Hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery

Objective: To determine the frequency of hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery

Study Design: Cross sectional study

Place and Duration of Study: Neonatal Intensive Care Unit [NICU], Military Hospital Rawalpindi, from Dec 2011 to Jul 2012

Material and Methods: We included 383 small for gestational age [SGA] neonates admitted in NICU. Blood glucose levels were checked in all neonates. Variables included in study were gestational age, gender, birth weight and mode of delivery

Results: Out of 383 SGA neonates enrolled by non-probability consecutive sampling, 191 [49.87%] were males and 192 [50.13%] were females. Out of these 203 [53%] were preterm, 165 [43.08%] were delivered at term and 15 [3.92%] were post-term SGA neonates with mean gestational age of 34 weeks 5 days. Out of the total 383 SGA neonates 208 [54.31%] developed hypoglycemia during stay in NICU and 175 [45.69%] remained euglycemic

Extremely low birth weight [ELBW] neonates were at highest risk to develop hypoglycemia[82.35%]. It was seen that SGA neonates delivered by instrumental vaginal delivery had highest risk of developing hypoglycemia i.e. 20 [76.92] out of 26 neonates. Out of 103 vaginal deliveries 41 [39.81%] had hypoglycemia and out of 254 Caesarean section 147 [57.87%] had hypoglycemia

Conclusion: Low birth weight neonates delivered by instrumental vaginal delivery were found to be at a higher risk of developing hypoglycemia

Frequency of intraventricular hemorrhage in premature infants

To determine frequency of IVH in premature infants delivered at Military Hospital Rawalpindi. Descriptive study. The study was conducted in the Neonatal Intensive Care Unit at Military Hospital Rawalpindi. From September 2006 to February 2007. In this study 100 premature babies were included. High frequency ultrasound was used for evaluating IVH because of its non-invasive nature, easy availability and conveniences. A total of 100 babies were included in the study. Sixty-one babies were delivered by spontaneous vaginal delivery [SVD] while 39 babies by lower segment cesarean section [LSCS]. Mean gestational age was 32.3 +/- 2.12 weeks. Mean birth weight of the babies was 1637.7 +/- 349.25 grams. Total 11 cases of IVH were detected in study. Frequency of IVH was 11% in premature infants. We suggest that any premature infant born before 32 weeks gestation or weighing <1500g should be evaluated for IVH by cranial ultrasound

Abdominal epilepsy

Abdominal epilepsy [AE] is a rather uncommon clinical entity in children that might create diagnostic confusion especially when it lacks the typical manifestations of an epileptic seizure. We report the case of a young boy having apparently unexplained episodes of paroxysmal abdominal symptoms with no other suggestion of an underlying epileptic disorder. The case also explains how the clinical presentation can be misleading unless a high index of suspicion is maintained to reach the ultimate diagnosis