Rotavirus is the most common cause of infectious gastroenteritis in infants and young children and estimated to cause more than 111 million cases of diarrhea annually. Most patients show no specific symptom or experience mild fever, vomiting, non-bloody diarrhea and symptoms often resolve within several days. However, some of patients suffer from severe complication such as necrotizing enterocolitis, intussusception, seizure, encephalitis, and cholestasis. We report a neonatal case of rotavirus infection presenting with reversible direct hyperbilirubinemia with a brief review of associated literatures.
Child ; Cholestasis ; Diarrhea ; Encephalitis ; Enterocolitis, Necrotizing ; Fever ; Gastroenteritis ; Humans ; Hyperbilirubinemia* ; Infant ; Infant, Newborn ; Intussusception ; Rotavirus Infections* ; Rotavirus* ; Seizures ; Vomiting

Pheochromocytoma is an extremely rare tumor in pregnant women with potentially fatal consequences. We report a case of pregnant woman at 22 weeks of gestation with pheochromocytoma. A correct diagnosis on the basis of differential clues from severe preeclampsia was obtained and laparoscopic adrenalectomy was performed.
Adrenalectomy* ; Diagnosis ; Female ; Humans ; Laparoscopy ; Pheochromocytoma* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

PURPOSE: This study was conducted to analyze recent trends and causes of maternal mortality in Korea between 2009 and 2014. METHODS: We investigated trends and causes of maternal death using the data from Complementary Investigations on the Infant, Maternal, and Perinatal Mortality carried out by Statistics Korea between 2009 and 2014. Maternal age, administrative district, causes of death and gestational age at the time of death were collected from data. Statistics including maternal mortality ratio (MMR) and maternal mortality rate were calculated. We also analyzed MMR according to the age, and administrative districts. The causes of maternal death were sorted and classified using International Classification of Diseases and World Health Organization recommendations. RESULTS: The average MMR during 6 years was 13.16 and maternal mortality rate was 0.45. MMR was highest in 2011 (17.2) and lowest in 2012 (9.9). The average MMR of the administrative districts varied greatly from 7.51 (Gwangju) to 26.84 (Jeju). The average MMR during the study period was lowest in maternal age of 20-24 (6.9), and highest in 45-49 (143.7). On average, direct and indirect maternal deaths accounted for 66.2% and 29.9% of total maternal death, respectively. The three most common causes of maternal deaths were obstetrical embolism (24.4%), postpartum hemorrhage (18.3%), and hypertensive disease of pregnancy (5.5%) in decreasing order of frequency. CONCLUSION: Although MMR is decreasing during the study period, it fluctuates widely according to maternal age, districts, and constant effort for improvements is necessary. To reduce maternal deaths, solution to control preventable causes of maternal deaths, careful management of pregnancies with advanced maternal age, and policy to solve the discrepancy in the medical services among diverse regions in the country are needed.
Cause of Death ; Embolism ; Gestational Age ; Humans ; Infant ; International Classification of Diseases ; Korea* ; Maternal Age ; Maternal Death ; Maternal Mortality* ; Perinatal Mortality ; Postpartum Hemorrhage ; Pregnancy ; World Health Organization

PURPOSE: Epidural hematoma (EDH) in newborn is very rare, but when it occurs it is usually due to birth injury. We have evaluated the incidence and clinical features of EDH related to birth in newborn. METHODS: We analyzed medical records of 12 newborns diagnosed with EDH at Cheil General Hospital and Women's Health Care Center from January 2000 to December 2015 retrospectively. RESULTS: The incidence of EDH related to birth was 0.01%, occurring in 1 of 10,000 live births. Of the total 12 cases, 10 occurred in male and 8 in vaginal delivery. Among them, 11 infants had evidences of birth injury. Clinical presentation was nonspecific: only 1 infant had neurologic symptoms. The temporooccipital area was the most frequent location of EDH. The median size of EDH was 3.2±0.8 cm in length and 1.2±0.7 cm in depth. Mass effect accompanied with midline shift on radiologic imaging was shown in one case. Surgical drainage was needed only in one infant with neurologic symptom and mass effect on radiologic imaging, while the others were treated conservatively. CONCLUSION: Neonatal EDH related to birth was treated conservatively in most cases. The radiologic mass effect and neurologic symptom should be considered as indication for surgical intervention.
Birth Injuries ; Drainage ; Hematoma* ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Live Birth ; Male ; Medical Records ; Neurologic Manifestations ; Parturition* ; Retrospective Studies ; Women's Health

