scholarly journals Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.

2021 ◽  
Vol 28 (08) ◽  
pp. 1114-1119
Author(s):  
Saqib Aslam ◽  
◽  
Sadaf Minhas ◽  
Muhammad Azhar Farooq ◽  
Beenish Bashir Mughal ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Full Term ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
The Mean

Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping. Study Design: Randomized Controlled Trial. Setting: KRL General Hospital Islamabad (Labor Room/ Neonatology). Periods: December 2017 to June 2018. Material & Methods: 190 full term neonates were selected and divided into 2 equal groups randomly: Early cord clamping group after delivery and late cord clamping group. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks. Of 190 neonates, 91 (47.9%) were males, 99 (52.1%) were females. Mean birth weight was 3.64 ± 0.72 kg while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively. Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, 35 (18.4%) neonates were anemic in this study. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Mean Hb levels were statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg. Rest of the stratification groups showed significant difference. Conclusion: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping.

Early versus delayed cord clamping in term neonates.

2021 ◽  
Vol 28 (05) ◽  
pp. 656-660
Author(s):  
Samina Mumtaz ◽  
Shagufta Tabassum ◽  
Saima Afzal
Keyword(s):  
Gestational Age ◽  
Controlled Trial ◽  
Hemoglobin Level ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
Group A ◽  
Group B

Objective: To compare mean hemoglobin levels of neonates after early and late cord clamping. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynaecology at Nishtar Hospital Multan. Period: June 2019 to December 2019. Material & Methods: A total of 60 women booked and unbooked were included in study. Selected patients randomized into group A and B, each group comprising of 30 patients depending upon the envelope with assigned treatment (either early or delayed cord clamping) picked up by the patient. Results: In present study, two groups were made. Group A consisted of 30 neonates in whom early cord clamping was done while in group B delayed clamping was done in 30 neonates. Mean age of mothers was 28.4±0.4 vs. 28.6±0.5 years in group A and B respectively. There were 25 mothers (83.3%) in group A and 21 mothers (70%) in group B between 25–30 years. There were 5 mothers (16.7%) in group A and 8 mothers (26.7%) in group B between 31–35 years of age. While none of the mother in group A and 1 mother (3.3%) in group B was between 36–40 years of age. Mean parity of the mothers was 1.1±0.2 vs. 1.4±0.2 in group A and B respectively. Eight mothers (85.4%) in group A and 7 mothers (82.5%) in group B were primipara. While 22 mothers (14.6%) in group A and 23 mothers in group B (17.5%) were para 1–3. Gestational age was 37–38 weeks in 13(43.3%) vs. 19(63.3%) women in group A and B respectively. While there were 17(56.7%) vs. 11(36.7%) women in group A and B respectively of the gestational age 39–40 weeks. Pre-delivery maternal mean hemoglobin levels was 11.9±0.1 gm/dl vs. 12.3±0.1 gm/dl in group A and B respectively. Pre-delivery maternal hemoglobin levels were 10–10.9 g/dl in 2 mothers (6.7%) vs. 1 mother (3.3%) in group A and B respectively. Neonatal mean hemoglobin levels were 16.8±0.2 g/dl vs. 17.7±0.1 g/dl in group A and B respectively. Out of the 31 booked mothers, neonatal mean hemoglobin level was 16.8±0.2 g/dl vs. 17.9±0.1 g/dl in group A and B respectively. While out of the 29 unbooked mothers, neonatal mean hemoglobin level was 16.7±0.2 g/dl vs. 17.5±0.1 g/dl in group A and B respectively. When compared the neonatal mean hemoglobin levels, there was significant difference between mean hemoglobin levels of neonates between the two groups (p=0.000). Conclusion: Delayed cord clamping in term neonates for a minimum of 2 minutes at birth is beneficial to the newborn in terms of improved hemoglobin levels. There is no significant difference seen in pre-delivery maternal hemoglobin levels and neonatal hemoglobin either in delayed cord clamping group or in early cord clamping group.

