Blood glucose level in newborn infants of high risk pregnancy

Under normal circumstances, the fetus receives a constant supply of nutrients and oxygen from his mother across the placenta. After delivery the newborn infant must rely on his endogenous source to maintain glucose homeostasis until an adequate food supply become available. A normal fasting blood glucose level depends on sufficient hepatic enzyme pathways for gluconeogenesis and glycogenolysis and normal hormonal activities for regulation of these processes. This study aimed at estimating the blood glucose level in newborn infants of high risk pregnancies as well as in high risk newborns. The study was carried out on 138 newborn infants at high risk, pregnant mothers, and high risk newborns, in addition to 20 healthy newborn infants of normal pregnancy. The groups included in the study were: Group [1] Diabetic Mothers: their number were 15. Group [2] Primiparous mothers over 35 Y: their number were 15. Group [3] Underweight mothers [under 60 kg]: their number were 5. Group [4] Mothers with Rheumatic heart disease: their number were 8. Group [5] Mothers with chronic hypertension; their number were 6. Group [6] Pre-eclamptic mothers: their number were 12. Group [7] Eclamptic mothers: their number were 6. Group [8] Multiparous mothers over 5 deliveries: their number were 8. Group [9] Premature newborns: their number were 25. Group [10] Small for date newborns: their number were 38. The blood glucose level in the newborns was done by the reflectometer method at birth, at 1 hour and at 4 hours after delivery. The results obtained, showed that in all infants, blood glucose level at 4 hours was significantly lower than its level at birth in all groups. Significant lower blood glucose level than that of the control groups was seen in infants of mothers suffering from diabetes, chronic hypertension and eclampsia. The same observation was seen in prematures and SGA newborns. On the other hand, no significant difference was seen in the rest of the groups

Inaccuracy in decision making in pediatric resuscitation

This survey was under taken to investigate the inaccuracy in resuscitation of cardiorespiratory arrest in children 101 junior practioners [59] junior hospital doctors [H>D.] and 42 doctors working in primary health care units [P.H.C.U.D.] attending for master degree in pediatric department of Zagazig University Hospital, were asked about the size of endotracheal tube, the dose of adrenaline, atropine and bicarbonate and the number of joules used for defibrillation, in three age groups [3 months, 3 and seven years]. The time allowed was fixed as 10 minutes. Most of doctors gave no answer regarding the size of endotracheal tube [54.23% of H.D. and 57.14% of P.H.C.U.D. and number of joules for defibrillation [81.36% of HD and 88.1% of MHCP]. Those who gave answers were all inaccurate, which reflect that they are unfamiliar with these lines of resuscitation. It was noticed that they answered in dose/kg body weight and not according to age. They used different dilutions of adrenaline [ml of 1/10000 and mg of 1/1000]. The least percentage of correct answer was for adrenaline dose, while the approximate answers were maximal about it. The highest percentage of accurate answers were those regarding bicarbonate [45.76 of HD and 30.95% of P.H.C.U.D.]. The comparison between doctors working in well, moderately and poorly equipped centers, showed that the best achievement was in the first group and the least in the third group. A simple versatile, and readily available reference chart such as that included in the recommendations is needed to aid rapid and accurate decision, due to the variation in size of children and comparative infrequency of cardiorespiratory arrest in this age group