scholarly journals Correlation of Apgar score with serum glucose, calcium and electrolytes on the asphyxiated neonates

2019 ◽  
Vol 5 (5) ◽  
pp. 125
Author(s):  
Ashekul Islam ◽  
Farhana Yesmin ◽  
Mohammad Sayedul Islam ◽  
Nasreen Chowdhury ◽  
Mohammad Mosleh Uddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Apgar Score ◽  
Fatal Outcome ◽  
Neurodevelopmental Outcome ◽  
Birth Asphyxia ◽  
Perinatal Period ◽  
Serum Glucose ◽  
World Health ◽  
Strong Positive Correlation ◽  
Neonatal Deaths

<p class="abstract"><strong>Background:</strong> Neonatal asphyxia is characterized by discrepancy of oxygen during perinatal period that can lead to severe hypoxic ischaemic organ damages followed by a fatal outcome including neurodegenerative diseases, mental retardation, and epilepsies. According to world health organization, four million neonatal deaths occurred each year due to birth asphyxia. Therefore, our study was designed to evaluate the status of serum glucose, calcium, electrolytes, and their correlation with the fetal risk factors associated with birth asphyxia.</p><p class="abstract"><strong>Methods:</strong> Neonates diagnosed with birth asphyxia were considered as “cases” while neonates birth either normal or by cesarean with having no abnormality were considered as “control”. Demographics and possible risk factors of both the mother and neonate were noted. All asphyxiated neonates and controls were chosen to examine for serum glucose, calcium and electrolytes. Automated analyzers were used to estimate serum glucose, calcium, sodium and potassium.  </p><p class="abstract"><strong>Results:</strong> We found that the mean serum glucose level was significantly lower in the asphyxiated neonates compared with controls, and consequently showed very strong positive correlation with the Apgar score. Furthermore, significant reduction levels were observed in serum calcium and sodium in the asphyxiated neonates, showing a linear correlation with the Apgar score. Moreover, higher serum potassium was detected in the asphyxiated neonates than in controls, showing a negative correlation with the Apgar score.</p><p class="abstract"><strong>Conclusions:</strong> We validated that the examined biochemicals of asphyxiated neonates was strongly correlated with the Apgar score. Our study reinforces for adequate clinical evaluation and biochemical monitoring for early diagnosis to prevent adverse neurodevelopmental outcome.</p>

scholarly journals Clinical Profile of Birth Asphyxia in Dhulikhel Hospital: A Retrospective Study

1970 ◽  
Vol 30 (3) ◽  
pp. 141-146 ◽  
Author(s):  
S Dongol ◽  
J Singh ◽  
S Shrestha ◽  
A Shakya
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Birth Asphyxia ◽  
Clinical Information ◽  
World Health ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Neonatal Deaths ◽  
Live Births ◽  
Infant Birth

Introduction: Birth asphyxia is defined by the World Health Organization "the failure to initiate and sustain breathing at birth." The WHO has estimated that 4 million babies die during the neonatal period every year and 99% of these deaths occur in low-income and middle income countries. Three major causes account for over three quarters of these deaths, serious infection (28%) complication of preterm birth (26%) and birth asphyxia (23%). This estimation implies that birth asphyxia is the cause of around one million neonatal deaths each year. One of the present challenges is the lack of a gold standard for accurately defining birth asphyxia. Because of same reason the incidence of birth asphyxia is difficult to quantify. Objective: The aim of this study was to assess the prevalence of birth asphyxia, identify the common obstetric and neonatal risk factors, and study the cause of death. Methodology: All babies born in Dhulikhel Hospital (DH) from Jan 2007 to Oct 2009 with a diagnosis of birth asphyxia (5 min Apgar < 7 and those with no spontaneous respirations after birth) were included in the study (n=102). Clinical information was collected retrospectively from maternal records (maternal age, gravida, type of delivery, presence of meconium, induced or spontaneous labour, and pregnancy complications). The NICU records provided additional information about new born infant (birth asphyxia, stages of birth asphyxia, birth weight, sex and subsequent mortality). Results: Among the 3784 live births there were 102 babies with birth asphyxia prevalence of 26.9/1000 live births. Babies with Hypoxic ischemic encephalopathy (HIE) Stage 1 had a very good outcome but HIE III was associated with a poor outcome. Males, primipara and pregnancies with complications were associated with a higher rate of birth asphyxia. Septicaemia, necrotizing enterocolitis, preterm delivery, convulsion and, pneumothorax were associated with higher mortality and morbidity. Conclusion: Birth asphyxia was one of the commonest causes of admission and mortality in NICU. Babies with HIE Stage III had a very poor prognosis. Birth asphyxia combined with other morbidities was associated with a higher mortality. Sepsis is the commonest morbidity in cases of birth asphyxia. Maternal gravida, pregnancy complication with PROM, meconium, APH, emergency caesarean section, preterm and male sex were the risk factors for birth asphyxia. Key words: Birth asphyxia; HIE; Neonatal sepsisDOI: 10.3126/jnps.v30i3.3916J Nep Paedtr Soc 2010;30(3):141-146

