ABSTRACT
Background: Anti HCV is transferred from positive mother to her newborn. To prevent this transfer of anti HCV, many health care providers stop the mother from breast feeding and recommend the checking of the newborn for anti HCV. If found positive, they take it as a chronic infection and recommend treatment of the child as soon as possible. Prohibition from breast feeding not only pushes these neonates towards nutritional deficiencies but also make them prone to infections. The testing also stigmatizes the mother and her newborn for life. The literature proves that this antibody transfer is passive and clears in majority of cases without any residual disease. Mother to infant transfer of anti-HCV and its natural course in Pakistani population is not known
Objectives: To determine the frequency of anti-HCV positivity and its natural course in infants born to anti-HCV reactive mothers
Subjects and Methods: Anti-HCV reactive mothers were registered from gynecology department and labor room of Nishtar Hospital Multan from 07-10-2010 to 07-04-2011, using non probability purposive sampling. The ALT of mothers was also checked. The babies born to these mothers were checked for anti- HCV by ELISA and ALT at 0 day [at the time of birth] and then at 6, 12, 18 and 24 months using venous blood samples. Data was entered and analyzed using SPSS-11
Results: Out of 35 anti-HCV reactive mothers; only one had ALT above the upper limit of normal [> 40 IU/L]. A total of 35 babies were born to these mothers, out of whom 34[97.1%] were reactive to anti-HCV at the time of birth and only one was non reactive. At 6 months 2 babies had expired and 3 were lost to follow up, leaving 30 babies. Out of these 30 babies 11 became non-reactive and 19 were still reactive for anti-HCV at 6months. At 12 months, all 19 anti-HCV reactive cases became non reactive, indicating passive transfer of antibodies from the mother to these neonates which they lost by 12 months. ALT of all babies except 3 was raised at 6 months [> 40 IU/L] which became normal during the subsequent visits
Conclusion: Almost all children born to anti-HCV positive mothers were reactive at the time of delivery but they all became non-reactive by the age of 12 months indicating passive transfer of anti HCV from the mother to the neonate
ABSTRACT
To compare the effects of epidural analgesia and parenteral nalbuphine in labouring women with term pregnancies on feto-maternal outcome. Randomized controlled trial. It was carried out in the Labour Room, Nishtar Hospital, Multan From June 2009 to December 2009. A total of 60 patients were included in the study. Patients were divided into two groups, having 30 patients in each group. In group-A, pain control was much better and satisfactory [VAS=00-1], duration of labour was slightly prolonged and instrumental delivery was more common. Low Apgar score and birth asphyxia were seen in group-B. No baby developed RDS in both groups. Feto-maternal outcome is much better in women having epidural analgesia with bupivacaine as compared to women having intramascular nalbuphine