Papers by Monica Hasmasanu
Children (Basel), Apr 19, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Obstetrică şi ginecologie, 2019
Bronchopulmonary dysplasia (BPD) is a common disease following the respiratory distress syndrome ... more Bronchopulmonary dysplasia (BPD) is a common disease following the respiratory distress syndrome in premature infants. The disease is particularly frequent in premature babies with a small gestational age, under 28 weeks. The pathogenesis of BPD is complex, its main mechanism being the impairment of the alveolization and vascularization of the lungs. The etiological factors involved in the appearance of the bronchopulmonary dysplasia are: oxygen therapy, mechanical ventilation, neonatal asphyxia, neonatal sepsis, deficient nutritional status. The prenatal factors playing a role in the pathogenesis of the disease are chorioamnionitis, premature rupture of membranes, and intrauterine growth restriction. The main trigger in the pathogenesis of the disease is inflammation acting on the fetal lung during the intrauterine period. This paper presents the case of a patient who developed severe BPD, while the respiratory distress was moderate, and he did not require surfactant therapy or ventilator support. The mother had premature rupture of membranes of over 14 days and chorioamnionitis confirmed by the histopathological examination.
Bronchopulmonary dysplasia (BPD) is a common disease following the respiratory distress syndrome ... more Bronchopulmonary dysplasia (BPD) is a common disease following the respiratory distress syndrome in premature infants. The disease is particularly frequent in premature babies with a small gestational age, under 28 weeks. The pathogenesis of BPD is complex, its main mechanism being the impairment of the alveolization and vascularization of the lungs. The etiological factors involved in the appearance of the bronchopulmonary dysplasia are: oxygen therapy, mechanical ventilation, neonatal asphyxia, neonatal sepsis, deficient nutritional status. The prenatal factors playing a role in the pathogenesis of the disease are chorioamnionitis, premature rupture of membranes, and intrauterine growth restriction. The main trigger in the pathogenesis of the disease is inflammation acting on the fetal lung during the intrauterine period. This paper presents the case of a patient who developed severe BPD, while the respiratory distress was moderate, and he did not require surfactant therapy or ventilator support. The mother had premature rupture of membranes of over 14 days and chorioamnionitis confirmed by the histopathological examination.
The objective is to assess co-morbidity and mortality in a group of premature infants under 32 we... more The objective is to assess co-morbidity and mortality in a group of premature infants under 32 weeks of gestation with respiratory distress transferred versus those born in the IIIrd level maternity. Material and methods. A clinical study, retrospective, longitudinal, conducted on a sample of 193 newborns with a gestational age below 32 weeks, hospitalized in Neonatology Section I, Obstetrics and Gynecology, Cluj-Napoca Clinical Emergency County Hospital, from 2011-2013, including 50 newborns transferred from maternity level I and IInd. Results. Preterm birth in a lower grade maternity has a higher incidence of immediate complications: respiratory distress with surfactant deficiency, bleeding and retinopathy of prematurity, chronic lung disease. Conclusion. Transferred prematures had more severe respiratory distress with significantly higher oxygen necessary in the first week of life and higher incidence of morbidities.
Acta Clinica Croatica, 2015
The aim of the study was to assess the use of echocardiographic measurements in newborns of diabe... more The aim of the study was to assess the use of echocardiographic measurements in newborns of diabetic mothers. Maternal diabetes is associated with an increased risk of morbidity and mortality in pregnancy and in perinatal period. Thirty-five newborns of diabetic mothers (pregestational or gestational diabetes; case group) and thirty-five controls (control group), born between January 2009 and december 2012 in Cluj-napoca (north-west of romania), were included in this study. A logiq e ultrasound with an 8 Mhz transducer was used to measure echocardiographic parameters. The interventricular septal thickness in case group was higher as compared with control group (at end systole = 6.61±1.64 mm vs. 5.75±0.95 mm, p=0.0371; at end diastole = 4.61±1.59 mm vs. 3.42±0.70 mm, p=0.0001). A risk ratio of 2.333 (0.656, 8.298) was obtained for septal hypertrophy. A higher proportion of septal hypertrophy was identified in the newborns of mothers with gestational diabetes compared to the newborns of pregestational diabetes mothers (p=0.0058). The mean birth weight was significantly higher in newborns of diabetic mothers (3695.57±738.63) as compared with controls (3276.14±496.51; p=0.0071). infants born to mothers with diabetes proved to be at a high risk of septal hypertrophy.
