scholarly journals N-terminal pro brain natriuretic peptide as a marker of myocardial dysfunction in newborns with perinatal asphyxia

2020 ◽  
Vol 7 (5) ◽  
pp. 997
Author(s):  
Mallesh Kariyappa ◽  
Sandesh Shivarudrappa
Keyword(s):  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Myocardial Dysfunction ◽  
Venous Blood ◽  
P Value ◽  
Neurological Outcomes ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Hypoxic Brain ◽  
Stage 1

Background: Perinatal asphyxia refers to a condition during first and second stage of labour in which impaired gas exchange leads to foetal hypoxemia. Perinatal asphyxia causes cardiac dysfunction in 24 to 60 percent of the cases. The reduced cardiovascular reserve is associated with hypoxic brain damage and has high impact on neonatal mortality and adverse neurological outcomes. It has been challenging to diagnose myocardial dysfunction in resource constraint setting. Aim and objective of this study was to Determine N-Terminal Pro BNP concentrations in perinatal asphyxia and correlate with modified Sarnat stages of hypoxic ischemic encephalopathy.Methods: Among 120 Neonates admitted in neonatal intensive care unit with diagnosis of perinatal asphyxia were considered for the study. 2mL of venous blood drawn within 48hours of life was analyzed for quantitative N-Terminal Pro BNP and was correlated with modified Sarnat stages of hypoxic ischemic encephalopathy.Results: A Total of 120 cases of perinatal asphyxia were considered for the study, among which 44 cases had HIE stage 1, 48 had HIE stage 2 and rest 28 had HIE stage 3. The mean and standard deviation of N-Terminal Pro BNP concentrations in stage 1 was 1,502.86±3,581.170 pg/mL, stage 2 was 4,916.31±8,001.674 pg/mL and stage 3 was 8,912.41±13,927.152 pg/mL with significant p value of 0.003.Conclusions: Early N-Terminal Pro BNP concentrations may provide a useful marker for the anticipated severity of myocardial dysfunction.

RELEASE OF NEUROPHYSINS I AND II DURING AND AFTER PARTURITION IN COWS

1977 ◽  
Vol 74 (3) ◽  
pp. 487-497 ◽  
Author(s):  
J. J. LEGROS ◽  
G. PEETERS ◽  
S. MARCUS ◽  
W. DE GROOT ◽  
R. REYNAERT
Keyword(s):  
Venous Blood ◽  
The Other ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Low Concentrations ◽  
Neurophysin Ii

SUMMARY Bovine neurophysin I and neurophysin II (bNpI and bNpII) have been assayed by radioimmunoassay in the jugular venous blood of cows during parturition. In general, low bNpI levels were detected on the day before labour began and during the first stage of labour. Neurophysin I was present in appreciable quantities in blood taken during the second stage of labour and in most cows the concentrations rose to a maximum during the expulsive stage. After delivery, the concentration of bNpI in the blood diminished. This pattern of release is similar to that reported for oxytocin at parturition in cows. As with bNpI, maximum levels of bNpII occurred during the expulsive stage of labour in some animals. In others, bNpII concentrations were very low or absent. Low concentrations of bNpII were found at the other stages of labour. Examination of the results from individual animals indicated that the release of the two neurophysins can be independent.

Factors affecting angiotensin II concentrations in the human infant at birth

1977 ◽  
Vol 52 (5) ◽  
pp. 449-456 ◽  
Author(s):  
Fiona Broughton Pipkin ◽  
E. M. Symonds
Keyword(s):  
Angiotensin Ii ◽  
Venous Blood ◽  
Human Infant ◽  
Hypertensive Disease ◽  
Blood Concentrations ◽  
Factors Affecting ◽  
Lower Segment Caesarean Section ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Arterial Blood

1. A radioimmunoassay for the measurement of angiotensin II in 1 ml of plasma has been developed and used to measure angiotensin II in maternal peripheral, cord venous and cord arterial blood in 45 patients at delivery. 2. In babies delivered vaginally, cord venous and cord arterial concentrations of angiotensin II were significantly higher than maternal venous blood concentrations. There was a significant relationship between both cord venous and cord arterial concentrations and maternal concentrations of angiotensin II. 3. Cord venous concentrations of angiotensin II were significantly greater than those in cord arterial blood in babies delivered vaginally but not in those delivered by lower-segment Caesarean section. This suggests the possibility that, during labour, the placenta may contribute to foetal concentrations of angiotensin II. 4. Maternal and cord venous concentrations of angiotensin II were significantly higher in patients with hypertensive disease of pregnancy than in those who had remained normotensive throughout pregnancy. 5. Cord venous concentrations of angiotensin II increased significantly with increasing duration of the second stage of labour.

