Mean Birth Weight Of Neonates Research Articles

Profile of postpartum patients with urinary retention at Koja Regional Hospital, Jakarta, Indonesia

HIGHLIGHTS Maternal age and fetal birth weight are key risk factors for PPUR. Among 300 subjects, 63.7% experienced PPUR, identified using the Suskhan score, with catheterization as a useful tool for prevention and management planning. ABSTRACT Objective: Postpartum urinary retention (PPUR) is a common voiding disorder, defined as the inability to void spontaneously within 6 hours after delivery with a residual bladder volume exceeding 200 mL. High rates of PPUR in Indonesia indicate a need for greater awareness and intervention. This study aims to assess the incidence and potential contributing factors of PPUR among postpartum patients at Koja Regional Hospital in Jakarta, Indonesia. Materials and Methods: A descriptive case-control study was conducted, including women who experienced urinary retention following vaginal delivery at Koja Hospital between September and December 2022. Residual urine volume was measured by catheterization 6 hours after delivery. Data analysis, performed using SPSS version 22, included patient demographics and clinical factors such as maternal age, parity, gestational age, neonatal birth weight, and postvoid residual urine volume. These factors were analyzed to determine their association with PPUR. Results: Out of 300 subjects selected through consecutive random sampling, 63.7% experienced PPUR, while 36.3% had normal urinary function. Patients with a mean age of 26.91 ± 5.02 years (p = 0.000), primiparous status (first-time mothers) (p < 0.001), and a mean neonatal birth weight of 2980.95 ± 450.52 grams (p = 0.000) showed a higher risk of developing PPUR compared to other postpartum patients. Conclusion: The study indicates a significant association between postpartum urinary retention and maternal factors, including younger age, primiparity, and higher neonatal birth weight. Identifying these high-risk factors can enhance PPUR management, allowing healthcare providers to implement targeted monitoring and preventive measures, potentially improving postpartum outcomes in this patient population. This underscores the importance of monitoring these risk factors to better manage and potentially mitigate the incidence of PPUR.

Impact of time interval from cesarean delivery to frozen embryo transfer on reproductive and neonatal outcomes

To evaluate differences in reproductive and neonatal outcomes on the basis of the time interval from cesarean delivery to subsequent frozen embryo transfer (FET). Retrospective cohort. Multicenter fertility practice. Women undergoing autologous elective single embryo transfer FET after prior cesarean delivery. Time from prior cesarean delivery to subsequent FET. live birth (LB). A total of 6,556 autologous elective single embryo transfer FET cycles were included. Frozen embryo transfer cycles were divided into eight groups on the basis of the time interval from prior cesarean delivery to subsequent FET in months. A secondary analysis was then performed with time as a continuous variable. The proportion of LBs did not differ significantly across all time interval groups and over continuous time (range: 40.0%-45.6%). The mean gestational age at the time of delivery did not significantly differ as the time between prior cesarean delivery and subsequent FET increased (range: 37.3-38.4). When time was evaluated continuously, the proportion of preterm births was higher with a shorter time between cesarean delivery and subsequent FET. The mean birth weight ranged from 3,181-3,470g, with a statistically significant increase over time. However, the proportions of extremely low birth weight, very low birth weight, and low birth weight did not significantly differ. There were no significant differences in reproductive outcomes on the basis of the time interval from cesarean delivery to FET, including LB. The proportion of preterm deliveries decreased with a longer time between cesarean delivery and FET. Differences in mean neonatal birth weight were not clinically significant because the proportion of low birth weight neonates was not significantly different over time. Although large, this sample cannot address all outcomes associated with short interpregnancy intervals, particularly rarer outcomes such as uterine rupture. When counseling patients, the timing of FET after cesarean delivery must be balanced against the risks of increasing maternal age on reproductive and neonatal outcomes.

Correlation Of Placental Changes With Fetal And Maternal Outcome In Mothers With Hypertensive Disorders Of Pregnancy

Hypertension represents one of the most prevalent complications encountered during pregnancy, significantly contributing to both maternal and perinatal morbidity and mortality. The placenta, acting as a crucial feto-maternal organ, plays a pivotal role in sustaining pregnancy and fostering the healthy development of the fetus. Notably, the weight of the placenta holds functional importance, as it correlates with the villous surface area and fetal metabolism. Motivated by this context, the present study endeavors to examine the morphological and histological alterations in the placenta associated with hypertensive disorders of pregnancy and to assess their correlation with maternal and fetal outcomes. Methods: A prospective investigation encompassing 120 cases was conducted, comprising 60 normotensive mothers (Group A) and 60 mothers with hypertensive disorders of pregnancy (Group B). Placental specimens obtained from these participants were subjected to morphological and histological analyses, with subsequent correlation with maternal and fetal outcomes. Results: Our findings revealed a notable reduction in placental weight and dimensions within Group B compared to Group A. Histopathological examination unveiled a significant increase in the incidence of syncytial knots, fibrinoid necrosis, hyalinization, and calcification in placentas from the hypertensive group, directly correlating with neonatal complications. Furthermore, the mean neonatal birth weight was significantly higher in Group A compared to Group B. Conclusion: Hypertensive disorders of pregnancy exert a substantial impact on placental morphology, leading to diminished weight and dimensions, indicative of placental insufficiency attributable to compromised utero-placental blood flow. These alterations ultimately influence neonatal weight and overall neonatal outcomes. Our study underscores the presence of distinct morphological changes in the placenta that detrimentally affect fetal growth.

