Third trimester maternal blood and at birth cord blood lipid profile characteristics in pregnant woman with or without fetal growth restriction

Background: To study the lipid profile of 3rd trimester pregnant women and their cord blood with and without intrauterine growth restriction Design: Observational study, Setting: Department of Obstetrics and Neonatology, in a teaching hospital in North India during February 2013 to August 2014.Methods: Third trimester pregnant women and their neonates. Enrolled 250 women were divided in intrauterine growth restricted and control groups. Outcome Measures: Venous blood Lipid levels of 3rd trimester mothers and their neonate at birth.Results: Women of IUGR group had significantly lowered total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL) and low density lipoproteins (LDL)210.2 (19.8), 221.6 (36.2),65.4(11.7)and 130.7 (20.8)compared to 251(55.3), 234.7(35.6), 70.8(19.9) and 181.3(16.8) mg/dl control group. The TC, TG and LDL levels in cord blood of IUGR group were 93.6(16.5), 50.4 (6.5) and 51.8(12.6) as compared 106.4(17.7), 30.7(4.4) and 55.9(12.1) mg/dl to control group (p value <0.05). HDL levels were significantly lower 15.8(4.6) in IUGR group as compared to 26.5(5.4) in control group. The LDL: HDL and TC: HDL ratio was significantly higher in IUGR group. Maternal weight, gestational age, urban residence, primi parity, birth weight and APGAR score were lower, while maternal age, parity, smoking, blood pressure, cesarean sections (%) and male sex (%) of baby was higher in IUGR group.Conclusions: Lipid profile of mothers of IUGR fetuses had significantly lowered cholesterol levels and their cord blood had shown atherogenic phenotype

Umbilical Cord Milking and Hematological Parameters in Moderate to Late Preterm Neonates: A Randomized Controlled Trial.

Objective: To investigate the effect of umbilical cord milking on hematological parameters at 6 weeks of age in late preterm neonates. Design: Randomized controlled trial. Setting: A tertiary care center of Northern India during 2013-14. Participants: 200 moderate to late preterm neonates randomly allocated to early cord clamping or umbilical cord milking group (100 in each). Intervention: In milking group, 25 cm length of cord was milked towards the baby thrice after separating (within 30 s) it from placenta. Main outcome measures: Hemoglobin and serum ferritin at 6 weeks of age. Results: Mean (SD) serum ferritin [428.9 (217.6) vs. 237.5 (118.6) ng/mL; P< 0.01] and hemoglobin [12.1 (1.5) vs. 10.4 (1.2) gm/dL; P<0.01] at 6 weeks were significantly higher in umbilical cord milking group. In early neonatal period, hemodynamic and hematological parameters were not significantly different. Higher incidence of jaundice with higher phototherapy rates (33% vs. 9%; P<0.01) were noted in umbilical cord milking group. Conclusion: In preterm neonates, umbilical cord milking at birth enhances iron stores at 6 weeks of age. Higher phototherapy rates with this intervention are a matter of concern.

Vitamin B12 Deficiency Presenting as Pyrexia of Unknown Origin: A Case Report.

Vitamin B12 deficiency is an uncommon cause of fever. Here we describe a case of a 16- year-old male who presented with pyrexia of unknown origin from one and half month subsequently on investigation patient diagnosed to nutritional megaloblastic anemia secondary to severe vitamin B12 deficiency after exclusion of other infective, neoplastic or inflammatory causes. Megaloblastic anemia (vitamin B12, folate deficiency) is a reversible cause of pyrexia that should be considered in any patient who presents with pyrexia from long time and pancytopenia.