Challenges Faced in Translating the Benefits of Surfactant Replacement Therapy to a Resource-Limited Setting.


:Aim To determine the challenges, if any, in translating the benefits of surfactant replacement therapy (SRT) to a resource-limited setting. Method This was a retrospective descriptive study comparing the outcome of 75 cases who received surfactant and 69 controls who did not at the University Hospital of the West Indies during the period 2001 to 2011. Descriptive analyses were performed. Statistical significance was taken at the level p < 0.05. Results Only 13% of neonates with respiratory distress syndrome received surfactant therapy. The median time of surfactant administration was 16.5 hours (interquartile range: 6-37 hours). The mean ± standard deviation time between repeat doses was 19.1 ± 14 hours. There was no difference in mortality between cases (67%) and controls (59%) (p = 0.32). However, the cases who survived were less mature (28.3 ± 2 weeks) and less clinically stable (CRIB II [Clinical Risk Index for Babies] score: 8.2 ± 3) than their controls who survived (30.0 ± 2 weeks; CRIB II score: 6.0 ± 3) (p = 0.01). There was no difference in mean gestational age or CRIB II scores between nonsurviving cases and controls. A high incidence of sepsis, pneumothoraces, and pulmonary hemorrhage was noted in both cases and controls. Conclusion SRT did not improve the overall outcome in preterm neonates treated with RDS. Challenges encountered in optimizing SRT included affordability and accessibility of surfactant, supportive equipment, and supportive therapies, as well as a high incidence of complications related to prematurity.


Am J Perinatol


Hamilton N,Trotman H




Has Abstract


2017-07-01 00:00:00












  • Intrapartum predictors of uterine rupture.

    abstract::This case-controlled study reviewed 26 cases of uterine rupture at an academic medical center. Controls were selected in a 2:1 design by reviewing the immediate successful vaginal birth after cesarean delivery (VBAC) before and after each case of uterine rupture. At less than 2 hours before delivery or acute uterine r...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Craver Pryor E,Mertz HL,Beaver BW,Koontz G,Martinez-Borges A,Smith JG,Merrill D

    更新日期:2007-05-01 00:00:00

  • Community-Acquired Pneumonia in Children: Myths and Facts.

    abstract::Community-acquired pneumonia (CAP) is the leading cause of death in children < 5 years of age worldwide. It is also one of the most frequent infectious diseases in children, leading to large antibiotic use and hospitalization even in the industrialized countries. However, the optimal management of CAP in children is s...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,评审


    authors: Yun KW,Wallihan R,Juergensen A,Mejias A,Ramilo O

    更新日期:2019-07-01 00:00:00

  • Vaginal Microbiota in Pregnancy: Evaluation Based on Vaginal Flora, Birth Outcome, and Race.

    abstract:OBJECTIVE:This study aims to evaluate vaginal microbiota differences by bacterial vaginosis (BV), birth timing, and race, and to estimate parameters to power future vaginal microbiome studies. METHODS:Previously, vaginal swabs were collected at 21 to 25 weeks (stored at -80°C), and vaginal smears evaluated for BV (Nug...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Subramaniam A,Kumar R,Cliver SP,Zhi D,Szychowski JM,Abramovici A,Biggio JR,Lefkowitz EJ,Morrow C,Edwards RK

    更新日期:2016-03-01 00:00:00

  • The frequency of hypoglycemia in full-term large and small for gestational age newborns.

    abstract::Although various authors recommend screening for hypoglycemia in large for gestational age (LGA) and small for gestational age (SGA) newborns, the frequency of hypoglycemia in these infants, using a recent definition of hypoglycemia, and the proper duration of screening are not documented. We determined chromogen test...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Holtrop PC

    更新日期:1993-03-01 00:00:00

  • Population study of the risk of fetal death and its relationship to birthweight, gestational age, and race.

    abstract::With more than 20,000 fetal deaths occurring annually in the United States, accurate epidemiological data concerning fetal death offer the potential to develop interventions aimed at saving a considerable number of fetuses. Currently, fetal death rates are determined by dividing the number of deaths by total births. T...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Ferguson R,Myers SA

    更新日期:1994-07-01 00:00:00

  • Fetal echocardiographic screening of pregnancies of mothers with anti-Ro and/or anti-La antibodies.