scholarly journals No Take Home Baby After Caesarian Birth for Foetal Distress in Women with Risk

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cord Compression ◽  
High Rate ◽  
Neonatal Deaths ◽  
Fetal Ecg ◽  
Foetal Asphyxia

Sometimes interventions are done for the baby in women with risks but it turns out to be unnecessary caesarian section (CS). However it may be delayed decision and / or delayed execution of intervention, CS too, with no take home baby. While lack of adverse outcome reflected that the decision was not for a compromised foetus, still birth or asphyxiated baby at birth meant delayed decision and / or execution. Recent studies revealed an estimated 9.04 million perinatal deaths related to birth asphyxia. Of them 1.02 million were intrapartum deaths leading to still births, many after CB for foetal concern. Birth asphyxia is a significant global health problem, responsible for around 1.2 million neonatal deaths each year worldwide [1-3]. Those who survive often suffer from a range of disorders. Chauhan et al. conducted, a meta analysis comprising of 169 articles and 37 reports and concluded that the overall risk of prompt CB for fetal concern was 3.1 % (43,340 of 13,98,9740 cases) [4,5]. From time to time several hospital based studies have proved the role of various antepartum or intrapartum maternal & foetal risk factors which lead to foetal asphyxia. It is known that some disorders which could cause foetal asphyxia are obvious during pregnancy, some are labour related, be it mother or baby. Kaye reported association of primiparity, anaemia, hypertensive disorders of pregnancy, foetal growth restriction, malpresentation, antepartum haemorrhage, premature rupture of membranes, prematurity, fever, oxytocin augmentation of labour, umbilical cord prolapse, as risk factors ,with complex interplay between factors which predispose foetuses to poor outcome, due to decreased oxygenation, ACOG reported that foetal hypoxemia which if not compensated or corrected in time progressed to birth asphyxia and even death, either in utero or immediately after birth [6,7]. Gaffineet and James have reported, intrapartum hypoxia complicating around 1% of labours, resulting in foetal / neonatal deaths in 0.5/1000 pregnancies and cerebral palsy in 1 in 1000 cases diagnosed after swift delivery for clinically diagnosed “fetal distress’’ [8]. Earlier Murphy et al had suggested that reduced uterine perfusion uteroplacental vascular disease, low fetal reserve foetal asphyxia, foetal sepsis and cord compression with other gestational and antepartum factors could affect the fetal response which needed to be known. However diagnosis of FD also has to be correct and timely [9]. Cardiotocography (CTG) has been criticized for unnecessary high rate of operative delivery [10-12]. In the study by Roy, non-reassuring fetal heart rate (FHR) detected by CTG did not correlate well with neonatal outcome [13]. In the era of defensive practices, ‘play safe’ attitude results in high CS rate for non-reassuring FHR. The concept of detecting fetal acidosis, using fetal scalp blood appeared attractive, but practical difficulties in carrying it out restricted its use [14,15]. Roy et al suggested that since non-reassuring FHR detected by CTG did not correlate well with adverse neonatal outcome and resulted in unnecessary CS, fetal ECG needed to be introduced in addition to conventional CTG, wherever possible [13]. There are many such issues about timely appropriate authentic diagnosis and action.