scholarly journals Study of perinatal asphyxia and its outcome concerning nucleated RBC count in venous blood of term neonates

2021 ◽  
Vol 8 (1) ◽  
pp. 54-63
Author(s):  
Dr. Pradeep Kumar Jena ◽  
◽  
Dr. Himansu Parida ◽  
Dr. Banashree Swain ◽  
Dr. Mangal Charan Murmu ◽  
...  
Keyword(s):  
Apgar Score ◽  
Perinatal Asphyxia ◽  
Venous Blood ◽  
Surrogate Marker ◽  
Birth Asphyxia ◽  
Neurological Impairment ◽  
Adverse Outcomes ◽  
P Value ◽  
Medical College ◽  
Nucleated Red Blood Cells

Introduction: Perinatal asphyxia is a serious problem globally and is one of the common causes ofneonatal mortality. Worldwide each year four million infants suffer from birth asphyxia. Of these onemillion die and an equal number develop serious sequelae. Perinatal asphyxia ranks as the secondmost important cause of neonatal death after infections accounting for about 23% of mortalityworldwide. Aim & objective: To establish the level of nucleated red blood cells as an indicator ofpoor immediate outcome in perinatal asphyxia. Method: It was a case-control study done in thedepartment of pediatrics, S C B Medical College & S V P PG I P, Cuttack. Observation: The NRBCcount was significantly higher in neonates with adverse outcomes than in those with favourableoutcomes (p-value <0.001). NRBC count cut-off of >27/100 WBC had a sensitivity of 75% andspecificity of 95.2% in predicting adverse outcome defined as death, hemiplegia, hypertonia orsignificant hypotonia, unreliable sucking and seizures resistant to Phenobarbital. Conclusion:Nucleated red blood cell count can be used as a surrogate marker for birth asphyxia. It has asignificant negative correlation with Apgar score at one minute and Apgar score at 5minutes &significant positive correlation with severity of hypoxic ischemic-encephalopathy, time is taken forrecovery of neurological impairment following birth asphyxia and duration of NICU stay.

scholarly journals FULL TERM BABIES;

2017 ◽  
Vol 24 (06) ◽  
pp. 828-833
Author(s):  
Abdur Rehman Malik ◽  
Ahmed Iqbal Quddusi ◽  
Nazia Fatima ◽  
Imran Iqbal ◽  
Azhar Mehmood Javeed
Keyword(s):  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Full Term ◽  
P Value ◽  
Cranial Ultrasound ◽  
Positive Correlation ◽  
Cranial Sonography ◽  
History Of ◽  
Moderate Positive Correlation

Introduction: Perinatal asphyxia is one of the most common causes of neonatalmorbidity and mortality in most countries of the world. The objective of my study was to assessthe correlation of clinical findings of perinatal asphyxia with cranial sonography in full termbabies. Study Design: Retrospective study. Setting: Neonatal Intensive Care Unit of Children’sHospital Multan. Period: January 2016 to October 2016. Material and Methods: 100 fullterm babies having history of delayed cry were scanned within three days of birth in NeonatalIntensive Care Unit of Children’s Hospital Multan. Clinically findings including full term babies,birth weight, grunting, cyanosis history of mode delivery, resuscitation history, delayed cry andhypoxic ischemic encephalopathy (HIE) grades were taken from baby’s hospital file record andstandard images including coronal and sagittal plans were taken by Ultrasound machine probeof frequency 3-5 MHz. Findings were recorded on data collection sheets and spread on EXELsheets. Correlation was found by using SPSS software. Result: Out of 100 neonates 63 weremale and 37 were female with birth weight (2.4-3.6) having mean ± SD 3.08 ± 0.53. HIE grades(mild, moderate and severe) were found in 12, 83, 5 babies respectively and ultrasound grades0 (normal/ mild echogenic), grade 1 (moderate echogenic) and grade 2 (severe/generalizedechogenic) were found in 32, 52, 16 neonates respectively with r= 0.37 and P-value < 0.05showing moderate positive correlation. Conclusion: Cranial ultrasound is a good screeningtool to evaluate asphyxiated neonatal brain. It has a moderate positive correlation with clinicalfindings.

