Small Neonates Research Articles

Gradual exacerbation of obstetric constraints during hominoid evolution implied by re-evaluation of cephalopelvic fit in chimpanzees.

Under the obstetrical dilemma hypothesis, sexual dimorphism in pelvic shape is a solution to accommodate high fetopelvic constraints. It is therefore unclear why chimpanzees display a human-like pattern of pelvic sexual dimorphism despite having easier births enabled by small neonates and capacious pelvic canals. Here we reassessed chimpanzee fetopelvic fit using three-dimensional simulations, revealing a similarly constricted midpelvis as in humans, with even narrower outlet dimensions. Geometric morphometric analyses confirm that female chimpanzees have larger pelvic canals than males despite a smaller body size and a morphology that maximizes pelvic dimensions favourable for parturition, particularly in smaller-bodied individuals. Together with evidence for increased neurological immaturity at birth relative to monkeys, our findings imply substantial obstetric constraints in chimpanzees and possibly other apes. We therefore propose that difficult birth did not arise abruptly in Homo with increasing encephalization but evolved gradually through a series of obstetric compromises from an already constricted birth canal shared across anthropoid primates. Specifically, we propose that obstetric selection pressures exacerbated incrementally with the stiffening of the symphysis that accompanied body size increase in hominoids, while subsequent adaptations to bipedalism shortened the ilium. The resulting contorted birth canal required obligatory fetal rotation, thus greatly increasing birth difficulty.

A swallowing and breastfeeding intervention programme for small and sick neonates embedded in kangaroo mother care.

Available evidence of oral sensorimotor interventions for small neonates is not strong. Evidence of interventions for sick term neonates is largely lacking. Studies are limited by risk of bias and inconsistency. Evidence of interventions relying on a single stimulation technique only appears to be low to very low. Ongoing research is required.Contribution:We describe a five-component neonatal swallowing and breastfeeding intervention programme embedded in the practice of kangaroo mother care (KMC). Drawing on oropharyngeal physiology, neonatology, neurodevelopmental care, breastfeeding- and KMC science, the programme is the product of collaboration between a speech-language therapist and a medical doctor, and their team. Its implementation is dependent on coaching mothers and the neonatal care team. Researchers are invited to determine outcomes of the programme.

Challenges Faced by Midwives who Care for Neonates in Neonatal Intensive Care Units of Public Hospitals in Limpopo Province, South Africa

Background Providing quality neonatal care is one of the most challenging healthcare service issues globally. Ensuring quality care during pregnancy and delivery is paramount to improving health outcomes and reducing mortality among neonates. About 2.9 million neonatal deaths occur worldwide, accounting for 40% under 5 years’ deaths. Midwives in the neonatal intensive care units of public hospitals in Limpopo province encounter challenges such as shortage of staff, inadequate and malfunctioning equipment, etc. when rendering care to small and sick neonates. Objective The purpose of this study was to explore and describe the challenges encountered by midwives who provide care to neonates at neonatal intensive care units of Public hospitals in Limpopo province, South Africa. Methods A qualitative, explorative, descriptive and contextual research designs were used. A non-probability purposive sampling was employed to select twelve (12) midwives who constituted the sample. The sample size was not pre-determined, however, it was determined by data saturation. Data were collected through one-on-one semi-structured interviews using an interview guide. Tesch’s eight steps were utilised to analyse data wherein themes and sub-themes emerged. Results The results revealed that midwives encounter several challenges such as shortage of staff, inadequate infrastructure or structure of NICU, work overload, lack of equipment and supplies, etc., when providing care to neonates in NICUs of the public hospitals. Conclusion The study recommended the implementation of hiring additional staff, staff training in neonatal care specialty and short courses, renovations of NICUs, consistent provision of equipment and material resources to improve the quality of neonatal care and reduce neonatal mortality.