Evaluation of the factors associated with anemia in neonates admitted to the Neonatal Unit of Maiwand Teaching Hospital: A cross-sectional study

BackgroundWhile anemia has been associated with severe outcomes in neonates, there is a lack of scientific data regarding the associated factors of this problem in newborn babies of Afghanistan; hence, this study was undertaken to fill that gap. The objective of this study was to evaluate the factors associated with anemia in neonates who were admitted to the Neonatal Unit. MethodsThis analytic cross-sectional study with retrospective document review was conducted at the Neonatal Unit of the Maiwand Teaching Hospital in Kabul City, Afghanistan, in 2023. SPSS 26 and certain statistical methods were used to carry out the statistical analysis. ResultsOf the 220 newborns enrolled in this study, anemia occurred in 26.8% of them. Based on gestational age, the occurrence rates of neonatal anemia within groups of term and preterm neonates were 23% and 41.3%, respectively. The occurrence of neonatal anemia was found to be 60% in extremely low birth weight, 41.2% in very low birth weight, 27.2% in low-birth-weight neonates, and 23.9% in normal birth weight neonates. The neonates in the anemic group versus the non-anemic group had a mean birth weight of (2516.18 ± 898.79 vs 2749.62 ± 766.02 g, P = 0.03, 95%CI= -691_-9.9), a mean gestational age of (35.47 ± 3.7 vs 37.4 ± 2.5 w, P = 0.04, 95% CI= -1.6_ -0.9), a mean age of (11.41 ± 6.39 vs 9.9 ± 6.88 days, P = 0.35, 95%CI= -1.6_4.6), a mean CRP level of (13.6 ± 7.6 vs 9.8 ± 5.6 mg, P = 0.01, 95%CI= 0.8_7.8) and a mean hemoglobin level of (11.1 ± 1.7 vs 17.3 ± 2.5 g, P = 0.04, 95%CI=-7.4_-5.1). There was a significant association between neonatal anemia and preterm birth (OR=2.4, P = 0.04, 95%CI=0.08_0.5), male sex (OR=2.4, P = 0.04, 95%CI= 0.1_0.3), neonatal sepsis (OR=2.5, P = 0.01, 95%CI= 0.1_ 0.6), cesarean delivery (OR=3.4, P = 0.00, 95%CI=1.7_6.5), maternal age greater than 35 years (OR=2.9, P = 0.03, 95%CI=0.04_0.6), no iron intake by the mother during pregnancy (OR=1.9, P = 0.002, 95%CI=1.1_3.4), antepartum hemorrhage (OR=4.7, P = 0.00, 95%CI=1.3_10.3), and poor household income (OR=2.6, P = 0.03, 95%CI=0.03_0.2). ConclusionsNewborns admitted to the Neonatal Unit had a significant prevalence of neonatal anemia. The highest occurrence rates were seen within groups of preterm and extremely low-birth-weight newborn babies. Neonatal anemia was found to be associated with lower mean neonatal birth weight and gestational age, as well as with preterm birth, male sex, a higher CRP level, neonatal sepsis, older maternal age, cesarean delivery, no maternal iron consumption, antepartum hemorrhage, and a poor household income.

Neonatal Birth Weight With Daily Compared With Every-Other-Day Glucose Monitoring in Gestational Diabetes Mellitus: A Randomized Controlled Trial.

