observed in neonates whose mothers were passive smokers. The deficiency in cerebral mass increased with greater smoking intensity. Active smoking by the mother during pregnancy inhibits the growth of the brain as well as that of the body mass of the neonate.

The use of fenoterol in the treatment of preterm labor is associated with the risk of many complications in the mother and the fetus. We present a case of a multipara treated with oral fenoterol due to threatening preterm labor 14 weeks. At 35 weeks of gestation the fetus was diagnosed with hypertrophic cardiomyopathy with severe impairment of the right ventricle. The only factor that might have caused such a state of the fetal circulatory system was fenoterol, used from 21 weeks of gestation. After the withdrawal of the fenoterol the fetal right ventricular function improved gradually. However fetal cardiac hypertrophy persisted until the birth at 39 weeks of gestation. Concentric hypertrophy of the right ventricular wall and interventricular septum were confirmed in the newborn.

Encephalopathy in a common neonatological sense is a term referring to a complex of clinical symptoms occurring in term infants in the first days of their life as a result of hypoxic-ischemic lesions. However, if we accept the encyclopedic definition of encephalopathy as a vast or multifocal brain lesions caused by a variety of factors, we may use the term to describe all patients with traumatic, hypoxic or toxic brain lesions, and therefore also newborns at different levels of maturity. Contrary to term newborns, in which case the hypoxic-ischemic encephalopathy are mostly intrauterine, for preterm infants there is a number of factors which destroy neural tissue postnatally The occurrence of those factors is often influenced by elements of essential intensive care. The article describes the most common biochemical disturbances and clinical causes.

The aim of this work was the assessment of the clinical condition, birth weight, frequency of premature birth and incidence of intrauterine growth restriction (IUGR) of the newborns whose mothers were active and passive smokers. This was a prospective study conducted in a group of 147 newborns born during the years 2003-2004 in the Princess Anna Mazowiecka Hospital, Warsaw, and hospitalized in the Neonatal and Intensive Care Department of Warsaw Medical University. Based on a questionnaire identifying the exposure to tobacco smoke and cotinine concentration in the mother's urine, the newborns were assigned to three groups: the newborns whose mothers were active smokers, the newborns whose mothers were passive smokers and the newborns of non-smoking mothers. There were no statistically significant differences in the Apgar score assessment at the 1st and 5th minute between the three groups of the newborns. Acid-base balance parameters (pH, BE) were also similar. The birth weight of the newborns of mothers who were active smokers was 325g lower than the birth weight of the newborns of non-smoking mothers. This difference was statistically significant p = 0.033. Maternal smoking in pregnancy was associated with an increased risk of deficit in birth weight 2.6 (1.0-6.9, CI 95%). In the group of the newborns whose mothers were active smokers, the incidence of lower birth weight (< 2500g) was also statistically significantly higher p = 0.01. There were no statistically significant differences in the incidence of premature birth and intrauterine growth restriction (IUGR).

Objective: To define the character of haemodynamic changes and brain-sparing phenomena in newborns of diabetic mothers., Methods: On the basis of blood indices flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA), right renal artery (RRA) and the superior mesenteric artery (SMA) the character of haemodynamic change and the brain-sparing phenomena in 53 newborns of diabetic mothers was analyzed. As a control group we chose 29 healthy newborns delivered at term. Doppler examinations were performed with ATL 3500 machine (Philips) using 7.5 MHz transducer and pulsed and colour Doppler. Pulsatility (PI) and resistance (RI) indices were calculated and analyzed., Results: In the MCA and ACA both indices (PI and RI) were lower than in abdominal arteries. We have found higher values of PI and RI in MCA than in ACA in both studied groups. In comparison to full-term newborns born from normal pregnancies, values of PI and RI in ACA were higher in IDM (infants of diabetic mothers) group (p<0.01)., Conclusions: In IDM similarly to neonates from physiological pregnancies we can observe physiological phenomenon of brain-sparing effect. In the IDM group postnatal haemodynamic disturbances are limited to the brain circulation only. In IDM in spite of absence of signs of hypoxia, some brain-sacrifice effect was observed. Haemodynamic disturbances were not observed in renal and mesenteric circulation.