Pregnancy outcome in undiagnosed gestational diabetes

To investigate the outcomes of macrosomia and compare the risk factors associated with neonatal and maternal complications between mothers with gestational diabetes [GDM] and Non-GDM mothers, and determine whether it is important to screen for GDM before birth. We sampled the venous blood of the mothers of 120 macrosomic neonates in the first 24 hours after delivery, and assessed glycohemoglobin [HbA1c] levels. A diagnosis of GDM was based on a HbA1c > 5.9%. Twenty-three [19%] mothers had an HgbA1c > 5.9%. Maternal and neonatal complications were not significantly different in undiagnosed GDM and non-GDM women. Except for the mother's age, parity, and BMI, other risk factors for the development of GDM didn't differ significantly between the two groups. The frequency of neonatal and maternal complications associated with the birth of macrosomic neonates are not significantly different between GDM and non-GDM mothers. Hence, the universal screening of pregnant women for GDM is not recommended

Sonographic measurement of abdominal esophageal length as a diagnostic tool in gastroesophageal reflux disease in infants

This study was conducted to provide sonographic measurements of the abdominal esophagus length in neonate and infants with and without gastroesophageal reflux disease [GERD] and to investigate its diagnostic value. GERD severity was also evaluated and correlated with esophageal length. It is a prospective case-control study. This prospective case-control study comprised 235 neonates and infants [120 without reflux and 115 with reflux]. There were 40 children without reflux in each of three age categories: less than 1 month, 1-6 months, and 6-12 months. Of the children with reflux, 40 were less than 1 month old; 37,1-6 months; and 38, 6-12 months. The abdominal esophagus was measured from its entrance into the diaphragm to the base of gastric folds in fed infants. GERD was sonographically diagnosed and confirmed by a barium meal. The number of refluxes during a 10-min period were recorded. Neonates and infants with reflux had a significantly shorter abdominal esophagus than subjects without reflux: the mean difference in neonates, 4.65 mm; 1-6 months, 4.57 mm; 6-12 months, 3.61 mm. Children with severe reflux had a shorter esophagus compared with those with mild and moderate reflux only in the neonate group. Therefore, thinking of GERD and carefully looking for its symptoms is necessary to avoid unnecessary utilization of healthcare resources in children with severe reflux

Influence of mode of delivery at term on the neonatal respiratory morbidity

Respiratory morbidity is an important complication of elective cesarean section. Our objective was to find out the incidence of respiratory distress in term neonates delivered by elective cesarean section and compare it with neonates delivered vaginally. We evaluated one thousands infants delivered by elective cesarean section and normal vaginal delivery for respiratory distress. Among 500 cesarean done, 27 [5.4%] neonates had respiratory distress and among 500 vaginal delivery infants, 8 [1.6%] developed respiratory Distress [P<0.001]. The odd ratio for neonatal respiratory distress was 3.38, almost threefold higher in cesarean section group than those delivered vaginally

Magnesium sulphate as a safe treatment for persistent pulmonary hypertension of newborn resistant to mechanical hyperventilation

To see the effects of magnesium sulphate in newborn with persistent pulmonary hypertension of newborn [PPHN] who did not respond to mechanical hyperventilation and are candidate for Extra Corporeal Membrane Oxygenation [ECMO]. Ten newborn who were admitted to Neonatal Intensive Care Unit [NICU] with profound hypoxia and respiratory failure due to PPHN were treated with conventional mechanical ventilation and then mechanical hyperventilation. The newborns who did not respond to mechanical Hyperventilation were treated with magnesium sulphate infusion. Nine out of ten babies survived and one of them died. The differences between the mean AaDo2, OI index, and PH after mechanical hyperventilation and magnesium sulphate administration was significant. Magnesium has a role in the treatment of PPHN patients who do not respond to hyperventilation or may be applied instead of hyperventilation