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Diagnostics
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Maternal–Fetal and Neonatal Diagnostics
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Maternal–Fetal and Neonatal Diagnostics

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 12052

Special Issue Editor

Dr. V. D’Andrea

E-Mail Website
Guest Editor
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Interests: neonatology; newborns; lung ultrasound; central vascular access; neonatal hemodynamics; targeted neonatal echocardiography

Special Issue Information

Dear Colleagues,

The scientific world is always on the move, and diagnostics to improve maternal–fetal and neonatal outcomes is a topic that has attracted much attention.

The proper clinical assessment of instruments determines the timing of maternal–fetal and subsequent neonatal investigations. Twin pregnancies complicated by twin–twin transfusion have benefited from early ultrasound diagnosis and laser therapy. Fetal echocardiography has revolutionized maternal–fetal and neonatal outcomes. The comprehensive use of ultrasound in the NICU has enabled the diagnosis and treatment of severe neonatal pathologies. Early diagnosis with increasingly specific and sensitive biomarkers for infectious diseases in the neonatal intensive care unit may also have a positive impact on long-term outcomes. The use of advanced technologies has improved the management of extremely premature infants, including ventilation with ever-gentler techniques, cruel and non-cruel hemodynamic assessment (TnEcho), and the continuous monitoring of organ perfusion (NIRS).

This Special Issue aims to summarize new developments in "Maternal–Fetal and Neonatal Diagnostics". I look forward to receiving your contributions.

Dr. V. D’Andrea
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • maternal–fetal and neonatal diagnostics
  • advanced diagnostic technologies
  • ultrasound diagnosis
  • fetal echocardiography
  • neonatal pathologies
  • specific and sensitive biomarkers
  • infectious diseases
  • neonatal intensive care
  • premature infants

Published Papers (7 papers)