Perinatologia, 2017
The objective is to assess co-morbidity and mortality in a group of premature infants under 32 we... more The objective is to assess co-morbidity and mortality in a group of premature infants under 32 weeks of gestation with respiratory distress transferred versus those born in the IIIrd level maternity. Material and methods. A clinical study, retrospective, longitudinal, conducted on a sample of 193 newborns with a gestational age below 32 weeks, hospitalized in Neonatology Section I, Obstetrics and Gynecology, Cluj-Napoca Clinical Emergency County Hospital, from 2011-2013, including 50 newborns transferred from maternity level I and IInd. Results. Preterm birth in a lower grade maternity has a higher incidence of immediate complications: respiratory distress with surfactant deficiency, bleeding and retinopathy of prematurity, chronic lung disease. Conclusion. Transferred prematures had more severe respiratory distress with significantly higher oxygen necessary in the first week of life and higher incidence of morbidities.
Clinical Laboratory, 2019
BACKGROUND Neonatal sepsis represents one of the common diseases in the neonatal intensive care u... more BACKGROUND Neonatal sepsis represents one of the common diseases in the neonatal intensive care unit. Here we aim to evaluate the differences between a group of preterm newborns with sepsis and a control group in relation to clinical and laboratory variables. In addition, our goal is to establish potential predictors of early-onset sepsis (EOS) and late-onset sepsis (LOS). METHODS The study included 113 preterm newborns with sepsis (EOS-63.72%/LOS-36.28%). Laboratory deter-minations included full blood count, CRP, biochemical determinations, blood culture. RESULTS The most important univariate neonatal predictors were gestational age (p < 0.001), surfactant adminis-tration (p < 0.001), mechanical ventilation (p < 0.001), heart failure (p < 0.001), a history of hypocalcemia (p = 0.037), Apgar score at 1 minute lower than 7 (p = 0.001), birth weight < 1,500 g (p = 0.005), number of hospi-talization days (p = 0.048), and number of weight recovery days < 10 (p < 0.05). The WBC and CRP parameters remained significant univariate predictors of sepsis on day 7 (p = 0.002; OR = 2.01 per 10,000 mm3 increase of WBC, 95% CI: (1.30; 3.09) and p = 0.001; OR = 4.27, 95% CI: (1.85; 9.88), respectively). Logistic regression anal-ysis showed maternal urinary tract infection (OR = 3.05), heart failure (OR = 5.28), the number of hospitalization days (OR = 1.09) and CRP (OR = 3.26) were significant independent risk factors for neonatal sepsis in preterms. The univariate predictors of EOS were gestational age (p = 0.002), birth weight (p = 0.014), 1-minute Apgar score (p = 0.012), maternal urinary tract infection (p = 0.008), surfactant administration (p < 0.001), heart failure (p < 0.001), and CRP level (p < 0.001). Surfactant administration (OR = 6.73) and CRP level (OR = 3.51) represent predictors of EOS in preterms according to the multivariate model. The univariate predictors of LOS were gesta-tional age (p = 0.001), birth weight (p = 0.048), 1-minute Apgar score (p = 0.001), surfactant administration (p < 0.001), hypocalcemia (p = 0.03), heart failure (p = 0.003), CRP level (p < 0.001), mechanical ventilation (p < 0.001), and the number of hospitalization days (p < 0.001). In the multivariate model, the number of hospitali-zation days (OR = 1.11) and heart failure (OR = 5.98) are independent predictors for LOS in preterms. CONCLUSIONS The study confirms the presence of maternal urinary tract infection, hospitalization days, heart fail-ure, and CRP level as predictors of neonatal sepsis in preterms with differences between EOS and LOS.
Srpski arhiv za celokupno lekarstvo, 2015
Introduction. Linear growth failure is caused by multiple factors including parental factors. Obj... more Introduction. Linear growth failure is caused by multiple factors including parental factors. Objective. The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. Methods. A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. Results. The age of mothers was significantly lower in the IUGR group compared to controls (p=0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to control...
