Study of Cord Blood Erythropoietin, Leptin and Adiponectin Levels in Neonates with Hypoxic Ischemic Encephalopathy

2020 ◽  
Vol 20 (2) ◽  
pp. 213-220
Author(s):  
Adel A. Hagag ◽  
Mohamed S. El Frargy ◽  
Amal E. Abd El-Latif
Keyword(s):  
Cord Blood ◽  
Gestational Age ◽  
Apgar Score ◽  
Moderate Degree ◽  
Early Predictors ◽  
Group I ◽  
Appropriate For Gestational Age ◽  
Group Ii ◽  
Normal Neonates ◽  
Ischemic Encephalopathy

Background: Hypoxic ischemic encephalopathy (HIE) is a serious condition which results in neonatal morbidity and mortality. Early prediction of HIE especially in the first six hours of birth leads to early treatment with better prognosis. Aim: The aim of this study was to compare the concentrations of leptin, adiponectin, and erythropoietin between normal neonates and those with HIE for the possible use of these markers for assessment of the degree of HIE and as markers for early prediction of HIE. Patients and Methods: This study was carried out on 50 appropriate for gestational age (AGA) neonates with HIE born in Tanta University Hospital during the period from June 2016 to March 2018 (Group I). This study also included 50 appropriate for gestational age (AGA) normal neonates not suffering from any complications and matched with group I in age and sex as a control group (Group II). For all neonates in both groups, the following were done: Complete prenatal, natal, and postnatal history, assessment of APGAR score at 5 and 10 minutes, complete clinical examination with special account on clinical evidence of encephalopathy including hypotonia, abnormal oculomotor or pupillary movements, weak or absent suckling, apnea, hyperpnea, or seizures, measurement of cord blood gases and measurement of serum erythropoietin, leptin and adiponectin levels by ELISA immediately after birth. Results: There were no significant differences between Group I and Group II regarding gestational age, male to female ratio, mode of delivery, and weight while there were significant differences regarding Apgar score at 1 and 5 minutes with significantly lower Apgar score at 1 and 5 minutes in group I compared with Group II. There were significantly lower cord blood PH and adiponectin level and significantly higher cord blood Leptin and erythropoietin in group I compared with group II. There were significant differences between cord blood adiponectin, leptin, erythropoietin, and PH in different degrees of HIE with significantly lower cord blood adiponectin and PH and significantly higher cord blood leptin and erythropoietin in severe degree of hypoxia compared with moderate degree and in moderate degree compared with mild degree of hypoxia. There was a significant positive correlation between cord blood erythropoietin and leptin and a significant negative correlation between cord blood erythropoietin and both adiponectin and PH in studied neonates with hypoxia. ROC curve showed that EPO had the best sensitivity and specificity followed by leptin then adiponectin while the PH had the least sensitivity and specificity as early predictors of hypoxic neonates. Conclusion and Recommendations: Neonates with HIE had lower cord blood PH and adiponectin levels and higher leptin and erythropoietin levels than normal healthy neonates at birth and during the early postnatal period. The significant differences between cord blood erythropoietin, leptin, and adiponectin between neonates with hypoxia compared with normal neonates may arouse our attention about the use of these markers in the cord blood as early predictors of neonatal HIE which can lead early treatment and subsequently better prognosis.

scholarly journals Cord Blood Bilirubin, Albumin and Bilirubin/Albumin Ratio versus Hydrogen Peroxide as Early Predictors of Significant Neonatal Hyperbilirubinemia

2020 ◽  
pp. 34-42
Author(s):  
Sohayla Abdel Rahman Deghady ◽  
Mohamed Ahmed Rowisha ◽  
Ashraf Mohamed Ibrahim ◽  
Walaa Arafa Kishk
Keyword(s):  
Hydrogen Peroxide ◽  
Cord Blood ◽  
Gestational Age ◽  
Albumin Ratio ◽  
Early Predictors ◽  
Group I ◽  
Blood Albumin ◽  
Group Ii ◽  
Positive Significant Correlation