Effects of extrinsic and intrinsic factors on parturition and reproductive output in wolverines

AbstractOne of the selective advantages of delayed implantation in carnivores is the flexibility to decouple the time between mating and parturition, allowing both to occur when conditions are most favorable. Terrestrial carnivores with delayed implantation have evolved reduced maternal energy expenditure through shorter gestation length, smaller neonates, and smaller litters, with a possible linkage between maternal body condition and time of birth or litter size. Using data on wolverine (Gulo gulo) females and cubs from management removals covering the entire latitudinal gradient of the Scandinavian population in 2001‐2022, I assessed the effect of extrinsic and intrinsic factors on variation in parturition date and litter size. Timing of parturition varied over 2 months, where 90% of the litters were born between 5 February and 11 March, with a birth peak on 23 February. Females living in winter grazing pastures of semi‐domestic reindeer (Rangifer tarandus) gave birth earlier than those outside, and along an elevation gradient parturition date was delayed at higher altitudes. I did not find evidence of an effect of latitude on parturition date. Furthermore, older females had greater odds than younger females of having litters with 3 cubs rather than 1 cub. To minimize the risk of harvesting lactating females, management regulations should implement harvest seasons that extend no longer than the end of January.

Preclinical validation of NeoWarm, a low-cost infant warmer and carrier device, to ameliorate induced hypothermia in newborn piglets as models for human neonates.

Approximately 1.5 million neonatal deaths occur among premature and small (low birthweight or small-for gestational age) neonates annually, with a disproportionate amount of this mortality occurring in low- and middle-income countries (LMICs). Hypothermia, the inability of newborns to regulate their body temperature, is common among prematurely born and small babies, and often underlies high rates of mortality in this population. In high-resource settings, incubators and radiant warmers are the gold standard for hypothermia, but this equipment is often scarce in LMICs. Kangaroo Mother Care/Skin-to-skin care (KMC/STS) is an evidence-based intervention that has been targeted for scale-up among premature and small neonates. However, KMC/STS requires hours of daily contact between a neonate and an able adult caregiver, leaving little time for the caregiver to care for themselves. To address this, we created a novel self-warming biomedical device, NeoWarm, to augment KMC/STS. The present study aimed to validate the safety and efficacy of NeoWarm. Sixteen, 0-to-5-day-old piglets were used as an animal model due to similarities in their thermoregulatory capabilities, circulatory systems, and approximate skin composition to human neonates. The piglets were placed in an engineered cooling box to drop their core temperature below 36.5°C, the World Health Organizations definition of hypothermia for human neonates. The piglets were then warmed in NeoWarm (n = 6) or placed in the ambient 17.8°C ± 0.6°C lab environment (n = 5) as a control to assess the efficacy of NeoWarm in regulating their core body temperature. All 6 piglets placed in NeoWarm recovered from hypothermia, while none of the 5 piglets in the ambient environment recovered. The piglets warmed in NeoWarm reached a significantly higher core body temperature (39.2°C ± 0.4°C, n = 6) than the piglets that were warmed in the ambient environment (37.9°C ± 0.4°C, n = 5) (p < 0.001). No piglet in the NeoWarm group suffered signs of burns or skin abrasions. Our results in this pilot study indicate that NeoWarm can safely and effectively warm hypothermic piglets to a normal core body temperature and, with additional validation, shows promise for potential use among human premature and small neonates.

Placentae of small appropriately-grown-for-gestational-age neonates exhibit sexually dimorphic transcriptomic changes representative of placental insufficiency

