Introduction: Neonatal hypoglycemia is a common metabolic problem which often goes unnoticed due to lack of specific symptoms. It is a common abnormality in low birth weight neonates. It is associated with neurological damage and death when it occurs in the first few days of life. Objective: To assess the demographic characteristics of low birth weight Newborn Admitted in Rajshahi Medical College Hospital, Rajshahi, Bangladesh. Methods: This descriptive, cross sectional hospital based study was aimed to describe the prevalence of hypoglycemia in low birth weight newborn admitted in Rajshahi medical college hospital in 1st 72 hours of life. A total of 264 neonates were enrolled in the study during the period of July 2015 to June 2017. Written informed consent was obtained. Clinical assessment and 72 hours blood glucose were recorded. Serial determination of blood glucose were recorded using glucometer at 1,2,6,12, 18, 24, 36, 48, 60 and 72 hours of age. Any abnormal result was immediately confirmed by the laboratory. Results: In our study we found 9.5% (n=25) Low Birth Weight newborn had hypoglycemia. The occurrence of hypoglycemia was within 1st 0-24 hours in 60% cases (n=15), >24-48 hours in 32% cases (n=8) and >48-72 hours in 8% cases (n=2). In this study male female ratio was 1.1:1. Mean±SD birth weight was 1681.82±301.69 grams and mean gestational age was 31.70±3.60 weeks. In this study majority of mother were <20 years of age and primiparous. Mean±SD maternal age was 19.86±5.960 years and mean± SD maternal weight was 48.23±3.592 kg. There was no significant relationship between increased incidence of hypoglycemia and sex, birth weight, gestational age of the baby and maternal age, maternal weight and parity of the mother. Conclusion: So low birth weight newborn should be kept under close observation and periodic monitoring of blood glucose should be done to avoid risk of hypoglycemia.
ORIGINAL RESEARCH ARTICLE | June 26, 2020
A Study of Perinatal Outcome in Women with Preterm Labour at a Tertiary Care Hospital
Dr. Kavita Chaudhary, Dr. Nupur Hooja, Dr. Premlata Mital, Dr. Urmila Kumari, Dr. Saloni Sethi, Dr. Ankita Chaudhary
Introduction: Preterm labor is the leading cause of neonatal morbidity all over the world. Over the past two decades despite major preventive efforts, the incidence of preterm birth has remained constant at about 5-10% of live births. The etiology is often multifactorial and poorly understood. Neonatal complications which arise from preterm births are birth asphyxia, respiratory distress, low birth weight, infective neonatal hypoglycemia and neonatal death. With this background the present study was done to find out perinatal outcome in women presenting with preterm labour. Material and methods: The present study was a descriptive study conducted in the Department of Obstetrics and Gynaecology. 100 consecutive women presented with preterm labour between 28 to <37 weeks were included in the study after obtaining written informed consent. Mode of delivery and neonatal outcome were noted. Data were compiled and analyzed. Results: Majority of the women were between 20 to 35 years of age, Hindu, Literate, belonging to rural area, low socio-economic status, and had normal BMI. 60% women were primigravida. 65% women had gestational age ≥34 weeks. Mean weight of the babies in our study was 1.7 ± 0.4 Kg and mean APGAR score at 5 min was 7.02 ±1.03. 46% babies were admitted in NICU for various reasons and 12% babies had perinatal death. Most common reason for NICU admission was birth asphyxia (42%) followed by extreme prematurity (16%), septicemia (12%) and jaundice (11%). Conclusion: Appropriate and innovative preventive intervention, customized individuals need may prevent preterm births and improve neonatal outcomes.
ORIGINAL RESEARCH ARTICLE | June 28, 2020
Comparison of Hemoglobin and Hematocrit Concentration between Rh- Hydropic, Non-Hydropic and Control Group; Severe Vs Mild Hydropic Group
Introduction: Maternal RBC alloimmunization results from exposure and response to a foreign RBC antigen. Transplacental fetal to maternal hemorrhage is the most common cause of alloimmunization. Rh incompatibility can lead to either fetuses with hydropic features or non hydropic. The precise mechanism leading to the development of hydrops is not certain. All direct fetal sequelae of hemolytic disease relate to the development of anemia. In general, the fetus tolerates mild to moderate anemia well. However, metabolic complications develop as the anemia worsens. Because the RBC is the principal fetal buffer, a metabolic acidemia with hyperlactatemia develops in fetuses with severe anemia. Objective: To compare the difference in mean hemoglobin and hematocrit concentration between Rh-hydropic, non hydropic and control group and further based on severity of hydrops. Methods: A Total of 40 pregnant patients were enrolled which included 10 hydropic fetuses of Rh isoimmunised mothers, 10 non hydropic fetuses of Rh isoimmunized mothers. Control group included 18 Rh positive women without any fetal complication and 2 fetuses in women undergoing cordocentesis. Blood sampling was done at time of intrauterine transfusion and sent for estimation of hemoglobin and hematocrit in fetal blood. Pregnancies were followed up till delivery and fetal outcome noted. Result: Mean values of haemoglobin in hydrops group are 4.54g %, as compared to 6.65g % and 14.26 g % in non-hydrops and control group. Mean haematocrit in hydropic group is 13.91% as compared to 20.25% and 43.51% in non hydropic and control group. The mean haemoglobin concentration in mild hydrops was 5.17g % as compared to 2.7g % in severe hydrops. Conclusion: There was severe hemoglobin and hematocrit deficit in hydropic fetuses as compared to non hydropic and normal fetuses matched for the gestation age. Thus severity of anemia can be considered a strong marker for development of hydrops in Rh isoimmunized fetuses.
ORIGINAL RESEARCH ARTICLE | June 30, 2020
The Relationship between Vascular Endothelial Growth Factor A (VEGFA) Gene Polymorphism and Pre-Eclampsia in Egyptian Pregnant Women
Sobhy Hassab El-Nabi, Islam El-Garawani, Ayman Elsayed, Heba Salama
Pre-eclampsia (PE) is a complicated heterogeneous disorder associated with an increased risk of maternal death. There is a major variation in the literature about the genetics of pre-eclampsia (PE). This study aims to estimate the association between Vascular Endothelial Growth Factor A (VEGFA) gene single nucleotide polymorphism (rs1570360) and the development of PE in the Egyptian population. Genotyping was performed using the tetra-primer amplification-refractory mutation system (ARMS-PCR) and the results were confirmed by the PCR-RFLP method in 100 patients with PE and 100 PE-free patients. Results revealed that GG (wild type) genotype of rs1570360 was identified in 100 patients, (42%) of them had pre-eclampsia. SNP genotype AA was found in 84 patients and (42%) of them had pre-eclampsia. The frequency of AG genotypes was significantly low (16 %). However, the odds ratio was 40.37 for homozygocity and 9.5 for heterozygous alleles. Our study concluded that the AA and AG genotypes were not associated with PE. There is a significant relationship between the AA allele polymorphism and the severity of PE.
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