Correlation between umbilical cord blood pH and meconium stained deliveries

Background: Among all live births approximately 13% neonates are born through meconium-stained amniotic fluid and out of these 5-10% developed MAS, which increases neonatal morbidity and mortality. The incidence increases as the gestational age advances with reported frequencies at 37, 40, and >42 weeks being 3%, 13%, and 18% respectively. Although there is a significant decrease in the occurrence of MAS and associated mortality in developed countries, MAS remains a major problem in developing countries. The objective was to study the correlation between umbilical cord blood PH and Meconium stained amniotic fluid.Methods: Observational study done in KIMS hospital Bangalore, Karnataka, India in a study period of 18 months on a sample size of 100. Within 30 sec of delivery a segment of umbilical cord was clamped at both ends. Cord blood was collected in heparinised syringe. It was then transported with cold ice packs and blood pH, pCO2, pO2 were measured.Results: In present study population, among those with MSAF, 72% had acidemia and 28% did not have acidemia. The mean (SD) of pH in the group with MSAF was 7.16 (0.10). The median (IQR) of pH in the group with MSAF was 7.14 (0.12). There was no significant difference between the groups (those with MSAF and those without MSAF but other risk factors) in terms of pH (W = 867.500, p = 0.580).Conclusions: The presence of acidosis in the umbilical cord blood, used as a biochemical marker for perinatal asphyxia can be used to evaluate the significance of intrauterine passage of meconium. But a normal acid-base status at delivery present in many cases of MSAF, suggests that either a pre-existing injury or a non-hypoxic mechanism is often involved. MSAF is not always secondary to an acute hypoxic event.

Base excess as a prognostic factor determining the perinatal outcome

Background: Umbilical cord blood gas assessment seems to be the most objective determination of fetal metabolic condition at the time of birth and can be used to assess the perinatal outcome of the baby. In the early stage of an impaired placental circulation, hypoxemia and hypercapnia result in a decrease in pH with BD maintained normal (respiratory acidemia), whereas if the hypoxic process develops into a sustained anaerobic metabolism the BD rises secondary to lactic acidosis and consumption of buffer.Methods: Observational study done in KIMS hospital Bangalore, Karnataka, India, in a study period of 18 months on a sample size of 100. Within 30 sec of delivery a segment of umbilical cord was clamped at both ends. Cord blood was collected in heparinised syringe. It was then transported with cold ice packs and blood pH, pCO2, pO2 were measured.Results: In present study, there was a significant difference between the 2 groups in terms of BE, BE being highest in the group without complication. There was a moderate negative correlation between duration of NICU stay (days) and BE (mmol/L), and this correlation was statistically significant. There was a significant difference between the 2 groups in terms of BE with the median BE (mmol/L) being highest in the group not requiring resuscitation. At a cutoff of BE (mmol/L) <-17.5, it predicts complications with a sensitivity of 71.4%, and a specificity of 88.2%.Conclusions: Hence cord blood base excess can be used as a prognostic factor in determining the perinatal outcome.

Effect of maternal height on neonatal outcomes in tertiary care hospital: a retrospective study

Background: Global or regional evidence showed maternal height as a strong predictor of child survival. However, there is limited information that confirms the intergenerational effect of short maternal height on the risk of offspring mortality in Bangladesh. Therefore, this study aimed to examine the association of maternal height with neonatal morbidity and outcome.Methods: In this analysis authors took data of 100 women who delivered in Kempegowda Hospital in the year 2018 including anthropometry of the mother at admission, anthropometry of the newborn, NICU admissions. Neonatal outcome was assessed by birth weight, anthropometry and NICU admissions against maternal stature which was stratified into 4 groups.Results: Comparison of mean birth weight, head circumference and length showed significant relation with maternal height (p<0.001).Conclusions: Findings should draw the attention of the programme and policymakers to focus on improving maternal nutrition for better offspring nutrition, health and survival.

Hypertonic saline and adrenaline nebulization in the treatment of bronchiolitis: a retrospective study

Background: Bronchiolitis is the leading cause of acute illness and hospitalization in young children. There is limited role for diagnostic laboratory or radiographic tests in typical cases of bronchiolitis. Several large recent trials have revealed lack of efficacy of either bronchodilators or corticosteroids. Novel treatment like hypertonic saline and adrenaline nebulizations need to be evaluated for their efficacy.Methods: In this retrospective case control study, we included children aged between 6 months to 2 years admitted for bronchiolitis between August 2017 till July 2018. Each of the 45 children treated with adrenaline nebulisation was assigned a child who was given hypertonic saline nebulization only matched for age and duration of symptoms.Results: 45 children given adrenaline nebulization and 45 children given only hypertonic saline nebulization were compared. Mean duration of stay for children treated with adrenaline nebulization was 5.3 days and those given hypertonic saline was 4.8 days.' p value of 0.29.Conclusions:' Adrenaline nebulization did not shorten hospital stay in children admitted for bronchiolitis as compared to children given hypertonic saline.

Cardiovascular malformations in infants of diabetic mothers: a retrospective study

Background: Despite improvements in medical care provided during pregnancy to diabetic mothers, the cardiac complications in their infants are still more frequent than in infants of general population.Methods: A retrospective case-control study was performed between the years 2017-2018 on two groups of newborns, recording details of outcome of live born babies born to diabetic and non-diabetic mothers.Results: Data were extracted from medical records, and the descriptive and analytical statistics of this information was duly applied. in a total of 50 studied infants, 40 cases (80%) of cardiovascular anomalies have been diagnosed. Most of the cardiac anomaly was hypertrophic cardiomyopathy. The incidence of cardiovascular anomalies in infants of diabetic mothers is significantly higher than the infants of non-diabetic mothers (P=0.002). The type of maternal diabetes (diabetes mellitus, overt or gestational diabetes) did not bring about any significant difference in the incidence of cardiac malformations in infants (P=0.406).Conclusions: The incidence of cardiovascular anomalies in infants of diabetic mothers is significantly higher than the infants of non-diabetic mothers. Many of the infants were asymptomatic and therefore clinical examination and follow up in infants of diabetic mothers is important.