IntroductionPrevious studies have reported that neonates less than the 25th BWC especially if they were male, were more likely to be associated with birth complications suggesting small neonates often identified as appropriately grown are at risk of adverse outcomes. We have questioned whether smaller neonates not typically categorized as “small for gestational age” may not reach their genetically determined growth due to placental insufficiency. MethodsRNA-Seq was performed on the Illumina NovaSeq 600 using term placentae from neonates that were less than the 10th birthweight centile (BWC) (n = 39), between the 10th and the 30th BWC (n = 15) or greater than the 30th BWC (n = 23). Bioinformatic analyses were conducted and statistical significance was assessed at a level of P < 0.05 for single comparisons or FDR <0.05 unless otherwise noted. ResultsGene set enrichment analysis revealed differences between BWC groups and in relation to the sex of the placenta. Genes associated with hypoxia, inflammatory responses, estrogen responsive genes, and androgen responsive genes were enriched (FDR <0.1) for in placentae of neonates <10th BWC regardless of sex and also in male placentae of neonates between the 10th-30th BWC. Female placenta of neonates between the 10th-30th BWC were comparable to placentae of neonates >30th BWC. DiscussionThese findings provide evidence that small male neonates may be at a greater risk of an adverse outcome than females due to changes in gene expression that are associated with placental dysfunction. The current data raises questions of whether placental pathology for smaller appropriately grown neonates should be scientifically and clinically examined in more depth.

Zero separation policy in small but stable neonates weighing 1500-2000 grams at birth: a single center study in New Delhi, India

Background Small but stable low birth weight (LBW) neonates have needs similar to babies of normal weight with the need for extra support with feeding and temperature maintenance. Most health facilities admit such infants in the neonatal unit leading to the separation of the mother and baby. This separation exposes the infant to a potentially contaminated environment of the Neonatal intensive care unit (NICU) which is hazardous for stable infants (Invasive interventions, Intravenous alimentation, Infections) and also hampers the establishment of breastfeeding. This study evaluated short-term outcomes of stable neonates weighing 1500-2000 grams at birth cared for in the mother-baby unit in the same room. as their mothers as per the ‘Zero-separation Policy’. Methods Neonates born vaginally with a birth weight of 1500-2000 grams with stable vitals were moved with their mothers to a 12-bed ’’mother-baby unit (MBU)“. Mothers were counseled regarding breastfeeding (BF), Kangaroo mother care (KMC), maintenance of general hygiene, and identification of danger signs. Infants developing moderate to severe hypothermia, hypoglycemia, feed intolerance (FI), jaundice nearing exchange transfusion range, respiratory difficulty, sepsis, seizures, or apnea, were moved to a neonatal unit for further management. Results Over 3 years, 489 neonates with a mean (± SD) birth weight of 1738 ± 102 grams and median gestation of 34 weeks (range: 32-41 weeks) were cared for with their mothers at the MBU. Seventy percent of infants exclusively received their mother’s own milk on day 1, which increased to more than 95% from day 4 onwards. Similarly, two-thirds of the mothers provided KMC for at least 5-8 hours on day 1, increasing to 85% by day 5. Neonatal hyperbilirubinemia requiring treatment was the most common morbidity (28.8%), most of which was managed at the bedside, followed by hypoglycemia (4.7%). Only 8% of neonates (n= 39/489) required transfer to the neonatal unit, mostly for hypoglycemia and hyperbilirubinemia. No baby developed hypothermia, apnea, FI, seizures, or hemodynamic instability. Successful discharge to home was accomplished in all neonates with no mortality. Conclusions Zero-separation policy is feasible in clinically stable low-weight or small neonates (of 1500-2000 grams) who can be nurtured with their mothers right from birth, ensuring timely feeding, KMC, and good hygienic practices.

A novel miniaturized adult pacemaker system for small neonates with congenital heart block

A novel miniaturized adult pacemaker system for small neonates with congenital heart block

The adaptive significance of large size at birth in marine snakes.

Evolutionary shifts from one habitat type to another can clarify selective forces that affect life-history attributes. Four lineages of snakes (acrochordids and three clades within the Elapidae) have invaded marine habitats, and all have larger offspring than do terrestrial snakes. Predation by fishes on small neonates offers a plausible selective mechanism for that shift, because ascending to breathe at the ocean surface exposes a marine snake to midwater predation whereas juvenile snakes in terrestrial habitats can remain hidden. Consistent with this hypothesis, snake-shaped models moving through a coral-reef habitat in New Caledonia attracted high rates of attack by predatory fishes, and small models (the size of neonatal terrestrial snakes) were attacked more frequently than were large models (the size of neonatal sea snakes). Vulnerability to predatory fishes may have imposed strong selection for increased offspring size in marine snakes.