To assess whether universal use of every-other-day glucose monitoring in patients with gestational diabetes mellitus (GDM) resulted in similar birth weights and medication use and was preferred by the patient compared with traditional daily glucose monitoring. This was a noninferiority randomized controlled trial conducted at a single New York City hospital between April 2021 and May 2022. Patients with singleton pregnancies who were diagnosed with GDM after 20 weeks of gestation and had a minimum of 7 days of previous daily blood glucose testing were randomly assigned to test blood glucose values daily or every other day. The primary outcome was neonatal birth weight. We calculated a total sample size of 196 participants needed for noninferiority to be tested, assuming the mean birth weight in the every-other-day group, compared with the daily group, was no higher than the predefined noninferiority margin of 200 g (80% power and one-sided alpha of 0.05). Postrandomization characteristics, including blood glucose values and medication initiation and timing, were recorded. Satisfaction with treatment group was assessed using the validated Oxford Maternity Diabetes Treatment Satisfaction Questionnaire. A total of 197 patients were randomized: 98 in the daily group and 99 in the every-other-day group. Baseline characteristics were similar between groups. The mean neonatal birth weight was similar between groups (mean±SD 3,090±418 g among newborns in the daily group compared with 3,181±482 g among newborns in the every-other-day group). For the primary outcome, the every-other-day group was found to be noninferior to the daily group with an upper confidence limit for the mean difference in mean birth weight of 197 g, which was below the noninferiority margin of 200 g ( P =.046). Postrandomization, there were no significant differences in the number of patients who required medication, the gestational age at which medication was started, or the type of medication used. Average fasting and postprandial glucose values were similar between groups. There was an increase in adherence to treatment group in those randomized to every-other-day blood sugars, but no difference in patient satisfaction. In patients with GDM, testing blood glucose values every other day was as effective as testing daily, without apparent effects on birth weight, medication initiation, or glucose control. Reduced frequency of blood glucose monitoring might help decrease the emotional, physical, and financial burden experienced by patients with GDM. ClinicalTrials.gov , NCT04857073.

Efficacy of Mannitol in the Management of Cerebral Oedema in Hypoxic Ischemic Encephalopathy Stage-II following Perinatal Asphyxia in a Tertiary Level Hospital

Background: The use of mannitol in reducing cerebral edema in case of perinatal asphyxia in Hypoxic Ischemic Encephalopathy Stage-II is considerably contributing.
 Objective: To find out the efficacy of mannitol in reducing cerebral edema in Hypoxic Ischemic Encephalopathy Stage-II following perinatal asphyxia.
 Methods: It was a prospective observational study done in the Paediatric department of Shahid Suhrawardy Medical College Hospital, Dhaka from September 2016 to February 2017. According to inclusion criteria total 120 neonates were included in this study by purposive sampling. Among them, 60 neonates were selected as case (treated with mannitol) and 60 were taken as control (treated without mannitol). Data were collected in a structured questionnaire.
 Results: During the study period, a total of 120 patients were studied. In the study group (Group -A), 78.33% were delivered by LUCS whereas in Group-B, the figure was 66.6%. The mean birth weight of neonates of these two groups were 1.9 + 0.76 kg and 1.73 + 0.89 kg respectively. PROM, APH, malpresentation, and multiple gestation were statistically significant risk factors in both groups (P=<0.05). About 79.67% neonates of group-A (with mannitol) and 70% of group-B (without mannitol) had radiological improvement following treatment revealing no statistically significant difference (P= >0.05).
 Conclusion: From the result of the present study, it can be concluded that there is no significant difference in the management of cerebral edema following perinatal asphyxia with HIE stage-II between the groups treated with mannitol and without mannitol.
 J Shaheed Suhrawardy Med Coll 2022; 14(1): 12-15

APGAR SCORE: COMPARISON OF GENERAL ANAESTHESIA VS SPINAL ANAESTHESIA

Caesarean section is a common obstetric operation performed to save the lives of both the mother and baby. This study aimed to compare the APGAR score of neonates in patients who received general anesthesia or spinal anesthesia during the procedure. For this prospective randomized controlled trial, 160 ASA class I and II patients who underwent elective caesarean section at 37 weeks or more of gestation were selected. The patients were randomly divided into two equal groups, A and B, with 80 patients in each group. Group A received spinal anesthesia with a 25-gauge pain spinal needle using hyperbaric bupivacaine 1.5ml, while Group B received general anesthesia with an endotracheal tube. After the baby's delivery, the APGAR score was assessed at 1 minute and recorded on a proforma. The results showed that the mean APGAR score at 1 minute in group A was 8.49, while in group B, it was 6.53. The mean age in group A was 30.09 ± 3.35 years, and in group B, it was 29.86 ± 3.16 years. The mean birth weight of neonates in group A was 2999.80 ± 275.78 grams, while in group B, it was 3066.25 ± 281.66 grams.In conclusion, the study found that the APGAR score was better in spinal than in general anesthesia.

