XXXX in near-term babies after caesarean section.

@entity1 @entity8855 @entity649 @entity519 @entity8438 @entity397 @entity2661 @entity551 @entity221
OBJECTIVE: Severe @entity649 ( @entity649 ) caused by @entity8438 is described not only in preterm @entity1 but also in (near-) term babies after caesarean section (CS), especially when carried out before the onset of labour. The aim of the present study was to document the severity of this theoretically avoidable entity in order to improve obstetric and perinatal care. @entity1 : All neonates admitted to the paediatric intensive care unit of the University Hospital of Bern between 1988 and 2000 with @entity649 on the basis of @entity8855 ( @entity8855 ) needing mechanical ventilation (MV) after CS and with a birthweight > or = 2500 g were analysed. @entity8855 was diagnosed when respiratory distress and the typical radiological signs were present. @entity1 were grouped into elective CS before onset of labour and before @entity397 of membranes (group 1, n = 34) and @entity1 delivered by emergency CS or CS after onset of labour or @entity397 of membranes (group 2, n = 22). Analysed indices for severity of @entity221 were duration of stay in intensive care unit and MV, ventilation mode, worst @entity519 ( @entity519 ), presence of pulmonary air leak, and systemic @entity551 . RESULTS: Mean gestational age (GA) was 37 2/7 weeks in group 1 and 36 2/7 weeks in group 2; no @entity1 had a GA of > or = 39 0/7 weeks. Duration of MV was 4.4 days in group 1 and 3.9 days in group 2. Thirteen @entity1 (38%) of group 1 and 7 (32%) of group 2 had to be managed by rescue high-frequency ventilation. A total of 7 @entity1 had an @entity519 >40. Eight @entity1 (24%) in group 1 and 4 (18%) in group 2 developed a pulmonary air leak. Fourteen neonates (41%) in group 1 had to be supported by @entity2661 versus 5 (22%) in group 2. There was one death in group 1. CONCLUSION: Severe @entity649 on the basis of @entity8855 can also occur in near-term babies after CS; even a fatal outcome can not be excluded. The severity of @entity221 in elective CS without labour may be quite high and is comparable to newborns delivered by CS (after onset of labour and/or @entity397 of the membranes) who were 1 week younger. No case of @entity8855 was found in our population when CS was carried out after completion of 39 post-menstrual weeks of gestation.