The Comparison of Hemoglobin Values Measured by Blood and Continuous Non-Invasive Monitoring (SpHb) in Newborn Infants

2020 ◽  
Author(s):  
Halil Kazanasmaz ◽  
Mahmut Demir
Keyword(s):  
Neonatal Intensive Care ◽  
Venous Blood ◽  
Newborn Infants ◽  
Blood Sampling ◽  
Neonatal Intensive Care Units ◽  
P Value ◽  
Invasive Monitoring ◽  
Non Invasive ◽  
The Difference ◽  
Venous Blood Sampling

Abstract Objective Hemoglobin (Hb) measurement is one of the most commonly used laboratory tests in medical practice. Unnecessary blood sampling, especially in neonatal intensive care units (NICUs), contributes to iatrogenic anemia. Continuous non-invasive monitoring of total Hb (SpHb) was compared with invasive venous blood samples (tHb) in NICU patients. Methods Three hundred and ten patients were identified in NICU. Non-invasive Hb measurement was performed immediately before venous blood sampling and comparison of invasive with non-invasive values was undertaken. Results There was a strongly positive correlation between SpHb and tHb (r = 0.965, p &lt; 0.001). Bland–Altman analysis was performed in 95% limits of agreement for Hb values measured by both methods. The mean bias between tHb and SpHb measurements was 0.05 g/dl (−1.85 to 1.96). In Passing–Bablok regression analysis, the CUSUM test p value was found to be 0.98 for Hb levels measured by SpHb and tHb; and the difference between the methods was not significant. Conclusion In newborns, SpHb method offers reliable Hb values, which are comparable with the more traditional tHb method. Continuous non-invasive monitoring of total Hb may help prevent unnecessary blood sampling and iatrogenic anemia. Further clinical studies are required for the effectiveness of the method in critically ill patients with circulatory disorders.

scholarly journals Alteration of Hepatic Function: Helpful to Diagnose and Assess Severity of Perinatal Asphyxia

1970 ◽  
Vol 34 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Md Tariqul Islam ◽  
Seikh Azimul Hoque ◽  
MA Matin ◽  
Md Nazrul Islam ◽  
Md Anwar Hossain ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Reference Group ◽  
Perinatal Asphyxia ◽  
Venous Blood ◽  
Rank Correlation ◽  
Hepatic Function ◽  
P Value ◽  
College Hospital ◽  
Spearman’S Rank Correlation ◽  
Organ Systems

Background and Objectives: Diagnosis of perinatal asphyxia is mostly establishedretrospectively. But it is difficult to diagnose perinatal asphyxia retrospectively in theabsence of perinatal records. As because of hypoxaemia, different organ systems ofthe body are affected in perinatal asphyxia, this study was done to assess the hepaticfunction for the diagnosis of perinatal asphyxia and to find out any correlation existingbetween hepatic enzyme change and the severity of perinatal asphyxia.Methods: A total of 70 full-term asphyxiated newborns (study group) were studiedduring January 2008 to December 2008 in the department of Paediatrics, MymensinghMedical College Hospital. After enrolment these babies were grouped according toSarnat and Sarnat stages of HIE as stage I, II and III. Another 50 healthy newbornswere also studied as reference group. Venous blood was analyzed between 2nd and5th day of life to estimate serum AST, ALT and alkaline phosphatase (ALP), serumtotal bilirubin (STB), serum total protein (STP), serum albumin and prothrombin time(PT). Unpaired student’s 't' test and Spearman's rank correlation was used for dataanalysis and P value of <0.05 were considered significant.Results: The mean AST, ALT, ALP, STP, S. albumin and TSB of asphyxiated babieswere 76.3±37.4 U/L, 82.2±48.08 U/L, 369.6±123.05 U/L, 55.7±8.8 U/L, 32.6±5.5 g/L& 5.5±2.01mg/dL respectively and those of normal babies were 23.5±8.5 U/L, 26.5±7.8U/L, 208.2±46.9 U/L, 66.3±10.4 g/L, 40.9±6.5 g/L and 4.5±1.2 mg/dl respectively andthese differences were statistically significant (P <0.001). On the other hand nosignificant changes were noted in prothrombin time. The rise of AST, ALT, ALP andPT also showed a significant positive correlation with the severity of asphyxia and thestages of HIE.Conclusion: It is concluded that estimation of hepatic enzymes can be used todiagnose perinatal asphyxia and also to assess its severity.Key words: Alanine aminotransferase; aspartate aminotransferase; newborn; perinatalasphyxia.DOI: 10.3329/bjch.v34i1.5695Bangladesh Journal of Child Health 2010; Vol.34(1): 7-10