Estimation of Foetal Weight by Ultrasonography and Neonate at Birth

Background: Ultrasonography intervention in delivery is highly sensitive and primary important for further tests of foetal well-being. Objective: The purpose of the present study was to observe the correlation of estimated foetal weight with neonatal birth weight. Methodology: This was a cross-sectional study on patients at the Labour Ward of Department of Obstetrics and Gynaecology at Sir Salimullah Medical College and Mitford Hospiptal, Dhaka, Bangladesh for six months. The women were selected who had normal pregnancy with early ultrasounographic examination for confirmation of gestational age, singleton live foetus, ultrasound examination for pregnancy profile done within 3 days before delivery. A sonographic foetal weight was estimated by using measurements of foetal body parts-biparietal diameter, abdominal circumference and femoral length. To measure the femur length, first a projection was made that shows a transverse section of one of the long bones, then scan at 900 to this to obtain a longitudinal section. Results: A total number of 100 patients were recruited for this study. The mean (±SD) sonographically estimated foetal weight was 3074±534gm with ranged from 2100 to 4100 gm. The mean (±SD) neonatal birth weight was 2978±466 gm with ranged from 2500 to 3800 gm (p<0.05). Sonographically estimated foetal weight less than 3000 g were correlated with neonatal birth weight. Out of the 100 cases 57(57.0%) cases had less than 3000 g estimated foetal weight and 43(43.0%) cases had 3000 g or more than 3000gm estimated foetal weight Sonographically. Among the 57 cases, which were less than 3000 g by Sonographically, 41 cases were less than 3000 g and 16 cases were found 3000 g or more than 3000 g in neonatal birth weight. Conclusion: Ultrasonography has definite value in the diagnosis of estimated foetal weight and can be regarded as a sensitive and specific imaging modality for pre-operative discrimination of the pregnant women. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):42-47

Association of Maternal Vitamin D levels with Neonatal Birth Weight

Objective: To determine Vitamin-D levels of mothers and comparing these levels with birth weight and head circumference of newborns. Methods: It was a cross sectional analytical study conducted in the Department of Obstetrics and Gynaecology, Central Park Medical College, Lahore. A total of 100 pregnant females admitted for delivery in our hospital and their newborns were included in the study. Maternal blood sample was collected immediately after delivery for measurement of 25-(OH)-vitamin D level. Newborns were physically examined and their birth weight and head circumference was recorded immediately after birth. All the information was recorded on a pre-designed . Newbornsproforma were categorized into two groups, neonates with birth weight >2500gm and neonates with birth weight <2500gm. Mothers were categorized according to their Vitamin D status as deficient, insufficient and sufficient. Maternal Vitamin-D status was correlated with neonatal birth weight. SPSS 23.0 was used to analyze the data. Results: Mean maternal vitamin D level was 22.74 ng/ml . Mean gestational age at delivery was 38 weeks and 6 days. 44% of the mothers had vitamin-D deficiency, 36% had vitamin-D insufficiency, while only a small percentage of 20% had sufficient Vitamin D levels. Mean neonatal birth weight was 2.99 Kg. 14 % of all the newborns had low birth weight(<2500gm). Mean maternal Vitamin D level of low birth weight neonates was significantly lower as compared to the mothers who gave birth to normal weight neonates. Chi square analysis signified the reverse relationship between maternal Vitamin D status and head circumference of the new born (p-value <0.001). Conclusions: Maternal Vitamin D deficiency could have a negative effect on overall neonatal health outcome by increasing the risk of low birth weight. Awareness programs and Vitamin supplementation should be introduced in antenatal health care to prevent adverse neonatal outcomes.

TRENDS OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE CENTRE IN URBAN INDIA

Introduction: Retinopathy of prematurity is the leading cause of preventable blindness in premature infants. Our study aims at nding the Incidence and severity of Retinopathy of prematurity (ROP) and its association with various risk factors like low gestational age, low birth weight, oxygen exposure, respiratory distress syndrome, sepsis, blood transfusion and intraventricular hemorrhage. This is a prospective observational study conducted in a tertiary ca Methods: re teaching hospital in Western Maharashtra. Patient data including systemic and ocular ndings were documented. Incidence and severity of ROP was calculated and the association of various risk factors with ROP was calculated using Chi-square test. Among the 266 babies i Results: ncluded in study, the Incidence of ROP was found to be 13.50% and Type I disease was found in 1.31%. The mean birth weight of neonates with ROP was 1230.2 ± 479.5 g and the mean gestational age was 30.27 ± 2.87 weeks. Development of ROP was signicantly associated with low gestational age (GA), low birth weight (BW) and Respiratory Distress Syndrome (RDS). Early screening of preterm babies is crucial Conclusion: for early diagnosis and treatment of ROP to prevent its sight threatening complications

Frequency of Hypomagnesemia in Neonates presenting with Hypocalcemia in a Tertiary Care Hospital

