Mean Birth Weight In Group Research Articles

Study of the Levels of Immunoglobulin G and Complement 3 in Gestational Diabetes and Their Newborn

Background: The most typical metabolic issue related to pregnancy is gestational diabetes. Because it eliminates undesired germs and causes inflammation, the complement system (C3) is an essential part of the cellular immune system. It has been linked to metabolic diseases, including diabetes, obesity, dyslipidemia, insulin resistance, and liver dysfunction. C3 is also becoming more well recognized as a risk factor for cardiovascular and metabolic diseases. Immunoglobulin levels in maternal blood and colostrum are decreased by hyperglycemia, which also affects IgG transfer across the placenta. Aim of study: to compare the levels of C3 and immunoglobulin G in the sera of pregnant women with gestational diabetes and their babies to pregnant women without the disease. Methods: a case control study that was carried out over the course of four months, from August 18 to December 20, 2020, at the department of obstetrics and gynecology at Salahaddin General Hospital/Salahaddin. It involved 92 pregnant women who separated into two groups and went to the delivery room to deliver a viable fetus: 47 pregnant women in the case group had been diagnosed with gestational diabetes mellitus, whereas the 45 pregnant women in the control group had no complaints and were matched with the other groups' ages and gestational ages. Results for C3 and IgG levels in maternal and cord blood were noted. Results: In this study, the case group's mean birthweight and maternal serum C3 levels were both considerably greater than those of the controls. The mean cord serum IgG level in the case group was substantially lower than that in the controls. Conclusion: Understanding the underlying chronic inflammation that affects the developing fetus' innate immune system and predisposes the person to future diabetes and its consequences may be possible with complement C3 estimate in GDM.

“FACTORS AFFECTING INITIATION OF BREASTFEEDING IN LBW AND VLBW BABIES; GROWTH OUTCOMES AT 6 MONTHS OF CORRECTED AGE WITH REFERENCE TO KMC”

LBW infants has higher risk of early infectious disease and growth retardation during infancy and childhood. Advances in NICU in perinatal care has improved survival of LBWto prevent long-term complications. Feeding practices like exclusive breastfeeding along with KMC support child. The objective is to determine factors affecting initiation of breastfeeding in LBW, VLBW babies and describe role of KMC regarding growth at 6 months of corrected age. Methodology:This is prospective study conducted on infants admitted at NICU and followed up for 6months. Parameters like weight, length and head circumference were done to all admitted babies in NICU. KMC was given one group. Results: In our study, 90 babies divided as two groups, Group A (45 babies)- KMC is given; Group B (45 babies)-KMC not given. Mean Birth weight in Group A(1.77kg) and Group B (1.58kg) respectively. Main factors affecting initiation of breastfeeding in babies were LSCS (63.3% and 48.9%), RDS (55.6% and 38.9%) respectively. Rates of exclusive breastfeeding is signicantly increased in Group A (92.2%) than Group B (72.2%). At 6 months of corrected gestational age, mean weight in Group A (5.68kg) is signicantly more than in Group B (4.88kg). Conclusion: LBW babies are more prone for growth retardation, can be prevented by early initiation of breastfeeding and good newborn care. Factors affecting initiation of breastfeeding in LBWand VLBWbabies are LSCS, RDS. KMC care helps to increase exclusive breastfeeding rates and improve growth outcome

TO COMPARE THE EFFECTIVENESS OF EXTRA-AMNIOTIC SALINE INSTILLATION THROUGH FOLEY CATHETER PRIOR TO ORAL MISOPROSTOL WITH ORAL MISOPROSTOL ALONE IN INDUCING LABOUR IN PREGNANCIES >28 WEEKS WITH INTRAUTERINE FOETAL DEATH- A RANDOMIZED CONTROLLED TRIAL AT TE

Background: The present study aims to compare the results of EASI followed by oral misoprostol and oral misoprostol alone for induction of labour in pregnancies of more than 28 weeks with intrauterine foetal death.
 Methods: The present observational and prospective study is an attempt to compare the efficacy of extra-amniotic saline instillation with Foley catheter prior to oral misoprostol and oral misoprostol alone in induction of labour of pregnancies more than 28 weeks with intrauterine fetal death.
 Results: Most of the cases delivered vaginally in both study groups. The mean induction delivery time in group I was higher than group II and the results were statistically significant on comparing both groups. In group I, 78% cases were delivered within 24 hours whereas in group II 96% cases delivered within 24 hours of induction. There was no significant difference in the mean number of required misoprostol in both groups (p>0.05). Need of supplementation with oxytocin was more in group I as compared to group II and the p value is significant (p<0.01). Mean birth weight in group I was 2.25±0.75 kg and in group II was 2.27±0.77 kg. Maximum number of babies had birth weight between 1.52-2.50 kg with 44% in group I and 40% in group II (p>0.05). Only 4 cases had uterine tachysystole and only 1case had postpartum pyrexia. Very few complications were recorded in both the study groups (p>0.05).
 Conclusion: We concluded that oral misoprostol tablet alone is more effective at inducing and setting up the active labour in pregnancies of >28 weeks with intrauterine foetal death than EASI followed by oral misoprostol. It is inexpensive, has a long shelf life, can be easily stored at room temperature and patient remains ambulatory after induction with oral misoprostol. Oral misoprostol alone seems to have an edge over extra-amniotic saline instillation followed by oral misoprostol in all aspects.
 Keywords: Misoprostol, Extra-amniotic saline, Induction of labour.