A PRELIMINARY INVESTIGATION OF PATHOGEN EXPOSURE OF ADULT FEMALE WHITE-TAILED DEER (ODOCOILEUS VIRGINIANUS) AND SURVIVAL OF ASSOCIATED FAWNS IN THE WESTERN DAKOTAS, USA.

Exposure of a dam to pathogens may potentially affect her fawns positively or negatively. Mammalian females transfer immunologic protection to their offspring via colostrum obtained while nursing. Conversely, chronic diseases in dams may potentially result in small and weak neonates, reduced milk production or quality, or infection. Little is known about how pathogen exposure in adult female white-tailed deer (Odocoileus virginianus) affects offspring survival. Our objective was to assess pathogen exposure for female white-tailed deer and subsequent survival rates of fawns in Dunn and Grant counties, North Dakota, and Perkins County, South Dakota, USA. We collected blood serum from 150 adult female deer during 2014. We compared survival of 49 fawns to maternal exposure to 10 pathogens from 37 of 150 adult females. There was no difference in fawn mass between dams based on antibody status and no difference in fawn survival for nine pathogens. The 12-wk survival for fawns born to mothers with antibodies against bovine herpesvirus 1 (BoHV-1, causing infectious bovine rhinotracheitis) was lower than for fawns born from mothers without antibodies against BoHV-1; however, the indirect or direct impacts of BoHV-1 exposure in mothers on fawn survival are unclear. Although our findings suggest that the cost of exposure to previous diseases may have minimal impact on short-term fawn survival for most pathogens, additional research with increased sample sizes is needed to confirm our findings.

Early Metformin in Gestational Diabetes

Gestational diabetes is a common complication of pregnancy and the optimal management is uncertain. To test whether early initiation of metformin reduces insulin initiation or improves fasting hyperglycemia at gestation weeks 32 or 38. Double-blind, placebo-controlled trial conducted in 2 centers in Ireland (one tertiary hospital and one smaller regional hospital). Participants were enrolled from June 2017 through September 2022 and followed up until 12 weeks' postpartum. Participants comprised 510 individuals (535 pregnancies) diagnosed with gestational diabetes based on World Health Organization 2013 criteria. Randomized 1:1 to either placebo or metformin (maximum dose, 2500 mg) in addition to usual care. The primary outcome was a composite of insulin initiation or a fasting glucose level of 5.1 mmol/L or greater at gestation weeks 32 or 38. Among 510 participants (mean age, 34.3 years), 535 pregnancies were randomized. The primary composite outcome was not significantly different between groups and occurred in 150 pregnancies (56.8%) in the metformin group and 167 pregnancies (63.7%) in the placebo group (between-group difference, -6.9% [95% CI, -15.1% to 1.4%]; relative risk, 0.89 [95% CI, 0.78-1.02]; P = .13). Of 6 prespecified secondary maternal outcomes, 3 favored the metformin group, including time to insulin initiation, self-reported capillary glycemic control, and gestational weight gain. Secondary neonatal outcomes differed by group, with smaller neonates (lower mean birth weights, a lower proportion weighing >4 kg, a lower proportion in the >90% percentile, and smaller crown-heel length) in the metformin group without differences in neonatal intensive care needs, respiratory distress requiring respiratory support, jaundice requiring phototherapy, major congenital anomalies, neonatal hypoglycemia, or proportion with 5-minute Apgar scores less than 7. Early treatment with metformin was not superior to placebo for the composite primary outcome. Prespecified secondary outcome data support further investigation of metformin in larger clinical trials. ClinicalTrials.gov Identifier: NCT02980276; EudraCT: 2016-001644-19.

