Faculty of Medicine

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    Item type:Publication,
    NEONATAL HYPOGLYCEMIA: A CONTINUING DEBATE IN DEFINITION AND MANAGEMENT
    (Macedonian Academy of Sciences and Arts / Sciendo, 2015-12)
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    Elizabeta Petkovska
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    Snezana Jancevska
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    Neonatal hypoglycemia (NH) is one of the most common abnormalities encountered in the newborn. Maintaining glucose homeostasis is one of the important physiological events during fetal-to-neonatal transition. Transient low blood glucose concentrations are frequently encountered in the majority of healthy newborns and are the reflections of normal metabolic adaptation processes. Nevertheless, there is a great concern that prolonged or recurrent low blood glucose levels may result in long-term neurological and developmental consequences. Strikingly, it was demonstrated that the incidence and timing of low glucose concentrations in the groups most at risk for asymptomatic neonatal hypoglycemia, did not find association between repetitive low glucose concentrations and poor neurodevelopmental outcomes. On the contrary, NH due to hyperinsulinism is strongly associated with brain injury. Fundamental issue of great professional controversy is concerning the best manner to manage asymptomatic newborns NH. Both, overtreating NH and undertreating NH are poles with significant potential disadvantages. Therefore, NH is one of the most important issues in the day-to-day practice. This article appraises the critical questions of definition (widely accepted blood glucose concentration: < 2.6 mmol/l or 47 mg/dl), follow-up ad management of NH
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    Physical birth outcomes in neonates prenatally exposed to buprenorphine – our first experiences
    (2019-09-17)
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    Introduction/Objective Buprenorphine appears generally similar to, and in some cases superior to, methadone in terms of maternal, fetal, and neonatal outcomes. The objective of the study was to assess some physical birth outcomes in neonates prenatally exposed to buprenorphine. Methods During a seven-year period, nine patients have been treated with buprenorphine during their pregnancy. All women underwent interview, clinical investigations, biochemical analysis, toxicological screening, viral markers for hepatitis B, C, HIV, with regular check-ups by an obstetrician and a psychiatrist. Newborn outcomes included: birth weight in grams, birth length in centimeters, physical anomalies, head/chest circumference in centimeters, Apgar score at 1 minute / 5 minutes, gestational age (weeks), newborn length of hospital stay in days, breast-feeding, the newborn’s need for pharmacologic treat￾ment after delivery. Results The mean birth weight was 2,991.11 ± 37 g; birth length was 49.44 ± 2.29 cm; head circumference was 33.11 ± 0.78 cm; chest circumference was 32.33 ± 1 cm; first minute Apgar score was 8.22, fifth minute 9.22; age at delivery was 38.77 ± 1.09 weeks; hospitalization after delivery 4.44 ± 1.13 days. None of the newborns had physical anomalies. Six of the newborns were breastfed. Conclusion Buprenorphine is a safe and important part of a complete comprehensive treatment approach in pregnant women with opioid use disorder. Buprenorphine treatment of maternal opioid use disorder indicated a low risk of preterm birth, normal birth weight and length, head and chest circumference, Apgar score, short hospitalization after delivery.