Appearance Of Baby Research Articles

Ethmocephaly: a rare but lethal congenital anomaly

Ethmocephaly is a rare but lethal congenital anomaly. Its incidence rate is 1 in 15,000 live births and 1 in 250 in abortuses. Babies have typical dysmorphic facies in form of orbital hypotelorism, proboscis and low set malformed ears. 32 years old, daily wage labourer delivered a baby with ethmocephaly. Baby had typical facies, and no extracranial abnormality present. Baby was stillborn. She had no antenatal checkup or ultrasonogram done. However, she had history of ingestion of certain plants during early months of pregnancy. Ethmocephaly is a lethal anomaly and mostly eliminated prenatally. Although there is no diagnostic test for ethmocephaly, and confirmation of it is done only by appearance of baby after birth, important clues like recognition of risk factors like maternal diabetes, alcohol intake, ingestion of certain plants, antenatal hydrocephalus, should not be missed. Importance of routine antenatal checkup and ultrasonogram is emphasized. Recognition of risk factors and a possible co-relation with ingestion of certain other plants is also emphasized.

The Relationship between Parental Stress and Nurses' Communication as Perceived by Parents of High-risk Newborns

This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.

Withdrawal of artificial nutrition and hydration in neonatal intensive care: parents' and healthcare practitioners' views.

Withdrawing Artificial Nutrition and Hydration (WANH) in the neonatal intensive care units (NICUs) has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders' experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals (HCP) perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 different clinical neonatology departments. We interviewed both the parents and some of the HCP who cared for the baby, at least 6months after this latter deceased. We proceeded through in-depth individual qualitative interviews. Content was analyzed for themes and patterns that emerged from the data. Some parents expressed that WANH offered an opportunity to the family to spend a few demedicalized days with the baby before she dies, without any tubes and machines, and to be well supported by the HCP during this palliative stage. But others evaluated the practice in retrospect as a terrible ordeal. All said that, at least, the time of waiting for death to ensue should not last too long. After a few days, it becomes unbearable because of the transformation of the baby's appearance and because they, as parents, began to wonder if she was not dying from starvation rather than from her initial disease. An important proportion of HCP also expressed some kind of ethical unease. This was due to the psychological violence involved in the decision for a human being to stop feeding a little one, and also to the difficulty to deal with the fundamental intention behind the decision of WANH: indeed, could it be claim that it does not presuppose the intention of provoking the infant's death? The discussion focuses on the point to know if WANH can be considered as a source of progress from an ethical point of view, particularly in comparison with earlier practices-that in France could involve active euthanasia by lethal injection. We argue that when HCP are merely focused on avoiding that WAHN could be construed as a way of intending to hasten the baby's death, the practice is at risk to be implemented in a way that becomes ethically counterproductive. Focusing on this intention easily distract the clinical teams from what should be their ultimate concern, namely the baby's comfort during the dying process, as well as the support owned to her parents. To conclude, we suggest that the ethical priorities, when WANH is decided, should be the support due to the patient and her family on the one hand, and, on the other hand to implement it in such a way that at least the baby seems to have died of her initial disease and never of starvation. This means that HCP have a duty to control the timing of death, even though this might be incompatible with the worry to avoid the intention of hastening the baby's death.

Colloidion Baby: A Rare Clinical Entity.

Colloidion baby is a rare clinical entity. Herein the neonate is born with a shiny, yellowish parchment like transparent membrane stretched over the skin. It was Hallopeau and Watelet in 1892, who first used this term and since then literature has a record of nearly 270 colloidian babies [1]. Eventually, these children will develop signs of one of the several types of ichthyosis, giving the skin ‘fish scales’ appearance [2]. We herein report one such case owing to its rarity. A primi gravida presented at 32 weeks of gestation according to her last menstrual period with complaint of leaking per vaginum for two days prior to presentation. There was no personal or family history of diabetes, any exposure to teratogenic drug, no history of any chronic medical disorders. Mother was diagnosed as pregnancy induced hypertension but was not on any treatment. Her present pregnancy was followed in a local hospital with regular follow-up with ultrasonography examination done one week prior to delivery showing oligohydramnios (decreased amniotic fluid index=4). There was no comment on any congenital malformations. On admission patient was haemodynamically stable. On abdominal examination, fundal height corresponded to 32 weeks of gestation with breech presentation with normal fetal heart rate pattern. On per vaginal examination cervix was closed and not effaced with high breech with clear dribbling liquid. She was started on intravenous antibiotics and betamethasone was given. Caessarean section was planned after 48 hours and a 1900 grams female baby was born with following morphological features [Table/Fig-1]. [Table/Fig-1]: Appearance of baby on day 1 of life. Thick shield like taut skin all over body with cracked pinkish areas in between, scanty hair, malformed ears, everted eyelids with exposed swollen conjunctiva, slit like nostril, open mouth, flexed limbs with malformed palms, oedematous feet were present. Baby did not need active resuscitation and was shifted to neonatal intensive care unit. Dermatological opinion was taken and a diagnosis of Harlequin ichthyosis was made. Baby was managed with intravenous fluids, intravenous antibiotics and topical emollients. Baby remained haemodynamically stable with cracks in the skin increasing [Table/Fig-2]. Baby was taken to home against medical advice on fifth day of life and lost to follow-up. [Table/Fig-2]: Appearance of baby on day 4 of life. Approximately 75% of collodion baby develops a type of autosomal recessive congenital ichthyosis, either lamellar ichthyosis or congenital ichthyosiform erythrodema) [3]. The third type of autosomal recessive congenital ichthyosis, Harlequin ichthyosis, is the most rare and severe form. Other rare causes of colloidion baby include-Epidermolytic hyperkeratosis (bullous congenital ichthyosiform erythroderma), Gaucher’s disease and Sjogren-Larsson syndrome. Although, the colloidian membrane develops due to an epidermal cornification disorder, keratinocyte protein and lipid metabolism defects resulting from autosomal recessive genetic mutations have also been notified as important cofactors [4]. Transglutaminase 1 gene mutation localized on the 14q11 have been implicated in congenital autosomal recessive ichthyosis [5]. Owing to impairment of the skin barrier function, collodion babies prone for a number of complications like hypernatremic dehydration, hypothermia, skin infections, fissures, conjunctivitis, sepsis, dehydration and constrictive bands of the extremities resulting in vascular compromise and oedema [1,2]. They require proper fluid and electrolyte balance, emollients and lubricants for hydrating the membrane. Suitable eye care and pain control should be carried out for the collodion babies with ectropion. Prophylactic antibiotics should be used to prevent sepsis. In the present scenario, owing to intensive care, the survival of neonates has increased. Humidified incubators and water dressings followed by emollient agents are important aspects in its management.

