Thyroid function test in pre-term neonates during the first five weeks of life

Congenital hypothyroidism [CHT] is one of the most common congenital endocrinal disorders. The prevalence of CHT is estimated about 1 in 3,000 newborns. The prevalence, etiology and associated disorders of abnormal thyroid screening tests are reported in different ranges. In this study, we assessed the pre-term newborns for CHT and associated factors that influence thyroid function. One hundred newborns with the gestational age fewer than 35 weeks were investigated. Baseline serum thyroid stimulating hormone [TSH] and free thyroxin [FT4] levels were measured during the first 5 days of life and were repeated during the first 5 weeks. We analyzed the effects of demographic factors and the presence of respiratory distress syndrome on the alteration of thyroid function tests during the first 5 weeks of life. The mean gestational age [GA] at delivery was 32.35 +/- 1.97 [range 28 to 35] weeks. CHT was observed in 13[13%] preterm infants. GA was the only factor which affect the FT4 changes over the two weeks follow-up [P < 0.001, b: -2.783, Power: 70.2%] although the differences between baseline and follow-up amount of TSH were not significantly influenced by GA [P = 0.062, power: 46%]. However, the adjusted TSH and FT4 serum level changes during follow-up were significantly different between two groups [between CHT and normal, P = 0.006, 0.000, respectively]. It seems that thyroid function tests should be repeated in preterm infants, especially for patients with lower gestational age, to confirm the diagnosis of CHT. Also, CHT should be considered among the newborns that are affected by RDS.

Neonatal ovarian cyst: a case report

Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Prenatal ultrasonography allows diagnosis of ovarian cysts and may suggest antenatal complications. The management of fetal ovarian cysts is still controversial despite the improvement in prenatal diagnosis with ultrasonography. Some studies suggest an aggressive management, while others plead for a conservative one. We report on the first successfully treated large neonatal ovarian cyst from Iran. She was a normal-term infant with respiratory distress due to the large size of the ovarian cyst diagnosed prenatally. We didn't find any other related anomaly in the neonate. Neonatal simple ovarian cysts are rare, but may cause complications. Most small simple cysts regress spontaneously; surgical intervention is reserved for complicated or large size ovarian cysts

[Frequency of multiple pregnancy and its complications in three educational hospitals, Tehran]

Multiple pregnancies are high-risk pregnancies since they are associated with increased perinatal and maternal problems. The aim of our study was to determine the frequency of multiple pregnancies and their maternal and perinatal complications. In a cross-sectional study we assessed 94 multiple pregnancies and 199 neonates in three educational hospitals [Baqiyatollah, Najmie and Mahdie] in Tehran in the first half of 2006. The information was collected from hospital registries of mothers and their neonates. Of 4584 deliveries, 84 [1.8%] were twins, 9 [0.19%] were triplets and 1 [0.02%] was quadruplets. 59 [62.7%] mothers had preterm labor and 14 [14.8%] had pre-eclampsia. We found discordant birth weigh>/=20% in 24 [25.4%] and Twin-to-Twin Transfusion in 3 [3.1%] mothers. 174 [87.4%] neonates were admitted in neonatal intensive care unit or pediatric department. The frequency of mortality and respiratory distress in neonates was 27 [13.5%] and 107 [53.7%], respectively. 39 [19.5%] of neonates had Apgar scores<7 and seizure was not observed in neonates. 65 [32.6%] neonates were normal weight [>2500 gram], 104 [52.4%] low birth weight, 21 [10.5%] very low birth weight and 9 [4.5%] extremely low birth weight. Hypocalcaemia, hypoglycemia and anemia was detected in 45 [22.6%], 24 [12%] and 48 [24.1%] neonates respectively. Regard to increasing the prevalence of multiple pregnancies, better use of infertility modalities, early diagnosis of the multiple pregnancies, prevention of preterm birth, close fetal surveillance, atraumatic labor and delivery can improve maternal and perinatal outcome