scholarly journals Influence of Different Methods of Intrapartum Analgesia on the Progress of Labour and on Perinatal Outcome

2019 ◽  
Vol 79 (04) ◽  
pp. 389-395
Author(s):  
Javier Ortiz ◽  
Thomas Hammerl ◽  
Maria Wasmaier ◽  
Valerie Wienerroither ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Short Term ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Arterial Ph ◽  
Intravenous Analgesia ◽  
Analgesic Technique ◽  
Umbilical Arterial Ph

Abstract Background Various methods of intrapartum analgesia are available these days. Pethidine, meptazinol and epidural analgesia are among the most commonly used techniques. A relatively new one is patient-controlled intravenous analgesia with remifentanil, although the experiences published so far in Germany are limited. Our goal was to study the influence of these analgesic techniques (opioids vs. patient-controlled intravenous analgesia with remifentanil vs. epidural analgesia) on the second stage of labour and on perinatal outcome. Material and Methods We conducted a retrospective study with 254 parturients. The women were divided into 4 groups based on the analgesic technique and matched for parity, maternal age and gestational age (opioids n = 64, patient-controlled intravenous analgesia with remifentanil n = 60, epidural analgesia n = 64, controls without the medicinal products mentioned n = 66). Maternal, fetal and neonatal data were analysed. Results The expulsive stage was prolonged among both primiparas and multiparas with patient-controlled intravenous analgesia with remifentanil (79 [74] vs. 44 [55] min, p = 0.016, and 28 [68] vs. 10 [11] min, p < 0.001, respectively) and epidural analgesia (90 [92] vs. 44 [55] min, p = 0.004, and 22.5 [73] vs. 10 [11] min, p = 0.003, respectively) compared with the controls. The length of the pushing stage was similar among primiparas in all groups but prolonged compared with the controls in multiparas with patient-controlled intravenous analgesia with remifentanil (15 [17] vs. 5 [7] min, p = 0.001) and epidural analgesia (10 [15] vs. 5 [7] min, p = 0.006). The Apgar, umbilical arterial pH and base excess values were similar between the groups, as were the rates of acidosis and neonatal intensive care unit admission. Conclusion Parturients with patient-controlled intravenous analgesia with remifentanil and epidural analgesia showed a prolonged expulsive stage compared with the opioid group and controls. The short-term neonatal outcome was not influenced by the three methods examined.

Liver laceration presented as intraabdominal bleeding in a newborn with hypoxic-ischemic encephalopathy

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Turkay Rzayev ◽  
Kivilcim Karadeniz Cerit ◽  
Nurdan Yildiz ◽  
Hulya Ozdemir ◽  
Asli Memisoglu ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Multiorgan Failure ◽  
Hypoxic Ischemic Encephalopathy ◽  
Case Presentation ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Abdominal Bleeding ◽  
Ischemic Encephalopathy

Abstract Objectives Birth injuries usually occur with two different mechanisms: trauma due to mechanic stress during labor and hypoxic-ischemic injury. Sometimes these two mechanisms can occur at the same time with a complex clinical picture. Case presentation The baby girl was born at 372/7 weeks after a prolonged second stage of labor, weighing 3,725 g, and was admitted to the Neonatal Intensive Care Unit with the diagnosis of hypoxic-ischemic encephalopathy. During follow up she developed multiorgan failure and severe anemia. On the third postnatal day, abdominal bleeding was detected. Laceration in the liver capsule was found and appeared to be the source of bleeding. Conclusions Abdominal bleeding secondary to mechanical laceration of the liver is hard to diagnose and may coexist with perinatal asphyxia.