Evaluation of Ain Shams University Hospitals Clinical Pathway for Pulmonary Artery Banding

Abstract Background Pulmonary artery banding (PAB) remains a useful surgical palliation for small neonates and early infants with excessive pulmonary blood flow who are unable or difficult to withstand an open heart surgery using cardiopulmonary bypass or in developing countries where the facilities not suitable for primary corrective surgery in those infants. Objectives In our current study we aimed to study clinical pathway of cases underwent PAB at ASU hospital pediatric cardiac surgery department with discussion of different causes of mortality and morbidity. Patients and Methods Study done by data collection retrospectively of 50 patients underwent pulmonary artery banding in the period from January 2018 to December 2019 who fulfilling the inclusion criteria with evaluation of different clinical pathways for the outcome mainly morbidities and mortality. Results We found that the major risk factors of mortality in cases underwent PAB in ASU hospitals includes patients diagnosed with TGA, low preoperative so2 ≤85, ventilation is high risk factor for mortality so it is recommended to extubate those patients on table or shortly after discharge to ICU as soon as possible, duration of intubation: the longer the duration of intubation, the higher the mortality, postoperative PG across band ≤45.that indicator for a loose band with still persistent pulmonary overflow, re-intubation, post operative morbidities are highly associated with mortality, 11 out of 12 mortality cases suffered from postoperative complications (91.7 % of mortality cases) that includes poor chest condition, stroke, postoperative convulsions and pulmonary hemorrhage. These morbidities result in prolonged intubation and prolonged ICU stay. Conclusion Pulmonary artery banding is palliative procedure done in infants with pulmonary artery overflow with unprotected pulmonary circulation in variable congenital cardiac diseases (VSD, single ventricle, TGA) as a primary stage for total repair when the infant gain weight and get older, the suitable age for banding is &amp;lt; 6 months.

Early warning for SpO2 decrease by the oxygen reserve index in neonates and small infants.

Continuously assessing the oxygenation levels of patients to detect and prevent hypoxemia can be advantageous for safe anesthesia, especially in neonates and small infants. The oxygen reserve index (ORI) is a new parameter that can assess oxygenation through a relationship with arterial oxygen partial pressure (PaO2 ). The aim of this study was to examine whether the ORI provides a clinically relevant warning time for an impending SpO2 (pulse oximetry hemoglobin saturation) reduction in neonates and small infants. ORI and SpO2 were measured continuously in infants aged <2 years during general anesthesia. The warning time and sensitivity of different ORI alarms for detecting impending SpO2 decrease were calculated. Subsequently, the agreement of the ORI and PaO2 with blood gas analyses was assessed. The ORI of 100 small infants and neonates with a median age of 9 months (min-max, 0-21 months) and weight of 8.35 kg (min-max, 2-13 kg) were measured. For the ORI/PaO2 correlation, 54 blood gas analyses were performed. The warning time and sensitivity of the preset ORI alarm during the entire duration of anesthesia were 84 s (25th-75th percentile, 56-102 s) and 55% (95% CI 52%-58%), and those during anesthesia induction were 63 s (40-82 s) and 56% (44%-68%), respectively. The positive predictive value of the preset ORI alarm were 18% (95% CI 17%-20%; entire duration of anesthesia) and 27% (95% CI 21%-35%; during anesthesia induction). The agreement of PaO2 intervals with the ORI intervals was poor, with a kappa of 0.00 (95% CI = [-0.18; 0.18]). The weight (p = .0129) and height (p = .0376) of the infants and neonates were correlated to the correct classification of the PaO2 interval with the ORI interval. The ORI provided an early warning time for detecting an impending SpO2 decrease in small infants and neonates in the defined interval in this study. However, the sensitivity of ORI to forewarn a SpO2 decrease and the agreement of the ORI with PaO2 intervals in this real-life scenario were too poor to recommend the ORI as a useful early warning indicator for this age group.