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Research

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11 pages, 3441 KiB  
Article
Use of the Dialkylcarbamoylchloride Dressing in the Care of Central Venous Access Exit Site in a Pediatric and Neonatal Population
by Giorgio Lamberti, Vincenzo Domenichelli, Simona Straziuso, Gabriella Pelusi, Miria Natile, Gina Ancora and Giovanni Barone
Diagnostics 2023, 13(9), 1520; https://doi.org/10.3390/diagnostics13091520 - 23 Apr 2023
Cited by 1 | Viewed by 1342
Abstract
Dialkylcarbamoylchloride dressing is a fatty acid derivative that has been shown in vitro to bind a number of pathogenic microorganisms. The purpose of this prospective study was to evaluate the safety and the efficacy of this technology in the care of the exit [...] Read more.
Dialkylcarbamoylchloride dressing is a fatty acid derivative that has been shown in vitro to bind a number of pathogenic microorganisms. The purpose of this prospective study was to evaluate the safety and the efficacy of this technology in the care of the exit site of central venous catheter in a paediatric and neonatal population. Methods: The study was conducted from September 2020 to December 2022 at the Infermi Hospital in Rimini. Central venous catheters were placed using the SIC bundle for insertion. Dialkylcarbamoylchloride dressing was placed below the subcutaneous anchoring at the time of CVC placement and at each dressing change. Data about the catheters and the exit site were recorded and then compared with an historical cohort. Results: 118 catheters were placed during the studied period. The dialkylcarbamoylchloride dressing was well-tolerated. No case of systemic or local infection was recorded. The comparison with the historical cohort showed a reduction in the rate of exit site infection (p value 0.03). Conclusion: Dialkylcarbamoylchloride dressing is well-tolerated in paediatric and neonatal population. It represents a promising tool as a strategy for infection prevention. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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6 pages, 934 KiB  
Communication
Ultrasound Imaging for Diaphragm Function in a Population of Healthy Infants: A Short Observational Report
by Danilo Buonsenso, Francesco Mariani, Rosa Morello, Gianmaria Cammarota, Cristina De Rose, Piero Valentini, Anna Camporesi and Luigi Vetrugno
Diagnostics 2023, 13(6), 1095; https://doi.org/10.3390/diagnostics13061095 - 14 Mar 2023
Cited by 1 | Viewed by 1270
Abstract
Introduction: Diaphragm ultrasound is increasingly used in adults, and more recently in pediatric practice. However, normal diaphragm parameters in healthy infants are unknown. This was a prospective observational pilot study aiming to define the normal diaphragm ultrasound characteristics in healthy infants during the [...] Read more.
Introduction: Diaphragm ultrasound is increasingly used in adults, and more recently in pediatric practice. However, normal diaphragm parameters in healthy infants are unknown. This was a prospective observational pilot study aiming to define the normal diaphragm ultrasound characteristics in healthy infants during the first 6 months of life. Methods: We recruited healthy neonates at 7 to 15 days of life, who were followed until the sixth month of life, undergoing five assessments in different time points. The measurements included diaphragm thickness at end expiration (TEE) and at end inspiration (TEI). The thickening fraction (TF) was calculated as (TEI-TEE)/TEE and expressed as a percentage, and as (TEI-TEE)/TEI. Results: A total of 37 toddlers, 16 of which were females (43.2%), were enrolled. Thirty-four children (91.9%) were of Caucasian ethnicity and the median gestational age was 38.4 (35.7–40) weeks. Normal TEE, TEI, and TF have been provided for each time point. Conclusion: We provided new insight regarding data about thickness and thickening function in healthy children to be used for future physiologic and pathologic pediatric studies. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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10 pages, 1885 KiB  
Article
Lung Ultrasound Score in Neonates with Congenital Diaphragmatic Hernia (CDH-LUS): A Cross-Sectional Study
by Chiara Maddaloni, Domenico Umberto De Rose, Sara Ronci, Iliana Bersani, Ludovica Martini, Stefano Caoci, Irma Capolupo, Andrea Conforti, Pietro Bagolan, Andrea Dotta and Flaminia Calzolari
Diagnostics 2023, 13(5), 898; https://doi.org/10.3390/diagnostics13050898 - 27 Feb 2023
Cited by 4 | Viewed by 3179
Abstract
Introduction: The use of a lung ultrasound (LUS) score has been described in the early phases of neonatal respiratory distress syndrome; however, there is still no data regarding the application of the LUS score to neonates with a congenital diaphragmatic hernia (CDH). The [...] Read more.
