Renal blood flow in neonates with perinatal asphyxia: quantification with color flow and pulsed doppler ultrasound

The aim of this work was to evaluate renal blood flow in asphyxiated newborns using Doppler ultrasonography and assess its value and accuracy in the early detection of renal dysfunction in such cases, thus permitting an early management hence a full recovery of any affected kidney. Twenty-six asphyxiated newborns with a mean gestational age of 39.62 +/- 0.94 weeks and a birth weight of 3.29 +/- 0.60 kg were studied. Twenty clinically healthy neonates matched for sex, gestational and birth weight were included as a control group. The studied cases were classified according to the absence or presence of renal involvement into two groups. The findings of this study suggested that the hypoxic ischemic insult was exerting an effect on the kidneys. Therefore, the presence of documented hypoxic-ischemic insult had an impact on the renal Doppler ultrasonographic measurements despite the absence of clinical and laboratory indices. This highlighted the value of renal Doppler US, with the measurement of RI, as a sensitive noninvasive technique for the early detection of renal dysfunction

Application of polymerase chain reaction to the diagnosis of congenital toxoplasma and herpes simplex virus infection

Because Polymerase Chain Reaction [PCR] is a sensitive, rapid and specific method, we applied it on the sera and CSF of 42 patients in whom congenital toxoplasmosis or herpes simplex virus infection were suspected clinically seeking for a rapid and better diagnostic approach for these treatable congenital infections in order to minimize their morbidity and mortality by early therapeutic intervention . PCR was also applied on the sera of 12 mothers, the CSF and sera of 10 controls. HSV1 IGM antibody was performed by enzyme linked immunoassay [EIA] on all samples. HSVDNA was detected successfully by PCR in serum and CSF samples of 32/42 patients [16/21 neonates, 76.2% ; 16/21 infants 76.2%] and in the sera of 9/12 mothers, while HSV[1] IGM antibodies were positive in 21/42 cases, 50% [9/21 neonates, 42.8% ; 11/21 infants 52.3%] with a sensitivity of 70.8% and 41.2% for serum and CSF respectively while specificity was 100% for both samples [PCR isa golden standard method 100%]. PCR proved to be superior to serology detecting 11 additional cases with congenital HSV infection. SO, PCR. could be usefull for the confirmative diagnosis of congenital HSV infection especially in serologically negative cases. Concerning toxoplasmosis, the system adopted in this study using the P30 gene failed to detect toxoplasma DNA in the serum and CSF samples of ail studied cases. Therefore, for adequate laboratory diagnosis of toxoplasmosis, combination of several different test systems including immunoblot technique in addition to PCR and usage of at least 2 different toxoplasma gondii strains as antigens is mandatory

Risk of transfusion acquired cytomegaly virus infection in neonates subjected to blood and exchange transfusion

In this study, polymerase chain reaction was applied on urine and blood samples of 50 neonates subjected to transfusion therapy as well as their mothers to detect CMV-DNA. Testing of neonates was performed before and after exposure to blood components. All donor's blood was retrogradely tested by the same PCR technique. Studied neonates were compared with 30 controls not subjected to transfusion therapy. PCR technique was standardized to avoid any possible contamination. The results showed that 12 neonates were CMV-DNA positive after transfusion in both urine and blood samples. They included five babies proved positive before transfusion. The other seven babies were negative before transfusion and become positive after their exposure to prove positive donor's blood. Eighteen donors were retrogradely found positive for CMV-DNA, as they transmitted infection to seven babies. The rate of transfusion transmitted CMV was therefore 38.8%. Maternal screening detected six CMV- DNA positive mothers with five affected offsprings giving a rate of materno-fetal vertical transmission [congenital, infection] of 83%. It was found that transfusion transmitted CMV infection is a serious problem in the neonatal units. Therefore, CMV screening of blood products or use of leukocyte depleted blood as an alternative method is strongly recommended in the neonatal period

Ocular biometry in full term newborn

This study was designed to re-evaluate the eye size and its measurements in fullterm newborns and to estimate these values in both sexes. Two hundred fullterm newborns [110 males and 90 females] delivered normally after a duration of 40.1 +/- 1.331 weeks gestational age were selected for this study. They were of birth weight 3.29 +/- 0.407 kgm, body length 51.1 +/- 2.08 cm and head circumference 34.59 +/- 1.565 cm. They were subjected to ocular ultrasound biometry for both eyes within one day after delivery. We found that, the mean axial length was 16.94 +/- 0.48 mm, the anterior chamber depth was 2.49 +/- 0.201 mm and lens thickness was 3.45 +/- 0.297 mm. There was a significant difference in these measurements between males and females in this sample of newborns