ABSTRACT
Neonatal subgaleal hemorrhage is a rare but potentially lethal complication of instrumental delivery, particularly vacuum extraction. It is often underreported and underdiagnosed. The prevalence of subgaleal hemorrhages varies from 0.04 to 0.15% of all deliveries. We describe two cases of severe subgaleal hemorrhage [SGH] and review the key elements of identification and treatment. The first case was a female neonate with birth weight 2220gr that was born by vacuum assisted vaginal delivery. At birth, the infant was pale, flaccid with no respiratory effort. She was grossly pale with poor perfusion, lethargic, decreased muscle tone, anemia, and hypovolemic shock. On her head a large fluctuant swelling was seen. She died at 20[th] hours of age. The second case was a full term male neonate that was born with cesarean section after an unsuccessful 2 to 3 time vacuum extraction. At birth the infant was limp, cyanotic with weak respiratory effort. After 7[th] hours, a severe fluctuant swelling was found on his head with head circumference of 38.5 cm and ecchymosis around his orbits. He developed anemia and seizure. After successful treatment, he was released from hospital. Increased awareness of SGH should lead to earlier identification, referral and treatment with resultant improved outcomes
Subject(s)
Humans , Male , Female , Hematoma , Infant, Newborn , Anemia, NeonatalABSTRACT
To determine the etiology and pathogenesis of enuresis among primary school children by using a special ultrasound [US] protocol for the assessment of bladder dysfunction and to compare excretion of urinary sodium and calcium in enuretic children. We conducted this cross sectional study on 66 enuretic children aged 6-12 years from September 2005 to January 2006 in Isfahan University of Medical Sciences, Iran. Ultrasound [US] was designed for the evaluation of bladder parameters using bladder volume and wall thickness index [BVWI%], and expected percentage bladder volume index for kidney volume. Sixty children [90.9%] had nocturnal enuresis, 5 [7.5%] had diurnal enuresis and one child [1.6%] had nocturnal and diurnal enuresis. Urinary infection was detected in one child [1.5%]. The incidence of urinary system abnormalities was 10.6% in all enuretic children. Hypercalciuria was seen in 9.2% and natriuresis in 20.3%. Normal bladder function [BVWI 70% to <130%] was seen in 67%, small bladder with a thick wall [BVWI <70%] in 27% and large bladder capacity with a thin wall [BVWI >130%] was seen in 6% of children with primary nocturnal enuresis [PNE]. There was a significant difference in BVWI between children with PNE and secondary nocturnal enuresis [P=0.01]. Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Our results show that US measured bladder parameters can provide useful clues for the underlying bladder dysfunction and may help to guide clinical management
ABSTRACT
To compare the blood lead levels of mothers and cord blood in intrauterine growth retarded [IUGR] neonates and normal term neonates. From April to December 2005, we carried out a cross-sectional, prospective study in Isfahan University of Medical Sciences, Isfahan, Iran. Blood lead levels were measured in the umbilical cord and maternal venous blood samples in 32 mother-infant pairs with IUGR full term neonates, and 34 mother-infant pairs with normal full term neonates. Blood-lead levels were analyzed by atomic absorption spectrometry. The mean lead concentration in neonates of IUGR and normal groups was not significantly different [107.47 +/- 16.75 versus 113.08 +/- 19.08 micrometer/L, p=0.2]. The mean lead concentration in mothers of IUGR group was lower than normal groups, but this difference was not significant [124.56 +/- 19.71 versus 135.26 +/- 26.91 micrometer/L, p=0.07]. Maternal lead levels were strongly related with cord blood in both IUGR and normal groups [r=0.8, p<0.0001]. Maternal and cord blood lead levels was not correlated with birth weight of newborns in either group. Overall, 65.6% of IUGR neonates and 76.4% of normal neonates was above the critical level defined for lead poisoning as>100 micrometer/L by the centers for disease control; however, this was not statistically different between the groups. Our results indicate that the mean lead level was not higher in IUGR neonates, and the whole blood lead was not related to the birth weight. In addition, maternal and cord blood lead levels were strongly correlated, and there were remarkable lead burdens on both the mothers and their neonates in this industrial area