Background: Hypocalcemia is a common neonatal occurrence, especially in neonates with high-risk including those babies born to diabetic mothers, neonates with perinatal asphyxia and premature babies. High calcium consumption can reduce magnesium absorption, while low magnesium intake can boost calcium absorption. Aim: To assess the frequency of hypo-magnesemia in neonates presenting with hypocalcemia in a tertiary care hospital. Design study: Cross sectional study. Methodology: Total 160 fulfilling the inclusion criteria at Services Hospital, Lahore were enrolled through non-probability convenience sampling. Gestational age, birth weight, gender and feeding pattern) were noted. Blood sample was obtained by using 3cc BD syringe and 20G butterfly needle with the help of a nurse under sterile measures. All clotted samples were stored and sent to the Pathology lab for the assessment of magnesium level. Reports were assessed and if magnesium level<0.7mmol/L, then hypomagnesemia was labeled. Data was evaluated by using SPSS v.24. Quantitative data was presented as mean±SD. Qualitative data was presented as frequency and percentage. Chi-square test was applied with P-value ≤0.05 taken as significant. Results: In this study, there were 75 (46.9%) male and 85 (53.1%) female neonates. The mean gestational age of neonates was 39.20±1.63weeks. The mean birth weight of neonates was 2.5±3.0kg. There were 46 (28.8%) who were on exclusive breast feeding, 55 (34.4%) were on formula feed while 59 (36.9%) were on both; breast and formula feed. The mean magnesium level of neonates was 0.90±0.63mmol/L. There were 113(70.6%) neonates with hypomagnesemia while 47 (29.4%) had normal magnesium level. Practical Implication: Literature has reported that the frequency of hypomagnesemia is high in neonates with hypocalcemia. In Pakistan there is little local evidence available in this regard. The information gained through this study will help to improve our clinical practice and to update guidelines for early screening and management of infants with hypocalcemia with co-existence hypomagnesemia. Conclusion: It was concluded that the frequency of hypo-magnesemia was high in neonates with hypo-calcemia in local population. Keywords: Prevalence, Calcium, Electrolytes Imbalance and Neonates.

Association of Urinary Tract Infection with Preterm Labor in Gravid Females in a Tertiary Care Hospital

Objective: To compare the frequency of preterm labour in pregnant patients with and without urinary tract infection in a tertiary care hospital in Punjab.
 Study Design: Cross-sectional comparative study.
 Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital, Lahore Pakistan, from Jul 2019 to Jan 2020.
 Methodology: Three hundred and eighty-five pregnant women were inducted into the study. The midstream urine sample was collected from patients between 24-28 weeks of gestation with complaints of burning micturition and was sent for microscopic examination. Urinary tract infection was diagnosed on the urinalysis report. Patients were followed till delivery.Patients were labelled as preterm who delivered neonates <37 weeks of gestation.
 Results: In this study, the mean age of the patients was 25.2±3.0. The majority of the patients were para 1-2. The mean body mass index was 25.3±1.9 kg/m2. Urinary tract infection was found in 12 patients (3.2%), and preterm labour occurred in 52 patients (13.5%). The mean birth weight of neonates was 3.0±0.5kg. A comparison of preterm labour in patients with and without urinary tract infections revealed that patients with urinary tract infections were associated with preterm labour (p<0.001).
 Conclusion: Urinary tract infection during pregnancy significantly impacts pregnancy outcomes, mainly preterm labour and low birth weight.

Low Dose Aspirin for Primary Prevention of Adverse Pregnancy Outcome

Background: Pregnancy is associated with various complications such as pre-eclampsia, SGA, preterm birth etc. Low dose aspirin is a possible medication to minimize these adverse outcomes. The aim of this study was to evaluate the use of low dose aspirin for primary prevention of adverse pregnancy outcome. Material Methods: This cross-sectional study was conducted in department of Gynaecology, North Bengal Medical College Hospital, Mirjapur Bkash Hospital, Mirjapur, Tangail, Bangladesh, during the period from June 2021 to August 2022. Total 200 pregnant women were included in this study. Results: In this study, the mean (±SD) age of the study subjects were 25.12 ± 5.49 years and 25.00 ± 4.83 years in LDA group and control group, respectively. There was no statistically significant (p>0.05) difference in age between the groups. The rate of caesarean section was higher in control group (68%) compared to LDA group (59%) but there was no statistically significant (p>0.05) difference among the groups. In our study, 8% pregnant women in LDA group and 19% pregnant women in control group had gestational hypertension, pre-eclampsia was seen in 6% and 13% pregnant women in LDA group and control group, respectively, preterm birth was seen in 8% and 17% pregnant women in LDA group and control group, respectively, SGA was seen in 19% and 32% pregnant women in LDA group and control group, respectively, and fetal distress was seen in 2% pregnant women in both LDA group and control group. There were statistically significant (p<0.05) differences in complications except fetal distress. Mean (±SD) neonatal birth weight was 2.88±1.03 kg and 2.74±0.85 kg in LDA group and control group, respectively and there was no statistically significant (p>0.05) difference. Conclusion: We found that low dose aspirin could significantly reduce the risk of adverse outcomes, especially for pre-eclampsia, SGA and preterm birth.