Reference values for the external genitalia of full-term and pre-term female neonates

2020 ◽  
Vol 106 (1) ◽  
pp. 39-44
Author(s):  
Sarah Castets ◽  
Kim-An Nguyen ◽  
Franck Plaisant ◽  
Malika Baya Prudon ◽  
Ingrid Plotton ◽  
...  
Keyword(s):  
Birth Weight ◽  
Reference Values ◽  
Gestational Age ◽  
Neonatal Period ◽  
External Genitalia ◽  
Full Term ◽  
Significant Difference ◽  
Study Centre ◽  
The Mean ◽  
A Prospective Study

Background and objectivesIdentifying virilisation of the genitalia in female newborns early during the neonatal period is important to diagnose pathologies. However, there is no clear threshold for clitoromegaly or for the anogenital ratio. The objective of this study was to define reference values for the external genitalia of full-term and pre-term female neonates.DesignThis was a prospective study of all females born in the study centre between May 2014 and July 2016. Clitoral length and anogenital ratio were measured in 619 newborns with a gestational age of 24+2 to 41+3 weeks during their first 3 days of life. Associations between the values at day 3 and gestational age, birth weight and other newborn characteristics were examined by linear regression.ResultsThe mean clitoral length at day 3 of life was 3.69±1.53 mm (n=551; 95th percentile, 6.5 mm; maximum, 8 mm), and the mean anogenital ratio was 0.42±0.09 (95th percentile, 0.58). There was no significant variation with gestational age or birth weight, and no significant difference between the results at day 0 and day 3.ConclusionThese results suggest that clitoromegaly can be defined as a clitoral length >6.5 mm. Values ≥8 mm should prompt further investigations. An anogenital ratio >0.6 should be considered a sign of virilisation. Since clitoral size does not vary with gestational age or birth weight, clitoromegaly should not be attributed to prematurity.

Effect of Delayed Cord Clamping Reduced Anemic Outcome in Preterm Neonate

2021 ◽  
Vol 104 (5) ◽  
pp. 695-700
Keyword(s):  
Intraventricular Hemorrhage ◽  
Preterm Neonate ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
Maternal Outcomes ◽  
Delayed Cord Clamping ◽  
Randomized Controlled ◽  
Cord Clamping ◽  
Significant Difference ◽  
The Mean

Objective: To compare the effects of immediate versus delayed cord clamping on neonatal outcomes in preterm neonates of gestational age of 32 to 36⁺⁶ weeks, and maternal outcomes. Materials and Methods: A randomized controlled trial was conducted in the Obstetrics and Gynecology Department at Bhumibol Adulyadej Hospital, in Bangkok, Thailand. The study compared the effects of immediate to delayed cord clamping at 60 seconds among preterm neonates born between 32 weeks, 0 day and 36 weeks, 6 days of gestation between August and October 2018. Results: The mean age of the participants was 26 years old, and half of the cases were nulliparous. One hundred ten women were randomly separated into two equal groups (n=55). Delayed cord clamping at 60 seconds increased hematocrit levels (Hct) in both two (p=0.004) and 48 (p<0.001) hours after delivery compared to the immediate cord clamping group. There were no differences in exposing the neonate to hypothermia, hypoxemia, Apgar score at 1-minute, polycythemia, intraventricular hemorrhage, hyperbilirubinemia, length of stay in hospital, and affecting the process of resuscitation. There were no statistical differences between the two groups in maternal outcomes such as retained placenta and postpartum hemorrhage. Conclusion: Delayed cord clamping at 60 seconds increased Hct in the newborn at two to 48 hours after birth. There was no significant difference in adverse maternal and neonatal complications within both groups. Keywords: Delayed cord clamping, Hematocrit, Preterm

scholarly journals Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial

2007 ◽  
Vol 47 (1) ◽  
pp. 12
Author(s):  
Nugroho Karyadiguna ◽  
Soetjiningsih Soetjiningsih ◽  
W. Retayasa ◽  
M. Kardana
Keyword(s):  
Birth Weight ◽  
Hepatitis B ◽  
Gestational Age ◽  
Controlled Trial ◽  
Chronological Age ◽  
Medical Procedures ◽  
Double Blind ◽  
Term Neonates ◽  
The Mean ◽  
Lidocaine Prilocaine

Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairsemotional bonding, and causes hyperalgesia. Combination oflidocaine and prilocaine cream is one of the topical analgesicsthat are easy to use and safe for neonates.Objective To assess the efficacy of lidocaine-prilocainecombination cream in reducing pain caused by intramuscularinjection of hepatitis B and to find out the correlation of sex,gestational age, birth weight, chronological age, and method ofdelivery with infant’s pain response.Methods A double blind randomized controlled trial wasconducted on term neonates. Subjects were selected consecutivelyand every subject was randomized to either receive lidocaine-prilocaine cream or placebo one hour prior to administration ofintramuscular hepatitis B vaccine. The administration wasrecorded by a handycam and the intensity of pain responses wasevaluated using DAN (Douleur Aigue Nouveau-ne) scale.Results Of 67 subjects, the mean of DAN scale was 7.60 (95%CI 7.27;7.95) in the lidocaine-prilocaine cream group and thiswas significantly lower (P<0.0001) than in placebo group, whichwas 8.82 (95% CI 8.56;9.09). ANCOVA showed that there wereno associations between sex, gestational age, birth weight,chronological age, and method of delivery with infant’s painresponse.Conclusion Lidocaine-prilocaine combination cream can reducethe pain caused by intramuscular injection of hepatitis B vaccineon term neonates.

