Online ISSN: 2515-8260

Keywords : Preterm


Outcomes Of Surfactant Therapy In Newborns With Respiratory Distress Syndrome In Relation To Age Of Presentation To NICU Of MGM Hospital

Dr. Mendu Shyam prasad, Dr. Tangedpally Swathi Reddy, Dr. Anitha chikati, Dr.K Sri Harsha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2686-2696

BACKGROUND:RDS is usually defined by the presence of acute respiratory distress with disturbed gas exchange in a preterm infant with a typical clinical course or x-ray.The main risk  factor for RDS,by far,is prematurity.The central feature of RDS is surfactant deficiency due to lung immaturity,commonly due to prematurity.Surfactant replacement therapy reduces mortality and several aspects of morbidity in babies with RDS.
METHODS:Newborns with RDS were intubated with endotracheal tube and surfactant was administered.The first dose of surfactant was given as early as possible to the preterm infants requiring MV for RDS then extubated and connected to nasal CPAP.The mortality,morbidities were compared.
RESULTS:Among the 150 preterms who were recruited in this study, outcomes of surfactant therapy is discussed in correlation with the time of presenation,hour of installation of surfactant,birth weight,gestational age,size for gestational age, severity of RDS,surfactant doses,length of hospital stay,type of assisted ventilation,duration of assisted ventilation,duration of supplemental oxygen,complications with surfactant therapy.We found that surfactant replacement therapy has a beneficial effect.
CONCLUSION:Out of 150 preterms with RDS who are more than 31 weeks of gestation,more than 1500 grams,appropriate for gestational age,Singleton neonates,mild and moderate respiratory distress,and who received single dose of surfactant with RDS, had better outcome and discharged.45.3% of the preterm new born who were given surfactant had fatal outcome.Only 54.7% of preterm newborns who were given surfactant have discharged.

Study of Outcome of HIV Infection Among Pregnant Females in a Tertiary Care Hospital of Kumaon Region

Geeta Jain, Himani Davar, Mamta Sountiyal, Mahima Rani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2004-2008

Background: Low birth weight, premature birth linkage with maternal HIV infection
has been reported by some studies. The study was done to estimate seroprevalence, the
socio-demographic profile and its outcome in HIV among pregnant females.
Materials and Methods: A total of 24 HIV positive pregnant females were registered in
which 18 delivered (total- 5400) at Obstetrics and Gynaecology Department, Dr. Sushila
Tiwari hospital, Haldwani during study period Dec 2019- Nov 2021. Seroprevalence,
demographic profile, pregnancy outcome and fetal complications of HIV infection were
described using frequency, percentages, mean, standard deviation using Microsoft
Excel software.
Results: The seroprevalence of HIV among pregnant females was 0.33%. Low birth
weight was seen in 25% newborns, 20.8% newborns were preterm. In present study, 1
(4.2%) new born each had NICU admission, congenital anomaly, IUD and 1 was still
born.
Conclusion: Adverse foetal outcome in forms of low birth weight, preterm birth, NICU
admission, congenital anomaly, IUD and still born was seen in HIV positive pregnant
females.

MATERNAL AND FETAL OUTCOME IN TWIN PREGNANCY IN TERTIARY CENTER

Neha Majotra, Aakanksha Mahajan, Rishu Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 12100-12109

Background: Multiple births are much more common today than they were in the past. The incidence of twin gestation has increased mainly due to advanced maternal age and assisted reproductive technology Throughout the world, the prevalence of twin births varies from approximately 2-20 /1000 birth. This delayed childbearing has resulted in an increased maternal age at conception. Twin gestation is considered as high-risk pregnancy as it contributes significantly to adverse maternal and perinatal outcomes. This study was conducted to evaluate the risks of pregnancy complications and adverse perinatal outcome in women with twin pregnancy. Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries.
Materials and Methods: Present study is a retrospective study of 223 cases of twin pregnancies admitted at our institute from Sept 2020 to Oct 2021 including all emergency as well as registered cases. In all cases a detailed history was taken, all routine and specific investigations were done. We studied maternal factors like age, parity, complications, mode of delivery and perinatal morbidity and mortality. Main outcome measures were maternal complications (i.e., anaemia, preterm labour, pregnancy induced hypertension, postpartum haemorrhage etc.) perinatal morbidity and mortality.
Results: In this retrospective study we observed 223 cases of twin pregnancies. In this study most of the patients (45.7%) delivered at 37- 42 weeks of gestation. 5% of patients had abortion at an early gestation. Majority of the patients delivered vaginally (51.56%), followed by LSCS (Lower Segment Caesarean Section) (48.43%). In this study low birth weight babies were the most common (138 babies) to the extent of 73.29%. We had 0.05% (13) extremely low birth weight babies. There were 38 neonatal deaths. We observed the highest incidence of twins in the age group of 26-30 years. The least were below the age of 20 years.
Conclusions: Most of the complications in multiple gestations can be prevented. High risk units in the obstetric ward and well developed NICU set up would reduce the maternal, perinatal morbidity and mortality. Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.