Efficacy of surfactant administration to preterm infants via thin catheter versus InSurE technique.

Objectives: To compare the efficacy of administering surfactant to preterm infants using thin catheter and Intubate-Surfactant-Extubate (InSurE) techniques in terms of need of mechanical ventilation within 1st 72 hours of life. Study Design: Randomized controlled trial. Setting: Neonatal intensive care unit (NICU), Federal Postgraduate Medical Institute and Shaikh Zayed Hospital (FPGMI and SZH), Lahore. Period: From November 2014 to April 2015. Material & Methods: A total of one hundred preterm infants who developed respiratory distress syndrome (RDS) and fulfilled the inclusion criteria were enrolled in the study. The enrolled infants were randomly divided into two groups each comprising fifty infants. The infants in Group A were administered surfactant via thin catheter technique, whereas those in Group B by InSurE technique. The infants were monitored by clinical and laboratory parameters for the need of mechanical ventilation within 1st 72 hours of life. Descriptive statistical analyses were performed. Results: Majority of the preterm infants in Group A (54%) and Group B (56%) were born through Caesarean section. Group A constituted 58% (n=29) males and 42% (n=21) female infants, while Group B constituted 52% (n=26) males and 48% (n=24) females. Mean gestational age in Group A and Group B was found to be 29.43±4.24 weeks and 28.54±3.87 weeks, respectively. Mean birth weight in Group A and Group B was found to be 1375.87+143.36 and 1392.87+129.27 grams, respectively. Efficacy of surfactant was recorded as 64% (n=32) in group A and 44% (n=22) in group B (p=0.04). Conclusion: Surfactant administration using thin catheter is significantly more efficacious than InSurE in respect of the need of mechanical ventilation during 1st 72 hours of life.

Analysis of the horizontal corneal diameter, central corneal thickness, and axial length in premature infants.

To determine the horizontal corneal diameter, central corneal thickness, and axial length in premature infants. Infants with a birth weight of less than 2,500 g or with a gestation period of less than 36 weeks were included in the study. Infants with retinopathy of prematurity (ROP) were allocated to Group 1 (n=138), while those without ROP were allocated to Group 2 (n=236). All infants underwent a complete ophthalmologic examination, including corneal diameter measurements, pachymetry, biometry, and fundoscopy. Between-group comparisons of horizontal corneal diameter, central corneal thickness, and axial lengths were performed. Independent sample t-tests were used for statistical analysis. Data was obtained from 374 eyes of 187 infants (102 female, 85 male). The mean gestational age at birth was 30.7 ± 2.7 weeks (range 25-36 weeks), the mean birth weight was 1,514 ± 533.3 g (range 750-1,970 g), and the mean postmenstrual age at examination was 40.0 ± 4.8 weeks. The mean gestational age and the mean birth weight of Group 1 were statistically lower than Group 2 (p<0.05). There were no significant differences in horizontal corneal diameter, central corneal thickness, and axial length between the two groups (p>0.05). The presence of ROP in premature infants does not alter the horizontal corneal diameter, central corneal thickness, or axial length.

Role of amnioseal in premature rupture of membranes

Interleukins (ILs) and matrix metalloproteinases actually target collagen IV in the amniochorion in premature rupture of membranes (PROM), IL-10 acts as a membrane protector. In order to counteract the immunological system involved in the pathogenesis, we have used a combination of proapoptotic bax gene P-53 inhibitor, myristoleate, with antimicrobial peptides, neutrophil defensins, and cytokine IL-10 enhancer. A comparative prospective randomized study was conducted from July 2006 to January 2007 in patients (46 cases and 60 controls) attending the Gynecology and Obstetrics Emergency Department, Eden Medical College, Kolkata, complaining of leakage per vagina in their antenatal period between 24 and 36 weeks of gestation. Combination of bax gene inhibitor, antimicrobial peptides, neutrophil defensins, and IL-10 enhancer in scheduled protocol was prescribed and cases followed up as per fixed protocols. In the 24–30 weeks group, mean prolongation of gestational age was 6.16±3.21 as against 2.66±1.05 (significant), while in 31–36 weeks mean prolongation was 4.69±0.84 as against 4.6±0.632 (significant). In the first group mean birth weight in cases was 1.77±0.66 kg as against 1.2±0.43 kg (significant), while in the second it was 2.18±0.56 kg as against 1.76±0.45 kg (significant). Associated complications were less in cases. Combination of bax gene inhibitor, antimicrobial peptides, neutrophil defensins, and IL-10 enhancer as per scheduled protocol can be advocated routinely in PROM barring a few situations with excellent fetal and maternal prognosis.