Evaluation of Intracranial Abnormalities by Transcranial Ultrasound in Neonates- An Observational Study

Introduction: Intracranial abnormalities include hydrocephalus, intracranial haemorrhage and related hypoxic-ischemic damage, for which diagnosis can be confirmed by the transcranial ultrasound. Apart from this, transcranial ultrasound may also be helpful in screening of suspected intracranial infections and tumour. Various studies have demonstrated high sensitivity and specificity of transcranial ultrasound in detecting various intracranial abnormalities. Aim: To evaluate the efficiency of ultrasonography in the diagnosis of intracranial abnormalities in neonates. Materials and Methods: This observational cross-sectional study was conducted in the Department of Radiodiagnosis, SBKS MIRC Sumandeep Vidyapeeth, Piparia, Vadodara from February 2019 to August 2020. Forty neonates with abnormal neurological presentation were included in the study and detailed data regarding prenatal, perinatal and postnatal period was obtained from parents and entered in questionnaire. Length, weight was noted. Further, all the neonates were subjected to relevant blood investigations such as Complete Blood Count (CBC), blood glucose and other investigations depending upon the clinical findings. All the neonates were then subjected to transcranial ultrasonography. Results: In present study, mean gestational age of 40 neonates was 35.38±3.59. Male preponderance was noted in present study with male:female ratio of 2.08:1. Mean birth weight of neonates was 2.11±0.60. Most common mode of delivery was vaginal in 57.5% cases followed by Lower (uterine) Segment Caesarean Section (LSCS) in 27.5% cases. Antenatally, steroids are given in only 25% of the cases in present study. Most common clinical manifestation was seizures and lethargy. Transcranial ultrasound revealed germinal matrix hemorrhage in majority of neonates. Conclusion: Transcranial ultrasound is recommended in every high risk neonate as a first line modality to assess the presence of intracranial abnormalities and for timely referral to higher- centres. It is quick, inexpensive, portable, non invasive and free from ionising radiation.

Impact of Family Participatory Care on Neonates- A Non Randomised Interventional Study

Introduction: Family Participatory Care (FPC) is a unique concept which involves parents in caregiving to their admitted babies. It helps in defining the family's role in clinical care delivery to newborns along with doctors and nurses. The Neonatal Intensive Care Unit (NICU) is the ideal area for FPC to take place because of the unique and vulnerable nature of the mother-neonate relationship as neonates that are admitted, face immense trials from their first day of life. Aim: To know the effect of FPC on outcome of admitted neonates, analyse the impact of this model on breastfeeding rate and to compare the rate of Kangaroo Mother Care (KMC) being given to neonates at follow-up. Materials and Methods: It was a non randomised interventional study done from August 2020 to April 2021, in the NICU at Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India. Two hundred neonates, who were sequentially admitted and later discharged, were taken into account, out of which, first 100 were taken as controls and next 100 were taken in the intervention group. Routine treatment and care were given to all the admitted neonates. In addition to this, parents of the study group of newborns were given education through four audio-visual sessions, comprising hygiene measures for entry into nursery, correct method of breastfeeding, KMC and then care at home after discharge. Follow-up was done after one week of discharge and at six weeks of age. Outcome measures were breastfeeding rate and KMC rate which were compared between two groups, at discharge and at follow-up of six weeks of age. Results: The mean birth weight of neonates, mean gestational age and the socioeconomic status were comparable in both the groups. Mean duration of hospital stay was 7.13 (±4.95) days in study group and 8.06 (±5.40) days in control group (p=0.206). Mean weight at discharge and that at six weeks was comparable in both groups. However, the average weight gain per day was significantly higher (25.61 g) in the study group than the control group (18.92 g). At discharge, 92 babies in the control group and 87 in the study group were given exclusive breastfeeding or expressed breast milk with spoon feeding. At six weeks follow-up, this number was 91 in the study group and 70 in the control group (p=0.001). KMC was given to all the neonates at discharge who had birth weight less than two kg. Among them, at the time of follow-up, 33/36 in the case group and 5/37 in the control group were receiving KMC (p-value 0.001). Conclusion: FPC is feasible and effective model in terms of better neonatal outcome.

