Maternal and neonatal profile and immediate outcome in ELBW babies

The present study was designed to ascertain the maternal and neonatal profile and immediate outcome of extremely low birth weight (ELBW) babies at a Level III neonatal intensive care unit (NICU). Case records of ELBW inborn babies delivered between August 2000 and August 2001 were analyzed by using a preset proforma. A total of 52 ELBW babies were admitted in NICU in the relevant period, out of which 30 (57%) survived. Maternal anemia and previous pre-term (PT) delivery were the common predisposing factors for PT delivery. Mean gestational age was 27.8 weeks and mean birth weight was 831 grams. Mortality was highest in babies less than 28 weeks gestation. Neonatal hyper-bilirubinemia (78%) and HMD/RDS (65%) were the commonest morbidity. Retinopathy of Prematurity (ROP) screening could be done in 35 babies (68%), out of which 22 were found to be normal.     

Maternal antenatal profile and immediate neonatal outcome in VLBW and ELBW babies

Objective To evaluate the antenatal profile of the mother and the immediate neonatal morbidity and mortality till discharge. Methods The study was a retrospective analysis of 92 patients of preterm labour who delivered babies weighing <1500 gms at 26 weeks to 34 weeks of gestation. The maternal demographic profile, causes of preterm labour, treatment profile and delivery outcome were recorded. Similarly the immediate neonatal morbidity and mortality were recorded in our case file. Both these data of maternal and neonatal profile were pooled and analysed. Results A total of 92 mothers in preterm labour at 26 to 34 weeks were admitted and subsequently delivered 70 VLBW babies (<1500 gms) and 36 ELBW babies (<1000 gms) including 8 pairs of twins and 3 triplets pregnancies. Majority of the patients (93.4%) were booked. Amongst the various high risk factors for preterm labour, anaemia, during pregnancy (32.6%), bacterial vaginosis (26%), gestational hypertension (18.4%) and pervious history of preterm labour (18.4%) were common associations. Calcium channel blocker (Depin) tocolysis was effective in postponing labour, from 48 hours to more than 2 weeks. The cesarean section rate was very high (67.3%) in our study. The commoner neonatal complications in both VLBW and ELBW babies were RDS, neonatal jaundice and sepsis. Features of IUGR were seen in both the groups (22.8% in VLBW and 22.2% in ELBW babies). The neonatal mortality rate till discharge was 15.7% in VLBW group and 33.3% in ELBW group. The morality rate was highest in 26 to 30 weeks gestation babies and in babies weighing <800 gms. Conclusion Antenatal profile of preterm labour in our series showed a number of high risk factors. The identification of common high risk factors is important for appropriate prenatal care. A better neonatal survival rate was possible due to timely intervention, appropriate management and NICU care facility available in our tertiary care centre.     

Anthropometric profile and perinatal outcome of babies born to young women (< 18 years)

This study was conducted to ascertain the sociodemographic profile, maternal characteristics, neonatal anthropometry and perinatal outcome in adolescent pregnancy (18 years or less). 128 consecutive primiparous women more than 18 years of age served as the control group. There were 4556 deliveries during the study period. Young adolescents accounted for 1.25% of total pregnancies. The proportion of shorter (<145 cm), lighter (<45 Kg), and anemic (Hb. <9 g/dL) women was significantly higher in the study group. Incidence of premature delivery in the young adolescents was significantly higher. Mean birth weight, length, head circumference and chest circumference of full-term babies of adolescent mothers were significantly lower.     

Iron-deficient anemic infants at play

The purpose of this study was to determine whether iron-deficient anemic infants show affective and attentional disturbances during play. The behavior of 21 iron-deficient anemic and 21 nonanemic 6- to 24-month-old Guatemalan infants and their mothers was analyzed during a videotaped 8-minute free-play session. There were no statistically significant differences between the two groups in measures of infant irritability, distractibility, or apathy. There were differences, however, in measures of spatial relations. In 71% of the anemic infants, the duration of child-initiated body contact with their mothers was high, compared with a high level of contact in only 26% of the nonanemic babies (p = 0.01). Mothers of anemic infants spent less time at a distance from them, were less likely to break close contact, and were more likely to reestablish close contact if the baby moved away (p less than 0.03). The increase in body contact was interpreted as a reflection of fearfulness, hesitance, or inactivity. The results suggest that the specific behavioral manifestations of iron deficiency anemia in infancy may vary with the context, differing in free play and structured developmental testing.     

Hematological findings in Kwashiorkor

Summary A comparative study of hematological features in children with kwashiorkor and those with anemia of other etiologic factors, showed that the anemia was more severe in the former group, the serum iron was normal and There was no evidence of megalopoiesis. There was a marked fatty change in the marrow and in the liver. In iron deficiency anemia, there was a marked hyperplasia of the marrow, without fatty change. From the departments of Pediatrics and Pathology, Gandhi Medical College and Hospital, Hyderabad, A. P.     

Common Hematological Disorders in Children

It is common for primary care physicians to be faced with children with hematological disorders in everyday practice. The article seeks to provide realistic information for the first-contact physician in handling common hematological diseases in children. Practical step-wise approach to understanding and investigating anemia and bleeding disorders is illustrated. Requirement of iron in normal children and management of iron deficiency anemia (IDA) and thalassemia is explained. The gold standard for IDA continues to be ferrous sulphate which has good bioavailability and is inexpensive. There is emerging concept of delayed clamping of umbilical cord at birth, particularly in regions with widespread IDA, to augment iron stores in infancy. Typical case scenarios of children with immune thrombocytopenia (ITP) and hemophilia are provided to facilitate the understanding of management in day to day practice. The vital role of the medical practitioner in shared care of patients with acute lymphoblastic leukemia and febrile neutropenia is emphasized. A risk based treatment algorithm for febrile neutropenia is provided.     

Flow Cytometry in Hematological Disorders

Flow cytometry with its rapidly increasing applications is being used essentially in all fields of diagnostic medicine. In hematological disorders it is most commonly used in diagnosis, characterization, prognostication and even selecting target therapy of acute leukemia and to some extent lymphomas. It is increasingly finding place in other fields of hematology i.e., non-malignant disorders of all blood cell types including RBCs and platelets along with leukocytes. In this review the authors have discussed some of these applications with an emphasis on disorders specific to pediatric patients.     

On babies and puppies

Indian Journal of Pediatrics -