Introduction: The use of a lung ultrasound (LUS) score has been described in the early phases of neonatal respiratory distress syndrome; however, there is still no data regarding the application of the LUS score to neonates with a congenital diaphragmatic hernia (CDH). The objective of this observational cross-sectional study was to explore, for the first time, the postnatal changes in LUS score patterns in neonates with CDH, with the creation of a new specific CDH-LUS score. Methods: We included all consecutive neonates with a prenatal diagnosis of CDH admitted to our Neonatal Intensive Care Unit (NICU) from June 2022 to December 2022 who underwent lung ultrasonography. Lung ultrasonography (LUS) was determined at scheduled time points: (T0) during the first 24 h of life; (T1) at 24–48 h of life; (T2) within 12 h of surgical repair; (T3) a week after the surgical repair. We used a modified LUS score (CDH-LUS), starting from the original 0–3 score. We assigned 4 as a score in the presence of herniated viscera in the hemithorax (liver, small bowel, stomach, or heart in the case of a mediastinal shift) in the preoperative scans or pleural effusions in the postoperative scans. Results: We included in this observational cross-sectional study 13 infants: twelve/13 had a left-sided hernia (2 severe, 3 moderate, and 7 mild cases), while one patient had a right-sided severe hernia. The median CDH-LUS score was 22 (IQR 16–28) during the first 24 h of life (T0), 21 (IQR 15–22) at 24–48 h of life (T1), 14 (IQR 12–18) within 12 h of surgical repair (T2) and 4 (IQR 2–15) a week after the surgical repair (T3). The CDH-LUS significantly dropped over time from the first 24 h of life (T0) to a week after the surgical repair (T3), according to ANOVA for repeated measures. Conclusion: We showed a significant improvement in CDH-LUS scores from the immediate postoperative period, with normal ultrasonographic evaluations a week after surgery in most patients. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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8 pages, 649 KiB  
Article
Multiple Pregnancy and the Risk of Postpartum Hemorrhage: Retrospective Analysis in a Tertiary Level Center of Care
by Giulia di Marco, Elisa Bevilacqua, Elvira Passananti, Caterina Neri, Chiara Airoldi, Alessia Maccarrone, Vittoria Ciavarro, Antonio Lanzone and Alessandra Familiari
Diagnostics 2023, 13(3), 446; https://doi.org/10.3390/diagnostics13030446 - 26 Jan 2023
Cited by 3 | Viewed by 1943
Abstract
The aim of our study was to identify characteristics associated with postpartum hemorrhage (PPH defined as blood loss >1000 mL) in twin pregnancies in order to select patients at higher risk to be treated. This retrospective study includes multiple pregnancies between 2015 and [...] Read more.
The aim of our study was to identify characteristics associated with postpartum hemorrhage (PPH defined as blood loss >1000 mL) in twin pregnancies in order to select patients at higher risk to be treated. This retrospective study includes multiple pregnancies between 2015 and 2020. The possible association between pregnancy characteristics and the primary endpoint (occurrence of PPH) was conducted using chi-square or Fisher exact test and Wilcoxon test. Then, univariate logistic models were performed considering as outcome the PPH, and the odds ratios with 95% CI were estimated. Finally, a multivariate logistic model was implemented, including all significant covariates. Seven hundred seven twin pregnancies giving birth beyond 32 weeks were included and of those, 120 (16.97%) had a PPH. The univariate analysis showed that factors significantly associated with PPH were: Preterm delivery, episiotomy, neonatal weight, and mode of delivery. The multivariate analysis showed that the most important factors were episiotomy and neonatal weight. The results show that the performance of episiotomy and the neonatal weight are the factors that most impact the risk of PPH in twin pregnancies. The correct identification of factors associated with PPH in twins could ideally allow to modify the clinical management and positively affect the rate of complications. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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8 pages, 573 KiB  
Brief Report
The Utility and Safety of a Continuous Glucose Monitoring System (CGMS) in Asphyxiated Neonates during Therapeutic Hypothermia
by Lucia Giordano, Alessandro Perri, Eloisa Tiberi, Annamaria Sbordone, Maria Letizia Patti, Vito D’Andrea and Giovanni Vento
Diagnostics 2023, 13(18), 3018; https://doi.org/10.3390/diagnostics13183018 - 21 Sep 2023
Viewed by 755
Abstract
Background: The present study was designed to assess the feasibility and reliability of a Continuous Glucose Monitoring System (CGMS) in a population of asphyxiated neonates during therapeutic hypothermia. Methods: This non-randomized feasibility study was conducted in the Neonatal Intensive Care Unit (NICU) facilities [...] Read more.