Aims: To evaluate significance of cord blood bilirubin, albumin, bilirubin /albumin ratio and hydrogen peroxide as early predictors of significant neonatal hyperbilirubinemia. Place and Duration of Study: Egypt, Tanta University Hospital (at delivery room and follow up was done in Neonatal Intensive Care Unit (NICU) over one year from April 2019 to April 2020. Methodology: We included 80 neonates allocated into two groups (40 each), Group I included neonates with gestational age between 30 to less than 35 weeks, Group II neonates with gestational age ≥35 weeks. They were subjected to history taking, clinical assessment and lab investigations (cord blood albumin, bilirubin, hydrogen peroxide level and blood bilirubin/albumin ratio, 3rd day total and direct serum bilirubin level and others). Follow up done for developing jaundice on 3rd day. Results: There was statistically significant increase in the incidence of significant hyperbilirubinemia in group I (82.5%) in comparison with group II (27.5%) (P-value <0.001). There was positive significant correlation between cord blood bilirubin (P<0.001), bilirubin/albumin ratio (P <0.001) and hydrogen peroxide (P=0.012 in GI) (P = 0.001 in GII) and 3rd day TSB levels in the studied groups. There was negative significant correlation between cord blood albumin and 3rd day TSB levels in the studied groups (P < 0.001). There was positive significant correlation between cord blood bilirubin (P <0.001 in GI) (P =0.024 in GII), bilirubin/ albumin ratio (P <0.001 in GI) (P =0.002 in GII) and hydrogen peroxide (P <0.001) and the duration of phototherapy in the studied groups. There was negative significant correlation between cord blood albumin and the duration of phototherapy in group I (P =0.001), while there was no significant correlation between cord blood albumin and the duration of phototherapy in group II (P = 0.118). Conclusion: When comparing the four cord predictors for significant indirect hyperbilirubinemia; bilirubin/albumin ratio was the most accurate predictor with higher sensitivity and specificity, followed by cord blood bilirubin, then albumin, while hydrogen peroxide was the least accurate in all neonates ≥ 30 weeks.

scholarly journals Outcome of babies admitted with hypoxic-ischemic encephalopathy in Neonatal Unit of Services Hospital, Lahore

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Muhammad Nasir Rana ◽  
Muhammad Yakoob Kazi ◽  
Ambreen Nasir ◽  
Muhammad Abbas
Keyword(s):  
Congenital Anomaly ◽  
Apgar Score ◽  
Descriptive Study ◽  
Neonatal Unit ◽  
Advanced Technology ◽  
Medical Sciences ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Ischemic Encephalopathy

Objectives: To determine the outcome of newborns, admitted with different stages of HIE in Neonatal Unit, Services Hospital, Lahore. Study design: Descriptive Study. Place and duration of study: Neonatology Section, Pediatrics Department, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore. Over a period of Six months, from 1st August 2005 to 31st January 2006. Material & methods: A total of 170 newborns having Apgar score less than 7 were included in the study. Babies with any congenital anomaly were excluded. Results: 80% were males. 17.64% had weight less than 1.5 Kg, 37.06% weight between 1.5 Kg to 2.5 Kg and 45.29% had weight more than 2.5 Kg. 90.5% of our babies were delivered in Services Hospital, Lahore. 77.64% babies were full term. Babies were divided into three groups; Group-I had Apgar score 0-3, Group-II between 4 & 5 and Group-III had Apgar score 6-7. In Group-I, 65% babies died, whereas 100% had any one of the complications, in Group-II, there were 22% deaths and no baby died from Group-III. Conclusions: Despite advanced technology, a high number of babies have HIE and its complications. It is better to prevent babies from HIE, because once HIE occur, you cannot save babies completely from its complications.

Maternal zinc and intrauterine growth retardation

1985 ◽  
Vol 68 (4) ◽  
pp. 395-399 ◽  
Author(s):  
Karen Simmer ◽  
R. P. H. Thompson
Keyword(s):  
Racial Differences ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Intrauterine Growth Retardation ◽  
Maternal Plasma ◽  
Intrauterine Growth ◽  
Group I ◽  
Appropriate For Gestational Age ◽  
Group Ii ◽  
Zinc Levels

