Comparison of hematological parameters among newborns with meconium stained amniotic fluid and clear amniotic fluid

Background: Meconium stained amniotic fluid is an indirect marker of fetal hypoxia. Fetal hypoxia affects bone marrow and affects production of cell lines. Indirect marker of erythropoietin activity is nucleated red blood cells count. Aim of the study is to compare hematological parameter in newborn born with meconium stained liquor and clear amniotic fluid. Also, to determine cut off levels of nucleated RBC as marker of fetal hypoxia in meconium stained amniotic fluid(MSAF).Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo medical college and hospital, Indore. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Cord blood samples were collected and hematological parameters were compared.Results: Hemoglobin % and WBC counts were seen in study group in comparison to control group, which is statistically significant (P<0.05). The reported NRBC/100 WBC between the two groups was statistically analyzed. The mean NRBC count in study group were 8.09'6.09 which was statistically higher than the corresponding values in control group 2.07'2.25 (P<0.05).Conclusions: Study concluded that the hemoglobin levels , WBC and NRBC counts in babies with meconium stained amniotic fluid is higher than those babies delivered with clear amniotic fluid and NRBC can be taken as a surrogate marker of hypoxia in a resource limited setting.

Effect of education and socio-economic status on parenting among pre-school and school going children

Background: Parenting is the process of promoting and supporting the physical, emotional, social and intellectual development of a child from infancy to adulthood. Parenting is a complex activity that includes much specific behavior that works individually or together to influence child's outcomes.Methods: It is prospective observational study carried out in the Department of Pediatrics, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India during the period from July 2008 to June 2010. Parents were interviewed with predesigned proforma. Parenting was graded in to three grades (1, 2 and 3) according to the performance of parents in various aspects of parenting.Results: In this study, 60 parents had 155 children constituting 2.5 children per family and male to female ratio was 1.18:1. We observed that literate parents performed well in all aspects of parenting (i.e. behavioral, physical, emotional, mental, spiritual, nutritional), but illiterate parents could not score on these points especially in spiritual and nutritional aspects. 33% graduate parents fulfilled the criteria for grade 3 parenting in nutritional aspects, 55% intermediate passed parents in nutritional aspects were in grade 3, whereas there were more than 50% parents in behavioral, physical and emotional aspects who had education level up to primary class.Conclusions: Educational status of parents has a positive impact on almost all aspects of parenting and the educational status of mothers appeared to be even more influential. Socioeconomic status of parents and residential area have a great influence on all aspects of parenting.

Association of gestational age, Apgar score and neonatal outcomes in newborns with meconium stained amniotic fluid

Background: Infants born with meconium stained fluid are at increased risk of fetal hypoxia, evidenced by increased rates of abnormalities indicated by fetal monitoring in labor, low neonatal Apgar scores, and fetal deaths. The study is conducted to determine association of gestational age, Apgar score and neonatal outcomes in newborn born with meconium stained amniotic fluid in tertiary care centre of central India.Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo Medical College and Hospital, Indore, Madhya Pradesh, India. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Gestational age, Apgar score and neonatal outcomes were compared among two groups.Results: The mean gestational age in study group was 38.89'1.14 weeks and in control group was 38.59'0.99 weeks. The mean Apgar score at 1 min was 5.80'1.59 in study group and in the control group was 7.86'0.35. 32 babies in meconium stained liquor had hypoxia of which 11 had respiratory distress, 11 required mechanical ventilation (MAS 08, sepsis 03), 2 newborns had HIE stage 2 and 5 patients died. The above findings suggest higher gestational age, lower Apgar score and poor neonatal outcomes are associated with meconium stained liquor.Conclusions: The study depicts significant co-relation with higher gestational age, lower Apgar at 1 and 5 minutes and poor neonatal outcome in babies with meconium stained amniotic fluid.

Partial trisomy 15: a rare occurrence

Partial trisomy 15q is a very rare entity and most of them are characterized by duplication of regions 15q21-15q26.3. This duplication is frequently associated with deletions in another chromosome resulting in unbalanced translocations. Authors report here, a rare case of partial trisomy 15, with breakpoints between 15q11.1 to q23, probably the first reported case with these breakpoints. Irrespective of the breakpoints, the phenotypic features are consistent in all affected cases and predominantly consist of craniofacial anomalies. In addition, finger abnormalities, very short neck, skeletal malformations and congenital heart disease may be present. Our neonate had typical dysmorphic features of arachnocamptodactyly, narrow face, large prominent, nose with broad nasal bridge, long philtrum, pointed chin, short neck, and low set deformed ears.' Neonates' cytogenetic analysis revealed additional chromosomal material on the long arm of the chromosome 15 from q11.1 to q23.1, which was suggestive of partial trisomy of chromosome 15. Most cases reported have had a stormy clinical course, however, our proband had only mild respiratory distress at birth and she was discharged in a few days.

Femoral hypoplasia-unusual facies syndrome: a rare clinical entity

Femoral hypoplasia-unusual facies syndrome (FH-UFS) is a disorder with multisystem involvement comprising predominantly of craniofacial dysmorphism with bilateral hypoplastic femurs. The exact etiology of this disorder is unknown, however maternal infections, drug and radiation exposure, oligohydramnios has been implicated. In affected children born to non-diabetic mothers, a genetic contribution is suspected; however, no chromosomal or gene mutations have been identified so far. The syndrome closely resembles with caudal dysplasia or syringomyelia which occur due to insufficient mesoderm in the caudal part of the embryo leading to lumbosacral defects, renal agenesis, and dysplastic lower limbs, however they lack craniofacial dysmorphism. The pathogenesis of FH-UFS involves poor development of subtrochanteric portion of the femoral cartilage. This results in shortening of proximal femur. Maternal diabetes justifies the teratogenic effect of hyperglycemia and ketones on fetus leading to dysmorphic features in fetus. Here, we are reporting a female neonate with characteristic phenotypic features of FH-UFS. She had cleft lip and palate, low set ears, retrognathia and micrognathia, dolichocephaly with bilateral femoral hypoplasia with talipes deformity of both feet. Karyotype was normal (46XX). Renal and cranial ultrasounds were normal. The 2D Echo revealed small 0.3mm PDA.