scholarly journals Risk Factors for Perinatal Arterial Ischemic Stroke

Cell Medicine ◽  
2018 ◽  
Vol 10 ◽  
pp. 215517901878534 ◽  
Author(s):  
Daniela Munoz ◽  
María José Hidalgo ◽  
Fernanda Balut ◽  
Mónica Troncoso ◽  
Susana Lara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Cesarean Section ◽  
Apgar Score ◽  
Birth Asphyxia ◽  
Arterial Ischemic Stroke ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Associated Risk Factors ◽  
Perinatal Arterial Ischemic Stroke

Introduction: Arterial ischemic stroke in newborns is an important cause of neonatal morbidity and mortality. Its pathophysiology and associated risk factors are not yet clearly understood and defined. Objective: The aim of this retrospective study was to investigate possible risk factors in diagnosed cases of PAIS (perinatal arterial ischemic stroke). Materials and methods: Case–control study. Clinical data of patients with PAIS diagnosis were analyzed. Two healthy controls were selected for each PAIS case, matched for gestational age. Risk factors were explored using univariable and multivariable analysis. Outcome: 40 patients were included in the study, 24 males and 16 females; 52.5% of cases were diagnosed within the first month of birth, and 47.5% were retrospectively diagnosed. The results showed a male predominance (66.7%). The distribution of cerebral ischemic injury was predominantly medial cerebral artery (87.5%) and occurred more commonly in the left cerebral hemisphere (62.5%). Significant risk factors in the univariate analysis (P < 0.05) were primiparity, stillbirth, neonatal sepsis, asphyxia, twin pregnancy, placenta abruption, emergency cesarean section, Apgar score ≤7 after 5 min, breech presentation, and hyperbilirubinemia. In the multivariate analysis, primiparity (OR 11.74; CI 3.28–42.02), emergency cesarean section (OR 13.79; CI 3.51–54.13), birth asphyxia (OR 40.55; CI 3.08–532.94) and Apgar score ≤7 after 5 min (OR 13.75; CI 1.03–364.03) were significantly associated factors with PAIS. Only five (16.6%) patients had an abnormal thrombophilia study. Conclusion: Risk factors of primiparity, emergency cesarean section, birth asphyxia, and Apgar score ≤7 after 5 min were significantly associated with perinatal stroke. More studies with a larger number of patients and with prolonged follow up are required to establish more clearly the associated risk factors involved in this pathology.

scholarly journals Risk Factors Determining the Outcome of 2-12 Months Age Group Infants Hospitalized With Severe Pneumonia

2013 ◽  
Vol 25 (1) ◽  
pp. 9-13 ◽  
Author(s):  
KMF Uddin ◽  
N Jahan ◽  
MA Manan ◽  
SA Ferdousi ◽  
T Farhana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Fatal Outcome ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Pneumonia ◽  
World Health ◽  
Normal Infant ◽  
Age Group ◽  
Health Organization

Pneumonia is one of the leading causes of morbidity and mortality in under fives throughout the world, particularly in developing countries. A case control study was carried out in Bangabandhu Memorial Hospital, University of Science and Technology during the period of January to July 2006. 192 hospitalized infants of 2–12 months age group with World Health Organization(WHO) defined severe pneumonia with radiological confirmation were enrolled in the study, while controls were normal infant of same age group attending EPI center for vaccination. The children were managed using a standard protocol, factors were examined by univariate logistic regression analyasis. The factors whose odds ratio were significantly below 25% and considered as medically important were included in multivariate logistic regression analysis. Out of 192 children, 136(70.8%) were male, 56(29.2%) were female, 2-6 months old infants were 120(62.5%), >6 -12 months infants were 72(37.5%), malnutrition were present in 155( 80.72%), 145(75.5%) lived in slum area, 66(33.7%) were treated by quack, 63% were completely immunized and 3(10.5%) died. On multivariate analysis the following risk factors were found significant i.e. malnutrition, indoor smoke resulting from burning wood and manure used as fuel, non immunization, poor economy , poor housing. Significant risk factors for mortality in severe pneumonia are associated with 3rd degree malnutrition and congenital abnormality of heart with Downs syndrome. Malnutrition, indoor smoke, non-immunization, poor economy, poor housing, and smoking in bed room are important risk factors associated significantly with severe pneumonia and fatal outcome was associated with 3rd degree malnutrition. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15901 Medicine Today 2013 Vol.25(1): 9-13