1. The levels of zinc in plasma, erythrocytes, polymorphonuclear (PMN) and mononuclear (MN) white cells were measured after delivery in women giving birth to appropriate-for-gestational-age (AGA) babies (group I mothers), or small-for-gestational-age (SGA) babies (group II mothers) and in non-pregnant controls. 2. Mean maternal plasma zinc and albumin levels 24-48 h after delivery were lower than in controls, but PMN and MN zinc levels were unchanged. PMN zinc levels were lower than those of MN cells. 3. PMN and MN zinc levels were significantly lower in group II mothers than in group I, irrespective of smoking habits. There were no racial differences in peripheral white cell zinc levels. 4. PMN, and to a lesser degree MN, zinc levels were lower in smoking than in non-smoking mothers. 5. Erythrocyte zinc did not correlate with other zinc measurements nor with the size of the babies. Fetal erythrocyte zinc levels were one-third of maternal levels. 6. A combination of smoking and/or low PMN zinc levels selects 85% of mothers having small-for-gestational-age babies.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

scholarly journals Aminoglycoside trough levels in neonates

2010 ◽  
Vol 138 (1-2) ◽  
pp. 50-55 ◽  
Author(s):  
Biljana Pejovic ◽  
Milica Rankovic-Janevski ◽  
Niveska Bozinovic-Prekajski
Keyword(s):  
Gestational Age ◽  
Trough Level ◽  
Inverse Correlation ◽  
Risk Groups ◽  
Target Range ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Difference ◽  
Trough Levels

Introduction. Drug safety depends on trough levels. Objective. Objective of the study was to measure gentamicin and amikacin trough levels in neonates and to identify risk groups by gestational and postnatal age. Methods. Gentamicin and amikacin were applied according to the clinical practice guidelines. Trough levels (mg/l) were deter- mined using fluorescence polarization immunoassay methodology. Target trough levels were <2 mg/l for gentamicin, and <10 mg/l for amikacin. Patients were divided in 3 groups by gestational age: I ?32, II 33-36, and III ?37 gestational weeks and, by postnatal age, in 2 groups: ?7 and >7 days. Results. Out of 163 neonates, 111 were receiving gentamicin and 52 amikacin. Mean amikacin trough level was 7.8?4.8 mg/l and, in group I 10.5?4.9 mg/l, which was above the target range and significantly higher than in group II (LSD, p<0.05). In the amikacin group, 26 patients were 7 and less, and 26 more than 7 days old, without significant differences in trough levels between the groups. In the gentamicin group, 52.3% of neonates had trough values within the target range. Gentamicin trough level in group I was above the trough range, 3.7?1.8, 2.3?1.5 in group II and, 1.8?1.4 mg/l in group III. The difference in trough levels among the groups was highly significant (F=9.015, p<0.001, ?2=17. 576, p<0.001). Further analysis revealed that differences between groups I and II (LSD, p=0.002) and between I and III (LSD, p=0.000) were highly significant. Conclusion. Obtained gentamicin and amikacin trough levels are high. Inverse correlation has been confirmed between trough level and gestational age, with highly significant difference, and the risk group has been identified. There is obviously a need to change the dosing regimen in terms of those with extended intervals, particularly for neonates of the lowest gestational age, along with pharmacokinetic measurements.

Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

2018 ◽  
Vol 61 (7) ◽  
pp. 1784-1793
Author(s):  
Lilian Cássia Bórnia Jacob-Corteletti ◽  
Eliene Silva Araújo ◽  
Josilene Luciene Duarte ◽  
Fernanda Zucki ◽  
Kátia de Freitas Alvarenga
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Pure Tone ◽  
Broadband Noise ◽  
Acoustic Reflex ◽  
Group I ◽  
Group Ii ◽  
Gestational Age At Birth ◽  
Age At Birth

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

Neonatal Polycythemia: I. Early Diagnosis and Incidence Relating to Time of Sampling

PEDIATRICS ◽  
1984 ◽  
Vol 73 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Mordechai Shohat ◽  
Paul Merlob ◽  
Salomon H. Reisner
Keyword(s):  
Early Diagnosis ◽  
Cord Blood ◽  
Gestational Age ◽  
Linear Correlation ◽  
Blood Viscosity ◽  
Full Term ◽  
Peripheral Vein ◽  
Dynamic Changes ◽  
Term Infants ◽  
Appropriate For Gestational Age