scholarly journals Effect of umbilical cord milking versus delayed cord clamping on preterm neonates in Kenya: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246109
Author(s):  
Mandeep Sura ◽  
Alfred Osoti ◽  
Onesmus Gachuno ◽  
Rachel Musoke ◽  
Frank Kagema ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Neonatal Jaundice ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
The Mean ◽  
Neonatal Polycythaemia ◽  
Umbilical Cord Milking

Background Delayed cord clamping (DCC) is a placental to new-born transfusion strategy recommended by obstetric and gynaecological societies. Though not widely adopted, umbilical cord milking (UCM) may achieve faster transfusion when DCC cannot be performed such as when a neonate requires resuscitation. Methods Pragmatic, two-arm, randomized clinical trial in which consenting women in spontaneous labour or provider-initiated delivery at 28 to less than 37 weeks at Kenyatta National Hospital in Nairobi, Kenya, were enrolled. At delivery, stable preterm infants were randomized to UCM (4 times) or DCC (60 seconds). Neonatal samples were collected for analysis at 24 hours after delivery. Maternal primary PPH (within 24 hours) and neonatal jaundice (within 1 week) were evaluated clinically. The primary outcome was the mean neonatal haemoglobin level at 24 hours after birth. Modified Intention to treat analysis was used for all outcomes. P-value was significant at p<0.05. Results Between March 2018 to March 2019, 344 pregnant women underwent screening, and 280 eligible participants were randomized when delivery was imminent. The intervention was not performed on 19 ineligible neonates. Of the remaining 260 neonates, 133 underwent UCM while 128 underwent DCC. Maternal and neonatal baseline characteristics were similar. The mean neonatal haemoglobin (17.1 vs 17.5 grams per decilitre, p = 0.191), haematocrit (49.6% vs 50.3%, p = 0.362), anaemia (9.8% vs 11.7%, p = 0.627), maternal PPH (2.3% vs 3.1%, p = 0.719) were similar between UCM and DCC respectfully. However, neonatal polycythaemia (2.3% vs 8.6%, p = 0.024) and neonatal jaundice (6.8% vs 15.6%, p = 0.024) were statistically significantly lower in UCM compared to DCC. Conclusion UCM compared to DCC for preterm neonates resulted in similar outcomes for neonatal haemoglobin, haematocrit, anaemia and maternal primary PPH and a lower proportion of neonatal polycythaemia and clinical jaundice. UCM offers a comparable method of placental transfusion compared to DCC and may be considered as an alternative to DCC in preterm neonates at 28 to <37 weeks’ gestation.

scholarly journals Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Maternal Risk Factors ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
The Mean

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.

Evaluation of Lipid Profile in Premature, Near-term and Term Newborn Infants

2017 ◽  
Vol 2 (09) ◽  
Author(s):  
Dr. Ram Manohar Kurrey ◽  
Dr. Kavita J. Lall ◽  
Dr. Karan Singh Chandrakar
Keyword(s):  
Lipid Profile ◽  
Total Cholesterol ◽  
Gestational Age ◽  
Newborn Infants ◽  
Precipitation Method ◽  
Assay Method ◽  
P Value ◽  
Term Neonates ◽  
Significant Difference ◽  
Near Term