    abstract::The objectives of this study are to assess the incidence of congenital complete heart block (CCHB) in pregnant women who are anti-Ro and/or La positive. Between January, 1988 and July 1997, 118 pregnancies in 105 women were assessed by fetal echo at 18, 24, and 32 weeks' gestation. Of these 105, 96 had no history of a...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Gladman G,Silverman ED,Yuk-Law,Luy L,Boutin C,Laskin C,Smallhorn JF

    更新日期:2002-02-01 00:00:00

  • Prenatal diagnosis of midgut volvulus by sonography and magnetic resonance imaging.

    abstract::We present a case of congenital midgut volvulus detected by prenatal sonography and ultrafast magnetic resonance (MR) imaging. At 34 weeks of gestation, enlarged hyperechogenic loops without peristalsis was identified by sonographic examination. On ultrafast T2-weighted single-shot fast-spin echo MR imaging, enlarged ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Miyakoshi K,Ishimoto H,Tanigaki S,Minegishi K,Tanaka M,Miyazaki T,Yoshimura Y

    更新日期:2001-12-01 00:00:00

  • Serum unconjugated estriols in insulin-dependent diabetic pregnancies: normative data and clinical relevance.

    abstract::The purpose of this study was to establish normative reference values for serum unconjugated estriol (E3) concentrations in insulin-dependent diabetic pregnancy. There were 1973 samples analyzed in 63 diabetic pregnancies not complicated by fetal distress and/or neonatal asphyxia. These samples were compared with 867 ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Miodovnik M,Mimouni F,Hertzberg VS,Siddiqi TA,Tsang RC

    更新日期:1988-10-01 00:00:00

  • Tocolytic treatment for preterm contractions with and without cervical changes.

    abstract::Our purpose was to evaluate the impact of intravenous and oral tocolysis on prolongation of gestation for women with preterm uterine contractions and/or labor. Candidates for evaluation and treatment including women with contractions between 24 and 35 weeks. Two hundred women (group I) without cervical changes met the...

    journal_title:American journal of perinatology

    pub_type: 临床试验,杂志文章


    authors: Brown HL,Hiett AK,Britton KA,Turnquest MA,Golichowski AM

    更新日期:1997-08-01 00:00:00

  • Percutaneous Inserted Venous Catheter via Femoral Vein in Extremely Low-Birth-Weight Infants: A Single-Center Experience.

    abstract:OBJECTIVE:This study aimed to assess the applicability of the insertion of small diameter catheters through the femoral vein in extremely low-birth-weight (ELBW) infants. STUDY DESIGN:All femoral small diameter catheters (Silastic or femoral arterial catheter [FAC]) inserted in ELBW infants in a tertiary level neonata...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Bergón-Sendín E,Soriano-Ramos M,Méndez-Marín MD,De Miguel-Moya M,Fontiveros-Escalona D,Diezma-Godino M,Pallás-Alonso CR,Moral-Pumarega MT

    更新日期:2020-12-01 00:00:00

  • Acyclovir treatment of primary herpes in pregnancy complicated by second trimester preterm premature rupture of membranes with term delivery: case report.

    abstract::Primary genital herpes simplex virus (HSV) infection in pregnancy is associated with an increased risk of vertical transmission to the fetus, especially with rupture of membranes. Two cases of primary herpes and two cases of recurrent herpes in pregnancy with preterm premature rupture of membranes and expectant manage...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Dietrich YM,Napolitano PG

    更新日期:2002-07-01 00:00:00

  • Congenital brucellosis: a rare cause of respiratory distress in neonates.

    abstract::Brucellosis represents a rare cause of neonatal infection. In this article we report a very unusual case of congenital infection due to BRUCELLA MELITENSIS in a term neonate presenting after birth with severe respiratory distress and radiological manifestations (lobar consolidation and diffuse interstitial infiltratio...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Sarafidis K,Agakidis C,Diamanti E,Karantaglis N,Roilides E

    更新日期:2007-08-01 00:00:00

  • Rationale for In-Neonatal Intensive Care Unit Administration of Live, Attenuated Rotavirus Vaccination.

    abstract::Rotavirus is the most common nonseasonal vaccine preventable illness. Despite increased severity of rotaviral illness in early infancy, most neonatal intensive care units (NICU) do not administer rotavirus vaccination either during the NICU stay at age of eligibility or at discharge as the Advisory Committee on Immuni...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,评审


    authors: Briggs-Steinberg C,Shah S

    更新日期:2018-12-01 00:00:00

  • Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization.

    abstract:OBJECTIVE: This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates wi...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Tıraş M,Can E,Hamilçıkan Ş

    更新日期:2021-01-04 00:00:00

  • Early Postnatal IGF-1 and IGFBP-1 Blood Levels in Extremely Preterm Infants: Relationships with Indicators of Placental Insufficiency and with Systemic Inflammation.

    abstract:OBJECTIVE:To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1-binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins w...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Leviton A,Allred EN,Fichorova RN,VanderVeen DK,O'Shea TM,Kuban K,Dammann O,ELGAN Study Investigators.