Glucose is essential for energy metabolism in human, especially in brain, and is a source of energy storage in the form of glycogen, fat and protein. During fetal life, the predominant source of energy is also glucose, which crosses the placenta by facilitated diffusion. There is very little endogenous glucose production under normal circumstances during fetal life. During labor, the fetus is exposed to physiological challenges that require metabolic adaptation. A healthy infant successfully manages the postnatal transition by mobilizing and using alternative. After birth, there is a rapid surge in catecholamine and glucagon levels, and a steady decrease in insulin, as blood glucose levels decline. These hormonal changes induce enzyme activities that lead to glycogenolysis and gluconeogenesis. During the first 24-48 hours of life, plasma glucose concentrations of neonates are typically lower than later in life. Distinguishing between transitional neonatal glucose regulation in normal neonates and hypoglycemia that persists or occurs for the first time beyond the first 72 hours of life is important for prompt diagnosis and treatment to avoid serious consequences.
Blood Glucose ; Brain ; Diagnosis ; Energy Metabolism ; Facilitated Diffusion ; Fetus ; Glucagon ; Gluconeogenesis ; Glucose* ; Glycogen ; Glycogenolysis ; Homeostasis* ; Humans ; Hypoglycemia ; Infant ; Infant, Newborn ; Insulin ; Parturition ; Placenta

In this article, the third author's name was published incorrectly.

The preoperative diagnosis of uterine torsion is very difficult due to the rarity of this disorder and its nonspecific clinical course. A primigravida woman visited our hospital with severe abdominal pain at 34 weeks of gestation. Emergency cesarean section was carried out due to development of fetal distress and severe abdominal pain. During the cesarean section, we noticed the uterus was rotated 180 degrees and the torsion was corrected after the delivery by making a vertical incision at the posterior uterine wall. High degree of suspicion and prompt management are important factors contributing to good prognosis of uterine torsion.
Abdominal Pain ; Cesarean Section ; Diagnosis ; Emergencies ; Female ; Fetal Distress ; Humans ; Pregnancy ; Pregnancy Trimester, Third* ; Prognosis ; Uterus

PURPOSE: We performed an analysis of the RSV outbreak in a postpartum center in Gyeongsangbukdo to provide preliminary data for health and hygiene management of postpartum care centers. METHODS: All of 22 newborns who were transferred to our hospital from a postpartum care center from December 2014 to January 2015 showed positive for RSV by viral culture and enrolled in the study group. To identify early symptoms in RSV infected newborn in the nursery 31 infants (1 month to 24 month of age) who were hospitalized in our hospital due to RSV infection during the same period were selected as control group and clinical symptoms were compared with the study group. A retrospective study was also performed on the newborns who were cared and not transferred to our hospital in the postpartum care center, as well as the facilities offered by the center. RESULTS: All of 22 neonatal patients who were transferred to our hospital had early symptoms of rhinorrhea and cough compared to control group. Rhinorrhea appeared 4.2±2.0 days before the admission, and cough occurred 1.0±1.1 days after rhinorrhea. The level of infection control specified by the law for general facilities relating to postpartum care centers was applied to the postpartum center, RSV infection was not controlled. Strict hand washing, individual equipment such as stethoscopes and exclusion of visitors with respiratory symptoms were done and infected neonates were segregated in separate air circulation system and cared by nurse-infant ratios from 1:1 to 1:2 depending on the needs of the individual neonates. Additional transmission was not observed after transfer to our hospital CONCLUSION: Neonates with cough and rhinorrhea were initial symptom for RSV infection in the postpartum center and should be evaluated for RSV infection during high risk season. Current guideline or support for infection control in postpartum center should be reevaluated for RSV infection control.
Cough ; Disease Outbreaks ; Gyeongsangbuk-do* ; Hand Disinfection ; Humans ; Hygiene ; Infant ; Infant, Newborn ; Infection Control ; Jurisprudence ; Nurseries ; Postnatal Care* ; Postpartum Period* ; Respiratory Syncytial Viruses ; Retrospective Studies ; Seasons ; Stethoscopes