The dynamic changes occurring in hematocrit and blood viscosity within the first 18 hours of life were studied in 50 full-term infants who were vaginally delivered and had weight appropriate for gestational age. In all cases, the cord was clamped within 30 seconds and cord blood was collected from the vein and artery. Subsequently, samples were taken from a peripheral vein at ages 15 minutes, and 2, 4, 6, and between 12 to 18 hours. Both the Hct and blood viscosity reach their peak at age 2 hours. The incidence of neonatal polycythemia varied greatly with age. Thus at the age of 2 hours, ten infants (20%) were polycythemic, whereas by age 6 hours only six (12%) of these infants were still polycythemic and by age 12 to 18 hours only one infant (2%) was polycythemic. A linear correlation was found between cord Hct levels and peripheral venous Hct levels by age 2 hours. None of the infants with cord blood Hct levels ≤56% had developed polycythemia, whereas ten of the 12 infants with cord Hct levels &gt;56% developed polycythemia. In this particular group of infants, cord blood Hct levels may be used for the screening of neonatal polycythemia.

NORMALAND ABNORMAL LIQUOR VOLUME AND ITS CORRELATION WITH PERINATAL OUTCOME

2021 ◽  
pp. 4-6
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Fetal Distress ◽  
Special Unit ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
One Year ◽  
Four Quadrant

Aim:To assess and compare the perinatal outcome among mothers with normal and abnormal amniotic uid volume. Method: A prospective comparative study was conducted for a period of one year from January 2020 to December 2020. Group I consist of 50 patients with normal amniotic uid and group II consists of 50 patients with either oligohydramnios or polyhydramnios. Amniotic uid index (AFI) was calculated using Phalen's four quadrant technique using ultrasound. The perinatal outcome was judged by assessing the fetal distress predicted by abnormal fetal heart rate (FHR) or meconium stained liquor, one minute and 5 minute Apgar score, frequency of admission to neonatal intensive care unit (NICU), baby weight of less than 10th percentile for gestation age and perinatal mortality. Results: Induction of labour, caesarean section and meconium stained liquor was found to be most common among the patients in group II (abnormal AFI) in comparison with normal AFI subjects and similarly the perinatal outcome measures like low birth weight, increased frequency of admission to NICU due to respiratory distress and a low APGAR score was more commonly found in abnormal AFI group and the difference was found to be statistically signicant. Conclusion: AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

scholarly journals The 5-minute Apgar Score as a Prognostic Factor for Development and Progression of Retinopathy of Prematurity

Folia Medica ◽  
2017 ◽  
Vol 59 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Vasil G. Marinov ◽  
Desislava N. Koleva-Georgieva ◽  
Nelly P. Sivkova ◽  
Maya B. Krasteva
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Apgar Score ◽  
Prognostic Significance ◽  
Significant Risk ◽  
Exact Test ◽  
Group I ◽  
Group Ii ◽  
Minute Apgar Score

Abstract Background: A low Apgar score at 5 minutes has been shown to be a risk factor for development of retinopathy of prematurity (ROP). Aim: To examine the prognostic value of Apgar score at 5 minutes for development and progression of ROP. Materials and methods: The study included 132 preterm infants who were screened from 4th week of life onward. Of these, 118 newborns were given Apgar score at 5 minutes. The prognostic significance of this index was studied as an absolute value and as a value ≤ 6. The patients were divided into two groups: group I had no evidence of ROP (n=82) and group II had some signs of ROP (n = 36). Group II was further divided into group IIA - spontaneously regressed cases (n=22), and group IIB with cases which progressed to treatment stages (n=14). We investigated 15 maternal and 20 newborn presumable risk factors for development and progression of ROP. Mann-Whitney U test, χ2 or Fisher’s exact test were used in the statistical analysis. Logistic regression was performed to find significant and independent risk factors for manifestation and progression of ROP. Results: A low 5-minute Apgar score and an Apgar score of 6 or less at 5 minutes were not statistically significant risk factors of ROP (р=0.191, р=0.191, respectively), but were significant risk factors for the manifested ROP to progress to stages requiring treatment (p=0.046, р=0.036, respectively). Conclusion: An Apgar score at 5 minutes of 6 or less was a significant and independent risk factor for progression of ROP to stages requiring treatment.

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