The aim of our research was to design and implement data collection instruments to be use in cont... more The aim of our research was to design and implement data collection instruments to be use in context of an observational prospective clinical study with follow-up conducted on new born with intrauterine growth restriction. Methods: The structure of the data collection forms (paper based and electronic based) was first identified and for each variable the best type to accomplish the research aim was established. The code for categorical variables has also been decided as well as the units of measurements for quantitative variables. In respect of good practice, a set of confounding factors (as gender, date of birth, etc.) have also been identified and integrated in data collection instruments. Data-entry validation rules were implemented for each variable to reduce data input errors when the electronic data collection instrument was created. Results: Two data collection instruments have been developed and successfully implemented: a paper-based form and an electronic data collection instrument. The developed forms included demographics, neonatal complications (as hypoglycemia, hypocalcemia, etc.), biochemical data at birth and follow-up, immunological data, as well as basal and follow-up echocardiographic data. Data-entry validation criteria have been implemented in electronic data collection instrument to assure validity and precision when paper-based data are translated in electronic form. Furthermore, to assure subject's confidentiality a careful attention was given to HIPPA identifiers when electronic data collection instrument was developed. Conclusion: Data collection instruments were successfully developed and implemented as an a priori step in a clinical research for assisting data collection and management in a case of an observational prospective study with follow-up visits.
Acta clinica Croatica, 2015
The aim of the study was to assess the use of echocardiographic measurements in newborns of diabe... more The aim of the study was to assess the use of echocardiographic measurements in newborns of diabetic mothers. Maternal diabetes is associated with an increased risk of morbidity and mortality in pregnancy and in perinatal period. Thirty-five newborns of diabetic mothers (pre- gestational or gestational diabetes; case group) and thirty-five controls (control group), born between January 2009 and December 2012 in Cluj-Napoca (north-west of Romania), were included in this study. A Logiq e ultrasound with an 8 MHz transducer was used to measure echocardiographic parameters. The interventricular septal thickness in case group was higher as compared with control group (at end systole = 6.61 ± 1.64 mm vs. 5.75 ± 0.95 mm, p = 0.0371; at end diastole = 4.61 ± 1.59 mm vs. 3.42 ± 0.70 mm, p = 0.0001). A risk ratio of 2.333 (0.656, 8.298) was obtained for septal hypertrophy. A higher proportion of septal hypertrophy was identified in the newborns of mothers with gestational diabetes compared to...
Children
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Romanian Journal of Pediatrics
Background. Sepsis continues to be one of the main death causes in the neonate population. The to... more Background. Sepsis continues to be one of the main death causes in the neonate population. The toll-like receptors are molecules that express in the plasma or endosomal membrane and recognize endosomal or microorganism components. While aiming at the identification of new neonatal sepsis biomarkers, the toll-like receptors (TLR) have been considered that some of them overexpress in contact with the bacterial components. Methods. Research in the PubMed database has been made by the following criteria: Inclusion criteria (PubMed database, Period 2005-2022, English & Humans, generated 29, Meta-Analysis - 0, Review - 6, Systematic Review - 0), Exclusion criteria (Studies on animal models, Articles with merely didactical content, Articles regarding only one of the words researched either only neonatal sepsis or TLR in another context than together, Articles that are not directly connected with the topic). Based on the above-mentioned criteria 13 articles were consulted, of which 7 articl...
Journal of Clinical Medicine
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Experimental and Therapeutic Medicine, 2021
Fetal inflammatory response syndrome is associated with increased neonatal morbidity and mortalit... more Fetal inflammatory response syndrome is associated with increased neonatal morbidity and mortality. The aim of the present study was to evaluate the dynamics of the plasmatic value of pro-inflammatory cytokines: tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and neutrophil activating peptide 78 (ENA-78) and the anti-inflammatory cytokine IL-10 in the first and third day of life and the correlation with neonatal morbidities and mortality. The current research was designed as a prospective case control study included 80 neonates hospitalized at the 3rd level Neonatal Intensive Care Unit (NICU),
Journal of Clinical Medicine, 2022
Background: An early form of preeclampsia is rare. Abnormal placentation, placental perfusion dis... more Background: An early form of preeclampsia is rare. Abnormal placentation, placental perfusion disorders, and inflammatory cytokine release will have an effect on the fetus and newborn. Material and methods: The study group consisted of preterm newborns whose mothers had a history of preeclampsia and a gestational age of between 30 weeks and 34 weeks + 6 days. The control group consists of neonates matched for gestational age with the case group, whose mothers had normal blood pressure. The incidence and severity of respiratory distress syndrome (RDS), intraventricular hemorrhage, hypoglycemia, pH gas changes, and hematological parameters were analyzed in the two groups. Results: The study group of preterm neonates had a lower birth weight than the control group (p < 0.001). Most of the deliveries in the group of newborns exposed to preeclampsia were performed by cesarean section. Severe forms of RDS were two times more frequent in the group of newborns exposed to preeclampsia com...
