Two cases of perinatal HIV and literature review

Dünya genelinde hâlihazırda yaklaşık 37 milyonkişide bulunan kazanılmış immün yetersizlik virüsü(HIV) giderek daha fazla sayıda insanı etkilemekteve bu nedenle, önemli bir sağlıksorunu olarak kabul edilmektedir. Türkiye iseHIV’in az görüldüğü ülkeler arasında yeralmaktadır. Çocukluk çağı HIV olgularının%90’ından perinatal yolla geçiş sorumludur veantiretroviral profilaksi ile geçiş riski %1’inaltına düşürülmüştür. HIV enfeksiyonununmortalite ve morbiditesi düşünüldüğü vakitkoruyucu tedavinin komplikasyonları gözealınabilir fakat olası toksisite yönündenhastaların yakın izlemi gerekmektedir. HIVolgularının engellenmesi büyük oranda perinatalsürecin doğru yönetimiyle mümkündür.Burada HIV pozitif annelerden doğmuş olan ikiolgu incelenmiş ve literatür eşliğinde perinatalyönetim süreci gözden geçirilmiştir.Already existing in 37 million people worldwide,human immunodeficiency virus (HIV) tends toaffect more people and, thus, it has becomea significant health problem. Turkey is oneof the countries where HIV infection is rarelyseen. Transmission is vertical at %90 of HIV ()infants and perinatal transmission of HIV hasbeen reduced to less than 1% with the use ofantiretroviral drugs. The risk of complicationsrelated with this prophylactic treatmentmight be accepted when relatively highermorbidity and mortality of HIV infection isconsidered. Meanwhile close follow-up ofpatients is required due to possible toxicity.The transmission of HIV into newborns can beprevented with appropriate management ofthe perinatal period. This report describes theperinatal management of two newborns thatwere delivered by HIV () mothers

Neonatal Resuscitation Practices in Turkey: A Survey of the Turkish Neonatal Society and the Union of European Neonatal and Perinatal Societies

Objective: Optimal care in the delivery room is important to decrease neonatal morbidity and mortality. We aimed to evaluate neonatal resuscitation practices in Turkish centers. Materials and Methods: A cross-sectional survey consisted of a 91-item questionnaire focused on delivery room practices in neonatal resuscitation and was sent to 50 Turkish centers. Hospitals with <2500 and those with ≥2500 births/year were compared. Results: In 2018, approximately 240 000 births occurred at participating hospitals with a median of 2630 births/year. Participating hospitals were able to provide nasal continuous-positive- airway-pressure/high-flow nasal cannula, mechanical ventilation, high-frequency oscillatory ventilation, inhaled nitric oxide, and therapeutic hypothermia similarly. Antenatal counseling was routinely performed on parents at 56% of all centers. A resuscitation team was present at 72% of deliveries. Umbilical cord management for both term and preterm infants was similar between centers. The rate of delayed cord clamping was approximately 60% in term and late preterm infants. Thermal management for preterm infants (<32 weeks) was similar. Hospitals had appropriate equipment with similar rates of interventions and management, except conti nuous-positive-airway-pressure and positive-end-expiratory-pressure levels (cmH2O) used in preterm infants (P = .021, and P = .032). Ethical and educational aspects were also similar. Conclusions: This survey provided information on neonatal resuscitation practices in a sam- ple of hospitals from all regions of Turkey and allowed us to see weaknesses in some fields. Although adherence to the guidelines was high among centers, further implementations are required in the areas of antenatal counseling, cord management, and circulation assessment in the delivery room