Difficulties in establishing the onset of neonatal sepsis has directed the medical research in recent years to the possibility of identifying early biological markers of diagnosis. Overdiagnosing neonatal sepsis leads to a higher rate and duration in the usage of antibiotics in the Neonatal Intensive Care Unit (NICU), which in term leads to a rise in bacterial resistance, antibiotherapy complications, duration of hospitalization and costs.Concomitant analysis of CRP (C Reactive Protein), procalcitonin, complete blood count, presepsin in newborn babies with suspicion of early or late neonatal sepsis. Presepsin sensibility and specificity in diagnosing neonatal sepsis. The study group consists of newborns admitted to Polizu Neonatology Clinic between 15th February- 15th July 2017, with suspected neonatal sepsis. We analyzed: clinical manifestations and biochemical markers values used for diagnosis of sepsis, namely the value of CRP, presepsin and procalcitonin on the onset day of the disease and later, according to evolution. CRP values may be influenced by clinical pathology. Procalcitonin values were mainly influenced by the presence of jaundice. Presepsin is the biochemical marker with the fastest predictive values of positive infection. Presepsin can be a useful tool for early diagnosis of neonatal sepsis and can guide the antibiotic treatment. Presepsin value is significantly higher in neonatal sepsis compared to healthy newborns (939 vs 368 ng/mL, p [ 0.0001); area under receiver operating curve (AUC) for presepsine was 0.931 (95% confidence interval 0.86-1.0). PSP has a greater sensibility and specificity compared to classical sepsis markers, CRP and PCT respectively (AUC 0.931 vs 0.857 vs 0.819, p [ 0.001). The cut off value for presepsin was established at 538 ng/mLwith a sensibility of 79.5% and a specificity of 87.2 %. The positive predictive value (PPV) is 83.8 % and negative predictive value (NPV) is 83.3%.

Background and aimsLow birth weight infants are at high risk of perinatal complications and death to normal or large infants. Umbilical cord abnormalities are associated with this group of infants due to chronic aggravation of umbilical blood flow. We want to establish the anatomical features of umbilical cord who can predict the outcome of newborn.Materials and methodsAnalytical study of low birth weight newborns, with a duration of 3 years conducted in National Institute of Mother and Child Health ‘Alessandrescu-Rusescu’, Neonatology Clinic. Were monitored type of conception and delivery, umbilical cord anatomic features, Apgar score, need for invasive resuscitation at birth (oxygen – positive pressure ventilation, achieving PEEP with T piece resuscitator, intubation), outcome of newborns.ResultsLow birth weight infants studied came from 90% investigated preganat women, multigestation 62,5% and primiparous 67,5%; naturally conceived in 78,3% cases and 21,6% in vitro fertilisation; equal proportion by gender; 43% term newborn, 8,3% between 33–36 weeks of gestation, 39,1% between 28–32 weeks of gestation and 9,1% under 27 weeks of gestational age; number of days oh hospitalisation were above normal in most cases. Cord appearance in this group was normal in 79,1% of cases, lin 9,1%, hypertrophic 10,8%, excess Wharton jelly in 5,8% of cases, meconium stained 3,8%. In the series with meconium stained umbilical cord, maternal hystory was infectious type in 75% of cases, 50% under 27 weeks gestational age, 75% with Apgar score under 1 at 1 minut after birth, and all newborns required resuscitation at birth; those with excess Wharton’s jelly came in 86% of cases from primiparous, 42,8% concevied by in vitro fertilisation and multipe fetuses, all at 28–32 weeks gestational age, need for resuscitation at birth 43%; hypertrophic cord was associated with maternal pathology like placenta praevia 25% and pregnancy hypertenison 25%, all naturally concieved, 50% with gestational weeks between 28 and 32, hospitalisation over one month; lin umbilical cord was associated with 72,7% multigestation of wich 37,5% primiparous, without significant pathology, naturally concevied, 63,6% between 33 and 36 weeks gestational age, 45,1% with Apgar score 5–7 and need for resuscitation at birth.ConclusionsIn this situation, we have the confirmation that the features of umbilical cord can be the first clinical exam of low birth weight newborns who could oriented the action of neonatal team and treatment for infants.

Context. Diabetes insipidus (DI) is rare in the neonatal period but of great importance due to increased renal risk and mental retardation despite treatment.Objective. This report describes the case of a patient with congenital nephrogenic diabetes insipidus (NDI). Detection of this pathology during the neonatal period, especially in premature newborns, is difficult because of the electrolyte variations that occur as a result of the immature kidney function.Subjects and methods. The subject was a preterm infant with very low birth weight (VLBW) and persistent hypernatremic hyperosmolarity that developed polyuria and polydipsia in the first weeks of life.Results. Taking into account blood and urine laboratory tests, vasopressin levels, as well as family history, the infant was diagnosed with congenital NDI. Early treatment allowed a good development, proving that the prevention of long-term complications is possible through multidisciplinary care and frequent monitoring. The particularity of this case was the presence of persistently elevated presepsin levels. This association prompted the investigation into underlying renal hypernatremia.Conclusions. NDI is a rare condition and the onset in the neonatal period is a sign of severity and hereditary causality. Early diagnosis, symptomatic treatment and multidisciplinary monitoring may decrease the risk of longterm complications.

This study aimed to identify the incidence of in vitro fertilization (IVF) in late preterm infants and the presence of respiratory pathology in this premature category compared with those conceived naturally. This retrospective study was performed over 6 months, including newborns with a gestational age between 34–36 weeks and 6 days in the Department of Obstetrics, Gynecology and Neonatology, Alessandrescu-Rusescu National Institute of Mother and Child Health. The following variables were assessed: infants' gestational age, delivery mode, respiratory morbidity, and the need for respiratory support. During the mentioned period, 112 late preterm infants were born, out of whom 9.8% represented late preterm infants conceived by in vitro fertilization. The delivery mode of late preterm infants conceived by in vitro fertilization was exclusively by C-section (100%) compared to those conceived spontaneously (44.5%). 18.1% of IVF late preterm infants developed transient tachypnea of the newborn. In the non-IVF group, respiratory distress syndrome was present in 5.9% and transient tachypnea in 33.6% of cases. No IVF late preterm infant required hospitalization in neonatal intensive care for more than 3 days, compared to 19.8% of naturally conceived late preterm infants. Respiratory distress syndrome very seldom occurs in late preterm IVF infants due to prenatal prophylactic treatment with corticosteroids. Respiratory pathology is rarely present due to very careful monitoring during pregnancy, the presence of a neonatal team in the delivery room for possible resuscitation, and providing proper care according to the good state of health during the short, one-week hospitalization.