Prediction of intracranial hemorrhages after mechanical thrombectomy of basilar artery occlusion

2019 ◽  
Vol 11 (12) ◽  
pp. 1181-1186 ◽  
Author(s):  
Ulf Neuberger ◽  
Fatih Seker ◽  
Silvia Schönenberger ◽  
Simon Nagel ◽  
Peter Arthur Ringleb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Basilar Artery ◽  
Mechanical Thrombectomy ◽  
Fatal Outcome ◽  
Artery Occlusion ◽  
Serum Glucose ◽  
Basilar Artery Occlusion ◽  
Glucose Levels ◽  
Potential Risk Factors ◽  
Logistic Regressions

BackgroundMechanical thrombectomy (MT) achieves high recanalization rates in basilar artery occlusion (BAO). A severe complication of MT in BAO is intracranial hemorrhage (ICH). Yet, knowledge of risk factors for ICH after MT in BAO is limited.ObjectiveTo evaluate clinical and procedural parameters of patients treated with MT owing to BAO to identify potential risk factors for ICH—in particular, symptomatic ICH (sICH), and assess their clinical relevance.MethodsWe conducted a retrospective analysis of 101 consecutive patients presenting with BAO, who were treated with MT in our centre. Important clinical and procedural parameters were analysed as possible predictors for any ICH and sICH according to the Heidelberg Bleeding Classification using univariate tests and multivariate logistic regressions.ResultsICH occurred in 25 (24.8%) patients, with a total of 7 (6.9%) developing sICH. Treatment with glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors was independently associated with any ICH (OR=24.67, 95% CI 4.90 to 124.03) and sICH (OR=7.08, 95% CI 1.36 to 36.78). Also, a longer onset-to-recanalization time increased the risk of both any ICH (OR=1.17, 95% CI 1.07 to 1.31) and sICH (OR=1.22, 95% CI 1.08 to 1.42). Higher serum glucose levels were associated with a higher incidence of any ICH (OR=1.39, 95% CI 1.06 to 1.85) and a higher risk of a fatal outcome (OR=1.03, 95% CI 1.01 to 1.05).ConclusionAdministration of GPIIb/IIIa inhibitor during the course of MT of BAO was identified as an important risk factor in the development of any ICH and sICH.

scholarly journals Study of cases of double mishap in a tertiary care teaching hospital

2019 ◽  
Vol 8 (4) ◽  
pp. 1650
Author(s):  
Fasiha Tasneem ◽  
Vijayalakshmi Shanbhag
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Active Management ◽  
World Health ◽  
Perinatal Morbidity ◽  
Neonatal Deaths ◽  
Third Stage ◽  
Mother And Child ◽  
Foetal Outcome

Background: “Make every mother and child count”- the slogan for World health day 2005 reflects the reality and need of the society even today. In India, many women die due to pregnancy-related complications and those who survive suffer from severe maternal morbidity. Authors have been impressed that the same obstetric conditions that kill mothers are also responsible for most of the stillbirths and many of the neonatal deaths as well. This is the study to identify the risk factors that has an effect on the health of both mother and baby, to evaluate the complications leading to maternal and perinatal morbidity or mortality so that timely interventions to prevent maternal and perinatal morbidity and mortality can be made.Methods: All the cases getting admitted in Dr SCGMC Nanded are analysed for maternal and foetal outcome over the study period of 18 months. The cases with both maternal and perinatal morbidity or mortality are included in the study. The associating factors and comorbidities if associated with the cases of double mishap are studied.Results: During the study period of 18mths, there were 21905 deliveries conducted in the study hospital and 742 reffered cases of outside hospital deliveries, it was found that there were 204 cases of double mishap. Out of 204 cases of double mishap, 71.56% had preeclampsia, 29.41% were anaemic, 6.86% had febrile illness, 4.41% were of placenta praevia, 33.33% had abruptio placenta.Conclusions: Authors can conclude by stating that through better antenatal care, early detection and proper management of risk factors like pre-eclampsia, anaemia and active management of third stage of labour with careful feto maternal monitoring the absolute goal of Obstetrics of having a healthy mother and healthy baby at the end of delivery can be achieved.