PURPOSE: The aim of this study is to determine the clinical characteristics of early onset sepsis (EOS) in micropreemie. METHODS: We retrospectively reviewed medical records of 107 extremely preterm infants born at 25 or less than 25 weeks of gestation and admitted to the neonatal intensive care unit of Samsung Medical Center from January 2013 to August 2015. Infants were divided into two groups based on the presence of culture-proven EOS in the first 7 days of life. Retrospective analysis of perinatal factors and laboratory findings within the first week of life was done between two groups. We compared the neonatal outcomes among two groups. RESULTS: Culture-proven EOS was diagnosed in 11 of 107 infants (10.3%). Main pathogen of EOS was Staphylococcus epidermidis (45.5%). There were no significant differences between control group and EOS group in gestational age, birth weight, Apgar score, delivery type and pathologic chorioamnionitis. Among 11 infants with EOS, 9 showed fetal tachycardia (P=0.001). And EOS group presented lower platelet count at 3rd day and 7th day of life than that of control group (P=0.033, P=0.045). Neonatal outcomes in EOS group were compatible with control group. Main cause of death was sepsis in EOS group. CONCLUSION: In micropreemie, EOS is important factor of mortality. Our data suggest that fetal tachycardia and low platelet count during the first 7 days of life were associated with EOS.
Apgar Score ; Birth Weight ; Cause of Death ; Chorioamnionitis ; Female ; Gestational Age* ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Mortality ; Platelet Count ; Pregnancy ; Retrospective Studies ; Sepsis* ; Staphylococcus epidermidis ; Tachycardia

PURPOSE: The aim of this study was to evaluate the usefulness of thyroid function screening in preterm infants and the relation between thyroid hormone level, perinatal environment, and clinical presentation after preterm birth. METHODS: We retrospectively evaluated 46 preterm infants from March 2013 to December 2014, who had been screened for congenital hypothyroidism during the 1st week with thyroid stimulating hormone (TSH), triiodothyronine (T3) and free thyroxine (fT4) measured by the radioimmunoassay method. The effects of pregnancy associated maternal factors, gestational age, growth parameters, Apgar score, 1st meconium passage time, respiratory distress syndrome and apnea on thyroid hormone levels were assessed by Mann-Whitney U-test and multiple linear regression analysis. RESULTS: With advancing gestational age, T3 and fT4 displayed a tendency to increase. FT4 showed a positive correlation pattern with antenatal steroid therapy, corrected gestational age at examination and a negative correlation pattern with 1st meconium passage time and apnea (P<0.05). TSH displayed a positive correlation pattern with 1st meconium passage time, 5-minute Apgar score and a negative correlation pattern with sampling age (P<0.05). CONCLUSION: In the preterm period, both fT4 and TSH seems to correlate significantly with various perinatal factors and clinical presentation. We recommend that early fT4 screening should be included in the screening for hypothyroidism in preterm infants.
Apgar Score ; Apnea ; Congenital Hypothyroidism ; Gestational Age ; Humans ; Hypothyroidism ; Infant, Newborn ; Infant, Premature ; Linear Models ; Mass Screening* ; Meconium ; Pregnancy ; Premature Birth ; Radioimmunoassay ; Retrospective Studies ; Thyroid Gland* ; Thyroid Hormones ; Thyrotropin ; Thyroxine ; Triiodothyronine