European Journal of Molecular & Clinical Medicine

Background: Deficiency of pulmonary surfactant is one of the most important factors contributing to the development of respiratory RDS [1]. In immature lungs, the elevated surface tension resulting from surfactant deficiency leads to alveolar collapse at the end of expiration, atelectasis, uneven inflation and regional alveolar over distension. Improved use of antenatal steroids, labour room CPAP, trial of CPAP before intubation and caffeine have changed the way a preterm baby with RDS is managed in the last decade. Many babies with RDS who used to receive prophylactic or early rescue surfactant are now managed with CPAP alone, others are administered surfactant only if they fail CPAP. But, in this process of trial of CPAP, a few babies receive surfactant as “late rescue” after few hours of trial of CPAP. Objective: To evaluate factors determining long duration of respiratory support (CPAP/ventilation > 120 hours) in VLBW babies in Indian NICU.
Aims and Objectives: To evaluate factors determining long duration of respiratory support (CPAP/ventilation > 120 hours) in VLBW babies in Indian NICU.
Material and Methods: A prospective longitudinal study was conducted at RDJM Medical College, Muzaffarpur, Bihar, India from October 2021 to September 2022. All legally viable preterm babies < 32 weeks and < 1500 grams (inborn or out born admitted within 2 hours of birth) were included in the study. A total of 50 Babies were included in the study.
Results and Observations: Out of 50 babies 9 babies were excluded from analysis due to major malformation in 6 and referral of 3 cases. A definite association was noted between gestation (86% of<28 weeks 46% of 29-30, 18% of 31-32 weeks babies, p=0.02) and long duration of respiratory support. Boys vs girls (61% vs 32%, p=0.06), babies born after spontaneous labor vs delivery for maternal/fetal reasons (67% vs 32%, P0.06) were likely to require long duration of respiratory support

Background:
Aims: The aim of my study is to evaluate the maternal and perinatal outcomes in pregnant women with Sickle cell anemia and Thalassemia.
Material and methods: The present study was undertaken in Mamata General Hospital with an aim to know the occurrence of sickle cell anemia and thalassemia in antenatal women and to evaluate the maternal and perinatal outcome.
Results: Out of the 30 women considered for the study, 20 had sickle cell disease and 10 had thalassemia. Most common age group was between 21-25years of age in both groups of women with 85% and 50% in each respectively. Mean age is 23±2years. Contracted pelvis was the indication in 17% in SCD. However abnormal color doppler study was the indication in 8% of SCD women and 17% in women with thalassemia. Maternal request and abruption were the indications in 8% each in SCD group. The need for transfusion was seen in about 45% of the SCD women and in 30% of the women with thalassemia. The incidence of Low birth weight of <2.5kg was among the most probable cause for neonatal morbidity in 40% of the neonates born under in each group with SCD and thalassemia.  There was 5% intrauterine fetal death and another 5% of the women had intrauterine growth retarded babies.  In thalassemia the most common fetal complications were neonatal jaundice in 30%, low birth weight in 20% and respiratory distress in 20% respectively.  The perinatal outcome in the 20 neonates born to women with SCD, 80% neonates were alive, intrauterine death was seen in 5% and neonatal deaths were 15%. Whereas in 10 neonates born to thalassemia women 70% of the neonates were alive and 30% neonatal deaths were recorded. Among the study group, the most preferred mode of family planning for the women with SCD in the present study was permanent sterilization in 50%. Next most preferred modality was injectable (DMPA) in 45%, and remaining 5% opted for barrier method of contraception.
Conclusion:   The obstetric outcome in women with Sickle-cell disease showed significant maternal morbidity. However though low in prevalence, the obstetric outcome in the group of women with thalassemia had low incidence of complications when compared to pregnancies with SCD. However both the groups were prone to neonatal morbidity and mortality.

Introduction:Early onset neonatal sepsis (EONS) remains a major cause for neonatal mortality
and morbidity.To reduce neonatal mortality due to neonatal sepsis, preventive strategies are
better than therapeutic measures. AIM:To identify maternal and foetal risk factors associated
with early onset neonatal bacterial sepsis (EONS), in babies born in a rural teaching
hospital.Methodology –During the study period, using simple random sampling method, total
204 neonates were selected. Of them, only 172 mothers of neonates (134 controls, 38 EONS
cases) gave written informed consent.Results- The birth weight was significantly low in babies
who developed EONS (mean weight 2.39± 0.8) compared to that of the control group(mean
weight 2.83±0.6).The Mean APGAR score at 5 minutes was significantly low in babies who
developed EONS (7.15± 1.03) compared to that of the control group (9.3±0.9).Late preterm (GA
32 to 36 weeks) was a risk factor for EONS. Prematurity was significantly associated with
EONS. Pregnancy domicile area of the mother was not associated with development of sepsis.
Conclusion-Ambuuse, Laryngoscope use, Oxygen use, ET intubation in the delivery room were
not associated with EONS risk. Baby not undergoing or not needing gastric lavage in the
delivery room was a protective factor against EONS

Introduction: Early onset neonatal sepsis (EONS) remains a major cause for neonatal mortality and morbidity.To reduce neonatal mortality due to neonatal sepsis, preventive strategies are better than therapeutic measures.
AIM:To identify maternal and foetal risk factors associated with early onset neonatal bacterial sepsis (EONS), in babies born in a rural teaching hospital.
Methodology –During the study period, using simple random sampling method, total 204 neonates were selected. Of them, only 172 mothers of neonates (134 controls, 38 EONS cases) gave written informed consent.
Results- The birth weight was significantly low in babies who developed EONS (mean weight 2.39± 0.8) compared to that of the control group(mean weight 2.83±0.6).The Mean APGAR score at 5 minutes was significantly low in babies who developed EONS (7.15± 1.03) compared to that of the control group (9.3±0.9).Late preterm (GA 32 to 36 weeks) was a risk factor for EONS. Prematurity was significantly associated with EONS. Pregnancy domicile area of the mother was not associated with development of sepsis.
Conclusion-Ambuuse, Laryngoscope use, Oxygen use, ET intubation in the delivery room were not associated with EONS risk. Baby not undergoing or not needing gastric lavage in the delivery room was a protective factor against EONS.Keywords: Neonatal sepsis, Low birth weight, preterm babies.
 

