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Introduction: Pregnancy-induced hypertension (PIH) is one of the risk factor in pregnancy leading to placental insufficiency which in turn is responsible for maternal and foetal morbidity and mortality. PIH causes morphological changes in placenta. Decreased placental surface area and variation in the attachment of umbilical cord on placenta are more commonly noted in PIH which hampers the uteroplacental perfusion resulting in foetal mortality and morbidity. Hence afforts were made to study the incidence of reduced placental surface area and mode of cord attachment on placenta. Materials and methods: The study was conducted in the Department of Anatomy, Sri Siddhartha medical college and Hospital, Tumakuru, Karnataka. A total of 100 (50 normal and 50 PIH) human placentae were studied. Placental surface area and mode of attachment of umbilical cord in normal and PIH pregnancy were measured and noted. This study was analysed statistically by using Unpaired t-test and Chi-square test. Results: The study revealed significantly decrease in placental surface area and also there is increased incidence of central and marginal attachment of umbilical cord in PIH cases. Conclusion: Study reveals, PIH cause morphological changes in placenta, it decreasing the uteroplacental blood flow which reduces foetal nutrition ultimately decreasing the neonatal weight.
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Background: Lack of thermal protection is one of the major challenges faced by developing nations for newborn survival. Early detection and subsequent prevention of hypothermia through Kangaroo Care could lead to significant health outcomes for the newborn. Hypothermia alert device is a bracelet that monitors for early hypothermia by sensing the extremities and sounding an alarm for parents to take action.Methods: In a randomized controlled trial, the effect of the hypothermia alert device on KMC compliance at home and weight gain of newborns on 4th week follow-up was evaluated. New borns discharged from the neonatal intensive care unit at Indira Gandhi Institute of Child Health (IGICH). Neonates who were LBW (less than 2500 grams) were included in the study once they were stable and ready for discharge. Neonates were given a hypothermia alert device to monitor their temperatures for hypothermia for 4 weeks. Weekly follow-ups were held with parents and to record measurements of growth. Additionally, parents were given a KMC diary to track sessions of KMC. Neonates were given either a placebo bracelet or a BEMPU Bracelet. Bracelets were identical and both monitored for hypothermia, however only the BEMPU Bracelet gave an alarm when the newborn was hypothermic.Results: Statistically 44 neonates completed the 4-week trial; 23 were in the control group and 21 were in the BEMPU group; of these, 19 participants in the control group completed KMC diaries and 19 BEMPU group completed KMC diaries. The results of the clinical trial reveal that parents of neonates in the BEMPU group demonstrated better compliance to KMC. In the BEMPU group, the average daily time spent doing KMC was significantly higher in first (3.02 v 1.96 h, p=0.016) and fourth (3.04 v 2.38 h, p=0.094) week of discharge. There was an increase of weight gain in the BEMPU group after the first (25.7 v 20.7 g, p=0.1.85) and fourth (28.3 v 22.9 g, p=0.057) week of discharge.Conclusions: The hypothermia alert device was found to be an effective intervention to promote parent adherence to Kangaroo Care and weight gain.
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Background: Birth weight is an important determinant of health of a child, with low birth weight associated withthe occurrence of many chronic diseases in adult life.Aim: The objective of this study is to determine the correlation between mode of insertion of umbilical cord andneonatal weight and some placental variables.Methods: Forty placentas were obtained from the Cape Coast Teaching Hospital in the Central Region. Umbilicalcord length was measured and its position on the placenta noted and recorded. The placentas were trimmed andmeasurements of placental weight, diameter, and thickness were measured using Olympic smart scale andanthropometric measure respectively and then the volume were also recorded.Results: Three forms of umbilical cord insertion on the placentas were observed: central, eccentric and marginal.The result obtained shows that 57.5% of the umbilical cord insertions were eccentric, central cord insertionswere 11 (27.5%) and marginal insertions were 6 (15%).Conclusion: The results were analyzed using Pearson’s Chi-square and showed that the umbilical cord insertsmore eccentrically and that mode of umbilical cord insertion has no association with the placental variablesand birth weight looked at and thus mode of cord insertion may not significantly influence birth weight of theneonate. There was however a positive association between placental index and umbilical cord length (P < 0.05).
