Cuza Voda Maternity Hospital
Cuza Voda Maternity Hospital
Iliev G.,Cuza Voda Maternity Hospital |
Iliev G.,Dr Gh Iliev Medical Center |
Dumitrascu I.,Grigore T. Popa University of Medicine and Pharmacy |
Grigore M.,Grigore T. Popa University of Medicine and Pharmacy |
And 7 more authors.
Donald School Journal of Ultrasound in Obstetrics and Gynecology | Year: 2014
Purpose: We present our experience in prenatal diagnosis and obstetrical management of congenital lung malformations (CLM). Materials and methods: The diagnosis of CLM was performed during routine second and third trimester fetal morphology assessment. The extent of the disease was established according to the type, localization and size of the pulmonary lesion and the presence of fetal complications (mediastinal shift, fetal hydrops, hydramnios). Termination of pregnancy (TOP) was indicated in cases associated with extrapulmonary anomalies, untreatable cases and fetal hydrops. After delivery a pulmonary X-ray and surgical examination was performed in all newborns. Results: We diagnosed 15 cases with congenital lung malformations. Of these, 9 had congenital cystic adenomatoid malformation (CCAM). TOP was performed in 6 cases with CCAM. Three cases had a favorable pre/postnatal evolution. Bronchopulmonary sequestration (BPS) was diagnosed in 3 cases, all with favorable perinatal evolution. Right pulmonary agenesis was diagnosed in one case and the outcome was neonatal death. One case of congenital high airway obstruction syndrome was followed by TOP. One case of severe bilateral pulmonary hypoplasia (secondary to a severe bilateral hydrothorax) resulted in neonatal death. Conclusion: Obstetrical management is established individually depending on the severity of the cases. © 2014, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.
Bell E.F.,University of Iowa |
Bivoleanu A.R.,Cuza Voda Maternity Hospital |
Stamatin M.,Cuza Voda Maternity Hospital |
Stamatin M.,Grigore T. Popa University of Medicine and Pharmacy |
And 2 more authors.
American Journal of Perinatology | Year: 2014
Objective The purpose of this study was to examine the attitudes of Romanian physicians toward withholding and withdrawing intensive care for infants whose prognosis is very poor. Methods A survey tool was developed by the authors and completed by participants in the annual meeting of the Neonatology Association of Romania. Results The majority of respondents attempt resuscitation of all live-born infants, have never stopped resuscitation at birth while the infant was still alive, and have never stopped respiratory support because of poor prognosis. Nearly all respondents were uncomfortable talking with parents about withholding or withdrawing intensive care, and they were also uncomfortable talking to the parents about the death of their infant. Conclusions Romanian physicians are uniformly reluctant to withhold or withdraw intensive care for infants, even those with very poor prognosis. In addition, physicians are very uncomfortable talking with parents about limiting or stopping support and talking about the death of an infant. Educational programs targeting the communication of difficult topics with parents have the potential to decrease the discomfort experienced by physicians in conversing with parents about their child's poor prognosis or death. © 2014 by Thieme Medical Publishers, Inc.