ABSTRACT
Background: Neonatal hyperbilirubinemia is a common condition that may occur in 60-70 % of term babies and the most common pathological cause leading to hyperbilirubinemia is ABO incompatibility. ABO incompatible newborns are reported to be at greater risk of significant hyperbilirubinemia and are associated with significant morbidity like development of kernicterus.' So early intervention, at proper time, is mandatory to prevent this sequel.Methods: A prospective study included 240 term new-borns with gestational age of >37 weeks and birth weight >2.5 kg born to 'O' blood group mothers. Soon after delivery, cord blood was sent for blood group, total bilirubin and direct coombs test. All enrolled new-borns were assessed clinically daily till day 5th for appearance of hyperbilirubinemia using Kramer method. The data was analysed using descriptive analysis, ROC curve in SPSS version 14.Results: Among two hundred forty ABO incompatible newborns, 40 (17%) had developed hyperbilirubinemia and among them most common blood group associated was B+ve (75%). Association between cord bilirubin content and maximum serum bilirubin content among newborn who developed hyperbilirubinemia was found to be significant (P value <0.01). As per ROC curve analysis, cord blood total bilirubin cut off value of 1.79mg/dl had sensitivity (82.5%), specificity (55.5 %), PPV (27.04%) and NPV (94.06).Conclusions: Cord blood total bilirubin levels ?1.79mg/dl has a good predictive ability for prediction of significant hyperbilirubinemia among ABO incompatible new-born. DCT is neither specific nor sensitive screening tool for development of Neonatal hyperbilirubinemia in ABO incompatibility.
ABSTRACT
Background: Severely anemic women reporting in labor remains one of the most important challenging situation for the obstetrician as well as for the mother and her family due to its adverse feto-maternal outcome. Various socio-demographic and obstetric conditions need to be explored which are important to tackle them, for primary prevention of anemia. The aim and objectives of the study were to estimate prevalence of severe anemia in pregnant women reporting in labor in a tertiary hospital of Delhi and to evaluate various socio-economic and associated obstetric factors associated.Methods: This is a hospital based, prospective, case contol study. Hemoglobin was estimated at the time of labor room admission. Fifty consecutive antenatal women with severe anemia (Group A) and 50 non-anemic women (Group B) were enrolled in early labor. Socio-demographic and obstetric factors, were recorded and analyzed.Results: Prevalence of severe anemia was estimated to be 2.23%. Determinants of severe anemia were found to be socio-economic status (p value 0.001), education (p value 0.001), rural living (p value 0.016), calorie intake (p value 0.001), BMI (p value 0.046), booking status of pregnancy (p value 0.001), gravida (p value 0.024), inter-conception interval (p value 0.002) and regular iron-folic acid intake (p value 0.001).Conclusions: Primary prevention of anemia by targeting these factors at the community/state/ national level, by the policy makers is important. Early booking and screening for anemia in antenatal clinics, providing iron supplements to anemic women for secondary prevention of severe anemia is recommended so that no woman reports with severe anemia in labor.