Medicina
Background and objectives: Premature newborns have a number of oxidative stress-inducing disorder... more Background and objectives: Premature newborns have a number of oxidative stress-inducing disorders. Antioxidant defense is deficient in premature newborns. Hydrogen donors can be used to evaluate the non-enzymatic antioxidant defense. By measuring hydrogen donors, a group of antioxidants can be assessed: tocopherol, ascorbic acid, and glutathione. These represent the most relevant group of non-enzymatic antioxidants. The main aim of this study was to evaluate the non-enzymatic antioxidant defense capacity of premature newborns by measuring hydrogen donors. Materials and Methods: We evaluated the non-enzymatic antioxidant capacity by hydrogen donor measurement in 24 premature newborns with various oxidative stress-inducing disorders and in 14 premature newborns without oxidative stress-inducing conditions. Statistical analysis was performed using the Statistica program (v. 8, StatSoft, Round Rock, TX, USA). Differences between groups were tested with Wilcoxon matched test for quantit...
Experimental and Therapeutic Medicine, 2021
Fetal inflammatory response syndrome is associated with increased neonatal morbidity and mortalit... more Fetal inflammatory response syndrome is associated with increased neonatal morbidity and mortality. The aim of the present study was to evaluate the dynamics of the plasmatic value of pro-inflammatory cytokines: tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and neutrophil activating peptide 78 (ENA-78) and the anti-inflammatory cytokine IL-10 in the first and third day of life and the correlation with neonatal morbidities and mortality. The current research was designed as a prospective case control study included 80 neonates hospitalized at the 3rd level Neonatal Intensive Care Unit (NICU),
Experimental and Therapeutic Medicine, 2022
Severe acute respiratory distress syndrome with coronavirus 2 (SARS-CoV-2) infection affected pre... more Severe acute respiratory distress syndrome with coronavirus 2 (SARS-CoV-2) infection affected pregnant women during the pandemic. Immunological particularity of this population and the increased need for medical assistance placed this population in a high-risk category for SARS-Cov-2 infection. Owing to high contamination risk and limited studies regarding vertical transmission, the labor and delivery of positive women required particular conditions. Cesarean section probably proved to be the optimal option for delivery of infants to reduce the risk of infection during birth. The aim of the present study was to present the management and outcome of infants born to mothers confirmed with coronavirus disease 2019 (COVID 19) prior to delivery. This is a longitudinal, retrospective study, analyzing demographics, laboratory data and management of neonates born to mothers with diagnosis of SARS-Cov-2 infection. The results showed that 5 neonates were born to SARS-Cov-2-positive mothers, all by Cesarean section and had a negative reverse transcription-quantitative polymerase chain reaction (RT-qPCR) test. None of the women breastfed during the hospital stay. The negative RT-qPCR test allowed us to reduce the hospital stay of infants and care in non-isolated areas. In summary, in the present study, vertical or perinatal transmission of the infection was not present. The testing of the pregnant women, their isolation and delivery in safe conditions for the medical staff were possible, with the latter using adequate protection equipment to limit their infection and the risk for the newborns.
Medical Ultrasonography
Fetal cardiac rhabdomyomas should trigger the awareness of a potential coexisting tuberous sclero... more Fetal cardiac rhabdomyomas should trigger the awareness of a potential coexisting tuberous sclerosis complex that can lead to a poor neurological outcome. This condition is not only uncommon but can be easily unrecognized prenatally in the absence of a meticulous neurosonogram and MRI. We emphasize that careful consideration of all prenatal facilities is required to confirm the diagnosis of tuberous sclerosis complex as early as possible during pregnancy.
Experimental and Therapeutic Medicine
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Papers by Monica Hasmasanu