I'm Your Peanut Butter Big Brother (review)

Reviewed by: I'm Your Peanut Butter Big Brother Deborah Stevenson Alko, Selina . I'm Your Peanut Butter Big Brother; written and illus. by Selina Alko. Knopf, 2009 34p. Library ed. ISBN 978-0-375-95627-0 $18.99 Trade ed. ISBN 978-0-375-85627-3 $16.99 Ad 5-8 yrs Our young narrator awaits a new sibling with anticipation and curiosity. He's particularly curious about the baby's appearance—will the new sib in their multi-racial family look like their father ("semisweet dark Daddy chocolate bar"), mother ("strawberry cream Mama's milk"), or various other relatives and friends with skin and hair in tasty edible tones? There's no real plot here, just a series of descriptions, and some of the scenarios eliciting those descriptions ("When we play, will you, like Lola, leap . . .") are awkwardly contrived. The subject is one rarely treated in children's literature, though, and it's a tasty celebration indeed of the various shades found in many individual families as well as the larger human clan. Alko's illustrations are high-energy gouache full-bleed images enhanced with collage elements. Some of the compositions are overweighted with floating background details that diffuse the focus, and the childlike vigor of the draftsmanship occasionally tips into crudeness (while the baby with pennies for eyes presents some unfortunate associations), but the images retain a lively intensity that underscores the celebratory tone of the text; viewers will be particularly taken by the food imagery, occasionally taken to a whimsical visual point (kids as gingerbread people, kids' faces on ice cream cones). Despite the book's flaws, this could make a useful counterpart to Joyce Carol Thomas' The Blacker the Berry (BCCB 7/08). Copyright © 2009 The Board of Trustees of the University of Illinois

Treatment Of Congenital Ichthyosis With Acitretin

We assessed the clinical efficacy, tolerability and safety of acitretin in a patient with ichthyosis. A newborn infant with ichthyosis who presented at birth with collodion baby appearance, was treated with acitretin. A moderate response to acitretin therapy (1 mg/kg/day) administered for 6 months was observed, with improvement in cutaneous lesions. Clinical improvement was achieved shortly after treatment. The treatment resulted in a satisfactory improvement in the skin condition of the case. The tolerance to the drug was good. Side effects were not observed. The oral acitretin treatment is efficient in severe congenital ichthyosis.

Parent stress in the neonatal intensive care unit and the influence of parent and infant characteristics.

This study investigated the stress experienced by parents in the neonatal intensive care unit (NICU), the infant and parent characteristics that resulted in different stress responses, and the characteristics that were predictive of stress. The Parental Stress Scale: Neonatal Intensive Care Unit was used to measure the stress of 162 parents. A Parent/Infant Demographic sheet provided information for determining which characteristics resulted in different responses and which variables were stress predictors. The highest levels of stress experienced were in the relationship with baby-parental role area, and regarding how the baby looked and behaved. The infant characteristic of gestational age resulted in significantly different scores concerning the baby's appearance and behavior. Consistent predictors of stress were length of stay, extreme prematurity, and a cardiovascular diagnosis. Identifying the stressors parents experience can assist NICU therapists in intervention planning. Family-centered care that addresses stressors concerning their roles and their understanding of their infant should be emphasized.

OC065: Uterine artery resistance at 10–14 weeks of gestation is correlated with trophoblast apoptosis

were analyzed using a General Linear Model Repeated Measures. There was a statistically significant difference (f = 6.721, p < 0.01) in attitude after the 3DUS however there was no difference between gender. Six questions had statistically significant differences (fetal cramping p < 0.012; fetal personality p < 0.001; baby thinking and feeling p < 0.009; waiting to hold baby p < 0.005; picturing baby appearance p < 0.011 and baby hiccoughs p < 0.006); they were analyzed non-parametrically as 2 related samples however due to a Statistical Type 1 error this was for exploratory analysis only. Line scores showed no significant difference. Conclusions: Evaluation of a Maternal-Fetal Attachment assessment showed parents experience a statistically significant change in attitude regarding their fetus after a 3DUS study. No significant difference was found between parental gender.