Carotid artery cut-down technique for ductus arteriosus stenting.

This study aims to evaluate early and mid-term outcomes of ductal stenting via carotid artery surgical cut-down technique in neonates. Between January 2015 and January 2022, a total of 17 neonates (12 males, 5 females; median age: 14 days, range, 5 to 34 days) who underwent carotid artery surgical cut-down technique for ductal stenting were retrospectively analyzed. Diagnoses of the patients, demographics, procedural success/failure, access-related complications, and neuroimaging findings were recorded. The primary indication for ductal stenting was pulmonary atresia in all patients. All patients who underwent carotid cut-down had vertical anatomy, with or without tortuous ductal anatomy, and they were not suitable for the femoral approach. The median body weight was 3 (range, 2 to 3.4) kg. Fifteen of the 17 interventions (88.2%) were successful. Two patients whose stenting failed underwent a systemic-to-pulmonary shunt operation. The early in-hospital mortality rate was 17.6% (n=3). No neurological or accessrelated complications were observed in any of the patients. Stenting the ductus arteriosus with challenging anatomy is feasible and safe with carotid artery cut-down, particularly in small neonates. Based on our study findings, this technique may offer an effective and less invasive alternative to the systemic-to-pulmonary shunt operation.

Transcatheter Closure of a Coronary Artery Fistula in a Neonate with Tetralogy of Fallot.

Coronary artery-to-pulmonary artery fistulae are a not uncommon finding in patients with Tetralogy of Fallot (TOF) and collateral-dependent pulmonary blood flow. Management for these fistulae is often primary surgical ligation or unifocalization at the time of complete repair, dependent on the presence of dual blood flow to the involved areas. We present the case of a 32-week premature boy weighing 1.79kg with TOF, confluent branch pulmonary arteries, major aortopulmonary collaterals, and right coronary artery to main pulmonary artery fistula. The patient demonstrated evidence of coronary steal into the pulmonary vasculature with an elevation in the troponin level without hemodynamic instability, and subsequently underwent successful transcatheter occlusion of the fistula via right common carotid access using a Medtronic 3Q microvascular plug. This case demonstrates the realistic potential for early coronary steal in this physiology and possibility of transcatheter therapy even in a small neonate.

MORPHOLOGICAL EVOLUTION AND DIAGNOSIS OF BRONCHOPULMONARY DYSPLASIA IN VERY PRETERM INFANTS

Bronchopulmonary dysplasia (BPD) remains one of the most common and severe diseases in very preterm infants, which can cause death. Since the first description of BPD in 1967, not only understanding of the disease’s nature, its definition, classification, epidemiology, features of the clinical course, diagnosis, prevention, treatment, and prognosis but the specific autopsy histopathological features have changed. The primarily reason for these is considered a change in the population of sick and dead infants as a result of improving clinical practice, increasing the survival rates of the most immature neonates, and reducing the incidence of severe BPD forms and the associated mortality.The BPD form that has been described initially is now called "old" BPD and is characterized by significant lung injury. In the smallest neonates, who were treated with exogenous surfactant, the histopathological signs of the disease changed, determining the need to modify the theoretical concept of BPD. The leading feature of the new BPD form was the disorder of lung development and formation, not their injury. Morphologically, this was manifested by a reduced number and simplified structure of acini, changes in the capillary structure with less obvious fibrosis of the lungs. Such morphometric methods as the radial alveolar count and the count of mean number of alveoli intercepts can be used for the histopathological diagnosis of a simplified lung structure. The use of these techniques helps to objectively assess lung growth retardation. Although the number of cases of "new" BPD currently prevails, some autopsies are still characterized by histopathological changes typical for the "old" form of the disease. A combination of classic and new features is also possible. When establishing a pathological diagnosis of BPD, it is essential to consider all specific histopathological changes that may indicate the presence and severity of the disease, as well as its role in thanatogenesis. This is important not only for the correct postmortem diagnosis of BPD, but also for the studying of various disease phenotypes.The article describes the main histopathological characteristic of various BPD forms, as well as methods of evaluating the simplified lung structure.

