Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates

Objectives: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Design: Hospital-based, cross-sectional. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Participants: 260 neonates with EGA 30- 42 weeks within 48 hours of life. Interventions: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Main outcome measures: Postnatal foot length in relation to Intra-Uterine Growth Pattern. Results: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). Conclusion: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants

Effect of Socio-demographic Characteristics on Obstetric Care-seeking Behaviours and Perinatal Outcome in Sagamu, Nigeria.

Background: The persistence of severe intra-partum events as causes of perinatal mortality may be due to the poor care pregnant women receive in labour. The quality and scope of care received in labour varies with the types of health facilities patronized. Objective: To describe the obstetric care-seeking behaviours of pregnant women in Sagamu, Nigeria and relate this to the perinatal outcome. Methods: A cross-sectional survey of parturient at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria was conducted between August 2013 and November 2014. Data were obtained on the demographic and obstetric profile, details of facilities visited during labour and perinatal outcome for analysis. Results: Out of 145 women, 93 (64.1%) received antenatal care at OOUTH. Of the 84 women who were first admitted in labour, 32 (38.1%) presented with emergencies. There were 140 live births and 10 still births; 34/140 (24.3%) of the live births were hospitalized mostly with asphyxia (13/34; 38.2%). One of the 34 hospitalized babies died from asphyxia thus the overall perinatal mortality rate was 73.3/1000 births. Women who presented with emergencies during labour and traversed other health facilities while in labour characteristically had low maternal education, low socioeconomic status and received antenatal care outside OOUTH. Poor perinatal outcome was significantly associated with unbooked status, presentation with emergencies during labour and traversing other health facilities in labour. Conclusion: Quality antenatal care and timely presentation during labour may influence perinatal outcome positively. Research should be focused on strengthening the existing health care structure.

Evaluating and managing neonatal acute renal failure in a resource-poor setting.

Acute renal failure (ARF) is encountered in neonatal care where it may be associated with significant morbidities. Pre-renal failure, which is due to impaired renal tissue perfusion, is the commonest type of ARF. It is amenable to treatment with excellent prognosis following prompt diagnosis and timely institution of appropriate intervention. Unfortunately, ARF in the newborn is usually asymptomatic and it is only suspected when a newborn infant has not been observed to pass urine over several hours or when serum Creatinine is observed to be elevated or rising. In resource-poor settings, it is often difficult to conduct detailed evaluation of suspected cases of newborn ARF due to lack of appropriate equipments and infrastructure. Similarly, therapeutic facilities are sparse and there is heavy reliance on conservative management of cases. Such difficulties encountered in the evaluation and management of newborns with ARF in most parts of the developing world, like Nigeria, where diagnostic and therapeutic facilities are limited are highlighted.