Perinatal arterial ischaemic stroke in neonate

Arterial ischemic stroke [AIS] is not uncommon in neonates, but in large part of developing world it has been missed and remains undiagnosed because of lack of resources and insufficient engagement by health care providers. The incidence of ischemic perinatal stroke ranges between 1 in 200 No, to 1 in 5000 births and is reported to be responsible for 30% to 50% of congenital hemiplegic cerebral palsy [CP] who were born at term or late preterm gestations. The true incidence of AIS from the developing world is not known as neuroimaging facilities are available in few centers; most of these cases remain undiagnosed. Over the past decades, ischemic perinatal stroke has emerged as an important cause of brain injury in the perinatal period and remains a leading cause of cerebral palsy. We are reporting a 3 days old male baby who presented with refractory seizures, subsequently diagnosed as arterial ischemic stroke

Short-term neonatal outcome in late preterm vs. term infants

To determine the short-term neonatal outcomes in late preterm infants [LPI's] as compared to term infants and their association with maternal risk factors. A case control, descriptive study. The Aga Khan University Hospital, Karachi, Pakistan, from January to December 2009. The study included 326 late preterm babies [defined as those born between 34 0/7 to 37 6/7 weeks of gestation] and equal number of term control babies at the Aga Khan University Hospital, Karachi, Pakistan. Data, including obstetric history, maternal complications, neonatal morbidities, etc., was retrieved from patients' medical records. The data was compared with the control group for complications, fetal morbidity and maternal morbidity. Late preterm infants constituted 10.6% of all deliveries and 77% of all live preterm births during the study period. Respiratory distress syndrome [RDS] [16.5% vs. 0.3%, p < 0.001], growth retardation [24.8% vs. 4%, p < 0.001], hyperbilirubinemia requiring phototherapy [37.9% vs. 11%, p < 0.001], and sepsis [4.9% vs. 0.3%, p < 0.001] were found to be the major morbidities in the study group. The need for resuscitation was 12.7 times higher in the study group as compared to the term babies [21.4% vs. 1.2%, p < 0.001]. NICU admissions in the study group were also higher [18.8% vs. 2.4%, p < 0.001]. Hypertension [12.5% vs. 1.5%, p < 0.001], diabetes [12.5% vs. 9.2%, p < 0.001], antenatal history of UTI [1.5% vs. 0.3%, p < 0.001], and prolong rupture of membrane [8.9% vs. 4%, p < 0.001] were significant maternal morbidities in the late preterm group. The late preterm group had greater morbidity, compared to term neonates. Prior awareness of the morbidities associated with late preterm babies is helpful for the health care providers to anticipate and manage potential complications in late preterm infants