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    Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit
    (Wiley, 2020) Emiroglu, Nuriye; Yilmaz, Fatma Hilal; Kececi, Ramazan; Yucel, Mehmet; Gultekin, Nazli Dilay; Altunhan, Huseyin
    Background This study was performed for examining the neonatal results and aetiological factors of neonates with hydrops fetalis (HF) and determining the factors affecting mortality. Methods The medical records of liveborn neonates with HF who were admitted to a tertiary Neonatal Intensive Care Unit (NICU) in Konya, Turkey, between 2013 and 2019 were reviewed retrospectively. The demographic data, prenatal intervention, clinical findings, and results of the patients were recorded. Results A total of 32.6% of the 46 liveborn HF infants had immune HF (IHF), while 67.4% had nonimmune HF (NIHF); there was prenatal diagnoses in 39 (84.7%) cases. Cordocentesis and blood transfusion (n = 14; 30.4%) were the prenatal diagnosis and treatment interventions with the highest rate. A total of 16 patients (34.7%) received in utero interventional treatment. It was determined that the mean gestational age was not associated with mortality; moreover, birthweight (BW), Apgar score and the need for mechanical ventilation affected mortality. Conclusion The prognosis changes according to different etiologies of HF. However, despite the developments in neonatal care, mortality is still high in HF infants.
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    Comparison of the Efficacy of Three Natural Surfactants in Preterm Turkish Newborns with Respiratory Distress Syndrome
    (Galenos Yayincilik, 2021) Yilmaz, Fatma Hilal; Tarakci, Nuriye; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Ozturk, Elif Nur Yildirim; Altunhan, Huseyin
    Aim: To determine the efficacy of three natural surfactant preparations in our community and the short- and long-term results of these on preterm infants. Materials and Methods: This was a retrospective research on 193 premature babies with respiratory distress syndrome (RDS). The patients were divided into three groups, each of which received one of three surfactants: Group 1; beractant (100 mg/kg); group 2; poractant alfa (first dose of 200 mg/kg, recurrent doses of 100 mg/kg); group 3; calfactant (100 mg/kg). The groups were compared according to demographic characteristics, 1- and 5-minute Apgar scores, weight percentiles by gestational week, presence of pulmonary hemorrhage, surfactant dose repetition, air leak, bronchopulmonary dysplasia (BPD), stage of intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), hemodynamically significantpatent ductus arteriosus (hs-PDA) and its medical or surgical treatment, retinopathy of premature (ROP) and its treatment, sepsis, ventilation time (both non-invasive and invasive), free oxygen need time, time to start full enteral feeding, discharge time, and mortality. Results: A total of 193 preterm infants with a mean gestational age of 28.9 +/- 3.1 weeks and mean birth weight of 1,190.4 +/- 504.3 grams were included in this study. The neonates were allocated into three different groups randomly, namely group-1 (n=77), group-2 (n=59), and group-3 (n=57). There were no differences in the clinical and demographic features of the groups. The incidence of pulmonary hemorrhage, surfactant dose repetition, air leak, ventilation time for both non-invasive and invasive, free oxygen need time, hs-PDA and surgical treatment of PDA, BPD, NEC (>= stage II), IVH (>stage III), ROP, time to start full enteral feeding, and discharge time were similar between the study groups. The sepsis and mortality rates were lower in group 3 compared to groups 1 and 2 (p=0.015, p=0.001). Conclusion: In this study, beractant, proctant alfa and calfactant had clinically similar efficacy in patients with RDS.
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    Is there a relationship between causative microorganisms and hearing loss in neonatal sepsis?
    (Wiley, 2021) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Yucel, Mehmet; Kececi, Ramazan; Arbag, Hamdi; Altunhan, Huseyin
    Background The aim of the present study was to determine the possible relationship between cultured microorganisms and hearing loss in infants admitted to the neonatal intensive care unit (NICU) who could not pass a standard hearing test. Method The medical records of infants treated at the NICU were retrospectively evaluated. The patients were first divided into two groups, and group 1 was divided into two subgroups: Group 1 included patients with hearing loss accompanied by proven sepsis caused by either gram-negative (group 1A) or gram-positive (group 1B) bacteria, and group 2 included patients with clinical sepsis. The groups were compared with potential risk factors related to hearing loss. Results Between January 2014 and January 2019, the cases of 3,800 infants admitted to the NICU were reviewed. Of 3,548 living babies, the Auditory Brainstem Response (ABR) test showed that 35 infants (0.98%) were diagnosed with hearing loss. In 12 infants with hearing loss, microbial growth in the blood cultures was detected, whereas in the remaining 23, the blood cultures were negative. Of the cases with microbial growth, five were gram negative and seven were gram positive. In the comparison of groups 1A, 1B, and 2, there were statistically significant differences in terms of risk factors such as low birth weight (p = .048), neonatal hospitalization time (p = .001), free oxygen support (p = .001), intraventricular bleeding (p = .001), loop diuretic use (p = .001), and blood transfusion (p = .048). Conclusion The relationship between hearing loss and microorganisms causing sepsis could not be determined in this research.
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    Management of Patent Ductus Arteriosus in Preterm Patients Who Were Given Surfactant
    (Bayrakol Medical Publisher, 2020) Yilmaz, Fatma Hilal; Emiroglu, Nuriye; Oflaz, Mehmet Burhan; Gultekin, Nazli Dilay; Yucel, Mehmet; Kececi, Ramazan; Altunhan, Huseyin
    Aim: Respiratory distress syndrome (RDS) and perinatal asphyxia are known to be risk factors in hemodynamically significant Patent Ductus Arteriosus (hsPDA). In this study, we aimed to reveal scientific data in respiratory distressed preterm infants in the light of the current literature and to discuss the management of PDA in babies born at 33d weeks of gestation and up to 33d weeks which we have treated and followed in our unit. Materials and Methods: The medical records of premature infants treated at Necmettin Erbakan University Neonatal Intensive Care Unit (NICU) between January 2016 and January 2019 were retrospectively evaluated. Results: Between January 2016 and January 2019, 476 patients born prior to 33d gestational weeks were admitted to our unit.. PDA was detected in 149 of these patients because of RDS due to the surfactants. In 112 (75.1%) of these patients, the PDA closed spontaneously within the first week of life. Thirty-seven (24.8%) patients developed hs-PDA. The incidence of premature retinopathy (ROP), bronchopulmonary dysplasia (BPD), and late neonatal sepsis morbidity was significantly elevated during the hospitalization (p=0.05, p=0.01, p=0.06). Invasive mechanical ventilation, non-invasive mechanical ventilation, and free oxygen requirement times were found to be longer (p= 0.0001, p= 0.004, p= 0.014). Complete enteral nutrition and discharge times were longer in the treated group (p= 0.03, p= 0.002). We identified the presence of Small for Gestational Age (SGA) (r = 0.30 p = 0.04) and low birth weight (r = 0.99 p = 0.02) in logistic regression analysis of the factors affecting the PDA as meaningful results. Discussion: The presence of hs-PDA in infants with RDS is directly proportional to the birth week and weight, the presence of SGA reduces the frequency of hs-PDAs, the presence of hs-PDA is associated with ROP, BPD, and late sepsis. The presence of hs-PDA has been found to be correlated with prolonged respiratory support and delayed discharge.