Dergiler / Dicle Tıp Dergisi / 2016 / Cilt: 43 - Sayı: 1

The Effect of Maternal Hypothyroidism on Fetal Umbilical Cord Brain-Derived Neurotrophic Factor Levels

Determining a Safe Time for Oral Intake Following Pediatric Sedation

Sayfa
107–111
DOI
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Özet

Objective: Brain derived neurotrophic factor (BDNF) is the most important neurotrophin, which helps the differentiation and growth of central and peripheral neurons, and facilitates synaptic transmission. In this study we aimed to investigate fetal cord BDNF levels of infants born from subclinical and clinical maternal hypothyroidism.Methods: This study was conducted on a total of 67 pregnant women who were followed up in Obstetrics and Gynecology outpatient clinics, 27 with maternal hypothyroidism and 40 age-parity matched healthy pregnants without hypothyroidism. Immediately after vaginal or cesarean delivery fetal cord blood samples were taken from these patients and BDNF levels were measured.Results: BDNF levels of infants born from pregnants with maternal hypothyroidism were significantly lower than the control group (23.3 ± 17.4 ng/dl and 50.7 ± 28.3 ng/dl respectively; p<0.001). In multiple linear regression analysis, while BDNF level was related with maternal hypothyroidism and infant sex, it was not associated with mode of delivery, maternal age, total weight gain during pregnancy, gestational age at birth, thyroid stimulating hormone (TSH) levels and other neonatal data.Conclusion: This study showed that fetal cord BDNF levels significantly decreased in infants of the pregnants with hypothyroidism.Key words: Pregnancy, maternal hypothyroidism, brain derived neurotrophic factor, levothyroxine

Abstract

Objective: While there are suggestions for oral hydration times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge.Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital admission.Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported.Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.Key words: Sedation, oral intake, postoperative nausea and vomiting

Anahtar kelimeler: Gebelik, maternal hipotiroidi, beyin kaynaklı nörotrofik faktör (BDNF), levotiroksin