    更新日期:2019-12-01 00:00:00

  • Does Ventilatory Time Retain Its Validity in Predicting Neurodevelopmental Outcome at Two Years of Age in High-Risk Congenital Diaphragmatic Hernia Survivors?

    abstract::Objective To evaluate if in high-risk non-extracorporeal membrane oxygenation (ECMO)-treated congenital diaphragmatic hernia (CDH) survivors, ventilatory time (VT) is correlated to and can be used as clinical marker of neurodevelopmental delay at 2 years of age. Study Design Cohort study was conducted between 2008 and...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Bevilacqua F,Morini F,Zaccara A,Valfrè L,Aufiero LR,Gentile S,Bagolan P,Aite L

    更新日期:2017-02-01 00:00:00

  • Does Hydroxychloroquine Protect against Preeclampsia and Preterm Delivery in Systemic Lupus Erythematosus Pregnancies?

    abstract:OBJECTIVE:Systemic lupus erythematosus (SLE) increases the risk of complications in pregnancy. Hydroxychloroquine (HCQ) decreases flares and neonatal lupus syndrome. Limited evidence suggests that HCQ also reduces preeclampsia and preterm birth in SLE pregnancies. We studied whether HCQ was associated with lower odds o...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Do SC,Rizk NM,Druzin ML,Simard JF

    更新日期:2020-07-01 00:00:00

  • Prenatal MRI evaluation of congenital diaphragmatic hernia.

    abstract::The objective of this paper is to evaluate the efficacy of various magnetic resonance imaging (MRI) sequences and the general usefulness of prenatal MRI in determining the position of the fetal liver and visualizing lung tissue in fetuses who have congenital diaphragmatic hernia (CDH). This was a retrospective review ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Hubbard AM,Crombleholme TM,Adzick NS,Coleman BG,Howell LJ,Meyer JS,Flake AW

    更新日期:1999-01-01 00:00:00

  • Postpartum myocardial infarction in a patient with antiphospholipid syndrome.

    abstract::Myocardial infarction in association with pregnancy in patients with the antiphospholipid syndrome has been reported once previously. Our patient, a 22-year-old multiparous woman, experienced a myocardial infarction in the postpartum period. She fulfilled the criteria for the diagnosis of the antiphospholipid syndrome...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Thorp JM Jr,Chescheir NC,Fann B

    更新日期:1994-01-01 00:00:00

  • An analysis of second-stage labor beyond 3 hours in nulliparous women.

    abstract:OBJECTIVE:To analyze outcomes after second-stage labor beyond 3 hours and determine if prolonged second stages were intentional. STUDY DESIGN:Retrospective cohort analysis of maternal and neonatal outcomes in nulliparous women based on second-stage duration. Medical records were reviewed for management decisions in wo...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Bleich AT,Alexander JM,McIntire DD,Leveno KJ

    更新日期:2012-10-01 00:00:00

  • Risk Factors Linked to Central Catheter-Associated Thrombosis in Critically Ill Infants in the Neonatal Intensive Care Unit.

    abstract:OBJECTIVE:Our study identified risk factors for the development of clinically identifiable catheter-associated thrombosis (CT). STUDY DESIGN:We performed a retrospective cohort study of neonates in whom a central catheter was present. A total of 1,475 catheters were identified in 766 patients during a 36-month study p...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Lambert I,Tarima S,Uhing M,Cohen SS

    更新日期:2019-02-01 00:00:00

  • Effective prenatal care decreases the incidence of low birthweight.

    abstract::In Finland a nationwide free prenatal care system was mandated by law in 1944. At present, 99.9% of Finland's pregnant women use it. The primary aim is to provide advice and care to all women in local centers and to identify pregnant women exhibiting risk factors and refer them to specialized prenatal units located in...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Hakala TH,Ylikorkala O