Definitive repair of pulmonary atresia with ventricular septal defect using valved conduit for low body weight infant

Pulmonary atresia with ventricular septal defect is a complex congenital heart defect whose management varies depending on the anatomy of pulmonary circulation and surgeon’s preferences. The surgical outcomes of complete repair in small infants and neonates in Vietnam have been seldomly reported. We reported our medium-term results of complete repair of this complex lesion using valved conduit in infants and neonates at our institution. The study included 25 patients with the body weight of less than 5kg who underwent definitive repair using valved conduit between January 2016 and December 2021. The median age at surgery was 66 days (IQR 45 – 116 days), and the mean body weight was 4 kg (3 – 5). Most (96%) attended all follow-up visits, and the average follow-up time was 37.4 months (8.4 – 69.3). There was 1 in-hospital death and 2 late mortalities. The 30-days and 5 years survival rate were 96% and 83%, respectively. One patient required conduit replacement at 3 years post operative because of conduit failure. The proportion of patients with freedom from conduit replacement at 5 years was 95%. Three cases required balloon dilatation of the left pulmonary artery due to stenosis. Freedom from all reinterventions and reoperations at 5 years was 52%. Definitive repair of this type of complex heart defect in small infants can be performed safely and resulted in good surgical outcomes.

Chronic Hypertension and Pregnancy (CHAP) Trial Consortium. Treatment for Mild Chronic Hypertension During Pregnancy

(N Engl J Med. 2022;386:1781–1792. doi: 10.1056/NEJMoa2201295) More than 2% of pregnancies are impacted by chronic hypertension (HTN), specifically among black women. Chronic HTN has been correlated with risk for preeclampsia, placental abruption, preterm birth, small-for-gestational-age birth weight, perinatal death, maternal death, heart failure, stroke, pulmonary edema, and acute kidney injury. International organizations recommend extending antihypertensive treatment to patients with severe HTN, but they differ in their recommendations for treating mild HTN because of increased risk of small birth weight neonates. This study identifies the impact of mild hypertensive treatment on adverse pregnancy events up to 2 weeks after birth, placental abruption, and negative perinatal outcomes including birth weight through a randomized assignment to either the mild HTN treatment group or the nontreatment group.

Effectiveness of Video Assisted Teaching Programme on Knowledge and Attitude of Postnatal Mothers regarding Kangaroo Mother Care at Selected Maternity Hospital, Jammu and Kashmir

Background: Kangaroo care also called skin-to-skin contact is defined as a method of holding a small neonate in skin to skin contact, prone and up right on the maternal chest. The neonate is enclosed in maternal clothing in order to maintain temperature stability. Methodology: A quantitative research approach with pre experimental one group pre test post test design was used. 75 postnatal mothers selected by purposive sampling technique admitted at Maternity Hospital SKIMS Soura, Srinagar Kashmir. Results: The mean post test knowledge score (35.20±5.167) of the study subjects was significantly higher than that of mean pre test knowledge score (10.47±4.833) at 0.05 level of significance. There was significant association between selected demographic variables like educational status, occupation and residence with the pre test knowledge score p≤0.05. The mean post test attitude score (57.01±4.557) of the study subjects was significantly higher than that of mean pre test attitude score (33.11±3.443) at 0.05 level of significance. Conclusion: Postnatal mothers had poor knowledge and attitude scores regarding kangaroo mother care. The video assisted teaching programme was found to be effective in improving the knowledge and attitude scores of study subjects, hence there was dire need to educate them regarding kangaroo mother care.

Pneumoperitoneum point-of-care ultrasound findings.

Pneumoperitoneum point-of-care ultrasound findings.