ABSTRACT
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.
ABSTRACT
Background: Dengue is a major public health problem throughout subtropical and tropical regions. In more severe or complicated dengue, patients present with a severe febrile illness characterized by abnormalities of hemostasis and increased vascular permeability, which in some instances results in a hypovolemic shock. Dengue is endemic in more than 100 countries in tropical and subtropical regions with an estimated 390 million infections occurring worldwide, among which 96 million infections are clinically apparent. The objective of this study is to assess the usefulness of serum albumin as a prognostic factor in dengue.Method: This observational study enrolled 100 patients who were admitted in KIMS Hospital from June 2017 to June 2018 without any co morbidities as mentioned in the exclusion criteria. On day 4 of illness hemoglobin, packed cell volume, platelet and serum albumin were done, and the participants were classified into 3 groups based on clinical manifestationResults: In this study, hemoglobin was elevated on day 4 in group 3 when compared to other groups and it was statistically significant. Hemoconcentration and low platelet values were also seen in group 3 when compared to other groups showing statistical significance.Serum albumin was also low in group 3 when compared to other groups, which was strongly significant.Conclusion: Hence serum albumin can be used as a prognostic factor in dengue.
ABSTRACT
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.
ABSTRACT
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.