THE EFFECT OF 3 REGIMENS (0.3MG VS0.5MG VS 1MG.I.M.) OF VITAMIN K1PROPHYLAXIS AT BIRTH ON VITAMIN K STATUS IN PRETERM AND/OR VLBW INFANTS

Dr.Charanraj Honnalli, Dr.K.Srinivasan Dr.Preeti Amarkhed,Dr.Giridhar Sethuraman

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1978-1985

Vitamin K deficiency of the newborn has the potential risk of Vitamin K deficiency-related bleeding (VKDB) between birth and up to six months.Vitamin K deficiency may cause unexpected bleeding during the first week of life in previously healthy appearing neonates (early vitamin K deficiency bleeding [VKDB] of the newborn. Sequentially Numbered, Opaque Sealed Envelopes (SNOSE) method as described by Doig, G.S et al. has been used for allocation concealment in the study. The allocated intervention sequence was kept in individual, serially numbered sealed opaque covers and was kept under the custody of a senior faculty of the department but not involved in the study or patient care. The proportion neonates, who had Necrotizing Enterocolitis (NEC) (≥ Stage 3 by Modified Bell staging) was 4.2%, 11.5% and 8.0% in intervention group A, B and C respectively. The difference in this proportion was statistically not significant (P value 0.631). The proportion neonates, who had pulmonary hemorrhage was 0.0%, 7.7% and 4.0% in intervention group A, B and C respectively. The difference in these proportion was statistically not significant (P value 0.382).
 

Clinical profile and risk factors of retinopathy of prematurity (ROP) in central Indian population

Dr. Vipin Thakur, Dr. Rashmi Randa, Dr. Shweta Sharma, Dr. Madhuri Tejwani, Dr. Amit Agarwal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3505-3514

Background: Retinopathy of prematurity (ROP) is a potentially blinding disorder of the neonates seen mostly in preterm neonates.
Objective: To study the incidence, risk factors, clinical profile and immediate outcome of neonates with ROP after screening.
Method: A prospective observational study was carried out among 336 neonates at Gandhi Medical College, Bhopal from January 2018 to June 2019. After recording detailed history of mother and neonate, eye examination and screening were performed.  Prevalence, epidemiology, clinical profile, risk factors and outcomes of ROP were assessed.
Results: The incidence of ROP in the present study was 19.94%, 31.3% babies developed stage 1 ROP, 26.8% developed stage 2 ROP, 23.3% had stage 3 ROP, 13.4% had stage 4 ROP and 5.97% had stage 5 ROP. Of the 67 babies who developed ROP 35.82% babies had spontaneous regression of ROP and developed mature retina whereas 64.18% babies required treatment of ROP.
Conclusion: Our study concludes that low birth weight, gestational age, oxygen administration, duration of oxygen exposure, mechanical ventilation, respiratory distress syndrome, surfactant use, sepsis, blood transfusion, bronchopulmonary dysplasia, and apnoea are the risk factors which play a significant role in development of ROP.

Feasibility of Transcranial Ultrasound as a Screening Tool for Hypoxic Ischemic Injury in Preterm Infants

Shehata SM, Taema MI, Omar Gamal Abdelaziz, Mohammed AA

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3907-3914

Background:Preterm neonates less than 37 weeks of gestational age are more liable to both
hemorrhagic and ischemic injuries due to vascular, cellular and anatomical features of
developing brain and physiological instability due to limited cerebral circulatory autoregulation,
Cranial ultrasoundis a safe imaging modality with no need to radiationexposure or sedation.
Aim and objectives:To verify the role of transcranial ultrasound as a screening tool for hypoxic
ischemic injury for preterm infant(below 37 weeks of gestation).
Subjects and methods:This cross sectional descriptive screening study was carried out at Radiodiagnosis
department upon 165 preterm neonates admitted to the neonatal intensive care unit
(NICU). It was conducted from April 2020 to Mars 2021 and designed to include all neonates
born before 37 GW after obtaining institutional review board approval from our university and
informed consent from the parents.
Results:Among all studied preterm 30.9% had abnormal cranial US findings, the commonest
abnormalities found were hemorrhage (47%), followed by hypoxic ischemic injury (41.1%) then
hydrocephalus among (25.4%).
Conclusion:We recommend screening for all preterm babies for hypoxic ischemic injuries. If
routine screening is not feasible in all newborns born under 37 weeks of gestational age, a
targeted screening for infants with at least one risk factor may be useful.