Histopathological Changes of Placenta in Maternal Hypertensive Disorders and its Association with Birth Weight: A Case-control Study

Introduction: One of the most common complications during pregnancy is hypertension. It leads to pathological changes which reduce the placental blood flow. Hypertensive disorders are strongly associated with foetal growth restriction, prematurity, lower foetal birth weights and contribute largely to perinatal mortality and morbidity. Aim: To study the histomorphological changes of placenta in cases of maternal hypertensive disorders and compare it with normal controls as well as find out its association with neonatal birth weight. Materials and Methods: A case-control study was conducted at the Department of Pathology of a Tertiary Care Hospital, Faridabad, Haryana, India. Duration of the study was 2 months from July to August 2018. This study is a part of Indian Council of Medical Research (ICMR) Short Term Studentship (STS) scheme for MBBS students. Control group was formed by 30 placenta of full term deliveries without any complications and 30 placenta of the females presenting with hypertensive pregnancies formed the case group. Specimens of placenta were studied in detail for morphological and histological changes. Neonatal Birth weight was recorded just after delivery of all the cases and controls. Analysis of statistical difference between the means of both groups was performed using student unpaired t-test. The data obtained was entered in Microsoft excel sheet and statistically analysed using Epi Info version 7. Results: Mean maternal age for cases was 28.60 years and controls were 25.23 years. This association was found to be significant. Mean for gestational weeks at the time of delivery was 34.93 weeks in cases and 37.20 weeks in controls (p-value <0.0001). Average placental weight in cases was 410.20 grams and in controls was 480.80 grams (p-value <0.001). Histopathological changes comprised of Syncytial knot formation, Cytotrophoblasts proliferation, proliferation of endothelial lining of capillaries, stromal fibrosis, calcification, hyalinisation of villi and infarction were comparatively more frequent in cases (n=30). Mean neonatal birth weight was found to be 2809.67±128.32 grams in control group as compared 2427.67±152.22 grams in cases (p-value <0.001). Conclusion: During pregnancy significant histomorphological changes in placenta are caused due to hypertensive disorders which lead to harmful and severe foetal outcomes. A valuable insight into the mechanism of placental dysfunction can be achieved through a detailed examination after delivery.

Clinical Characteristics of Pregnant Women with Sars-Cov2 Infection in the 3rd Trimester of Pregnancy

Objectives: The aim of our study is to present the cclinical characteristics of pregnant women with SARS-COV2 infection in the 3rd trimester of pregnancy. Methods: We retrospectively reviewed the medical records of all pregnant women from March to December 2020 in Infanta Leonor University Hospital, in Madrid. Infected women during the 3rd trimester of pregnancy or at delivery time with SARS-CoV2 diagnosis composed infected group, and non-infected women with SARS-CoV2 composed non-infected group. The infection status was determined via RT-PCR of nasopharyngeal swab specimen. Women in our study were not vaccinated because in the first and second waves of the epidemic the indication for vaccination in pregnant women was not clear. Results: 1262 non-infected pregnant women and 86 SARS-CoV2 positive pregnant women were admitted to our clinic during the study period. Within the group of infected pregnant women, they were 49 cases (56.98 %) symptomatic and 37 cases (43.02 %) asymptomatic. In the group of symptomatic infected women, the majority were mild cases (80.23 %). In the group of uninfected pregnant women, the main complication was gestational diabetes 14 (1.09 %) We did not find any complications during pregnancy in case group. Cesarean section was performed in 16.67 % of the infected pregnant women and in 21.71 % of the control group. Mean neonatal birth weight was 3.240 g in case group and 3.210 g in non-infected group. Neonatal admission to NICU was 9.52 % in cases while in the control group was 1.19 % being the most frequent reason for admission due to respiratory distress syndrome. Conclusion: SARS-CoV2 infection in pregnant women in the third trimester does not worsen the prognosis of pregnancy in our study, although metaanalyses suggest heightened risk of COVID-19 severity and adverse pregnancy and perinatal outcomes among women with certain demographic and health profiles.

Near Infrared Light Source Versus Naked Eye Visualization for Establishing Intravenous Access in Neonates: A Randomized Control Trial

Objective: To compare efficacy of near infrared light (NIR) versus naked eye (NE) visualization for intravenous access in the neonates. Methods: This was a randomized controlled trial carried out in a tertiary care center in New Delhi, India from 2015 to 2017. A total of 480 admitted neonates, who required placement of intravenous catheter were randomized to receive intravenous access attempt with NE group or using NIR source group. Primary outcome was first attempt success rate of establishing intravenous access. Secondary outcomes were to compare the time to establish intravenous access, number of pricks taken, and cost of consumables used.Results: Of 240 neonates in each group the mean birth weight of neonates in NE group and NIR group being 1665 ± 820 grams and 1600 ± 778 grams, respectively (p-value = 0.363). Mean gestational age of neonates were 31.78 ± 3.9 weeks in NE group and 31.79 ± 3.9 weeks in NIR group (p-value= 0.972). First-attempt success rate in NE group and NIR group was 122 (50.8%) and 124 (51.7%) respectively. The median(IQR) of time taken to establish intravenous access was 37.5 (13- 134.7) sec and 43 (17-221.2) sec in the NE group and NIR group, respectively (p-value = 0.307). There was no significant difference between the groups for secondary outcomes. Conclusion: Use of NIR source as compared to NE visualization, for establishment of intravenous access in neonates, does not improve first attempt success rate. Keywords: Near Infrared Light, Neonate, Vein Viewer. Clinical Trial Registry #: CTRI/2017/01/007693

