Newborn screening for congenital hypothyroidism in a public sector hospital

Congenital hypothyroidism if left untreated results in growth failure, irreversible mental retardation, and cretinism. National neonatal screening programs are therefore, launched to diagnose congenital hypothyroidism and manage it timely. To screen newborns for congenital hypothyroidism in two public sector hospitals of Lahore. Cross sectional descriptive study conducted at departments of Gynae/Obs and Pediatric Shaikh Zayed Hospital and Jinnah Hospital, Lahore from February 2010 to November 2011. Awareness brochures for congenital hypothyroidism were developed and attached with the antenatal card of each pregnant case attending antenatal clinic at Gynae/Obs OPD. Newborns who had stayed in hospital for more than 24 hour, and whose parents consented for heal prick were tested for blood spot thyroid-stimulating hormone. Results were reported within four days and thyroid-stimulating hormone >/= 20mIU/L was taken as high value. Parents of those neonates who had high value were contacted to give a fresh sample for confirmation. Confirmed results were provided within next 4-5 days to the parents and treating pediatrician for appropriate treatment. A total of 1357 samples were screened using blood spot thyroid-stimulating hormone and out of these 1330 were normal [< 20mIU/L] while 27 had high levels [>/= 20mIU/L]. These 27 neonates were further tested using confirmatory tests for serum thyroid-stimulating hormone, T3 and T4. After confirmatory tests only one case had congenital hypothyroidism who was referred for treatment. Three cases were suspected to have subclinical hypothyroidism and these were retested after six months which, picked another case of confirmed subclinical hypothyroidism who was referred for treatment. The incidence of congenital hypothyroidism was 2 out of 1357 cases. The screening could pick 2 cases of hypothyroidism from a total of 1357 cases which is high when compared to global rates. Routine screening of neonates for thyroid disease can pick the disease early and thus prevent later complications

Placenta previa and correlation with scarred uterus

Placenta previa refers to placenta that is situated wholly or partially in the lower uterine segment. Placenta previa is an obstetric complication that may cause serious morbidity and mortality to both fetus and mother. To determine the frequency of placenta previa among patients with scarred and unscarred uterus. To list the complications associated with placenta previa in patients with scarred and unscarred uterus. Cross sectional descriptive study for six months from 25.08.05 to 24.02.06. It was carried out in the department of obstetrics and gynaecology, Jinnah Hospital, Lahore. Total 50 women having placenta previa were enrolled. The frequency of placenta previa in scarred and unscarred uterus and its complications were studied. The study showed that out of 50 cases of placenta previa, 44% of the women were more than 30 years of age and 76% of the women were in 3rd. and higher gravida group. 44% of the women had uterine scar. There was not significant difference in the complications associated with placenta previa in scarred or unscarred uterus except for morbidly adherent placenta, which was seen in 72.73% of cases having scarred uterus as compared to 27.27% of cases having unscarred uterus. The clinical outcomes of placenta previa are highly variable and cannot be predicted confidently from antenatal events. Nonetheless, in the majority of cases without bleeding, outpatient management would appear safe and appropriate irrespective of the degree of placenta previa