Shoulder Dystocia: What is the Risk of Recurrence?

Shoulder dystocia is a unpreventable obstetric emergency complicating 0.19-3.3% of deliveries. Although a large number of potential risk factors for shoulder dystocia have been investigated, only in about one quarter of cases has at least one significant risk factor has been found, and the positive predictive value of antepartum factors individually and combined is low: <2% and <3%, respectively. There are few data on the risk of recurrence of shoulder dystocia in subsequent pregnancies and on the identification of women at risk of recurrence. Because the predisposing factors for the initial dystocia might be present in all subsequent pregnancies, it is assumed that previous shoulder dystocia is a risk factor for recurrence. This retrospective study evaluated the risk of recurrence of shoulder dystocia and investigated potential risk factors for recurrence in a population of Lebanese women. The investigators used medical records and charts to identify 193 women with shoulder dystocia (0.9%) among a population of 22,207 who had vaginal deliveries between 1990 and 2005. Of the 193 women with a first episode of shoulder dystocia, subsequent vaginal delivery occurred in 44 cases (index pregnancy). Recurrent shoulder dystocia was found in 11 cases (11/44, 25%). The investigators compared pregnancy characteristics among index pregnancies who developed recurrent shoulder dystocia (group I, n = 11) and those with no recurrence (group II, n = 33). No significant difference was found between the two groups for gestational age at delivery, parity, maternal age, duration of labor, gender, history of macrosomia, and obesity. The only significant differences between these groups were a larger mean birth weight for group I compared to group II (4019 ± 430 versus 3599 ± 398 gm, P ≤ 0.005); a higher percentage of women in group 1 with larger birth weight than in their prior pregnancy (72.7% versus 33.3%, P ≤.035); and a higher rate with macrosomia (≥4000) gm in group I (63.6% versus 15.2%, P ≤.004). Among these variables in multiple logistic regression analysis, the only independent risk factor associated with recurrence was larger birth weight in subsequent pregnancy (P ≤.008). The data show that the risk of recurrence of shoulder dystocia is about 25% in this study population, a rate higher than in previous studies. The investigators conclude that a lower birth weight than the previous pregnancy and absence of macrosomia (<4000 gm) may lower the risk.

Congenital diaphragmatic hernia: influence of associated malformations on survival.

The medical records of 116 consecutive cases of congenital diaphragmatic hernia (CHD) among 368,772 live births at the three maternity hospitals in Dublin were examined and the incidence of associated malformations and their impact on survival analysed. The patients were divided into two groups: group I included 64 (55%) patients who died during resuscitation and stabilisation before surgery at a mean age of 11.2 hours and group II included 52 (45%) patients who were operated upon. All patients in group I underwent detailed postmortem examination as did the 45% patients who died in group II. The mean (SD) gestational age for group I patients (36.1 (4.5) weeks) was significantly lower than the mean gestational age of group II patients (39.0 (2.4) weeks). Similarly, the mean birth weight of group I patients (2415 (906) g) was significantly lower than that of group II patients (3140 (563) g). Of the newborns who died before surgery, 40 (62.5%) patients had 79 associated malformations. The major associated anomalies were: cardiac (n = 16), neural tube defects (n = 15), skeletal (n = 8), chromosomal (n = 5), urinary tract (n = 6), gastrointestinal (n = 3), omphalocele (n = 4), craniofacial (n = 5), pulmonary (n = 2), and syndromes (n = 2). Sixteen (40%) of these patients were found to have multiple anomalies. Of the 52 patients who were operated upon, only four (7.7%) had associated malformations. Our data shows that associated malformations in neonates with CDH is a major factor influencing outcome in this congenital malformation.

514 THE INFLUENCE OF SOCIOECONOMIC FACTORS ON THE OCCURRENCE OF FETAL ALCOHOL SYNDROME

Although alcoholism is widespread among women in the reproductive age group of all socioeconomic levels in U.S., FAS has been reported almost exclusively from poor families. This study compares the incidence of FAS in the children of two distinct income groups of chronic alcoholic mothers. These two groups consisted of mothers and their offspring. Group I; 36 mothers and 109 offspring from Hollingshead' & Redlich's classification of class I-II, and group II; 48 mothers and 133 offspring from class V. Several parameters were studied. There was a highly significant difference in the incidence of FAS among the two groups; 4.5% of children in group I, and 70.9% children in group II had full or partial FAS. The mean birth weight of group I children was -ISD, while group II fell into -2SD. Other parameters studied including neonatal complications, congenital malformation rate, failure to thrive, small head circumference, mental retardation, developmental lag and number of hospitalization were all significantly greater in group II children. 21% of group I children, and 71% of group II children had attention deficit disorder. Children, over the age of 12 showed a high incidence of alcohol abuse (28% in group I, 75% in group II). There was a drop in educational level in both groups, as compared with their mothers. In conclusion, partial and full FAS were more prevalent among the low socioeconomic classes.