The Association of Maternal Height With Mode of Delivery and Fetal Birth Weight at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Study Objectives: The aim of this study was to find if there is an association between maternal height and mode of delivery, as well as an association between maternal height and baby’s weight as a secondary outcome.Method: This retrospective record review was performed at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, including patients admitted between January 2016 to December 2017. All nulligravida with singleton term pregnancies who gave birth were included in this study. Pregnant women with planned elective cesarean section (CS) and incomplete records were excluded. The maternal demographic and clinical data (age, height, weight, hypertension, gestational diabetes (GDM), body mass index (BMI), smoking status, gestational age, regional analgesia during delivery, type of delivery, postpartum hemorrhage (PPH), and episiotomy), neonatal birth weight, and Apgar score were obtained from KAUH computerized records. Our primary outcome was the mode of delivery. The secondary outcome was the classification of neonatal weight into small for gestational age (SGA), appropriate for gestational age (AGA), or large for gestational age (LGA). Maternal height was divided into seven groups. Descriptive statistics using mean and standard deviation were used for continuous variables. Frequencies and percentages were used for categorical variables. Student's t-test and chi-square tests were used to evaluate the differences between continuous and categorical variables.Result: A total of 1067 women were included in this study. Most were at 40 weeks of gestation age (14.9%) with a mean height of 156.4±6.2 cm. Of the total, 76.9% were spontaneous vaginal delivery without operative assistance, 15.9% were delivered via CS, and 7.2% delivered vaginally with the assistance of forceps or ventouse. The mean neonatal birth weight was 2994 ± 451 gms with most neonates (87.3%) having a birth weight between 2500 and 4000 gms. Most babies were of average weight for their gestational age at delivery. There was a significant negative association between maternal height with CS (p=0.017). Moreover, there was a correlation between maternal height and the baby’s birth weight (p=0.01), and we found that for every 1 cm increase in women’s height, the baby's weight increases by 12.8 gms.Conclusion: Our study didn’t find an association between maternal height and vaginal delivery or operative vaginal delivery. However, there was an impact of maternal height on CS delivery. Therefore, we suggest screening for short maternal height as they have an increased risk of having an emergency CS. In our secondary outcome, we found a positive association between maternal height and baby's birth weight.

The association between chronic liver diseases and preeclampsia

BackgroundPreeclampsia is a multisystem disorder characterized by an abnormal vascular response to placentation associated with increased systemic vascular resistance. As liver involvement is one of the main clinical features of preeclampsia, we sought to determine if there is an association between chronic liver diseases and preeclampsia.MethodsA retrospective matched case–control analysis was conducted in a tertiary medical center. Three hundred eleven (311) pregnant women with preexisting chronic liver disease (study group), including viral and autoimmune hepatitis, non-alcoholic fatty liver, Wilson disease, and cirrhosis, were match for age, parity, and number of fetuses to 933 healthy pregnant women (control group). The primary outcome measure was the incidence of preeclampsia in each group. Secondary outcome measures were obstetrical and neonatal complications. Confounders found to be significant on univariate analysis were evaluated using logistic regression models, and odds ratios (OR) and confidence intervals (CI) were calculated.ResultsPreeclampsia was diagnosed in 28 women (9.0%) in the study group and 33 women (3.54%) in the control group (p < 0.001).On multivariate analysis adjusted for maternal age, parity, previous preeclampsia, chronic hypertension, gestational diabetes mellitus, pregestational diabetes mellitus, antiphospholipid syndrome, and mode of conception, chronic liver disease was found to be an independent risk factor for preeclampsia (aOR 2.631, 95% CI 1.518–4.561). Although there was no difference in the gestational week at delivery between the groups (38.6 ± 2.13 vs. 38.8 ± 2.17 for study and control group, respectively, p = 0.410), the study group had a lower mean neonatal birthweight (3088 ± 551 vs. 3182 ± 566 g, p = 0.011). There were no between-group differences in the other parameters evaluated.ConclusionIn our study, preexisting chronic liver disease was associated with a 2.6-fold increased risk of preeclampsia.