Serum Retinol and β-carotene Levels and Risk Factors for Cardiovascular Disease in Morbid Obesity

2010 ◽  
Vol 80 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Gabriela Villaça Chaves ◽  
Gisele Gonçalves de Souza ◽  
Andréa Cardoso de Matos ◽  
Dra. Wilza Abrantes Peres ◽  
Silvia Elaine Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Morbid Obesity ◽  
Serum Levels ◽  
World Health ◽  
Morbidly Obese ◽  
Serum Retinol ◽  
Significant Difference ◽  
Β Carotene

Objective: To evaluate retinol and β-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. Methodology: Blood serum concentrations of retinol and β-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and β-carotene serum levels were evaluated. Results: Metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of β-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, β-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average β-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. Conclusion: Considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

Prevention of Preterm Birth

2018 ◽  
Vol 11 (2) ◽  
pp. 95-104
Author(s):  
Ivan D. Ivanov ◽  
Stefan A. Buzalov ◽  
Nadezhda H. Hinkova
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
High Risk ◽  
Medical Science ◽  
Secondary Prophylaxis ◽  
High Risk Group ◽  
Screening Methods ◽  
Perinatal Complications ◽  
Social Significance ◽  
Neonatal Deaths

Summary Preterm birth (PTB) is a worldwide problem with great social significance because it is a leading cause of perinatal complications and perinatal mortality. PTB is responsible for more than a half of neonatal deaths. The rate of preterm delivery varies between 5-18% worldwide and has not decreased in recent years, regardless of the development of medical science. One of the leading causes for that is the failure to identify the high-risk group in prenatal care. PTB is a heterogeneous syndrome in which many different factors interfere at different levels of the pathogenesis of the initiation of delivery, finally resulting in delivery before 37 weeks of gestation (wg). The various specificities of risk factors and the unclear mechanism of initiation of labour make it difficult to elaborate standard, unified and effective screening to diagnose pregnant women at high-risk for PTB correctly. Furthermore, they make primary and secondary prophylaxis less effective and render diagnostic and therapeutic measures ineffective and inappropriate. Reliable and accessible screening methods are necessary for antenatal care, and risk factors for PTB should be studied and clarified in search of useful tools to solve issues of risk pregnancies to decrease PTB rates and associated complications.

Does HbA1cc Play a Role in the Development of Cardiovascular Diseases?

2018 ◽  
Vol 24 (24) ◽  
pp. 2876-2882 ◽  
Author(s):  
Kailash Prasad
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Cardiovascular System ◽  
Half Life ◽  
Serum Levels ◽  
Serum Glucose ◽  
Cvd Risk ◽  
Factors Affecting ◽  
Diagnosis And Management ◽  
Coronary Artery Atherosclerosis

Cardiovascular diseases (CVD) may be mediated through increases in the cardiovascular risk factors. Hemoglobin A1c (HbA1c) also called glycated hemoglobin is presently used for the diagnosis and management of diabetes. It has adverse effects on cardiovascular system. This review deals with its synthesis and effects on the cardiovascular system. The serum levels of HbA1c have been reported to be affected by various factors including, the lifespan of erythrocytes, factors affecting erythropoiesis, agents interfering glycation of Hb, destruction of erythrocytes, drugs that shift the formation of Hb, statins, and drugs interfering the HbA1c assay. Levels of HbA1c are positively correlated with serum glucose and advanced glycation end products ( AGE), but no correlation between AGE and serum glucose. AGE cannot replace HbA1c for the diagnosis and management of diabetes because there is no correlation of AGE with serum glucose, and because the half-life of protein with which glucose combines is only 14-20 days as compared to erythrocytes which have a half-life of 90-120 days. HbA1c is positively associated with CVD such as the carotid and coronary artery atherosclerosis, ischemic heart disease, ischemic stroke and hypertension.HbA1c induces dyslipidemia, hyperhomocysteinemia, and hypertension, and increases C-reactive protein, oxidative stress and blood viscosity that would contribute to the development of cardiovascular diseases. In conclusion, HbA1c serves as a useful marker for the diagnosis and management of diabetes. AGE cannot replace HbA1c in the diagnosis and management of diabetes. There is an association of HbA1c with CVD which be mediated through modulation of CVD risk factors.

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