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Objective To discuss the relationship between matrix metalloproteinases 9 (MMP-9) and the pathogenesis of preeclampsia , birth weight and placental weight , through detecting the expression of MMPS-9 in the placenta of the patients with preeclampsia. Methods The levels of MMP-9 in the placenta were detected by immunohistochemical SP method in 60 patients with preeclampsia and 30 pregnancy women. Results (1) The optical density value of MMP-9 in preeclampsia group was lower than the control group , the optical density value of MMP-9 in SPE group was lower than the MPE group (P < 0.05). (2) The placenta weight and birth weight in preeclampsia group were lower than the control group , the placenta weight and birth weight in SPE group was lower than the MPE group (P < 0.05). (3) The expression level of MMP-9 were positively correlated with placental weight and birth weight (P < 0.05) in the control group. (4) The average optical density value of MMP-9 in neonatus with weight < 2 500 g was lower than neonatus with weight≥2 500 g (P < 0.05). Conclusion The MMP-9 in the placenta of patients with preeclampsia was down-regulated , and its expression was abate when the illness grew worse. The MMP-9 may be involved in the pathogenesis of preeclampsia , and it is associated with fetal growth restriction.
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Objectives: The aim of the study was: (1) To know the frequency of suboptimal infant breastfeeding behavior (SIBB), delayed onset of lactation (DOL) and excess neonatal weight loss (EWL) in mother-infant pairs with a high motivation to breastfeed; (2) to see if SIBB influenced lactational problems represented by: a] DOL, b] EWL; (3) in addition, we have tried to assess the risk factors for SIBB and other risk factors for DOL and EWL. Material and methods: A longitudinal hospital-based observational study. Infant breastfeeding behavior was assessed by IBFAT score, DOL was measured by maternal perception of breast fullness and maternal motivation by an initial interview based on breastfeeding self-efficacy scale. Results: Frequency of SIBB was 13.3% on Day 0, 6.6% on Day 3 and 2.9% on Day 7. DOL occurred in 11.8% of mothers and excess weight loss in 17.7% of infants. Prolonged labor, medications given during labor, inadequacy of sleep during peripartum and use of supplementary feeds were found to be significantly associated with SIBB. Infants with SIBB on Day 0 were 17 times more likely to have SIBB on Day 3 and they were also four times more likely to have excess weight loss. Failure of exclusive breastfeeding (EBF) occurred in 8.1% and showed a significant association with SIBB, but at two weeks all were breastfeeding exclusively. Conclusion: Infant behavior plays an important role in the success of early breastfeeding and if suboptimal, contributes to failure of EBF. Both infant behavior and onset of lactation constitute significant predictors of excessive weight loss and short-term failure of exclusive breastfeeding and help in determining the need for intensive lactation counseling in high-risk cases.
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Objetivos: evaluar el hierro y la transferrina séricos, la capacidad de fijación de hierro de la transferrina y el porcentaje de saturación de la misma, en una submuestra de gestantes del Bajo Cauca antioqueño, y asociar estos indicadores con la antropometría materna y el peso al nacer. Métodos: estudio descriptivo, transversal en 16 mujeres en el tercer trimestre de la gestación; la transferrina sérica se midió por nefelometría, el hierro sérico y la capacidad de fijación de la transferrina por fotocolorimetría; el porcentaje de saturación se calculó con la fórmula estándar. Para la antropometría materna se tuvieron en cuenta el Índice de Masa Corporal (IMC) y la ganancia de peso; se pesó a los recién nacidos en la sala de partos, con un equipo de alta precisión. Resultados: el hierro sérico y el porcentaje de saturación de la transferrina indicaron eritropoyesis deficiente en hierro y anemia, pese a que la hemoglobina estaba por encima de 11,3 g/dL. La concentración de hemoglobina fue menor en las madres con IMC bajo, y el peso al nacer se correlacionó positivamente con este indicador. Conclusión: el hierro sérico y el porcentaje de saturación de la transferrina pueden ser biomarcadores del estado del hierro de más pronta respuesta que la hemoglobina a la deficiencia de este mineral; para mejorar el peso de los neonatos se debe monitorizar el hierro materno y satisfacer las necesidades de este mineral.
Objectives: To evaluate seric iron, transferrin iron binding capacity and its saturation index in a group of pregnant women in Antioquia, northwestern Colombia, and to associate these indicators with maternal anthropometry and neonatal weight. Methodology: This was a descriptive, cross sectional study of 16 women in the third trimester of pregnancy. Seric transferrin was determined by nephelometry, seric iron and transferrin iron binding capacity were measured by photocolorimetry; the saturation index of transferring was calculated by a standard chemical formula. Maternal anthropometry was based on the body mass index (BMI) and total body weight gain; neonatal weight was measured in the delivery room, with a high precision equipment. Results: Seric iron concentration and transferring saturation index indicated iron-deficient erythropoiesis and anemia, even though the average haemoglobin concentration was above 11.3 g/dL. Hemoglobin concentration was lower in mothers with low BMI, and neonatal weight correlated positively with maternal hemoglobin. Conclusion: Seric iron and transferrin saturation index may be biomarkers of the iron status with earlier response than hemoglobin to the deficiency of this mineral. Maternal iron should be monitorized and iron needs satisfied in order to improve the weight of newborns.