Background: The present study was designed to assess the feasibility and reliability of a Continuous Glucose Monitoring System (CGMS) in a population of asphyxiated neonates during therapeutic hypothermia. Methods: This non-randomized feasibility study was conducted in the Neonatal Intensive Care Unit (NICU) facilities of Fondazione Policlinico A. Gemelli IRCSS. Infants matching the criteria for hypothermic treatment were included in this study and were connected to the CGMS (Medtronic, Northridge, CA, USA) within the first 12 h of life. Hypoglycemia was defined as a glucose value ≤ 47 mg/dL, and hyperglycemia was defined as a glucose value ≥ 180 mg/dL. Data obtained via the CGMS were compared with those obtained via a point-of-care blood glucometer (GTX). Results: The two measuring techniques were compared using the Modified Clarke Error Grid (MCEG). Sixteen infants were enrolled. The sensor had an average (standard deviation) duration of 93 (38) h. We collected 119 pairs of glycemia values (CGMVs) from the CGMS vs. GTX measurements. The CGMS detected twenty-five episodes of hypoglycemia and three episodes of hyperglycemia. All the CGMVs indicating hyperglycemia matched with the blood sample taken via the point-of-care glucometer. Conclusions: The use of a CGMS would be useful as it could detect more episodes of disglycemia than standard care. Our data show poor results in terms of the accuracy of the CGMS in this particular setting. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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14 pages, 2858 KiB  
Systematic Review
The Role of Ultrasound in Epicutaneo-Caval Catheter Insertion in Neonates: Systematic Review, Meta-Analysis and Future Perspectives
by Vito D’Andrea, Valentina Cascini, Rosellina Russo, Alessandro Perri, Giorgia Prontera, Gina Ancora, Giovanni Vento, Gabriele Lisi and Giovanni Barone
Diagnostics 2023, 13(17), 2850; https://doi.org/10.3390/diagnostics13172850 - 3 Sep 2023
Cited by 5 | Viewed by 1023
Abstract
Chest and abdominal X-rays after the insertion of an epicutaneo-caval catheter in infants are the standard method of checking the tip location in many neonatal intensive care units. The role of ultrasound in the tip location of the epicutaneo-caval catheter in neonates has [...] Read more.
Chest and abdominal X-rays after the insertion of an epicutaneo-caval catheter in infants are the standard method of checking the tip location in many neonatal intensive care units. The role of ultrasound in the tip location of the epicutaneo-caval catheter in neonates has been the subject of many recent studies. This systematic review investigates the accuracy of epicutaneo-caval catheter tip location by comparing ultrasound and conventional radiology. We performed a systematic literature search in multiple databases. The selection of studies yielded nineteen articles. The systematic review and meta-analysis were performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis). The analyses showed that ultrasound is a better imaging technique for epicutaneo-caval catheter tip location in the neonatal intensive care unit than conventional radiology. By improving operator training and selecting a standardized echography protocol, ultrasound could become the gold standard for visualizing the epicutaneo-caval catheter tip in the neonatal intensive care unit. This would have some important benefits: (1) increased accuracy in tip location (2); a more rapid use of the central venous access (3); and a significant reduction in radiation exposure. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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7 pages, 2123 KiB  
Case Report
Lung Ultrasound in the Early Diagnosis and Management of the Mild Form of Meconium Aspiration Syndrome: A Case Report
by Alessandro Perri, Simona Fattore, Giorgia Prontera, Maria Letizia Patti, Annamaria Sbordone, Milena Tana, Vito D’Andrea and Giovanni Vento
Diagnostics 2023, 13(4), 719; https://doi.org/10.3390/diagnostics13040719 - 14 Feb 2023
Cited by 2 | Viewed by 1619
Abstract
MAS is a common cause of neonatal respiratory distress in term and post-term neonates. Meconium staining of the amniotic fluid occurs in about 10–13% of normal pregnancies, and about 4% of these infants develop respiratory distress. In the past, MAS was diagnosed mainly [...] Read more.
MAS is a common cause of neonatal respiratory distress in term and post-term neonates. Meconium staining of the amniotic fluid occurs in about 10–13% of normal pregnancies, and about 4% of these infants develop respiratory distress. In the past, MAS was diagnosed mainly on the basis of history, clinical symptoms, and chest radiography. Several authors have addressed the ultrasonographic assessment of the most common respiratory patterns in neonates. In particular, MAS is characterised by a heterogeneous alveolointerstitial syndrome, subpleural abnormalities with multiple lung consolidations, characterised by a hepatisation aspect. We present six cases of infants with a clinical history of meconium-stained fluid who presented with respiratory distress at birth. Lung ultrasound allowed the diagnosis of MAS in all the studied cases, despite the mild clinical picture. All children had the same ultrasound pattern with diffuse and coalescing B-lines, pleural line anomalies, air bronchograms, and subpleural consolidations with irregular shapes. These patterns were distributed in different areas of the lungs. These signs are specific enough to distinguish between MAS and other causes of neonatal respiratory distress, allowing the clinician to optimise therapeutic management. Full article
(This article belongs to the Special Issue Maternal–Fetal and Neonatal Diagnostics)
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