    更新日期:1989-04-01 00:00:00

  • Lung Ultrasound Findings in Congenital Pulmonary Airway Malformation.

    abstract:BACKGROUND AND OBJECTIVE:Congenital pulmonary airway malformation (CPAM) is a group of rare congenital malformations of the lung and airways. Lung ultrasound (LU) is increasingly used to diagnose neonatal respiratory diseases since it is quick, easy to learn, and radiation-free, but no formal data exist for congenital ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,多中心研究


    authors: Yousef N,Mokhtari M,Durand P,Raimondi F,Migliaro F,Letourneau A,Tissières P,De Luca D

    更新日期:2018-10-01 00:00:00

  • Recombinant human Clara cell secretory protein treatment increases lung mRNA expression of surfactant proteins and vascular endothelial growth factor in a premature lamb model of respiratory distress syndrome.

    abstract::Infant respiratory distress syndrome (IRDS) can lead to impaired alveolarization and dysmorphic vascularization of bronchopulmonary dysplasia. Clara cell secretory protein (CC10) has anti-inflammatory properties but is deficient in the premature infant. Because surfactant and vascular endothelial growth factor (VEGF) ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Wolfson MR,Funanage VL,Kirwin SM,Pilon AL,Shashikant BN,Miller TL,Shaffer TH

    更新日期:2008-11-01 00:00:00

  • Nonimmune hydrops fetalis secondary to premature closure of the foramen ovale.

    abstract::Premature closure of the foramen ovale is a rare cardiac anomaly. Severe right-sided heart failure accounts for the hepatomegaly, ascites, pleural and pericardial effusions, and generalized edema of these hydropic fetuses. Premature closure of the foramen ovale should be a part of the differential diagnosis when unexp...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Coulson CC,Kuller JA

    更新日期:1994-11-01 00:00:00

  • Conservative versus aggressive management of preterm rupture of membranes. A randomized trial of amniocentesis.

    abstract::Amniocentesis to guide the management of preterm pregnancies complicated by premature rupture of the membranes (PROM) has been adopted at several centers. The purpose of this study was to evaluate this practice prospectively among comparable groups of patients, which has not previously been reported. Forty-seven patie...

    journal_title:American journal of perinatology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Cotton DB,Gonik B,Bottoms SF

    更新日期:1984-07-01 00:00:00

  • Effect of magnesium sulfate on the vascular actions of norepinephrine and angiotensin II.

    abstract::Magnesium sulfate is used for seizure prophylaxis in patients with preeclampsia. It also has significant effects on calcium metabolism and could, therefore, alter the pressor response to calcium-dependent vasoconstrictors. The present in vivo rat study examined the effect of magnesium sulfate to alter the pressor resp...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Aisenbrey GA,Corwin E,Catanzarite V

    更新日期:1992-09-01 00:00:00

  • Twin pregnancy after orthotopic liver transplantation, with exacerbation of chronic graft rejection.

    abstract::We report the sixth pregnancy and the first occurrence of twins after liver transplantation, and the second time cyclosporine was used in pregnancy for that indication. The pregnancy was interrupted at 33 weeks, menstrual age, for exacerbation of chronic graft rejection and intrauterine growth retardation of both twin...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Grow DR,Simon NV,Liss J,Delp WT

    更新日期:1991-03-01 00:00:00

  • Intrauterine coxsackie virus, group B type 1, infection: viral cultivation from amniotic fluid in the third trimester.

    abstract::We report a case that presents clear evidence of an intrauterine infection of twin fetuses with an enterovirus. The mother had signs and symptoms of chorioamniotitis at 34 weeks' gestation. Coxsackie virus, group B type 1 (CVB1), was cultured from amniotic fluid obtained by transabdominal amniocentesis when the membra...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Strong BS,Young SA

    更新日期:1995-03-01 00:00:00

  • Prolactin and plasma prostaglandin metabolite levels in patients undergoing nipple stimulation contraction stress tests.

    abstract::Twenty-five patients undergoing nipple stimulation contraction stress tests were enrolled in this study. Plasma 13,14-dihydro, 15-keto prostaglandin F2 alpha and plasma prolactin concentrations were analyzed before and during the contraction stress tests. Prolactin concentrations were significantly higher (p less than...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Rijhsinghani AG,Dubin NH,Zacur HA,Johnson TR,Niebyl JR

    更新日期:1990-01-01 00:00:00