In this study we evaluate the activity of lipid profile in premature, near term and term neonates. A total number of 68 newborn infants were selected for this study. They were delivered normally, or by caesarean section, and their gestational age was included. The infants with congenital anomalies or those, whose mothers had medical problems, were excluded from the study. The gestational age was determined according to the date of the last menstrual period, or the early ultrasound in 20 weeks of gestation. All the information related to the newborns and their mothers were recorded in the prepared forms. Following the delivery, blood samples were taken from the umbilical cord immediately, and were separated after clotting, for at least 30 min at room temperature. Serum was stored at 4°C to -80C for a maximum of 2 days, prior to the analysis. Total cholesterol, triglycerides and HDL were analyzed by enzymatic method using auto-analyzer. Serum Total Cholesterol estimated by enzymatic kit method, Triglyceride estimated by bioluminescent assay method and HDL-cholesterol estimated by phasphotungstate precipitation method manufactured by ERBS Transasia. LDL-C and VLDL-C calculated by Friedewald formula. The three groups were significantly different, regarding the means of age, weight and cholesterol and LDL-C level, whereas no significant difference was observed concerning the level of triglyceride and HDL-C,. Gender has no effect on the level of cholesterol, triglyceride, HDL-C and LDL-C in the total population and in all subgroups (P value more than 0.05). On the basis of present study we assume that the cholesterol level was higher in those with prematurity and pre-term delivery, and is also inversely correlated with the infant’s birth weight. Therefore, we believe that monitoring, observation and early-lifestyle modifications may decrease the severity of atherosclerosis in the vessels in adulthood. This study says, it is evident that the total cholesterol and LDL cholesterol in premature and near term neonates was higher than a term neonates ; triglyceride and VLDL were higher in term neonates as compared to near term neonates. Fall in HDL was significantly observed in premature neonates than term neonates and near term neonates but no significance found in term and near term neonates.

scholarly journals Neonatal Outcomes in Meconium Stained Amniotic Fluid Delivery: A Rural Perspective

2021 ◽  
Author(s):  
Gajanan Venkatrao Surewad ◽  
Khyathi Ambatipudi ◽  
Nageswara Rao Kalavakuri
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Andhra Pradesh ◽  
Birth Asphyxia ◽  
Instrumental Delivery ◽  
Normal Vaginal Delivery ◽  
P Value ◽  
The Mean

Introduction: Presence of meconium in amniotic fluid is a potentially serious sign of foetal compromise and has demonstrated that the incidence of MSAF rises with gestational age. The incidences of admission to Neonatal Intensive Care Unit (NICU) with various neonatal disorders were higher in pregnancies complicated by MSAF. Aim: To study clinical profile and outcomes in neonates born through MSAF at tertiary care hospital in rural area of Andhra Pradesh. Materials and Methods: This cross-sectional, descriptive study included a total of 4462 infants who were admitted in the NICU of Nimra Institute of Medical Sciences and Hospital, Andhra Pradesh from December 2017 to January 2020. All pre-term, term and post-term infants, delivered normally or by caesarean section or instrumental delivery, with MSAF, were included in the study. A detailed ante-natal, natal and postnatal history was taken for the neonates to detect the aetiology of MSAF, type and duration of delivery and any complications Post delivery. All the clinical assessment and lab investigations, X-ray assessments were done for the subjects as and when required. The observations were noted along with the treatment given. Results: Out of 4462 infants admitted in study period, 436(9.78%) had MSAF and 96 (22.01%) developed Meconium Aspiration Syndrome (MAS). MSAF infants born by Normal Vaginal Delivery (NVD) formed 220 (50.46%), Lower Segment Caesarean Section (LSCS) 176 (40.37%) and 40 (9.17%) instrumental delivery. MAS infants born by LSCS formed 38 (21.59%), NVD 52 (23.63%) and instrumental delivery 6 (15%).The mean gestational age was 38-40 weeks. MAS developed in 18 (50%) infants with gestational age >42 weeks, 12 (12%) between 40-42 weeks and 50 (23.36%) between 38-40 weeks (significant relationship, p-value 0.012). The mean birth weight was 2.599±441 kg. MAS developed more in infants of birth weight 2-2.499 kg and least were of birth weight between 1.5-1.999 kg. Male to female ratio was 1.27:1. Thick MSAF was seen in 160 (36.69%) and thin MSAF in 276 (63.31%) infants (p-value 0.001). In MAS infants, 82 had thick and 14 thin MSAF. Among MSAF alone infants (n=340), 142 (41.75%) were associated with birth asphyxia. Among MAS infants, incidence of birth asphyxia was 66 (68.75%). Thirty eight MAS infants developed complications. Pneumothorax was the most common complication. Overall, mortality was 160 (36.69%). MAS contributed to 22.5% of these deaths. A 60 (62.5%) MAS infants were discharged and 36 (37.5%) died. Conclusion: MAS was most consistently associated with thick MSAF. Preventive measures like timely evaluation of high risk factors, preparedness for untoward intrapartum events and close monitoring of MSAF infants can be taken to minimise the mortality and morbidity rates, because it is a global problem especially in under-developed countries.

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