Postpartum haemorrhage and associated factors among mothers who gave birth in South Gondar Zone public health facilities, Ethiopia: a cross-sectional study

2021 ◽  
pp. postgradmedj-2020-139382
Author(s):  
Asrat Hailu Dagne ◽  
Shimeles Biru Zewude
Keyword(s):  
Associated Factors ◽  
Postpartum Haemorrhage ◽  
Cross Sectional Study ◽  
Labour Induction ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Care Visit

BackgroundPostpartum haemorrhage is one of the direct and the leading causes of maternal morbidity and mortality. There are many risk factors of postpartum haemorrhage, which vary in different settings. Therefore, the purpose of this study was to assess postpartum haemorrhage and associated factors among mothers who gave birth in public health facilities.MethodsA cross-sectional study was employed from 17 November 2019 to 15 February 2020. The study participants were selected using a systematic sampling technique. The data were entered and cleaned using EpiData V.3.1 then exported to SPSS V.20 for analysis. Factors associated with postpartum haemorrhage were selected for multiple logistic regression at the probability value (p value) of less than 0.2 in the χ2 analysis. Statistically significant associated factors were identified at probability value (p value) less than 0.05 and adjusted OR (AOR) with a 95% CI.ResultsThe mean age of participants was 31.3 (SD ±5.7) years. This study found that the prevalence of postpartum haemorrhage was 13.6% (67). Age of participants (AOR 12.5, 95% CI 4.0 to 38.6), disrespectful maternity care (AOR 8.4, 95% CI 3.2 to 22.0), labour induction and augmentation (AOR 6.97, 95% CI 2.34 to 20.8), the prolonged second stage of labour (AOR 9.9, 95% CI 2.6 to 37.1) and no antenatal care visit (AOR 10.1, 95% CI 3.4 to 29.7) were statistically significant associated factors of postpartum haemorrhage.ConclusionsThe prevalence of postpartum haemorrhage is high. The age of the participants, disrespectful maternity care, labour induction and augmentation, the prolonged second stage of labour and no antenatal care visit were independent predictors of postpartum haemorrhage.

scholarly journals COMPARISON OF DURATION OF LABOUR BETWEEN PRIMIGRAVIDAS WITH AND WITHOUT AMNIOTOMY

1969 ◽  
Vol 3 (2) ◽  
pp. 379-382
Author(s):  
NAZIA LIAQAT ◽  
SAADIAYASMEEN ◽  
FARHAT NASIR ◽  
REHANA RAHIM.
Keyword(s):  
P Value ◽  
Stage Duration ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Number Of Patients ◽  
Group A ◽  
The Subject ◽  
The Mean ◽  
Group B ◽  
Duration Of Gestation

BACKGROUND: Amniotomy is a common and routine obstetrical procedure in many labour wards. It ismostly performed with the intention of accelerating the process of labour. The procedure is not risk free andthe results of various studies performed on the subject are diverse. The rationale of this study was to obtainconclusive evidence on the effect of amniotomy on the duration of labour and to establish protocols forlabour wards in the light of thatevidence.OBJECTIVES: To compare the duration of labour between primigravidas with and without amniotomy.METHODOLOGY: The total number of patients was 50 in each group; A and B who were subjected toamniotomy and no amniotomy respectively. Duration of First and Second stage of labour were noted andStudent T- test was applied to find the significance of difference in the duration of First and Second stages oflabour of the two groups. Data was analyzed using SPSS version 17.0.Results:: The mean ages of patients in Group A and B were 22.6+ 2.66 and 23± 2.03 years respectively (pvalue 0.647). The mean duration of gestation of Group A was 38.8+0.50 weeks and of Group B was 39.16 ±0.52 weeks (p value 0.0634). The duration of First Stage was 169+77 min in Group Aand 205+105 minutesin Group B (p value 0.2877). The Second stage duration was 78.6+45 in Group A and 72 ±32 minutes inGroup B (p value 0.6434).CONCLUSION: Amniotomy has no significant effect in shortening the duration of labour inprimigravidas.KEYWORDS: Amniotomy, Primigravidas, Labour

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