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 Posted: Wed Dec 5th, 2007 07:10 pm
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Doc C
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Location:  Eastern Shore, Maryland USA
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I was a premature twin myself. In that era, put you in an incubator, put you in the corner and wish you a lot of luck. Bama, correct about RLF, now termed retinopathy of prematurity (ROP). In a nutshell, it's when abnormal blood vessels form around the retina eventually leading to scar tissue which could lead to detachment of the retina thus blindness. Too much oxygen can promote the growth of abnormal vessels prior to 32 weeks. Now with frequent exams and laser or cryotherapy blindness is an extremely low occurrence. The incidence quoted is between 3 - 6% foe infants less than 32 weeks. I know 2 pediatricians who cared for premature infants in the 50's and lost a major malpractice suit due to oxygen administration and subsequent blindness. In this current time, if you have a baby with ROP/blindness, you'll soon be hearing from a plantiff's lawyer. We still do not know what the correct amount of oxygen to give these infants, i.e. what is too much or to little. Another problem is 3rd world countries where the incidence of ROP is skyrocketing due to their inability to monitor oxygen levels appropriately in their premature patients. By the way, oxygen is the most common drug used in the NICU's. One of the main reasons I stopped taking care of extremely premature infants (1lbs, 23 - 25 weekers) in Level III NICUs and just do part time in Level II NICU's (regular, health baby nurseries are termed Level I) was the ethical issues I was having to deal with. I had serious concerns about the long term consequences for these infants, i.e. blindness, deafness, severe mental retardation, cerebral palsy.

Doc C

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