Use of systemic retinoids accelerates the shedding of hyperkeratoic plates and improves scaling. Together with enhanced moisturisation, electrolyte care, sepsis prevention & physiotherapy, survival of 81% has been reported.

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Objetivo: Analisar o impacto da pré-eclâmpsia (PE) grave nas mortalidades materna e neonatal e fatores associados em gestantes portadoras. Métodos: Revisão de literatura incluindo estudos publicados entre 2014 e 2019, realizada na base de dados Medical Literature Analysis and Retrieval System Online (MEDLINE) via Pubmed em outubro de 2019. Mediante os descritores mortalidade neonatal, pré-eclâmpsia e mortalidade materna, inicialmente, encontrou-se 1669 estudos. Desses, 16 analisaram gestantes de qualquer idade e etnia com PE grave e foram selecionados para a revisão. Resultados: As mortalidades neonatal e materna apresentaram medianas de proporções iguais a 9.32% e 1%, respectivamente. Sobre os resultados neonatais: a mediana de recém-nascidos (RNs) prematuros encontrada foi de 33.9%, a mediana de peso ao nascer de 2042.65g (classificada como baixo peso) e a mediana da porcentagem dos RNs internados em UTI de 46.6%. Observa-se que a mortalidade materna foi abordada em apenas 7 dos artigos analisados (43.75% do total de artigos selecionados). Considerações finais: A presente revisão sistemática conclui que a PE grave apresenta impacto relevante na mortalidade neonatal e nos demais resultados neonatais avaliados. A respeito da mortalidade materna, há uma lacuna de produções científicas datadas no período analisado que busquem suas associações diretas com a PE grave.

the survival rates without NA at 28 days of age were 52%(n=27) in sIUGR twins and 96% (n=50) in the larger twins, respectively. Conclusions: FLP for monochorionic twin gestations with sIUGR presenting with oligohydramnios of the sIUGR twins could be considered as one of the prenatal treatment options. Objectives: To evaluate pregnancy characteristics and outcomes in monochorionic diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) in a tertiary centre in Western Australia, where selective reduction or placental laser photocoagulation is not routinely practised for this indication. Methods: MCDA twins with sIUGR diagnosed after 16.0 weeks gestational age between 2010 and January 2017 were identified. A composite definition of the estimated fetal weight (EFW) or abdominal circumference less than the 10th centile of the smaller twin, or difference of greater than 25 percent in EFW was used. Exclusion criteria included TTTS, congenital anomalies, higher order multiples, or demise of one/both twins at the referral scan. Parameters assessed included GA at diagnosis, EFW centiles, UA and MCA Dopplers, AFV, GA at birth and birth weight centiles, and maternal and neonatal outcomes up to 28 days of life. Results: 93 cases were eligible for inclusion. The median GA and mean difference in EFW centile between the twins at diagnosis were 23.5 and 28.5 respectively. The percentages of Type 1, 2 and 3 sIUGR were 67, 19, and 14 respectively. sIUGR was positively associated with abnormal cord insertion and a smaller placental share for the smaller twin. Three pregnancies were complicated by fetal demise with two of these being unrelated to sIUGR. There was one neonatal death due to complications of extreme prematurity. The overall perinatal mortality ratio was 27 per 1000 births. The median GA at delivery was 33.5 with the most common delivery indication being worsening fetal condition. Types 2 and 3 sIUGR were delivered earlier than those with Type 1; mean 30.3 vs 34.3 weeks, and associated with lower birth weights and more severe neonatal morbidity. Conclusions: This study showed that cases with more severe Doppler abnormalities were delivered at an earlier GA with correspondingly greater neonatal morbidity. The majority of twin pairs survived the neonatal period.