Background: The objectives is to Screening of all the antenatal pregnant women for
thyroid dysfunction, To study the maternal and fetal noutcome in pregnancy thyroid
dysfunction, To provide adequate treatment and there by reduce adverse outcome,
Follow up of cases six weeks post partum.
Materials and Methods: Prospective, observational study. 110 patients were included.
The study was conducted at Department of Obstetrics and Gynecology (OBG), Modern
Govt MaternityHopsital, Petlaburz attached to Osmania Medical College, Hyderabad,
Telangana, India during the period from 1st December 2019 to 30th June 2021.Mothers
attending for ante-natal check-up and having either a detected or documented thyroid
dysfunction. An Institutional Ethics Committee approval was obtained. Written
informed consent was obtained from all the study participants. The mothers during
their first visit were included for detailed history, clinical examination and blood
investigations as follows.
Results: No age related influence in the presence of thyroid dysfunction, there was no
statistical significance. it was observed that 68% of abortions were in primigravida, it
was found that with increase in gravida abortion rate was less. the mode od delivery
had no significant variations in both hypo/hyperthyroidism. it was noted that
subclinical hypothyrid and overt hypothroid cases resulted in more preterm deliveries
than hyperthyroid patients.the study showed no significance difference in newborn
thyroxine levels among thyroid dysfunction groups.
Conclusion: The study showed that thyroid dysfunction is more among the pregnant
women. Hypothyroidism is the major thyroid dysfunction among the antenatal women.
The women with thyroid dysfunction had more incidents of adverse outcomes of
pregnancy like increased abortion rates, caesarean deliveries on the mothers and
preterm babies and lbw on the newborn.

Background:To determine the number of women with asymptomatic bacteriuria
(Group A) and the number of women with symptomatic bacteriuria (Group B) (Group
B). To identify the most common pathogenic organism in women with asymptomatic
bacteriuria. To compare the outcomes of pregnancies in groups A and B (maternal and
foetal morbidity).
Materials and Methods: Pregnant women visiting the antenatal clinic of the Department
of Obstetrics and Gynecology in Govt Medical College/General Hospital Suryapet for
the first time in 20 weeks to 36 weeks were the subjects of this prospective study.
Results: The study included 250 pregnant women starting at 20 weeks of gestation.
Urine culture and sensitivity testing were performed to check for asymptomatic
bacteriuria. Asymptomatic bacteriuria was found in 8.8 percent of the study population.
E.Coli was the most common pathogen, accounting for 63.63 percent of all cases.
Asymptomatic bacteriuria was associated with increased maternal morbidity (18.18
percent ). Those who did not have asymptomatic bacteriuria had lower morbidity (9.1
percent ). Fetal morbidity was higher (21.4 percent) in kids whose mothers had
asymptomatic bacteriuria than in those whose mothers did not have silent bacteriuria
(9.3 percent ). Preterm labour was the most prevalent maternal morbidity (18.18
percent), while low birth weight was the most common foetal morbidity (18.18 percent ).
There was no maternal or foetal death.

Background: To determine the clinical value of first trimester and second-trimester
uterine artery Doppler indices in the prediction of adverse pregnancy outcome
(preeclampsia, IUGR, unexplained stillbirths).
Materials &Methods:This was a prospective study in which uterine artery Doppler was
performed at 22-24 weeks of gestation 100 high-risk women attending antenatal OPD at
Dr psims & rf in the first trimester between 11 to 13 weeks6days POG for early
pregnancy scan and uterine artery Doppler, followed with second-trimester uterine
artery doppler at the time of anomaly scan 18 to 20weeks from June 2019 to June 2020.
Results: Among the high-risk women in the present study the risk factors are chronic
hypertension (40%), precious pregnancy (10%), overt DM (12%), previous history of
preeclampsia (15%),RPL(10%),SLE (7%), twins (3%), oligohydramnios (3%).
Abnormal uterine artery Doppler indices had the highest sensitivity (100.0%) for
predicting preeclampsia in the mother and the lowest sensitivity (51.4%) for predicting
preterm. For predicting pre-eclampsia, IUGR, neonatal mortality, preterm the
sensitivity of RI was 100%,85.7%,83.3%,51.4% respectively, and the specificity was
92.3%,100%,95.8%,100% respectively. Overall, 35 (35.0%) women had a preterm
delivery, 16 (36%) had a cesarean delivery, and 19 (61%) had a spontaneous vaginal
delivery. Among the preterms, 18(51.4%) died due to prematurity and its associated
complications. The positive predictive value of abnormal uterine artery Doppler was
highest for preeclampsia (36.84%) among all adverse pregnancy outcomes assessed.
Conclusion: Uterine artery Doppler ultrasonography at 22-24 weeks of gestation is a
significant predictor of at least one adverse pregnancy outcome, with the highest
prediction for preeclampsia.

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.

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.